Beginning 09/01/2021 all full CNA tests are done through Headmaster D & S. Please see the information on Testing Updates In Missouri for clarification on how to proceed with setting up the final examination for students.
For up to date information or any questions, feel free to visit the Health Education Unit webpage or you may call 573-526-5686 or email at cnaregistry@health.mo.gov.
Long-Term Care (LTC) Facility COVID-19 Testing Requirements (QSO 20-38-NH, revised 9/10/2021)
Please read the memo carefully. CMS has revised testing requirements for nursing homes including testing of symptomatic residents and staff, and routine testing of staff. Two major changes are:
Table 1: Testing Summary
|
Testing Trigger |
Staff |
Residents |
|
Symptomatic individual identified |
Staff, vaccinated and unvaccinated, with signs or symptoms must be tested. |
Residents, vaccinated and unvaccinated, with signs or symptoms must be tested. |
|
Newly identified COVID- 19 positive staff or resident in a facility that can identify close contacts |
Test all staff, vaccinated and unvaccinated, that had a higher-risk exposure with a COVID-19 positive individual. |
Test all residents, vaccinated and unvaccinated, that had close contact with a COVID-19 positive individual. |
|
Newly identified COVID- 19 positive staff or resident in a facility that is unable to identify close contacts |
Test all staff, vaccinated and unvaccinated, facility-wide or at a group level if staff are assigned to a specific location where the new case occurred (e.g., unit, floor, or other specific area(s) of the facility). |
Test all residents, vaccinated and unvaccinated, facility-wide or at a group level (e.g., unit, floor, or other specific area(s) of the facility). |
|
Routine testing |
According to Table 2 below |
Not generally recommended |
Table 2: Routine Testing Intervals by County COVID-19 Level of Community Transmission
|
Level of COVID-19 Community Transmission |
Minimum Testing Frequency of Unvaccinated Staff+ |
|
Low (blue) |
Not recommended |
|
Moderate (yellow) |
Once a week* |
|
Substantial (orange) |
Twice a week* |
|
High (red) |
Twice a week* |
+Vaccinated staff do not need to be routinely tested.
Please see the full memo for complete details at https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/interim-final-rule-ifc-cms-3401-ifc-additional-policy-and-regulatory-revisions-response-covid-19-0.
National Consumer Voice for Quality Long-Term Care has a NEW Enrichment Booklet offers residents a variety of activities to keep them entertained and active. This book includes puzzles, word searches and crosswords; prompts for residents to write about the connections in their lives; trivia questions, which can be done alone or with others; and more!
Download and print the Enrichment Booklet for free or purchase hard copies of the booklet from the online store.
10-Digit Mandatory Dialing Changes Will Impact Fire Alarm Panel Automatic Dialing
The Federal Communications Commission (FCC) has adopted an order approving the designation of “988” as the 3-digit abbreviated dialing code for the National Suicide Prevention Lifeline. As a result of this designation, beginning October 24, 2021, a 10-digit telephone number (area code + phone number) will be required to complete all local calls from area codes 314, 417, 660, and 816. All licensed long-term care facilities in Missouri are required to have a fire alarm panel that dials a monitoring company during a trouble call or fire signal. It is imperative that facility staff verify or reprogram the fire alarm panel to ensure it will dial out with the area code. This will need to be confirmed with the fire alarm and/or monitoring company. For additional information regarding 10-digit mandatory dialing changes, please refer to the FAQs About 10-Digit Dialing document developed by the Missouri Public Service Commission.
Please see the DHSS Health Update entitled “Update: Indications for Monoclonal Antibodies in Management of COVID-19.”
Should you have any questions, please contact the Missouri Department of Health and Senior Services’ Bureau of Communicable Disease Control and Prevention at 573-751-6113.
There has been a significant change in the ordering process for monoclonal antibody infusion medications. If you are currently utilizing these medications, please review the attached notice and plan on attending the webinar tomorrow. Also attached is information on reporting usage through the Teletracking system. Reporting through this system is highly encouraged as the usage reported will determine future amounts allocated to the state.
