COVID-19 Prevention Training

CDC has launched a Long-Term Care Frontline Staff Training Webinar Series for staff who care for vulnerable residents of nursing homes and assisted living facilities. A flyer for these trainings is also attached.  These five short webinars review basic infection prevention steps essential for preventing the spread of COVID-19:

LTC Staff Training Webinars

CDC has launched a Long-Term Care Frontline Staff Training Webinar Series for staff who care for vulnerable residents of nursing homes and assisted living facilities. These five short webinars review basic infection prevention steps essential for preventing the spread of COVID-19.

See flyer and please feel free to share!

FILLAKIT Transport Media Ordered from Missouri State Public Health Laboratory

Saline media ordered from the Missouri State Public Health Laboratory (MSPHL) with labeling of Fillakit should not be used for sample collection until further notice. Facilities should place an order for replacement from the Online Order form on the SPHL’s website at https://health.mo.gov/lab/index.php or https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/specimen-collection-supplies.php.

See the memo for additional information.

Battelle Decontamination Sites

The 13 out-state drop-off/pick-up armory sites and the Jefferson City processing site will be closing as of June 30. The decontamination site will continue to operate for the foreseeable future and healthcare providers may ship masks to the decontamination site via FedEx free of charge. Battelle will provide shipping labels for use to ship labelled N95 respirators free of charge. Healthcare providers may contact Battelle at https://www.battelle.org/ to request labels.

Please see the attachment below for more information.
Battelle Shipping Email

Statewide Announcement

Thank you to everyone that has worked to reduce the spread of COVID-19 in our communities. Our efforts have prevented countless infections and saved lives. Unfortunately, this virus is relentless and remains present in our communities. As we continue reopening our economy and communities, we too must be relentless in our prevention efforts.

Prevention and testing will be key to a safe reopening. As activities resume, it is critical that we continue with prevention efforts both at work and at home. The following preventions should continue to be diligently followed:

  • Practice good hand hygiene.
    • Wash your hand often with soap and water for 20 seconds.
    • Use hand sanitizer if soap and water are not available.
  • Continue to practice social distancing.
    • Maintain 6 feet of spacing between yourself and others not living in your household.
    • Maintain social distancing while at work, as much as possible.
  • Wear cloth face coverings when out in public.
    • Face coverings have been shown to cut transmission by 50% or more.
  • Don’t touch your face (eyes, nose, mouth) with unwashed hands.
  • Stay home if you are sick and seek medical care and screening for COVID-19 if you have COVID-19 symptoms.

CDC COCA Call: Applying COVID-19 Infection Prevention and Control Strategies in Nursing Homes

June 16, 2020: Applying COVID-19 Infection Prevention and Control Strategies in Nursing Homes
Presenters: LCDR Kara M. Jacobs Slifka, MD, MPH (USPHS), Infection Prevention and Control Team, COVID-19 Response, Centers for Disease Control and Prevention and Nimalie D. Stone, MD, Infection Prevention and Control Team, COVID-19 Response, Centers for Disease Control and Prevention

During this COCA call, presenters will use case-based scenarios to discuss how to apply infection prevention and control guidance for nursing homes and other long-term care facilities that are preparing for and responding to COVID-19.

If you are unable to attend the live COCA Call, the recording will be available for viewing on the COCA Call webpage a few hours after the live event ends.

The slide set will be available under “Call Materials” on the COCA Call webpage.

Please click this link to join the webinar: https://www.zoomgov.com/j/1615543668.

QIN-QIOs Targeting Assistance to Nursing Facilities to Improve Infection Control

The Centers for Medicare & Medicaid Services (CMS) has funded Health Quality Innovators (HQI) to deliver no-cost assistance to nursing homes in Missouri through the CMS Quality Innovation Network – Quality Improvement Organization (QIN-QIO) Program.

Through this initiative, which HQI calls the Health Quality Innovation Network (HQIN), facilities that have an opportunity to improve their infection control efforts based on publicly available data on Nursing Home Compare are being tapped by HQIN to receive targeted virtual assistance. Selected facilities will receive performance data reports, quality coaching, improvement tools, peer-to-peer forums and educational programming.

HQI has been providing free, expert help to nursing homes for more than 35 years. Their team of quality improvement experts is made up of seasoned post-acute nurses and administrators, including an Infection Preventionist, MDS specialists and QAPI-Certified professionals.

