03/23/2020

Today's COVID-19 Report: Stay at Home Order Signed

Today's COVID-19 Report: Stay at Home Order Signed

Here are the latest need-to-know updates for Monday, March 23 regarding the COVID-19 pandemic.

'Stay at Home' Order Signed

Ohio Governor Mike DeWine, Lt. Governor Jon Husted, and Ohio Department of Health Director Amy Acton,  announced Sunday that Ohio will be under a "Stay at Home" order. This is the most dramatic action taken so far by the state to combat the spread of COVID-19 in Ohio. 

The order will go into effect beginning today, Monday, March 23, at 11:59 p.m. and will remain in effect until 11:59 p.m. on April 6, 2020, unless the order is rescinded or modified. You can read the full Director's Stay At Home order online.

The Administration has provided a Stay At Home FAQ to provide guidance. The 'Stay at Home' order will not affect providers of long-term care, post-acute care, or senior housing, which fall under essential Human Services Operations. 

According to the order:

"For purposes of this Order, individuals may leave their residence to work for or obtain services at any Human Services Operations...

Human Services Operations includes, but is not limited to: long-term care facilities; day care centers, day care homes, group day care homes; residential settings and shelters for adults, seniors, children, and/or people with developmental disabilities, intellectual disabilities, substance use disorders, and/or mental illness; transitional facilities; home-based settings to provide services to individuals with physical, intellectual, and/or developmental disabilities, seniors, adults, and children; field offices that provide and help to determine eligibility for basic needs including food, cash assistance, medical coverage, child care, vocational services, rehabilitation services; developmental centers; adoption agencies; businesses that provide food, shelter, and social services, and other necessities of life for economically disadvantaged individuals, individuals with physical, intellectual, and/or developmental disabilities, or otherwise needy individuals.

Human Services Operations shall be construed broadly to avoid any impacts to the delivery of human services, broadly defined."

Other essential services that will continue to stay open include grocery stores, gas stations, and more. Ohioans are now ordered to practice social distancing. 

Temporary Pandemic Child Care Licenses 

Beginning on Thursday, March 26, all operating child care centers in Ohio must do so under a Temporary Pandemic Child Care license. Governor DeWine announced the closure of all child care in Ohio except for those operating Temporary Pandemic Child Care licenses. 

This is an effort to reduce the risk of community spread through children and to support essential health care workers. Healthcare workers, including clinicians, nurses, and other support staff, will be given priority access to child care. 

The following guidelines have been released:

• There should be no more than six children in a class.
• Ratios must be kept at one teacher to no more than six children.
• Children whose parents are employed by the same entity should be kept together whenever possible.
• The same teachers and children in each room should be maintained whenever possible.
• There should be limited use of shared space or mixing of groups.
• If shared space is used, a rigorous cleaning schedule must be in place.
• Parent interaction should be limited at drop off and pick up.

The program will operate until April 30, with the potential to extend and adjust as needed.

Telehealth Rule Updated

On Friday, March 20, the Ohio Department of Medicaid (ODM) issued the following rule and appendix which update the telehealth rule for practitioners.  This rule will allow multiple healthcare practitioner types to perform and bill for telehealth services. 

Telehealth rules have been updated in response to COVID-19 pandemic and will be remain in effect as long as the Governor maintains the State of Emergency. 

ODH Increases Frequency of PPE Surveys

On Monday, the Ohio Department of Health (ODH) shared a new link for today’s PPE survey, noting that henceforth, they will be sending out surveys on Monday and Wednesday, and requesting follow up on Tuesday and Thursday. This will increase their ability to identify severe PPE shortages and target emergency supplies to those areas.

PPE Distribution

ODH provided an update on the Strategic National Stockpile of PPE during a call with LeadingAge Ohio last night. According to ODH, Ohio has applied early and received its allotment. The amount received did not meet the amount nor the type of amount requested. Their message:  conserve, conserve, conserve. 

ODH expressed hope that cancelling elective surgeries will add resources. Ohio has requested additional supplies from the Centers for Disease Control and Prevention (CDC). The President announced yesterday that there will be more supplies but there has not been information released yet.