Status Update re: Monoclonal Antibody (mAb) Infusion Medication Ordering:
Missouri Department of Health and Senior Services (DHSS) was notified by U. S. Department of Health and Human Services (HHS) yesterday, September 14, 2021, that effective immediately the states are responsible to review and approve all monoclonal antibody medication orders. This includes orders for REGEN-COV (casirivimab and imdevimab) and the Eli Lilly cocktail of bamlanivimab/etesevimab through AmeriSource Bergen. This was DHSS’ first notification of this change. We had no prior information to allow for planning, development of platforms for ordering/approvals or procedures, or messaging. Thus, all of this is occurring currently and as quickly as possible. Information on this change is still forthcoming from HHS, thus we may have process implementation delays at the state level as a result.
mAb Request Process Implementation and Timeline:
DHSS will host a webinar to introduce the state’s new mAb request process, details are below:
Friday, September 17, 2021
10:30-11:30 a.m.
|
Join from the meeting link |
|
https://stateofmo.webex.com/stateofmo/j.php?MTID=mcb62b527fff05778bd574584e06c8b6d |
|
Join by meeting number |
|
Meeting number (access code): 2462 582 1044 |
|
Meeting password: pcGjudFE679 |
Tap to join from a mobile device (attendees only)
+1-650-479-3207,,24625821044## Call-in toll number (US/Canada)
+1-312-535-8110,,24625821044## United States Toll (Chicago)
The Department of Health and Senior Services, Section for Long-Term Care Regulation has drafted emergency and proposed amendments affecting the transfer and discharge hearings referenced in regulation set 19 CSR 30-82.050.
The emergency amendment for 19 CSR 30-82.050 was filed on September 1, 2021, with an effective date of September 16, 2021 and expiration of March 14, 2022. The emergency amendment can currently be viewed at https://www.sos.mo.gov/adrules/EmergenciesforInternet/emergency. The proposed amendment covering this same material will also be published in the same issue of the Missouri Register. The Register publication date is October 1, 2021 for the emergency and proposed amendments and can be found at http://www.sos.mo.gov/adrules/moreg/moreg.asp.
NOTE: The public comment period for the proposed amendments will be from October 1, 2021 – October 31, 2021. The Department will be accepting comments during the comment period by mailing the comments to: Carmen Grover-Slattery, Regulation Unit Manager, Section for Long-Term Care Regulation, Division of Regulation and Licensure, PO Box 570, Jefferson City, MO 65102-0570 or by emailing to: RegulationUnit@health.mo.gov.
The proposed amendment can be reviewed on our website at: https://health.mo.gov/about/proposedrules/.
Reminder: After submitting the initial survey, a confirmation email will be provided for a link to update your survey each day (instead of submitting a new survey). Submitting a new survey results in multiple surveys showing on the map with different bed numbers. This makes it difficult to know which totals are current. Please use the link emailed after the initial submission to edit facility bed availability. Please do not submit an “initial” submission more than once. If information does not change from day to day, the submitter can simply update the date and submit – the prior day’s information will populate.
The survey information will populate an accompanying dashboard that will be available to hospitals to use as a tool in finding placement for those patients who would be best served in a long-term care setting. This dashboard may be accessed at https://mophep.maps.arcgis.com/apps/opsdashboard/index.html#/f1e0745f93fe46b482d8ff4585f821bf. To view instructions on utilizing the dashboard, click on ‘Instructions’ under the map for information.
The Department of Health and Senior Services is planning for the upcoming approval of booster COVID-19 vaccination doses and long-term care facilities will be a priority. The federal pharmacy program used to administer first and second doses will not be available, so it is important to ensure long-term care facilities receive the needed support for the administration of booster doses. We are asking for your feedback regarding your facility’s readiness to administer booster doses. https://www.surveymonkey.com/r/VTT296F
For those SNFs (Medicaid/ Medicare certified) that already completed the NHSN survey, we already have your results no further action is needed.
For questions regarding this survey, please contact Lana Hudanick at Lana.hudanick@heatlh.mo.gov or 314-982-8260. Please reply by September 15, 2021.
The deadline to complete the DHSS COVID-19 After Action Report (AAR) Survey has been extended to Friday, September 3, 2021. Your assistance in helping us gather this important data is greatly appreciated. Please feel free to share the link with your state, regional, and local partners in the following categories:
Please let us know if you have any questions or difficulties with the survey.