To learn more about HQI and HQIN, visit www.hqin.org or contact Dana Schmitz, dschmitz@hqi.solutions.

PPE Updates

In an effort to expand the PPE reserves and simplify the PPE process, the state has created a new COVID-19 webpage dedicated to be a one-stop shop for all information related to PPE. The PPE webpage will provide Missouri’s latest information and resources in three categories including how to access PPE, guidance for use and optimization for maintaining your PPE supply for the duration of the COVID-19 epidemic.

You can use this website to access the PPE marketplace, too.

Also, NEW to this website and to the state is the State PPE Reserves option.

Missouri has limited PPE reserves to assist in filling these critical needs and will prioritize healthcare providers providing direct care to confirmed or suspected COVID patients. Note requests should only be submitted after all normal supply chains, including the Missouri COVID Supply Solution (aka Missouri PPE Marketplace), have been exhausted and you have a supply of fourteen days or less on hand as the quantities and types of PPE available through the state are limited. Use this link https://survey123.arcgis.com/share/35c0d11050b04a809028d2caf9fd45fd?portalUrl=http://mophep.maps.arcgis.com to access the PPE Request Form. You will receive an automatically generated email notifying you of receipt of your request. Requests will be evaluated in the order in which they are received. If your request is approved, either in full or partially, you will receive an electronic notification upon shipment. If denied, you will receive an electronic verification of the decision.

 

PPE options for Non-profits and Governmental Entities

Because we know many of you continue to struggle with obtaining PPE items, we wanted to make sure you are aware that not-for-profit entities may purchase items from Missouri Vocational Enterprises (MVE). MVE operates through Missouri’s Department of Corrections and produces and sells a number of items. MVE may sell these items to any state agency, local government entities, or any not-for-profit agency.

MVE has a variety of janitorial supplies, personal products (soap, toilet tissue, etc.), laundry supplies, and disinfectant supplies. Most of these items can be found on the MVE website (https://docservices.mo.gov/mve/products/consumables/consumable.html). In addition, MVE has recently begun selling certain PPE items including cloth face coverings, isolation gowns, and hand sanitizer (gallon jugs). These items are not listed on their website at this time but information is attached or below. PPE items are being prioritized to state agencies but may also be purchased by local government and not-for-profit entities as supplies are available. For awareness, DMH has received cloth face coverings and hand sanitizer but have not yet received our order for isolation gowns. As with all PPE, some items are more readily available then others.

If you have a need for these items, we would encourage not-for-profit providers to explore all avenues to obtain needed items, including those available through MVE. You can visit their website to see items available and details for the ordering process. To order cloth face masks, isolation gowns, or sanitizer, you may need to call and speak with their customer service staff, they are very helpful – contact numbers can be found on the website. Again, only not-for-profit entities, state agencies, and local government entities may purchase items from MVE.

Finally, in regards to hand sanitizer, it is available in one gallon jugs only. The price per gallon is $20. Orders are limited to 100 gallons per order and no more than one order per week. The product number is F-617 Hand Sanitizer.

 

We hope this information is helpful to you. Thank you so much for all you do and are doing to provide care and services to our vulnerable populations.

Missouri COVID Supply Solution – Message to Health Care Providers

The State of Missouri has been actively engaged in outreach to businesses in an effort to open up new supply chains for PPE and other critical medical supplies. In an effort to streamline this process, we are very excited to announce the Missouri COVID Supply Solution is live and ready for your use. This application is designed to match health care providers to suppliers of PPE and other medical supplies.

To participate, please go to the Missouri COVID Supply Solution to register as a health care provider using Edge, Chrome, Firefox, or Opera as your internet browser (https://ppe-supply.uk.r.appspot.com/#/). Once your registration is complete, you can immediately begin adding your current PPE inventory and amounts you want to purchase. Once you complete this step, you can begin searching PPE suppliers. In order for the state to understand demand for PPE supplies, please update your PPE inventory amounts every three days within the solution.

Thank you for your participation in the Missouri COVID Supply Solution.

New QIPMO Newsletter – April 2020

The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls – Volume 7, Issue 3.

