IHA Daily Briefing: March 25

Wednesday, March 25, 2020
State Offers Economic Help During COVID-19 Crisis
Illinois COVID-19 Update
Senate Poised to Pass Sweeping COVID-19 Bill
National COVID-19 Update
Hospital Resource Calculator for COVID-19
Temporary Telehealth Coverage Announced
MAPS White Paper: A Valuable Patient Safety Resource

State Offers Economic Help During COVID-19 Crisis
Gov. J.B. Pritzker and other state officials this afternoon outlined actions the state is taking to help residents, businesses, and healthcare providers during the COVID-19 crisis. The Governor said that the state tax filing deadline is being extended from April 15 to July 15 to align with the federal tax filing deadline.

Concerning the state’s large backlog of unpaid bills, Treasurer Michael Frerichs announced that the state is taking steps so the Comptroller can pay medical bills and move money to healthcare providers:

“We have rolled over $200 million in investment notes or loans [to help] the state comptroller pay medical bills. My office can invest up to $2 billion in the state of Illinois bill backlog at a reduced market based rate, as opposed to nine or 12% late payment interest rate penalty. During this time of need, this authority not only saves money, it gets more cash out the door to our healthcare providers. We are continuing our discussions with the Comptroller and the Governor’s Office of Management and Budget about ways to support the state’s cash flow using legal tools we already have.”

Illinois COVID-19 Update
At today’s press briefing, the Illinois Dept. of Public Health (IDPH) announced  330 new COVID-19 cases, for a total of 1,865 cases in 35 counties statewide. Three new deaths were reported—a Kane County man in his 90s, a Cook County man in his 60s, and a Will County woman in her 50s—for a total of 19 deaths. The age of cases ranges from younger than one year of age to 99 years of age.

IDPH Director Ngozi Ezike, M.D. reminded people to continue to stay at home, wash their hands and cover their cough and sneeze. She also reiterated that people who have COVID-19 symptoms should first contact their physician for guidance. Dr. Ezike said that people with mild symptoms are advised to fight the illness at home so that those who are gravely ill can be treated in a hospital setting.

The Office of the Medical Examiner of Cook County notified hospitals that any COVID-19 deaths should be immediately reported to the office by calling 312-666-0200.

At the request of IHA, IDPH established an email portal: dph.hospitaladmin@illinois.gov  to receive COVID-19 questions, comments, and ideas from the hospital community and IHA.  A team of staff assigned from the IDPH director’s office will review the emails, with a goal of responding within 24 hours.

Yesterday, IHA sent members an update memo on key supply, production and donation issues related to personal protective equipment (PPE).

In partnership with Chicago Dept. of Transportation, Divvy is launching a 30-day program to give critical healthcare workers free bike share memberships. Starting today and through April 30, eligible healthcare workers can sign up through their employer to access unlimited 45-minute trips on Divvy bikes for 30 days. Hospital administrators and/or human resources departments should reach out to herobikes@Lyft.com to start the process. 

This afternoon, the Chicago Blackhawks announced that the United Center will be repurposed to serve as a COVID-19 Emergency Relief Hub. The arena and outside campus will be transformed into a logistics hub where we will be assisting front line food distribution, first responder staging and the collection of critically needed medical supplies.

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

Senate Poised to Pass Sweeping COVID-19 Bill
Earlier today, the U.S. Senate reached bipartisan agreement on a nearly $2 trillion stimulus package to respond to the COVID-19 pandemic. The Senate is expected to vote on the sweeping legislation later today, and the U.S. House could vote as early as tomorrow, although timing could shift. The IHA-supported package includes numerous actions to provide direct funding and support to hospitals and health systems responding to the COVID-19 outbreak. Among the healthcare provisions are:   

  • $100 billion in emergency funding for hospitals and other eligible healthcare providers through the Public Health and Social Services Emergency Fund to reimburse healthcare-related expenses or lost revenues not otherwise reimbursed and directly attributable to COVID-19;   
  • Suspension of the 2% Medicare sequestration from May 1 through Dec. 31, 2020;   
  • Expansion of the existing option for hospitals to request and receive “accelerated” Medicare payments. These payments are essentially an advance on future payments and are also available to critical access hospitals (CAHs) and children’s hospitals. The bill increases the amount most hospitals could receive to 100%, while CAHs could receive up to 125%. Recoupment would begin after four months, however hospitals would have at least 12 months to pay off the amounts in full; and   
  • Elimination of Medicaid disproportionate share hospital (DSH) program cuts in 2020 and part of 2021.

IHA will provide additional details and summaries in the coming days.  

National COVID-19 Update
Current Centers for Disease Control and Prevention (CDC) figures show a total of 54,453 confirmed and presumptive positive cases of COVID-19 in the U.S. in 54 states and U.S. territories, with 737 deaths. New York State leads the nation with more than 26,300 cases.

