IHA Daily Briefing: March 18

Wednesday, March 18, 2020
Action Needed: COVID-19 Advocacy Alert
IDPH, ACS: Cancel Elective Surgeries
COVID-19 Update
KFF: Literature Review of ACA Medicaid Expansion

Action Needed: COVID-19 Advocacy Alert
Members of Congress are currently drafting a third COVID-19 response bill, which is expected pass in the coming days. Senate Majority Leader Mitch McConnell announced that the Senate will not adjourn until it completes work on a bipartisan bill. The U.S. House could call a vote within 24 hours of Senate passage. IHA is urgently requesting that direct funding and support for hospitals and health systems be included, among other priorities.

Members are asked to contact your Representatives and Senators and urge them to include direct funding and support for hospitals in the third COVID-19 response legislation. Illinois hospitals are on the front lines of this public health emergency and must have a direct infusion of funds to remain viable and combat this public health emergency, and preserve $365 million in weekly pay and benefits for front-line healthcare workers as hospital revenues plummet.

To look up your Senators’ and Representatives’ contact information, click here and fill in your local information in the “Find Politicians” box.  To send email messages to your members of Congress, click here.

IDPH, ACS: Cancel Elective Surgeries
Yesterday, the Illinois Department of Public Health (IDPH) recommended the cancelling of all non-emergent, elective surgeries and procedures to immediately decompress the healthcare system during the COVID-19 response. According to the guidance, “elective” is defined as those procedures that are pre-planned by both the patient and the physician that are advantageous to the patient but are not urgent or emergent. IDPH says that physicians should use their medical judgment to determine the need for surgery to prevent unnecessary procedures from occurring and potentially exposing others.

In addition, IDPH says that accommodations should be made for the need to continue performing emergent procedures. Considerations should also be made to reallocate healthcare workers, space, and supplies to accommodate a surge of patients seeking care for COVID-19.

The guidance provides information on staffing, space and supplies/resource considerations.

Also, the American College of Surgeons (ACS) has released “COVID-19: Guidance for Triage of Non-emergent Surgical Procedures” to provide surgeons with additional guidance on the management of non-emergent operations during the Coronavirus Disease 2019 (COVID-19) pandemic. The document was developed in response to the rapidly evolving challenges faced by hospitals in response to COVID-19 outbreak, including broad calls to curtail “elective” surgical procedures. This document follows the release of the College’s “COVID-19: Recommendations for Management of Elective Surgical Procedures.”

COVID-19 Update
Today, in a daily media briefing, Gov. J.B. Pritzker and Illinois Dept. of Public Health (IDPH) Director Dr. Ngozi Ezike announced 288 COVID-19 cases, up 128 since yesterday, in 17 counties statewide. Dr. Ezike said that unfortunately these numbers will go up and the state will experience many more deaths before it gets better.

Dr. Ezike said that she is concerned with the wellness of healthcare workers and that screening of those workers is taking place to keep people and patients safe. She also noted how important it is to keep hospital beds available for those who are critically ill. Those who can weather the illness out at home are encouraged to do so to ensure that hospital resources are not strained. Dr. Ezike wants to avoid a situation where decisions must be made on who receives care and who doesn’t.

The goal is to “break the cycle of disease transmission” by staying home.

The state of Illinois today launched a new website, Coronavirus.Illinois.gov, with the latest information and resources for the public.

According to reports, a Chicago City Hall worker has tested positive for COVID-19. Health officials believe that the employee did not contract the virus at work. Also, there are reports of two confirmed cases of COVID-19 at Three Crowns Park retirement community in Evanston.

Today, Chicago Mayor Lori E. Lightfoot announced that the City of Chicago will be temporarily suspending debt collection practices and non-safety related citations and impounds, as well as penalties for late payment. This penalty relief package directs a temporary suspension of late fees and defaults on payment plans, including city tickets, utility bills, parking and red-light citations, booting and other non-public safety relates violations. Additionally, there will be no new interest accumulated on current compliance plans. These measures are to help reduce the financial impact of COVID-19 on city residents and take effect immediately today through April 30, 2020.