In this issue:

  • Be a Nurse!
  • Your Role in Infection Prevention
  • Nursing Care to Manage Respiratory Distress/Illness
  • Environmental Cleaning and Disinfecting in a COVID-19 World
  • Staying Social while Social Distancing

Please visit QIPMO’s website here for this and other previous newsletters.

Transfers Between Hospitals and LTC

The Missouri Hospital Association, Long Term Care Associations and the Department have collaborated to provide guidance on transfers between hospitals and long-term care communities. These documents may be used to help guide decision making during this time.

Please see the documents below for further reference.
Post-Acute Care and Behavioral Health to Hospital Transfer
Hospital to Facility Transfer

CDC PPE Calculator Released

The personal protective equipment (PPE) burn rate calculator is a spreadsheet-based model that provides information for healthcare facilities to plan and optimize the use of PPE for response to coronavirus disease 2019 (COVID-19).

Please see the following CDC web page for details: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/burn-calculator.html

OCR Issues Guidance to Help Ensure First Responders and Others Receive Protected Health Information about Individuals Exposed to COVID-19

OCR Issues Guidance to Help Ensure First Responders and Others Receive Protected Health Information about Individuals Exposed to COVID-19
March 24, 2020

The Office for Civil Rights (OCR) at the U.S Department of Health and Human Services (HHS) issued guidance on how covered entities may disclose protected health information (PHI) about an individual who has been infected with or exposed to COVID-19 to law enforcement, paramedics, other first responders, and public health authorities in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule.

The guidance explains the circumstances under which a covered entity may disclose PHI such as the name or other identifying information about individuals, without their HIPAA authorization, and provides examples including:

  • When needed to provide treatment;
  • When required by law;
  • When first responders may be at risk for an infection; and
  • When disclosure is necessary to prevent or lessen a serious and imminent threat.

This guidance clarifies the regulatory permissions that covered entities may use to disclose PHI to first responders and others so they can take extra precautions or use personal protective equipment. The guidance also includes a reminder that generally, covered entities must make reasonable efforts to limit the PHI used or disclosed to that which is the “minimum necessary” to accomplish the purpose for the disclosure.

“Our nation needs our first responders like never before and we must do all we can to assure their safety while they assure the safety of others,” said Roger Severino, OCR Director. “This guidance helps ensure first responders will have greater access to real time infection information to help keep them and the public safe,” added Severino.

The guidance may be found at: https://www.hhs.gov/sites/default/files/covid-19-hipaa-and-first-responders-508.pdf

For more information on HIPAA and COVID-19, see OCR’s February 2020 Bulletin: https://www.hhs.gov/sites/default/files/february-2020-hipaa-and-novel-coronavirus.pdf

CMS QSO Memo Regarding Prioritization of Survey Activities

CMS Memo QSO-20-20-ALL: https://www.cms.gov/files/document/qso-20-20-all.pdf

Infection Control Survey Checklist

CMS is prioritizing surveys by authorizing modification of timetables and deadlines for the performance of certain required activities, delaying revisit surveys, and generally exercising enforcement discretion for three weeks. During this three-week timeframe, beginning March 20, 2020, only the following types of surveys will be prioritized and conducted:

  • Complaint/facility-reported incident surveys: State survey agencies (SSAs) will conduct surveys related to complaints and facility-reported incidents (FRIs) that are triaged at the Immediate Jeopardy (IJ) level. A streamlined Infection Control review tool will also be utilized during these surveys, regardless of the Immediate Jeopardy allegation.
  • Targeted Infection Control Surveys: Federal CMS and State surveyors will conduct targeted Infection Control surveys of providers identified through collaboration with the Centers for Disease Control and Prevention (CDC) and the HHS Assistant Secretary for Preparedness and Response (ASPR). They will use a streamlined review checklist to minimize the impact on provider activities, while ensuring providers are implementing actions to protect the health and safety of individuals to respond to the COVID-19 pandemic.

CMS is disseminating the Targeted Infection Control Survey checklist developed by CMS and CDC so facilities can educate themselves on the latest practices and expectations. CMS expects facilities to use this new process, in conjunction with the latest guidance from CDC, to perform a voluntary self-assessment of their ability to prevent the transmission of COVID-19. The checklist is attached.

