Category: SLCR Guidance

More Community Testing

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Community sampling gives the state a better sense of COVID-19 prevalence in a given area, which will help guide its response and ease uncertainty for Missourians. If prevalence is low, this will help reassure citizens that it is safe to begin re-engaging in the community and returning to somewhat normal operations. If prevalence is higher, quick and proactive steps will be taken to keep the virus from spreading further in the community.

Any Missouri residents who wish to be tested with a nasal swab to see if they have an active COVID-19 infection can do so at the specified sites in each region at no cost to the individual. Missouri residency is the only requirement; individuals do not have to live in the county in which they are tested, and they do not have to be experiencing symptoms.

Location selection for this period of community sampling is based on inadequate testing according to the number of confirmed cases and the number of total tests conducted prior to these events. Counties hosting upcoming community testing events are Scott, Platte, Stoddard, Carter, Ripley, Cass, Franklin, Johnson, Pettis, Lafayette, Ray, Warren, Carroll, Chariton, Lincoln, Lewis, Moniteau, Pike, Scotland, Montgomery and Osage.

Appointments can now be made online for events June 8-12 on the DHSS registration site. Events scheduled from June 13-20 will continue to be added over the next few days.

For more from this press release go to https://health.mo.gov/news/newsitem/uuid/9fe780c4-ee40-438d-ade1-d3e57126add7/community-covid-19-testing-events-continue-throughout-missouri.

Upcoming Testing Locations:

    • Joseph – June 9
    • Sikeston, Scott County – June 8
    • Platte City, Platte County – June 8-9
    • Dexter, Stoddard County – June 10
    • Van Buren, Carter County – June 11
    • Doniphan, Ripley County – June 11
    • Peculiar, Cass County – June 11-12

Use this link to register and remember check back as more testing locations will be added next week.
https://dcphdo02redcap.azurewebsites.net/redcap/surveys/?s=FAMNRL3LF7

COVID-19 Data Update

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The Department of Health and Senior Services posted a State of Missouri COVID-19 analytics update on June 3. The link is here: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/pdf/analytics-update060320.pdf.

This analytics updated includes multiple data points inform Missouri’s COVID-19 response. Check the update to find out more about:

  • Syndromic surveillance
  • Healthcare system capacity (bed, PPE, and staff availability)
  • Testing
  • COVID-19 cases and deaths
  • Economic and social impact
  • Insights from U.S. states, nationally, and other countries
  • Evidence from scientific literature
  • Mathematical disease modelling

Suicide Prevention Training

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Department of Mental Health is offering free Question, Persuade, Refer (QPR) Gatekeeper Training for anyone who wants to:

  • Recognize the warning signs of suicide
  • Know how to offer hope
  • Know how to get help and save a life

See the flyer to register for these virtual suicide prevention trainings. Suicide is the 10th leading cause of death in Missouri. Register soon as virtual seating is limited.

Community Testing Opportunities

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Upcoming Testing Locations:

County

Location

Testing Dates

Greene County

Ozark Empire Fairgrounds, Springfield

June 4 & 5

Cape Girardeau County

Arena Park, Cape Girardeau

June 5

Buchanan

St. Joseph 4th Street & Francis Parking Garage

June 9

More community testing sites are being developed and will be added, please check this link to stay up-to-date on community testing options.

https://dcphdo02redcap.azurewebsites.net/redcap/surveys/?s=FAMNRL3LF7

Phase 1 Extension

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Governor Parson extends Phase 1 of “Show Me Strong Recovery” plan through June 15.

See the press release here – https://governor.mo.gov/press-releases/archive/governor-parson-extends-phase-1-show-me-strong-recovery-plan-through-june-15.

Also, this link will take you to local public health orders. Check here to see what is going on in your county or town – https://governor.mo.gov/press-releases/archive/governor-parson-extends-phase-1-show-me-strong-recovery-plan-through-june-15.

Reminder – Community Testing Opportunities, some open to all Missourians

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Missouri continues to announce community testing events across the state. Several communities will be conducting COVID-19 testing over the next two weeks. For these testing events, participants will not be required to have a doctor’s authorization and there will be no charge to participants. Anyone who wants to be tested may participate – you will not be required to have a known exposure or be experiencing symptoms. If you are experiencing symptoms and have struggled to be tested, you can register for one of these testing events. Many of these testing events do not require you to be a resident of the county conducting testing. You must, however, be a resident of Missouri.

