IHA Daily Briefing: June 10

Thursday, June 10, 2021
OSHA Issues Rule on COVID Healthcare Workplace Safety 
Rural-Urban Disparity in Mortality Increasing 
Firm Selected to Support Illinois Medicaid Modernization 
IHA Partner Offers Complimentary Staffing Webinar 
CDC Request for COVID-19 Vaccination upon Discharge 
State, National, Global COVID-19 Updates 
Briefly Noted

OSHA Issues Rule on COVID Healthcare Workplace Safety
This morning, the Occupational Safety and Health Administration (OSHA) issued a final rule requiring healthcare employers to protect workers against on-the-job COVID-19 infection. The emergency temporary standard (ETS) applies only to the healthcare sector.

OSHA says the ETS is aimed at protecting workers facing the highest COVID-19 hazards—those working in healthcare settings where suspected or confirmed COVID-19 patients are treated. This includes employees in hospitals, nursing homes, and assisted living facilities; emergency responders; home healthcare workers; and employees in ambulatory care facilities where suspected or confirmed COVID-19 patients are treated. The ETS exempts fully vaccinated workers from masking, distancing, and barrier requirements when in well-defined areas where there is no reasonable expectation that any person with suspected or confirmed COVID-19 will be present.

Key requirements of the ETS concern: Developing and implementing a COVID-19 plan; patient screening and management; standard and transmission-based precautions; personal protective equipment; aerosol-generating procedures on a person with suspected or confirmed COVID-19; physical distancing; physical barriers; cleaning and disinfection; ventilation; health screening and medical management; vaccination; training; anti-retaliation; record keeping; and reporting work-related COVID-19 fatalities and in-patient hospitalizations to OSHA.

The ETS is effective immediately upon publication in the Federal Register. Employers must comply with most provisions within 14 days, and with provisions involving physical barriers, ventilation, and training within 30 days.

For more information, go to OSHA’s COVID-19 Healthcare ETS webpage, which includes several documents about the rule and implementation. Also see OSHA’s press release.

In addition to the healthcare-focused ETS, OSHA is issuing updated guidance to help employers and workers in other industries protect workers who are still not vaccinated, with a special emphasis on other industries noted for prolonged close-contacts like meat processing, manufacturing, seafood, and grocery and high-volume retail.

Rural-Urban Disparity in Mortality Increasing
The disparity in mortality between rural and large urban areas is increasing, according to a research letter published in the June 8 Journal of the American Medical Association.

Sarah H. Cross, Ph.D., M.P.H., at Duke University, and colleagues examined trends from 1999 to 2019 in rural-urban differences in age-adjusted mortality rates (AAMRs) in the U.S. The AAMRs were calculated per 100,000 population and stratified by age, sex, and race/ethnicity; the annual percentage change (APC) in AAMR was estimated. Key findings include:

  • Rural areas had the highest AAMRs;   
  • The overall AAMR decreased in large metropolitan areas (from 861.5 to 664.5/100,000) and in rural areas (923.8 to 834.0/100,000).   
  • There was an increase in the difference in AAMRs between large metropolitan areas and rural areas, from 62.3 to 169.5/100,000, an increase of 172%;   
  • Declines were seen in AAMRs for all ages except for rural residents aged 25 to 64 years, who had an increase in AAMR; and   
  • The difference in AAMRs between large metropolitan and rural areas increased for men and women (95.8 to 187.7/100,000 and 32.9 to 144.5/100,000, respectively).

“To reverse increasing rural-urban disparities, researchers, funders, and policy makers must understand the factors worsening rural health and design programs and policies accordingly,” the authors write.

Firm Selected to Support Illinois Medicaid Modernization
According to a press release from CNSI, Illinois has selected CNSI’s Medicaid Management Information System (MMIS) for core claims processing, encounter data processing, and MC-Track® managed care coordination platform. CNSI says it will also support Illinois’ MMIS migration to the Amazon Web Services secure public cloud to power their infrastructure, become more agile, and lower costs. The Centers for Medicare & Medicaid Services (CMS) approved the four-year contract, which includes CNSI’s Fast Healthcare Interoperability Resources® (FHIR) based interoperability solution.

CNSI describes itself as a leading provider of innovative, healthcare technology-driven products and solutions that improve health outcomes and reduce healthcare costs.

