April 7 Covid-19 Update

April 7, 2020

BAKER ADMINISTRATION UPDATES

 

Crisis Standards of Care Advisory Committee issues guidance on Crisis Standards of Care:

A Crisis Standards of Care Advisory Committee was convened by the Commissioner of Public Health to prepare guidance in the event of the potential scarcity of necessary medical treatment resources in the Commonwealth caused by a surge in need due to the number of people suffering from COVID-19. This Committee included medical experts and ethicists from across the Commonwealth, representing both large academic medical centers and community hospitals and charged with expeditiously developing recommendations for ethical, equitable and transparent guidelines for providing acute care during a crisis.

Members of the committee included:

  • Scot Bateman, MD, Director, Office of Ethics, UMass Memorial Medical Center

  • Monica Bharel, MD, MPH, Commissioner, Massachusetts Department of Public Health

  • Paul Biddinger, MD FACEP, Medical Director for Emergency Preparedness, Partners Healthcare

  • Peter A. DePergola II, Ph.D., M.T.S., Director of Clinical Ethics, Baystate Health

  • Lachlan Forrow, MD, Director of Ethics and Palliative Care, BIDMC,

  • Eric Goralnick, MD MS, Medical Director, Emergency Preparedness, Brigham Health

  • Joshua Kornbluth, MD, Director, Michael Neeley Neurosciences Critical Care Unit, Tufts Medical Center; Co-Chair, Tufts Medical Center Hospital Ethics Committee

  • Abraar M Karan, MD MPH DTM&H, Massachusetts Department of Public Health

  • Christine Mitchell, RN, Executive Director, Center for Bioethics, Harvard Medical School

  • Emily Rubin, MD, Pulmonary Critical Care Medicine; Co-Chair of Optimum Care Committee, Massachusetts General Hospital

  • Rev. Dean Shapley, MDiv, Director of Mission and Chaplaincy, Lowell General Hospital/Circle Health

  • Robert Truog, MD, Director, Center for Bioethics, Harvard Medical School

  • Sally Vitali, MD, Associate Medical Director, Medical Surgical Intensive Care Unit & Respiratory Care and ECMO, Boston Children’s Hospital

  • Michael Wagner, MD FACP, Chief Physician Executive, Wellforce

  • J. Matthias Walz, MD, FCCP, Professor and Chair, Department of Anesthesiology and Perioperative Medicine, UMass Memorial Healthcare

  • Ellen Weinstein, JD, Deputy General Counsel, BMC Health System

The Committee was able to leverage extensive prior planning work by the Department of Public Health and by the experts on the Committee to make its recommendations. The guidelines were reviewed by the Medical Advisory Group of the COVID-19 Response Command Center and approved by the Commissioner of Public Health.

The full guidelines are below: https://drive.google.com/file/d/15TOKNX3sLYtwe4Yj2K99aH-SV5Q3EEaX/view?usp=sharing

DPH Order requiring grocery stores to limit capacity:

The Department of Public Health issued an Executive Order requiring grocery stores to limit occupancy to no more than 40 percent of maximum occupancy. Stores with a maximum capacity of 25 are exempt from this limit.

The full order is here: https://www.mass.gov/doc/order-grocery-stores-40-percent/download

Cash infusion for MassHealth to fund health care providers: 

The Baker-Polito Administration has announced a new infusion of $800 million at MassHealth in critical stabilization funding to support health care providers impacted by and responding to COVID-19. This funding will support hospitals, nursing facilities, primary care providers, behavioral health providers, and long-term services and supports providers and will be distributed starting this month and through July. This funding is in addition to the $290 million in immediate cash relief and $550 million in accelerated payments to providers announced in March. The Executive Office of Health and Human Services will continue to monitor and evaluate the situation.

These resources include:

  • More than $400 million to hospitals

  • The majority of this funding will support 28 safety net and high-Medicaid hospitals, to address lost revenue and increased costs for hospitals at the front lines of treating patients with COVID-19

    • This includes a 20% rate increase for COVID-19 care, as well as a 7.5% across-the-board rate increase for other hospital care

  • More than $80 million for Nursing Facilities

  • $50 million will be dedicated funding for all nursing facilities across the state

    • Facilities and units within nursing facilities that are designated COVID-19 sites of care will receive approximately $30 million in additional funding to support their capacity to care for COVID-19 patients

  • More than $300 million for other health care providers that are delivering medical care for COVID-19 or providing services that keep residents safe in their homes and out of the hospital, including:

  • More than $50 million for community health centers

  • Around $30 million for personal care attendants

  • Funding for ambulance providers physicians, community behavioral health providers, and Home Health Agencies

  • Funding for certain long-term services and supports day programs such as Adult Day Health or Day Habilitation programs that have converted from group programs to actively serving members via alternative means

List of sites in Massachusetts to get tested for COVID-19

New testing sites are being set up across the Commonwealth for residents to get tested for COVID-19.  The testing sites below are available by appointment only. If you believe you may need a test, first contact your health care provider. If they recommend that you should be tested, but their facility cannot offer the test, obtain a referral and contact one of the facilities listed below. You may need to undergo an additional eligibility screen before you can be tested. If you have a clinician’s referral, contact one of the sites below to make an appointment. These sites do NOT take walk-ins and require an appointment.