The American College of Surgeons (ACS) continues to provide guidance for surgeons to curtail recommendations for elective surgical procedures to preserve the necessary resources for care of critically ill patients during the COVID-19 pandemic. Today, the ACS has released “COVID-19: Elective Case Triage Guidelines for Surgical Care,” a new surgical triage document, developed following expert review in several specialties, that provides trusted information from the most current best evidence available several surgical areas.

Nebraska Medicine and the University of Nebraska Medical Center, nationally recognized leaders in the treatment, training and quarantine methods for highly infectious diseases since caring for patients during the 2014 Ebola outbreak, have developed a webpage compilation of COVID-19 resources for providers.

The Centers for Medicare & Medicaid Services (CMS) has issued a memo to state survey agency directors on its prioritization of survey activities. The memo notes that only complaint/facility-reported incident surveys, targeted infection control surveys and self-assessments are the only types of surveys that will be prioritized and conducted from March 20 and the following three weeks.

During the COVID-19 pandemic, the U.S. Dept. of Homeland Security’s Cybersecurity and Infrastructure Security Agency (CISA) and the Federal Emergency Management Agency’s Office of Business, Industry, Infrastructure and Integration (OB3I) are holding conference calls every Tuesday and Thursday from 2-3 p.m. (CT). These calls are to discuss the current situation and supply chain issues, and provide regional updates along with an open forum for questions and answers. The call number is: 800-593-7177; PIN: 7963614.

The National Library of Medicine (NLM) announced today that it has expanded access to scientific papers on coronavirus for researchers, care providers, and the public, and for text-mining research. This work makes use of NLM’s PubMed Central® (PMC), a digital archive of peer-reviewed biomedical and life sciences literature. PMC currently provides access to nearly 6 million full-text journal articles.

The latest WHO situation report shows more than 372,000 COVID-19 cases globally, with over 16,200 deaths. The European Region now leads the world in cases and deaths, with more than 195,500 confirmed cases with over 10,100 deaths. The Western Pacific Region ranks second with more than 96,500 confirmed cases and more than 3,500 deaths.

Hospital Resource Calculator for COVID-19
Rush University Medical Center put together a tool that allows hospitals to predict resource utilization during the COVID-19 pandemic. The tool is meant to be a rough guide to predict hospital resources like beds, ventilators, and PPE utilization for a few weeks. The tool allows hospitals and health systems to plug in their own numbers and generate a prediction of their potential needs. The tool can be found here (best used in Google Chrome or Firefox browsers) and instruction for use can be found here.

Temporary Telehealth Coverage Announced
On Mar. 19, Governor Pritzker issued an Executive Order, while the Department of Healthcare and Family Services (HFS) issued Emergency Rules (89 Ill. Adm. Code 140.403(e)) and a Provider Notice, all focused on temporary broadened telehealth coverage and reimbursement. The temporary coverage and reimbursement details and restrictions to help facilitate services during the public health emergency have been outlined in an IHA memo.

The Executive Order requires commercial insurers regulated by the Dept. of Insurance to cover costs of all clinically appropriate, medically necessary telehealth services rendered by in-network providers.  The Executive Order does not apply to out-of-network telehealth services. In addition to telehealth platforms stipulated in the Illinois Insurance Code (215 ILCS 5/356z.22) services may be delivered via video (e.g., FaceTime, Facebook Messenger video chat, Google Hangouts video, Skype) or telephonically (e.g., landline or cellular).

The Medicaid Emergency Rules and Provider Notice stipulate that HFS will reimburse medically necessary and clinically appropriate telehealth for patients with Medicaid fee-for service (FFS) and Managed Medicaid (HealthChoice Illinois).  Providers will be paid at the same reimbursement rate as in-person services with dates of service after March 9.

MAPS White Paper: A Valuable Patient Safety Resource
Maternal opioid use, workplace violence de-escalation and care transition handoffs—these are some of the top issues addressed in Patient Safety Focus: Top 10 Safety Issues for 2020, a white paper from the Midwest Alliance for Patient Safety (MAPS).

Last month, the report was provided to members of the MAPS Patient Safety Organization (PSO) as a resource to improve quality care and reduce medical errors.

The white paper includes evidence-based recommendations and strategies for:

  1. Care transition handoffs;   
  2. Clostridioides difficile infections;   
  3. Discharge against medical advice;   
  4. Emergency department boarding of behavioral health patients;   
  5. Maternal opioid use;   
  6. Medical device-related pressure injuries;   
  7. Patient and family engagement;
  8. Post-error support for clinicians;
  9. Social determinants of health screening; and
  10. Workplace violence de-escalation.

The publication is designed to help MAPS members enhance the patient safety work they're already doing. If you are not a MAPS member, you can purchase the white paper today to use in your patient safety work.

MAPS PSO has been federally certified since 2010 and is an IHA company. To learn how MAPS can help your organization improve patient safety here.