IHA Partner Offers Complimentary Staffing Webinar 
What are optimal staffing levels in your hospital or across your health system? IHA Strategic Partner Medical Solutions can assist your organization with identifying staffing patterns and forecasting future need based on industry trends.

Medical Solutions is offering a complimentary webinar, “Strategies to Optimize Your Staffing Levels Post COVID-19,” on June 29 to discuss optimal staffing and market trends. From 10-10:30 a.m., the Medical Solutions teams will present:

  • An in-depth look at the effects of the pandemic on core hospital staff;   
  • A review of unemployment statistics in the first quarter of 2021, comparing nursing and other professions;   
  • An overview of bill rate data from the past three quarters, as well as other indicators; and   
  • Insight into how superior clinical and compliance teams help efficiently optimize staffing levels.

IHA encourages hospital and health system members to participate in the webinar to stay ahead of staffing needs—one of the biggest issues impacting your ability to meet patient needs during COVID-19.

During the online registration, you will have the opportunity to submit questions ahead of the webinar. The Medical Solutions team will address your specific questions and provide additional resources during the webinar. Register today.

If you are unable to join or if you would prefer a one-on-one discussion, please contact Courtney Dobernecker at Courtney.Dobernecker@medicalsolutions.com or 402-225-0483, or Nick Hovermale at Nick.Hovermale@medicalsolutions.com or 402-704-1374.

CDC Request for COVID Vaccination upon Discharge 
The Centers for Disease Control and Prevention (CDC) is asking jurisdictions to distribute a portion of their existing COVID-19 vaccine allocation to hospitals, emergency departments (EDs), and urgent care (UC) facilities to be used to vaccinate patients upon discharge. CDC recently shared with immunization program managers across the country the document “Increasing Access to Vaccination Opportunities: COVID-19 Vaccination upon Discharge from Hospitals, Emergency Departments, and Urgent Care Facilities.”

CDC says for hospitals, ED, and UC facilities already administering COVID-19 vaccines at discharge, there is no need to change established processes, especially those working well. EDs serve as the primary healthcare access point for up to a fifth of the U.S. population and UCs account for up to 29% of all primary care visits. These settings are therefore important access points for people who have not yet been vaccinated against COVID-19.

State, National, Global COVID-19 Updates 
Governor J.B. Pritzker announced today that Illinois will move to a full reopening, also known as Phase 5, the final phase of the Restore Illinois plan, on Friday, June 11. On Friday, the state will eliminate all capacity limits on businesses, large-scale events, conventions, amusement parks, and all other venues. Mask requirements for vaccinated and non-vaccinated individuals continue to align with CDC guidelines.

Today the Illinois Department of Public Health (IDPH) is reporting 366 new confirmed and probable cases, 764 people in the hospital with COVID-19, and a test positivity rate of 1.3%. These are some of the lowest COVID-19 statistics reported in Illinois to date. Additionally, IDPH is reporting 209 people with COVID-19 in the ICU and 103 people on ventilators. These are also some of the lowest counts since the pandemic began.

Currently, 11.9 million doses of the COVID-19 vaccine have been administered to Illinois residents. The Centers for Disease Control and Prevention (CDC) is reporting more than 68% of residents age 18 and older in Illinois have received at least one dose of vaccine and 51% of adults are fully vaccinated. Additionally, more than 88% of Illinois seniors have received at least one dose of vaccine.

Wednesday’s CDC figures showed more than 33.2 million confirmed and presumptive positive cases of COVID-19 in the U.S. (a daily increase of more than 13,000 cases), with 595,625 deaths (a daily increase of 287).

Today’s WHO Coronavirus Disease Dashboard showed more than 174 million COVID-19 cases globally (a daily increase of more than 380,000 cases), with more than 3.75 million deaths. The Region of the Americas (includes the U.S.) continues to lead the world with more than 68.9 million cases and more than 1.8 million deaths.

Briefly Noted 
UnitedHealthcare today announced (via Twitter) that it is delaying until the end of the COVID-19 public health emergency the implementation of its new policy retroactively denying coverage for emergency department claims it deems non-emergent. The policy was to take effect July 1. The American Hospital Association and other health groups had raised concerns about the policy.

Reminder: Within the coming weeks, IHA will releasing the final distribution of approximately $7 million in funds that were not distributed during Phase 1 of the Hospital Assessment Program due to the closure of certain hospitals. If the bank account your hospital used to receive Phase 1 Program payments has changed, please notify IHA by June 18. See an IHA memo for more information (password required).