IHA Daily Briefing: Aug. 5

Friday, Aug. 5, 2022
DHS Publishes ‘988’ Frequently Asked Questions
EPA, FDA on Ethylene Oxide Emissions, Risk
Update on Federal Bebtelovimab Supply
IL Increases Medicaid Reproductive Reimbursement Rate
Illinois COVID-19 Update
Briefly Noted

DHS Publishes ‘988’ Frequently Asked Questions
The Illinois Dept. of Human Services – Division of Mental Health (DHS-DMH) has developed a new webpage, Illinois 988 FAQs – August 2022 Edition, in response to a set of questions curated by the National Alliance on Mental Illness – Illinois.

The Department emphasizes that the transition to 988 as the three-digit dialing code for the existing National Suicide Prevention Lifeline is considered a catalyst and the beginning of a transformation across the U.S. that is expected to take five years to fully realize. DHS-DMH also shared that the federal Substance Abuse and Mental Health Services Administration (SAMHSA) has offered the following projected timeframe for 988-related goals to be realized:

  • By 2023, 988 Lifeline Call Centers should develop the capacity to handle 90% of the calls routed to them as the “Primary Call Center.”
  • By 2025, 80% of individuals across the nation should have access to mobile crisis response teams.
  • By 2027, 80% of individuals across the nation should have access to crisis receiving and stabilization units within their local area.

Preparation for each of these three pillars of a crisis continuum is currently in different phases of planning and implementation, and DHS-DMH intends to meet or exceed these timelines within Illinois.


EPA, FDA on Ethylene Oxide Emissions, Risk
Ethylene oxide (EtO) sterilization is the method most commonly used in the U.S. to sterilize medical devices, used on more than 20 billion devices sold in the country each year—or approximately 50% of devices that necessitate sterilization.

While emphasizing medical device sterilization is necessary to prevent serious infections, this week the U.S. Food and Drug Administration (FDA) issued a statement highlighting the agency’s efforts to reduce EtO use, while supporting initiatives and programs to promote innovation in medical device sterilization. The FDA stressed that EtO remains the only method of sterilization for many devices, and expressed concerns that disruptions in commercial sterilizer facility operations could lead to shortages of critically needed medical supplies.

That same day, the U.S. Environmental Protection Agency (EPA) announced plans to propose an air pollution rule later in the year targeting emissions of EtO at commercial sterilizers. As part of that proposal, the EPA conducted a risk assessment that identified 23 commercial sterilizers in several states and territories that were found to emit high levels of EtO. None of these sterilizers is located in Illinois.

The EPA is hosting an Aug. 10 webinar focusing on the national scope of EtO risk and its forthcoming proposal of air pollution regulation targeting EtO emissions. Click here to register.


Update on Federal Bebtelovimab Supply
The federal supply of the monoclonal antibody Bebtelovimab is expected to run out during the third week of August, according to a notice distributed by the Illinois Dept. of Public Health (IDPH). IDPH noted that after this time the product may be commercially available.

The Department underscored that the change does not apply to oral COVID-19 treatments, including Paxlovid and Molnuparavir, which do not have any current supply constraints. Additionally, Remdesivir is currently commercially available, and is not allocated through the federal government. Evusheld, the monoclonal used for preexposure prophylaxis for COVID-19 is not impacted, nor experiencing supply constraints.

Due to the scarcity of Bebtelovimab, which is still effective against COVID-19 variants BA.4, BA.5 and BA2.75, IDPH is strongly recommending limiting the use of Bebtelovimab to those who do not qualify for Paxlovid, Molnupiravir or Remdesivir AND who meet the following criteria for prioritization:

  • Those living in long term care facilities.
  • Those older than 65 years of age.
  • Those who are unvaccinated.
  • Those with specific active immunocompromising conditions.

Moreover, IDPH stressed the importance of the clinical community using evidence-based clinical judgment in triaging the use of these products. The Department noted that clinicians may use their discretion based on additional non-discriminatory factors that they believe are important to the triaging of Bebtelovimab, as long as it is limited to the Emergency Use Authorization product guidelines.


IL Increases Medicaid Reproductive Reimbursement Rate
Yesterday, Gov. JB Pritzker announced a 20% increase in Medicaid reimbursement rates for abortion services, citing the need for increased financial support for providers responding to growing demand as a result of the restrictions on reproductive care in surrounding states. The rate increase will take effect Sept. 1, allowing abortion providers to recoup more costs, enabling them to continue to provide care without financial strain.

The Governor also eliminated a requirement that providers must receive a Medicare denial before they can request Medicaid payment, expanding provider options for patients who receive both Medicare and Medicaid. Doing away with the Medicare denial requirement is intended to allow patients to access these services without going through a burdensome, time-consuming denial process. The Governor’s press statement noted many of the patients who will be impacted are people with disabilities.


Illinois COVID-19 Update
The Illinois Dept. of Public Health (IDPH) today reported 6,257 new confirmed and probable COVID-19 cases and four COVID-19 deaths.

Most recent IDPH hospitalization data show 1,413 individuals in Illinois were reported to be in the hospital with COVID-19. Of those, 140 patients were in the ICU and 51 patients were on ventilators.

The seven-day rolling average of vaccines administered daily in Illinois is 9,626 doses. IDPH reported that 78.2% of Illinoisans (18 years and older) have been fully vaccinated, while 86.3% have received at least one vaccination dose. For the Illinois population 12 years and older, 77% have been fully vaccinated, while 85% have received at least one vaccination dose. For the Illinois population 5 years and older, 73.6% have been fully vaccinated and 81.3% have received at least one dose.


Briefly Noted
Two studies on severe maternal morbidity (SMM) were recently published in JAMA Network Open, examining trends and state variation in SMM, which is a leading indicator of maternal health, revealing life-threatening complications during delivery hospitalization. The studies were commissioned by the Health Resources and Services Administration, as part of an ongoing effort to understand the increasing trend in SSM. Click here to access the study “Trends in Severe Maternal Morbidity in the US Across the Transition to ICD-10-CM/PCS From 2012-2019 | Bleeding and Transfusion” and click here to access the study on “Associations Between State-Level Severe Maternal Morbidity and Other Perinatal Indicators | Hypertension.”