Mayor Lightfoot will hold a “State of the City” COVID-19 address on March 19 at 5 p.m.

On Thursday, March 19, the Illinois Dept. of Healthcare and Family Services (HFS) will host a webinar at 10 a.m. for hospitals with inpatient psychiatric units for children/adolescents to discuss new protocols due to the COVID-19 outbreak. Pre-register for the webinar through the State of Illinois WebEx Portal.

The Illinois House of Representatives has cancelled its session scheduled for next week.

Today, President Trump said he would invoke a federal law—Defense Production Act—to give the president authority to have private industries expand production of critical materials to fight the COVID-19 outbreak.

This afternoon, the U.S. Senate passed an $8.3 billion emergency aid package to help Americans suffering from the economic impacts of COVID-19. The bill provides a 6.2% increase in the Federal Assistance Percentage Program (FMAP) for all states and territories. The House passed the measure late Monday and now heads to President Trump for his approval.

Current Centers for Disease Control and Prevention (CDC) figures show a total of 7,038 confirmed and presumptive positive cases of COVID-19 in the U.S. in 54 states and U.S. territories. Ninety-seven deaths have been reported.

The latest release of the CDC’s Morbidity and Mortality Weekly Report covers the COVID-19 outbreak in a long-term care facility in King County, Washington and discusses severe outcomes in COVID-19 patients from February through March.

The Centers for Medicare & Medicaid Services (CMS) held a National Stakeholder Call on March 13, to update the healthcare community on the rapidly evolving COVID-19 situation. The transcript and audio recording from that call is now available to download. Future CMS calls, transcripts and audio recordings will be posted on that page as they become available.

Telligen will hold a COVID-19 Prevention and Preparedness webinar for nursing home providers on March 19 from 3-4 p.m. CT. This webinar will be interactive and will provide nursing home personnel and infection preventionists the opportunity to share challenges and ask questions in regards to implementing current guidance. Click here for more information and to register.

The latest WHO situation report shows more than 179,000 COVID-19 cases globally, with over 7,400 deaths. The Western Pacific Region has the most cases with more than 91,700 confirmed cases and more than 3,350 deaths.

See IHA’s COVID-19 webpage for a variety of resources in a central location.

KFF: Literature Review of ACA Medicaid Expansion
According to a Kaiser Family Foundation (KFF) review of more than 400 studies and policy reports, it reports that the Affordable Care Act’s (ACA) Medicaid expansion has increased health coverage, affordability, and access to care while reducing uncompensated care costs for hospitals and clinics and potentially contributing to budget savings for states.

The literature review, with 80 studies newly included since its August 2019 update, references the effects of Medicaid expansion a decade after the ACA became law, and at a time when more states are considering expansion. To date, 36 states and the District of Columbia have adopted the expansion. Later this year the Supreme Court will hear arguments in Texas v. U.S., the legal challenge that could roll back the Medicaid expansion and other provisions of the ACA.

Key findings from the research review show that:

  • Medicaid expansion is associated with decreased mortality. Additional studies suggest that expansion has contributed to reductions in mortality rates for certain specific conditions;
  • Expansion states experienced significant coverage gains and reductions in uninsured rates among the low-income population broadly and within specific vulnerable populations. The current spread of the novel coronavirus and the sometimes fatal COVID-19 disease it causes has renewed concerns about the uninsured and how they will fare in a crisis;
  • Multiple studies suggest that expansion can result in state savings through the infusion of federal funds and by offsetting state costs in other areas. Additional studies show that expansion results in reductions in uncompensated care costs for hospitals and clinics; and
  • Medicaid expansion has improved access to care, utilization of services, the affordability of care, and financial security among the low-income population. Findings on expansion’s effect on provider capacity are mixed, with studies showing increases, decreases, or no effects on measures like appointment availability or wait times.