John Whitaker – John.Whitaker@health.mo.gov
Brendan Bagby – Brendan.Bagby@health.mo.gov
The Department of Health and Senior Services (DHSS) is revising the hours of operation for the Missouri Adult Abuse and Neglect Hotline to 7:00 a.m. to 8:00 p.m., 365 days a year, effective September 1, 2021. The Hotline’s former hours of operation were 7:00 a.m. to midnight, 365 days a year. This change will allow the Department to better serve those who need to report concerns of abuse, neglect, and exploitation of vulnerable individuals 60 and older and people with disabilities between 18 and 59.
During fiscal year 2020, DHSS received and investigated 40,714 community and facility reports of abuse, neglect, bullying, and exploitation, involving seniors and adults with disabilities. That amounts to an average of over 111 reports every day. The number of cases continues to rise, but still vastly understates the extent of the problem as experts believe that for every case of adult abuse or neglect reported, as many as 23 cases go unreported.
In November of 2019, DHSS implemented the Adult Abuse and Neglect Hotline online reporting system allowing concerned citizens and mandated reporters to electronically submit reports of abuse, neglect, and exploitation in an efficient, secure, and confidential manner on a web-based platform. The online reporting portal is available 24 hours a day, 7 days per week and provides an alternative to calling the Adult Abuse and Neglect Hotline both during and outside of normal business hours. Since the implementation of online reporting, approximately one-third of all reports are submitted this way. While online reporting has helped to ease the Adult Abuse and Neglect Hotline’s call volume demands, additional efforts are still needed to ensure that no call goes unanswered. The new operational hours for the Hotline will allow for increased staffing during times of highest call volume. This will help reduce wait times for those reporting and make it easier to reach a trained intake professional between 7:00 a.m. and 8:00 p.m. Please note that 9-1-1 should be accessed for emergencies as the Adult Abuse and Neglect Hotline online reporting system is not intended for emergency response.
If you suspect abuse, neglect or financial exploitation of the elderly or an adult with a disability, you may call the Adult Abuse and Neglect Hotline toll-free at (800) 392-0210 or visit www.health.mo.gov/abuse/ to make a report online.
If you have any questions regarding the change in the hours of operation for the Adult Abuse and Neglect Hotline, please reach out to the Department at 573/526-3625 or DSDSOfficeofConstituentServices@health.mo.gov.
Public Health: Better Health. Better Missouri.
SLCR has received questions regarding whether or not Skilled Nursing Facilities can be a clinical or on the job training sight for students entering health care fields. The quick answer is YES! Long-term care facilities can use the guidance from CMS memo QSO 20-39-NH and DHSS visitation guidance as a way to say “YES” to hosting schools who are training our next workforce in long-term care. Students can be considered health care workers who are not employees of the facility but provide direct care to the facility’s residents. They can be permitted to come into the facility as long as they are not subject to a work exclusion due to an exposure to COVID-19 or showing signs or symptoms of COVID-19 after being screened. Facilities should work with the schools to ensure they are aware of infection control policies and procedures and to whom questions can be addressed.
The most recent visitation guidance from CMS and DHSS can be accessed on our website: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/professionals.php.
For questions related to this, please contact Angela.Duvall@health.mo.gov.
Following recent announcements from the US Food and Drug Administration and the Centers for Disease Control and Prevention, certain immunocompromised individuals can begin receiving third doses of COVID-19 vaccine in Missouri.
A third dose of the PfizerNBioTech or Moderna vaccines may be administered to moderately to severely immunocompromised people due to a medical condition or combination of immunosuppressive medication or treatments including but not limited to the following:
Individuals who do not meet the criteria for “moderately to severely immunocompromised” do not need a third dose at this time.
In line with federal guidelines, Missouri will use a self-attestation model for people who are moderately to severely immunocompromised. Individuals will not be required to provide documentation of their health status, and they can get third doses at all venues where first and second doses are available.