Pre-registration for each event is strongly encouraged – https://dcphdo02redcap.azurewebsites.net/redcap/surveys/?s=FAMNRL3LF7. Check this site often as new testing locations will be added as they are finalized.

Upcoming Testing Locations:

County

Location

Testing Dates

Jackson

Silverstein Eye Center Arena-Independence

May 26-30

Andrew County

Savannah Fire Department

May 29

Pemiscot County

Pemiscot Memorial Hospital, Hayti

May 29-30

St. Charles County

Youth Activity Park, Dardene Prairie

May 29 & 30

Grundy County

First Christian Church, Trenton

May 30

Boone County

Hickman High School, Columbia

June 1 & 2

Jefferson County

Faith Community Church, House Springs

June 1 & 2

Jefferson County

Hillsboro Civic Center, Hillsboro

June 3

Greene County

Ozark Empire Fairgrounds, Springfield

June 4 & 5

Cape Girardeau County

Arena Park, Cape Girardeau

June 5

 

World Elder Abuse Awareness Day Webinar Series

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June 3, 2020
June 10, 2020
June 19, 2020
June 24, 2020

In recognition of World Elder Abuse Awareness Day (June 15th), there will be a series of free webinars throughout the month of June that are designed to raise awareness of elder abuse risk factors in the current pandemic. The 45-minute webinars are being hosted by The St. Louis Elder Financial Protection Multidisciplinary Team and The Oasis Institute.

Please see the flyer for details including instructions on how to register.

Community COVID-19 Sampling Events to be Conducted Throughout Missouri

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Several counties throughout Missouri have already participated in community sampling efforts in order for public health officials to learn more about the prevalence of COVID-19 transmission. As part of Gov. Mike Parson’s plan announced on May 21 to rapidly increase COVID-19 testing volume to 7,500 tests per day in Missouri, six additional counties will host testing events. The goal is to test nearly 10,000 people over a 10-day period at events in Boone, Cape Girardeau, Greene, Jackson, Jefferson and St. Charles Counties.

Community sampling gives the state a better sense of COVID-19 prevalence in a given area, which will help guide its response and ease uncertainty for Missourians. If prevalence is low, this will help reassure citizens that it is safe to begin re-engaging in the community and returning to somewhat normal operations. If prevalence is higher, quick and proactive steps will be taken to keep the virus from spreading further in the community.

Any Missouri residents who wish to be tested with a nasal swab to see if they have an active COVID-19 infection can do so at the specified sites in each region at no cost to the individual. Missouri residency is the only requirement; individuals do not have to live in the county in which they are tested, and they do not have to be experiencing symptoms.

  • Boone County
    • June 1-2, 7 a.m.-7 p.m., Hickman High School, Columbia
  • Cape Girardeau County
    • June 5, 7 a.m.-7 p.m., Arena Park, Cape Girardeau
  • Greene County
    • June 4-5, 7 a.m.-7 p.m., Ozark Empire Fairgrounds, Springfield
  • Jackson County
    • May 26-30, 7 a.m.-7 p.m., Silverstein Eye Center Arena, Independence
  • Jefferson County
    • June 1-2, 7 a.m.-7 p.m., Faith Community Church, House Springs
    • June 3, 7 a.m.-7 p.m., Hillsboro Civic Center, Hillsboro
  • St. Charles County
    • May 26-28, 7 a.m.-7 p.m., St. Charles County Public Health Department, St. Charles
    • May 29-30, 7 a.m.-7 p.m.. The Youth Activity Park, Dardenne Prairie

Online pre-registration is highly encouraged and will allow for the testing event to run efficiently for patients. Those without access to online pre-registration can call the Missouri COVID-19 hotline for registration assistance at 877-435-8411.

Selection for community sampling is based on locations with the ability to draw participants from a broader region as well as locations that have expressed a need for additional testing resources. It is not based on the number of COVID-19 cases in these counties. CARES Act funding will be used for community sampling. Some counties have also elected to provide community sampling using local funding.

The community-based testing will be operated by the Department of Health and Senior Services and Missouri National Guard in coordination with the hosting local public health agencies.