The list of testing sites is here: https://www.mass.gov/doc/ma-covid-19-testing-sites

Nursing Home resource line for family and community members of nursing home residents: 

The Baker-Polito Administration also announced the launch of a new Nursing Home Family Resource Line, a dedicated telephone line that will connect family members of nursing home and rest home residents with the information and resources they need. This resource was created so that family and community members have one central contact that they can reach out to if they have questions or concerns about the care their loved one is receiving during the COVID-19 outbreak. The line is staffed from 9 AM – 5 PM, seven days a week. Staff will coordinate across state agencies to help callers find answers to their questions.

Families and community members can call the line at (617) 660-5399.

EOHED Guidance on e-commerce distribution, warehouses, and call centers as essential businesses:

EOHED released guidance clarifying the essential status of distribution, warehouse, and call center facilities, and that guidance is below.

The current list of essential services includes:

Workers supporting ecommerce through distribution, warehouse, call center facilities, and other essential operational support functions.

  • What does “ecommerce” mean in the context of the essential services list?

    • Although ecommerce in other contexts can refer broadly to any commercial transaction conducted electronically on the Internet, for purposes of the Essential Services Order, ecommerce means telephone, internet, or other electronic transactions that result in (1) the shipping of goods and products that themselves would qualify a seller as providing a COVID-19 Essential Service if the seller offered the products through other means and these were the only products the seller offered; or (2) or the shipping of goods and products that are necessary for other COVID-19 Essential Services providers to conduct their essential work; or (3) the shipping of goods and products from a warehouse or distribution center that includes within its normal inventory goods covered in (1).  This reflects the intention of the Order to substantially limit the number of workplaces open during the state of emergency in order to reduce out-of-home activity and transmission of the virus.

    • Based on this rule, operations that offer only products such as furniture, most clothing for consumer purchase, cosmetics, jewelry, recreational equipment, or other consumer specialty items are not COVID-19 Essential Services.  These operations are required to close their bricks-and-mortar locations in Massachusetts and may not remain open in order to conduct e-commerce.

  • I am a retailer with a bricks and mortar location, but I also sell products on-line.  May I continue to sell products on-line while my store is closed?

    • It depends. Individual business owners are permitted to enter into brick and mortar locations to perform necessary operations including shipping packages from the store.  While this order is in effect, employees should not be permitted or required to enter bricks and mortar retail locations to prepare products for shipment or for any other reason.  Workers may enter into distribution and warehouse facilities only to support the kinds of ecommerce described above.

  • Can all distribution centers, warehouse, and call centers continue to operate?

    • No.  Distribution centers, warehouses, and call centers can continue operate only if they support the types of ecommerce described above.

Full guidance from EOHED on essential services is here: https://www.mass.gov/info-details/covid-19-essential-business-faqs

 

Drive through testing site launched in Lowell with CVS offering real time test results:

The Baker-Polito Administration and CVS announced the launch of a new rapid testing site in Lowell, which will enable on-the-spot COVID-19 testing and results at no cost. The new CVS site in Lowell will use the new Abbott ID NOW™ COVID-19 test. CVS Health will be transitioning its efforts to support COVID-19 testing in Mass. to the Lowell location, which allows for up to 1,000 patients to be tested per day and receive results on-site so they can properly quarantine or seek treatment as appropriate. As a result, the company will be halting COVID-19 testing at the original Shrewsbury pilot testing site.

Similar to the CVS rapid COVID-19 test sites in Georgia and Rhode Island, testing at the Lowell site will be overseen by licensed health care providers from MinuteClinic, the retail medical clinic of CVS Health. The rapid COVID-19 testing will take place in the parking lot of the Showcase Cinemas located at 32 Reiss Avenue, in Lowell, and no testing will take place at CVS Pharmacy or MinuteClinic locations. Patients will need to pre-register in advance online at CVS.com in order to schedule a same-day time slot for testing.

For more information visit: https://www.cvs.com/minuteclinic/covid-19-testing

Guidance for nurseries, greenhouses, garden centers, and agricultural supply stores:

The Department of Public Health provided guidance for the operation of nurseries, greenhouses, garden centers, and agricultural supply stores.

The full guidance is here: www.mass.gov/doc/dph-nurseries-guidance/download

 

Massachusetts RMV-Approved Defensive Driving Courses

Due to coronavirus concerns, to ensure the health and well-being of our instructors and students, the National Safety Council and the Massachusetts Registry of Motor Vehicles (MA RMV) have canceled all MA classroom driver safety classes through May 4. This includes the 8-hour Driver Retraining Program, 4-hour Driver Attitudinal Retraining Program and the 4-hour State Courts Against Road Rage (SCARR) Program.

The MA RMV has temporarily approved an alternative way to deliver the statutorily required content in the form of a 4-hour online class. For a limited time, participation in the online course will fulfill your in-person class requirement. The process is easy and convenient, and the online course can be completed right from your own home.

If you have a constituent with any questions regarding this new and temporary situation you can referred them to the following website for detailed information and sign-up at the NSC: https://www.nsc.org/road-safety/services/state-programs/massachusetts

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