Developments
around COVID-19 are occurring by the hour. The following items were key
developments among those emerging last week.
National
and Massachusetts States of Emergency
President
Trump declared a national state of emergency on Friday afternoon. The move
frees up $50 billion to states and territories to fight COVID-19. U.S. Health
& Human Services is granted more authority under the declaration, allowing
it to waive the three-day hospital stay requirement for skilled nursing
facility coverage, and limits on the numbers of beds and length of stay in
critical access hospitals, among other potential actions. Massachusetts Governor
Charlie Baker had declared a state of emergency in Massachusetts on Tuesday
afternoon.
Baker
Bans Elective Surgeries, Endorses Telehealth
Governor
Charlie Baker announced at yesterday’s 6 p.m. press conference that all
non-urgent elective surgeries must be cancelled, effective Wednesday. Some
Massachusetts hospitals had already begun to phase out such surgeries,
undertaking various facility-specific strategies. The state directive creates a
uniform policy that will free up beds and resources to counter any
COVID-19-generated surge.
Details
are expected to emerge today but it appears that there will be regular reviews
of the policy as the impact of COVID-19 is better understood.
The
state is also barring visitors to any post acute or nursing facility. In
addition, hospitals now must screen all visitors to the facility and can deny
visitation to anyone. This applies across all facilities, even those licensed
by the Department of Mental Health.
Governor
Baker also announced an important strategy for which MHA had been advocating.
Effective immediately, all telehealth services in the state -- not just those
related to COVID-19 -- must be covered by private and public insurers. These
are important moves by the state and MHA endorses the governor's actions.
Laboratory
Testing Authorization Expanded
A key
concern in Massachusetts and around the U.S. is the inability of hospitals and
other caregivers to quickly provide COVID-19 testing. Patients are flooding
emergency rooms demanding tests and hospitals want to test their workforce to
ensure they can maintain an adequate supply of caregivers. On Thursday, CMS and
the FDA finally announced that hospital labs can begin testing immediately as
long as they are CLIA certified (that is, approved through the Clinical
Laboratory Improvement Amendments of 1988). Two large commercial labs also
received FDA clearance to begin processing COVID-19 tests.
DPH
also altered its testing oversight, allowing clinicians to send tests directly
to FDA-approved labs without first receiving DPH approval. A new, single-swab
testing directive, as opposed to two swabs, will speed up processing of
samples.
Legislature
Passes $15 Million Funding
The
Massachusetts House and Senate quickly passed a $15 million bill to fund “monitoring,
treatment, containment, public awareness, and prevention efforts” against the
2019 novel coronavirus by DPH, regional and local boards of health, and other
public groups. Governor Baker signed the bill Thursday.
Courts
Issue Standing Order
On Saturday,
the Trial Court issued standing orders to take effect on Wednesday, March 18 in
order to reduce the need for people to go to courthouses. MHA had raised with
the courts concern from hospital systems about how commitment hearings would
proceed in the event that access to courts was limited. The standing order for
the District Courts and the Boston Municipal
Court allows commitment hearings to occur via
videoconferencing.
Travel
and Meeting Policies Changed
MHA
joined many other government entities and private businesses in curtailing
employees business travel, urging workers to forego national and international
travel, and shifting all face-to-face meetings that involve more than 10 people
to conference calls or webinars. MHA employees that travel to one of the “Level
3” countries must self-furlough for 14 days before returning to work. Beginning
today, MHA employees are encouraged to work from home.
School
Closures Raise More Questions
“Social distancing” may be the best way to curtail the spread of the
novel coronavirus. But as school districts yesterday were ordered closed for
three weeks, the parents of children – many of them employed by the
commonwealth’s important healthcare sector – may need to stay at home to care
for their youngsters. Can daycare rules be waived to allow medical facilities
to set up child care centers? What are the other options? MHA is investigating
the issue with the state and its membership.