Effective August 28, 2020, the Authorized Electronic Monitoring in Long-Term Care Facilities Act became law. Due to concern for spread of COVID-19, current state and federal guidelines are in place that restrict visitation of all visitors and non-essential health care personnel to residents of long-term care facilities. Please see the Guidance for LTC Facilities Regarding Electronic Monitoring Device Placement, Discontinuance or Removal.

The Department of Health and Senior Services (DHSS) is pleased to announce the availability of Electronic COVID-19 Case Reporting. All entities currently required to complete a Communicable Disease Case Report (CD-1) should begin reporting positive COVID-19 cases via the new system*. This system will replace the paper CD-1 process and allow for more timely, appropriate, and accurate data for COVID-19 case reporting.

The new system also fulfills the requirement for residential congregate facilities to report COVID-19 cases under the Congregate Facility Reporting Order. Congregate facilities will no longer need to enter positive case information into the former system, which has been taken down.

The Electronic COVID-19 Case Reporting System can be found on DHSS’ main COVID-19 webpage: www.health.mo.gov/coronavirus. Please do not enter lab result information unless you are a reporting laboratory or you are entering on behalf of the laboratory.

Testing spreadsheets should continue to be provided by facilities to the Division of Regulation and Licensure. Testing spreadsheets can be uploaded at: https://health.mo.gov/safety/longtermcare.php.

*If your organization has already developed an electronic reporting process with DHSS, please continue to follow this process. The Electronic Reporting System is a replacement for those entities currently emailing, faxing or mailing a CD-1 form for COVID-19 case information.

In order to allow for more accurate submission of your data on the Electronic COVID 19 Case Reporting form, please note the following:
      -When you hit the “Submit” button on page 5 of the form make sure you add today’s date.
      -Make sure you choose Resident, Staff, Contracted Staff or “No” on page 2 of the form.

As of July 15^th, 192 qualifying Medicaid & CHIP eligible providers in Missouri have applied for the Medicaid & CHIP Provider Relief Fund distribution out of the 5,725 providers identified in the data that your team supplied to CMS. Of these, 93 Medicaid & CHIP providers have been paid from this distribution. To ensure that all qualifying providers are aware of the opportunity, as well as the new application deadline, we are requesting that states reach out to your medical, dental, and long-term services and supports (LTSS) providers to remind them that they can begin the application process here. 

The application deadline has been further extended to offer providers additional opportunity to apply for funding. You must act by Friday, Aug. 28, 2020 at 11:59 p.m. ET to be considered for payment from this distribution. Read more about the extension here.

To support these efforts, included below some resources that the HRSA team has released on the Provider Relief Fund to share:

• Program Overview:
  The bipartisan Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act provide $175 billion in relief funds to hospitals and other health care providers, including those on the front lines of the coronavirus response. A portion of these funds, under the Medicaid and Children’s Health Insurance Program (CHIP) Provider Distribution, provide help for providers and clinicians who treat our most vulnerable populations, including low-income and minority patients. This is allocated for eligible providers that participate in state Medicaid and CHIP Programs and that did not receive a payment from the Provider Relief Fund General Allocation. The payment to each provider will be approximately 2 percent of reported gross revenue from patient care.

• Fact Sheet
  The Health Resources & Services Administration (HRSA) released a Fact Sheet for Medicaid and CHIP Providers that is now available on the Provider Relief Fund website.

• Recorded Webcast
  A recording of the June 25 webcast is now available at https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/for-providers/index.html.

• Frequently Asked Questions (FAQs)
  In order to better address your most important concerns, HRSA has updated their FAQs to address common questions, including those submitted during the previous webcasts. The FAQs include expanded information on eligibility, application, payment process, and more.

• Application Instructions
  Medicaid and CHIP Provider Distribution Instructions and the Medicaid and CHIP Provider Distribution Application Form are available at hhs.gov/providerrelief. HRSA recommends downloading and reviewing these documents to help you complete the process through the Enhanced Provider Relief Fund Payment Portal.

• Additional Information
  For additional information, please call the Provider Support Line at (866) 569-3522; for TTY, dial 711. Hours of operation are 7 a.m. to 10 p.m. Central Time, Monday through Friday. Service staff members are available to provide real-time technical assistance, as well as service and payment support.

Many long-term care facilities have begun reporting COVID-19 data into the CDC’s NHSN Long-term Care Component. In an effort to have a more complete representation of COVID-19 data for the State of Missouri, we are asking facilities who are not yet reporting (SNF, ICF, ALF, RCF, ICF/IID) to consider reporting data through the CDC’s NHSN Module and those facilities that are currently reporting to begin sharing their data (conferring rights) with DHSS. In order to share the data you enter into the CDC’s NHSN site, you must join the “Missouri Group” within NHSN and select the option to “Confer Rights”.

Once you have completed the NHSN enrollment process and received your acceptance notification from NHSN, you can login to the NHSN site to:

1. Access the COVID-19 Module within the Long-Term Care Component
2. Join the Missouri Group (using the guidance below)
3. Confer rights to grant the state health department access to your facility’s information.

How do I join the Missouri Group and confer rights to the department?

NHSN website provides instructions – https://www.cdc.gov/nhsn/pdfs/groups-startup/JoinGroup-current.pdf.

The document is titled: NHSN Data Sharing: Joining a Group and Accepting the Confer Rights Template.

Please use the following information to join the Missouri group:
Group ID: 20503
Use password: MHIRS29

DHSS is also encouraging facilities to report each day. This will allow more accurate and timely data that could be used for increased allocation of resources for facilities that start to see increased cases, rather than responding up to a week later when outbreaks are identified.

A Frequently Asked Questions document is now available on the NHSN LTCF COVID-19 Module website. The document was developed to answer the most common questions received from facility and group users participating in the NHSN LTCF COVID-19 Module. The questions are organized by the four COVID-19 Module pathways, as well as enrollment, groups, the CMS rule, and data entry and analysis. Additionally, at the end of the document, there are examples of how to count data for reporting.

An updated list of laboratories on state contract has been placed on the DHSS website at https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/cares-act-funding.php under the Word document titled State and Community-Based COVID-19 Testing Qualified Vendor List.

This Qualified Vendor List has information regarding daily testing capacity, specimen types, billing, turn-around-time, etc., for the laboratories on state contract. The pricing is for work completed at the state/local government’s request, but may be honored for private entities at the lab’s discretion.

This information is being provided to assist with completing testing either for an outbreak situation or for reopening purposes. There are laboratories not listed on the qualified vendor list that conduct testing as well. There is no requirement to utilize a laboratory on this list.