Though the contents of the memo and checklist are provided by CMS, DHSS is adhering to the same requirements for all facilities. All facilities should complete the infection control self-assessment.

PPE resource request for accessing state cache assets posted: Accepting requests Monday, March 16, 2020

The resource requesting process for PPE in our state cache was posted to the DHSS website this at this link:

https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/professionals.php.

All resource requests must go through the respective healthcare coalition (maps and contact information are on the website). The healthcare coalition then submits to the Missouri Department of Health and Senior Services for review, approval and processing. All shipments will occur from Jefferson City and be sent via either Federal Express (FedEx) or United Parcel Service (UPS).

Supporting Coronavirus Prevention in LTC Facilities

Some LTC homes will make the difficult decision to limit and/or restrict entry of family and friends into their care settings. To help family and friends understand restrictions being put into place by many LTC providers, Consumer Voice, a national Ombudsman program resource, has put together a webpage: https://theconsumervoice.org/issues/other-issues-and-resources/covid-19.

News Release: Missouri opens novel coronavirus information hotline

JEFFERSON CITY, MO –The Missouri Department of Health and Senior Services (DHSS) activated a statewide public hotline for citizens or providers needing guidance regarding the novel coronavirus, or COVID-19. At 8 a.m. today, the hotline opened and can be reached at 877-435-8411. The hotline is being operated by medical professionals and is available 24 hours a day, 7 days a week.

“Communication is vital to our response to this rapidly-evolving situation,” said Dr. Randall Williams, director of DHSS. “For several weeks, our COVID-19 webpage has been and continues to be a great resource for the public, but having the hotline as an additional resource will likely be invaluable as citizens seek guidance for their concerns.”

To date, 46 patients in Missouri have been tested for the virus that causes COVID-19; one of those has tested positive.

“It is important to know what to do if you have concerns about an illness during this outbreak,” said Williams. “For those who may be at risk for COVID-19, we encourage them to utilize this hotline or call their health care provider or local public health agency to inform them of their travel history and symptoms. They’ll be instructed on how to receive care without exposing others to the possible illness.”

Simple preventive actions that help prevent the spread of all types of respiratory viruses include:

  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available.

For more information, visit www.health.mo.gov/coronavirus or the CDC’s COVID-19 website.

# # #

Past Missouri COVID-19 news releases:

About the Missouri Department of Health and Senior Services: The department seeks to be the leader in protecting health and keeping people safe. More information about DHSS can be found at http://health.mo.gov or find us on Facebook and Twitter @HealthyLivingMo

CMS Memo: QSO-20-17-ALL: Guidance for use of Certain Industrial Respirators by Health Care Personnel

Guidance for use of Certain Industrial Respirators by Health Care Personnel

  • The Centers for Medicare & Medicaid Services (CMS) CMS is committed to taking critical steps to ensure America’s health care facilities are prepared to respond to the threat of the Coronavirus Disease 2019 (COVID-19) and other respiratory illnesses.
  • The memo clarifies the application of CMS policies in light of recent Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) guidance expanding the types of facemasks healthcare workers may use in situations involving COVID-19 and other respiratory infections.

Please see the memo for further details.

 

For additional information, please visit the Department’s website at health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/. This site also contains a link specific to long-term care communities.

CMS Memo: QSO-20-14-NHL: Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in nursing homes (REVISED)

Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in nursing homes (REVISED)

  • CMS is committed to taking critical steps to ensure America’s health care facilities and clinical laboratories are prepared to respond to the threat of the COVID-19.
  • Guidance for Infection Control and Prevention of COVID-19 – CMS is providing additional guidance to nursing homes to help them improve their infection control and prevention practices to prevent the transmission of COVID-19, including revised guidance for visitation.
  • Coordination with the Centers for Disease Control (CDC) and local public health departments – We encourage all nursing homes to monitor the CDC website for information and resources and contact their local health department when needed (CDC Resources for Health Care Facilities: https://www.cdc.gov/coronavirus/2019- ncov/healthcare-facilities/index.html) .
  • Following the Food and Drug Administration’s (FDA) emergency use authorization (EUA) expanding the use of certain industrial respirators to health care personnel, CMS is clarifying that such use is appropriate in Medicare/Medicaid certified providers and suppliers.

 Please see the memo for further details.

For additional information, please visit the Department’s website at https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/.