The materials received thus far will be distributed to county drop sites. Key stakeholder groups for distribution of PPE include EMS, hospitals, long-term care, and law enforcement.  Providers low on PPE have been directed to reach out to their local Ohio Emergency Management Agency. 

We will continue to push state and federal authorities on the need for more PPE for providers. 

Adult Day to Close

Governor DeWine announced this weekend that adult day for individuals with developmental disabilities will close; this service area affected is in addition to his announcement of today’s (March 23) close-of-business closure of senior centers and senior adult day facilities. Small groups and services in homes will be offered. 

Anti-Malarials

Ohio State of Ohio Board of Pharmacy is working to limit stockpiling of two anti-malarial drugs that have been touted by President Donald Trump as a possible — but unproven — treatment for COVID-19. The Board passed a rule related to prescribing chloroquine and hydroxychloroquine for purposes of COVID-19. 

Unless otherwise approved by the Board’s executive director, no prescription for chloroquine or hydroxychloroquine may be dispensed by a pharmacist or sold at retail by a licensed terminal distributor of dangerous drugs unless:

• The prescription bears a written diagnosis code from the prescriber;
• If written for a COVID-19 diagnosis, the diagnosis has been confirmed by a positive test result, which is documented on the prescription and both of the following apply:
  • The prescription is limited to no more than a fourteen-day supply, and
  • No refills may be permitted unless a new prescription is furnished.

Prescriptions for either presumptive positive patients or prophylactic use of chloroquine or hydroxychloroquine related to COVID-19 is strictly prohibited unless otherwise approved by the Board’s Executive Director in consultation with the Board President, at which time a resolution shall issue.

The new rule is needed to make sure the drugs are available for one of their primary approved purposes: treating autoimmune disorders like rheumatoid arthritis and lupus, pharmacy board members said. Research will continue on the possible effectiveness of anti-malarials and other treatment options for COVID-19. 

COVID-19 Ohio Data 

Dr. Acton shared on Sunday that there are now 351 confirmed cases of COVID-19 in Ohio and three deaths. A total of 83 people are hospitalized. There have been confirmed deaths in Cuyahoga, Erie, and Lucas counties. COVID-19 has been confirmed in 40 Ohio counties.

Yesterday's full update can be viewed on the Ohio Channel's website.

U.S. Senate Activity

The Senate will vote again today at noon, according to Majority Leader McConnell, as negotiations continue on a massive coronavirus relief package. The bill as it stood yesterday contained $75 billion from appropriations for providers, among other provisions. Stay tuned. 

HCBS Guidance for States from CMS

The Centers for Medicare and Medicaid Services (CMS) has issued guidance, mostly aimed at state agencies, on how to expand home care, personal care, and respite services. LeadingAge plans to issues extended guidance on this topic in the near future.

The CMS FAQs cover a range of topics and issues that reflect questions and concerns raised by state Medicaid and CHIP agencies. The document includes answers to questions related to the flexibilities CMS is affording to states in managed care, benefits, financing, 1115 demonstrations, and leveraging 1135 waivers offered as part of the President’s declaration of a national emergency. 

Quality Reporting Relief Guidance from CMS  

CMS also issued guidance yesterday announcing relief for clinicians, providers, hospitals and facilities participating in reporting programs in response to COVID-19. 

CMS announced it is granting exceptions from reporting requirements and extensions for clinicians and providers participating in Medicare quality reporting programs with respect to upcoming measure reporting and data submission for those programs.  The action comes as part of the Trump Administration’s response to 2019 Novel Coronavirus (COVID-19).

'The Source' Weekly Newsletter Suspended, Daily Alerts to Continue

LeadingAge Ohio's weekly newsletter 'The Source', typically distributed on Thursdays, is being suspended to focus on providing timely, almost-daily member alerts related to COVID-19. Weekly fixtures like 'You Asked, We Answered' and more will be addressed in the daily alerts and included in resources like our Q&A document which is updated several times per week to reflect pressing member questions.

Questions

There will be another all-member call to be held on Thursday, March 26 at 10:30 a.m. Call in information will be shared in daily COVID-19 reports later in the week.

Please send all questions to COVID19@leadingageohio.org.