Notice for Non-State Agency Healthcare Partners: The DHSS PPE Warehouse will end distribution of PPE items from the state cache on June 30, 2023.

This change comes as the federal public health emergency comes to end today, May 11, the supply chain has stabilized resulting in adequate stock at suppliers, and COVID cases/outbreaks trend downward. The State of Missouri plans to maintain a PPE cache for future public health emergencies and enhance overall healthcare preparedness. Facilities should prepare for June 30^th by working with multiple vendors to procure supplies and maintain adequate stock that accounts for potential order or allocation delays. DHSS will continue to ship COVID antigen test kits and COVID/FLU antigen test kits as requested. For questions related to the end of PPE shipping, please reach out to sns@health.mo.gov.

It’s not too late! The Department of Health and Senior Services (DHSS) is still accepting applications for ARPA reimbursement to operators of Residential Care Facilities (RCFs) and Assisted Living Facilities (ALFs) who have not yet applied. Through Missouri’s State Fiscal Recovery Funds, operators may seek reimbursement for expenses incurred between April 1, 2021 and March 31, 2022 that were directly related to preparing, preventing, and responding to the COVID-19 pandemic.

If you operate an RCF or ALF and haven’t already applied for this funding opportunity, please ensure you are registered as a vendor to receive payment from the State of Missouri. Before operators can complete an application for this opportunity, they must register as a vendor with the state’s financial system – SAM II. If the operating entity is already registered as a vendor with the State of Missouri, you do not need to re-register.

The SAM II registration Vendor Input Form can be found at https://oa.mo.gov/sites/default/files/vendor_input_ach_eftd.pdf. The completed Vendor Input Form must be sent directly to the Office of Administration by fax at 573-526-9813 or by mail to Office of Administration/Accounting, PO Box 809, Jefferson City, MO 65102.

Operator Tips in Registering as a Vendor with the State of Missouri:

• Be sure to register only the legal operating entity and not all individual facilities owned by the same operating entity.
• Be sure the address used in the State’s financial system is the same address that will be used as the operator’s address on the application and any accounts payable documentation.

Once SAM II registration is submitted, an application for reimbursement must be submitted through the State of Missouri’s American Rescue Plan Act (APRA) Portal located at https://moarpa.mo.gov/. Frequently Asked Questions and an Application Checklist can be found on the “Apply Now” page under the “Operators of Residential Care / Assisted Living Facilities” Grant Program. Requests for additional information about this opportunity should be submitted to LTCARPAReimbursements@health.mo.gov.

Funding for this initiative has been made available through the American Rescue Plan Act (ARPA). Missouri’s ARPA funding opportunities are located here: https://moarpa.mo.gov/available-funding-opportunities/.

Vaccines, Treatments and Promising Practices to Improve Resident Outcomes

CMS QI Voices: Improving COVID-19 Outcomes in Nursing Homes Across America, a new audio series produced by the Centers for Medicare & Medicaid Services (CMS), is available for listening at https://qioprogram.org/cmsqivoices.

This audio series is designed to help busy medical directors, administrators and directors of nursing and education keep residents and staff safe with actionable information to increase COVID-19 vaccination and use of available treatments and improve infection prevention efforts in nursing home and long-term care settings.

In a special series of three 15-minute episodes, CMS Chief Medical Officer Dr. Lee Fleisher leads clinical discussions with experts from the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA) Center for Biologics and Research and the Administration for Strategic Preparedness and Response. These episodes cover:

• The safety and efficacy of the new bivalent COVID-19 vaccine in long-term care.
• The benefits, risks and side effects of therapeutics for nursing home residents diagnosed with COVID-19.
• National programs and partnerships that support nursing homes teams’ efforts to promote COVID-19 infection prevention and vaccination.

In the remaining five-minute episodes, CMS leaders talk with CMS Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) and the nursing homes they serve to discuss:

• How to increase COVID-19 vaccine confidence in care settings with high resident turnover.
• How one nursing home is using the power of peer ambassadors to increase vaccine confidence.
• What nursing home staff need to keep doing to help stop the spread of COVID-19.
• When, who and how to cohort in your nursing home.
• How a nursing home serving Native American residents uses a culturally inclusive approach to address health equity and increase vaccine confidence.

The CMS QI Voices: Improving COVID-19 Outcomes in Nursing Homes Across America audio series is available wherever listeners have online access. Nursing home teams may listen at https://qioprogram.org/cmsqivoices or contact LTC@hqi.solutions for more information about the audio series.

The Delta variant quickly became the predominant circulating SARS-CoV-2 strain in the USA during summer 2021. Missouri identified a high number of outbreaks in long-term care facilities (LTCFs) across the state with low vaccination rates among LTCF staff members and poor adherence to mitigation measures within local communities. Ten long-term care facilities in Missouri worked with CDC to evaluate case data to assess disease transmission, vaccination status, and outcomes among residents and staff, including onsite visits to facilities with recent COVID-19 outbreaks in communities with substantial transmission to assess mitigation measures. Attached is a copy of the published findings from that study.

New virus variants are causing significant change in symptoms, and WHO list of COVID symptoms is becoming less relevant. There is a shift to “cold” like presentation without loss of smell/taste, etc. Unfortunately, for older citizens, delirium and psychiatric effects are longer lasting now.

The Division of Community and Public Health shared the attached article from the British Medical Journal for long term care providers to review. 

Thank you for your continued partnership in improving the health and well-being of one of our most vulnerable populations.

In line with our efforts to promote COVID vaccinations to nursing home teams and residents, the Centers for Medicare & Medicaid Services (CMS) has released a new audio series. Conversations with the Centers for Medicare & Medicaid Services Chief Medical Officer provides nursing homes with the facts on COVID-19 vaccines and therapeutics that support better resident outcomes. In these conversations with Dr. Lee Fleisher, the CMS CMO, nursing home leaders will hear from Centers for Disease Control and Prevention (CDC) and U.S. Food and Drug Administration (FDA) experts.

As part of this audio series, titled Quality Improvement (QI) Voices: Improving COVID-19 Outcomes in Nursing Homes Across America, each episode gives listeners a closer look at the projects and the people who are improving health care quality and outcomes. These brief conversations include detailed show notes for even more insights into the process behind health care quality improvement – and how listeners might adapt these to their own organizations.

Three episodes, each under 15 minutes long, have been released: The Facts Behind the Updated COVID-19 Vaccine: Safety and Efficacy, Long-term Care Treatment Options for COVID-19 and CDC Programs for COVID-19 Infection Prevention and Vaccination in Nursing Homes. I encourage you to take full advantage of this cadre of information and resources.

According to the CDC, older adults are more likely to get very sick from COVID-19. This could mean hospitalization, intensive care, a ventilator to help them breathe, or possibly death. The risk increases as we age and those 85 years and older are the most likely to get very sick.

Our best defense against COVID-19 is vaccination. Vaccines reduce hospitalizations and deaths for those 65 and older. The Health Quality Innovation Network (HQIN) recently launched a campaign to improve vaccination rates among our most vulnerable populations. As part of our Take Aim at a Healthy New Year initiative, we have developed an electronic informational package (below) to help you spread the word about vaccinations and how they can help keep us all healthier.

If you have any questions about this initiative, please contact the HQIN team at 1-877-731-4746 or email LTC@hqi.solutions.

Thank you for your commitment to our shared goals. We wish you a healthy new year!

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