Over the next two weeks, the state will aggressively execute on this testing strategy, as well as the box-in strategy for outbreaks within facilities and sentinel testing of vulnerable populations. With these strategies in place in addition to the testing already occurring each day, Department of Health and Senior Services Director Dr. Randall Williams believes the state will reach its goal of 7,500 tests per day. “We have worked hard to determine how to best utilize the testing capacity we now have in our state in order to protect the health of Missourians,” he said.

Once Missouri’s overall testing numbers have increased, the state will reevaluate and determine next steps.

“I cannot emphasize enough how important testing is to our overall recovery plan. All four pillars of our recovery plan are important, but testing will be the key,” Gov. Parson said. “The more testing we do, the more knowledge we have on what the situation in Missouri actually looks like, and the better-equipped we are to move forward.”

Those who would like to be tested can pre-register for the site nearest them at http://health.mo.gov/communitytest. More information can be found at http://health.mo.gov/coronavirus.

SLCR Region 2 Office Move

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The Section for Long-Term Care Regulation, Region 2 Office in Poplar Bluff will be moving to a new address on May 27, 2020. Please note only the address is changing. The phone and fax numbers will remain the same.

Section for Long-Term Care Regulation, Region 2 Office
1903 Northwood, Suite 4
Poplar Bluff, MO  63901
Phone:  (573) 840-9580
Fax:  (573) 840-9586

Paid Feeding Assistants Waiver

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Please review the updated CMS guidance – COVID-19 Emergency Declaration Blanket Waivers & Flexibilities for Health Care Providers (PDF) including the waiver for Paid Feeding Assistants. The waiver now allows training to be conducted in 1 hr. vs. 8 hrs. However, the content for the training remains the same.

Please refer to our website for the content: https://health.mo.gov/safety/cnaregistry/feedassistant.php.

Questions regarding this waiver should be directed to CNARegistry@health.mo.gov.

COVID-19 Community Testing

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Community testing events serve the residents of the county where the event is being held. DHSS is partnering with local health departments and health care providers to offer these events, and different communities will be reached at different times. Also, some events may not require you to be a resident of the county where an event is taking place. If you are not a resident of a county currently holding a community testing event, you can continue to check back at the link as new sites will be added as events are planned. Please review the information or check your local health departments social messaging for more information.

Click this link to access the information: https://dcphdo02redcap.azurewebsites.net/redcap/surveys/?s=FAMNRL3LF7.

Here is list of currently scheduled community testing opportunities.

  • John and Beacon, Kansas City – May 19, 20, & 21
  • Savannah High School, Andrew County – May 22
  • Andrew County – May 22 & 29
  • New Madrid County – May 26 & 27
  • South Harrison High School, Harrison County – May 27
  • Pemiscot County – May 28 & 29

New COVID-19 Dashboard

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This NEW dashboard contains tons of COVID-19 data that the public can review at will. Cases by county info is still included and is expanded to show daily % increase in cases, 7-day % increase in cases and number of new cases over the last 14-days. In addition, the dashboard includes information on testing, demographics, deaths and hospitalizations.

The link to the dashboard is http://mophep.maps.arcgis.com/apps/MapSeries/index.html?appid=8e01a5d8d8bd4b4f85add006f9e14a9d.

DHSS Revised Guidance for Facilities with COVID-19 Positive Cases

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These guidelines describe implementation steps to help limit the spread of infection when a staff member or resident develops COVID-19 in your facility. The guidance can be found under the Long Term Care Facilities Link at https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/professionals.php#collapseSix. The title of document is COVID-19 LTCF Guidance.

** Please review the document as there are important changes to the guidance, including facility-wide testing upon identification of a positive case and routine follow-up testing.

NHSN- Missouri Group Request

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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 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.

Congregate Facility Order

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Please see attached order requiring all congregate living facilities to report positive polymerase chain reaction (PCR) test results on one or more residents or one or more staff members, who physically worked at such facility within fourteen days prior to testing positive, within 24 hours. Congregate living facilities include residential care facilities, assisted living facilities, intermediate care facilities and skilled nursing facilities.

See this guidance for specific reporting details.

PPE Updates

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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 PCR Testing Update for Providers

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The Department of Health and Senior Services would like to notify Missouri health care providers of changes in guidance due to expanded COVID-19 testing availability within the state. The testing landscape has shifted significantly in the past eight weeks, and through partnerships with private laboratories, we encourage testing of both symptomatic and asymptomatic individuals. DHSS does not need to approve testing when performed outside of the State Public Health Laboratory.

See the attachment or visit this link to read this full guidance: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/pdf/mo-pcr-testing-update-providers.pdf.

Serological Testing Quick Facts for Providers

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  • There are multiple antibody tests for COVID-19 with variable performance.
  • At this time, it is not clear which antibody responses are protective or sustained.
  • Antibody tests should not be used as the sole test for diagnostic decisions.
  • Until more is known about protective immunity, serology results should not be used to make staffing decisions or decisions regarding the need for PPE.

See the attachment or visit this link to read this in full: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/pdf/serological-testing-quick-facts-providers.pdf.

COVID-19 Testing Reimbursement

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Below is a communication to providers around billing for COVID 19 testing. This includes information for billing Medicaid and for testing and treatment of the uninsured.  DHSS is working on guidance to assist homes in determining the best way to obtain facility-wide testing for their communities. Further guidance will be forthcoming.

Provider Communication – Billing for COVID 19 Testing

Visitor Restrictions and Non-Essential Services (Beauty Shop)

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At this time, DHSS is continuing to follow the guidelines from the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services related to restricting visitors in long term care homes. On 4/27/20, our Department Director, issued an order continuing the current restrictions on visitors in long term care homes. We know that these restrictions are incredibly hard on residents, families and friends- however- we have also seen the devastation that COVID-19 can quickly bring in a long term care home- both in small counties and large cities. https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/pdf/economic-reopening.pdf. We are closely monitoring the situation at state and federal levels. We are hopeful families and residents will soon be united face to face. Until then, we encourage you to assist family in communicating with their loved ones virtually, via FaceTime or Skype. Non-essential services, including beauty shop should also be restricted. DHSS has posted guidance for Community Integration for adults 65 and older and other high risk populations. These tools will assist you in helping individuals to reintegrate into the community, once the restrictions have been lifted.

State of Missouri COVID-19 Analytics Update

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The Department of Health and Senior Services (DHSS) posted to the website on 5/5/2020 a presentation showing the multiple data points to inform Missouri’s COVID-19 response. Included in this data, but not limited to the below, is:

  • Hospitalized cases by region
  • Hospital and ICU bed availability by region
  • Cumulative and daily testing numbers
  • Positivity Rates and Positivity Rates by county
  • Cases and Cases per 100K by county
  • New case growth, including 7-day % case increase
  • Modeling of hospitalization rates

Here is the link to this data.
https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/pdf/analytics-update.pdf.

 

First Phase of “Show Me Strong Recovery” Plan and Economic Reopening Order

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Goes into effect at 12:01 a.m., Monday, May 4, 2020
Statewide Stay-at-Home Order still applies until then.

We have received several questions regarding the impact the Economic Reopening Order has on long-term care communities. The order addresses long-term care communities, specifically in paragraph #3 of the order, which states, “In accordance with the guidelines from the President, the CDC, and the Centers for Medicaid and Medicare Services, people shall not visit nursing homes, long-term care facilities, retirement homes, or assisted living homes unless to provide critical assistance or in end-of-life circumstances. Elderly or otherwise vulnerable populations should take enhanced precautionary measures to mitigate the risks of contracting COVID-19.”

The guidance below issued by the Department on March 13th and March 17th continues to be in place.
LTC Memo
LTC Leaving Facility

CMP Application Process for Communicative Technology

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CMS has created a process to enable states to approve requests for communicative technology that meet CMS parameters. The parameters are detailed in the instructions portion of the application template (below). This template and process will reduce the amount of time for approval of CMP funds for technology that allows residents to engage in virtual social and telehealth visits as restrictions have been placed on visitors to prevent the spread of COVID-19.

The application is for nursing homes certified to participate in Title 18 and Title 19 of the Social Security Act. We encourage companies that operate more than one home to complete one application for all certified homes to the extent possible. This will reduce the number of applications and will help expedite the approval process.

Applications should be submitted to slcr@health.mo.gov. Questions regarding the application process may be sent to this address as well.

Once an application is approved, SLCR will contact each applicant to explain the payment process.

COVID-19 Application Template Final
COVID-19 Application FAQ