This guidance does not apply to those who received the Janssen/Johnson & Johnson vaccine. For people who received either Pfizer-BioNTech or Moderna’s COVID-19 vaccine series, a third dose of the same mRNA vaccine should be used. A person should not receive more than three mRNA vaccine doses at this time. If the mRNA vaccine product given for the first two doses is not available or is unknown, either mRNA COVID-19 vaccine product may be administered. Individuals should wait at least 28 days between their second and third doses.
Announcements from federal health officials came after the analysis of studies demonstrating that immunosuppressed people are more likely to get severely ill from COVID-19, are at higher risk for prolonged infection, are more likely to transmit the virus, and experience lower vaccine effectiveness.
Additional information regarding this guidance can be found on the CDC website at https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html.
Interim clinical considerations for use of COVID-19 vaccines can be found at https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html.
Missouri’s revised standing orders can be found at https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/statewide-orders.php.
Below is a link to the Missouri Department of Health and Senior Services COVID-19 after action survey. This survey is designed to gather feedback from a variety of healthcare and public health partners and organizations. Please respond by selecting the discipline that reflects your organization and submit one survey per organization, excluding state agency partners. Your responses to this survey should be based on your organizations role and perspective of the COVID response. Receiving input from a variety of stakeholders, at all levels of the response, will help us better identify our strengths and weakness of the public health and medical services emergency Support function.
Please see this FAQs for more information. Thank you in advance for your participation!
We have recently noticed several facilities that have used their fire alarm zones as part of their evacuation plan. The fire alarm zones are the zones on the fire alarm panel used to help staff identify the location of the fire. These are different from smoke zones, which are the zones in the building created to prevent the spread of smoke and fire and allow staff time to complete a full evacuation of the building. Many facilities have fire alarm zones that do not match the smoke zones in the facility. Often times there are more fire zones to help staff identify the location of a fire.
To start a smoke zone evacuation, it may be necessary to evacuate multiple fire alarm zones at the same time. The evacuation plans need to have these smoke zones clearly labeled and all staff need to know where they will move the residents in the event of a fire. The facility cannot base their evacuation plans on the fire alarm zones.
In this example, the facility has eight fire alarm zones (Fire Zones 1-8). The facility has a smoke barrier wall that divides the facility into two smoke zones (Smoke Zones A and B). The facility also has a secured unit, but the controlled egress doors (locked keypad doors) are not a part of the smoke barrier wall, so the secured unit is part of Smoke Zone A.
If a fire occurs in Fire Zone 4, it means that an evacuation of all residents would need to occur throughout Smoke Zone B, which would include all residents in Fire Zones 3, 4, and 5. The evacuation plan may mention things like room number, dining rooms, etc., but should avoid using fire zones to describe the smoke zones. Although it is important to know which smoke zone activated the fire alarm system, staff cannot move the residents from Fire Zone 4 to Fire Zone 5, as they are still within Smoke Zone B. Staff must completely move the residents out of Smoke Zone B.
In addition, it is significant to note if a fire occurred in Smoke Zone A (i.e. Fire Zones 1 or 6), the staff would need to move residents in the secured unit from Smoke Zone A. Staff cannot leave the residents in the secured unit since a smoke barrier wall does not protect the secured unit and it is not its own smoke zone.
The facility must have the evacuation plans posted on at least every floor of the facility [19 CSR 30-85.022 (33)(B)(2)] which directs all staff, residents, and visitors where to go in the event of a facility evacuation. The policy and procedure for evacuations also needs to be in the emergency preparedness manual.
NFPA 99, 2012 edition
15.7.4.3.1: Where buildings are required to be subdivided into smoke compartments, fire alarm notification zones shall coincide with one or more smoke compartment boundaries or shall be in accordance with the facility fire plan.
The healthcare continuum is again becoming strained with the number of positive cases across the state. This portal was originally established in November to improve communication across the care continuum to assist in ensuring Missourians have access to the right care in the right setting.
We are renewing our request for long-term care communities to complete a brief survey each day in order to identify available beds for potential admissions. Participation in the bed availability survey is voluntary. The survey may be accessed at https://arcg.is/1rjKy8.
The dashboard was reset on July 15th, so any homes that have not submitted data since the reset occurred will need to submit an initial survey – old update links will no longer work. Homes that have submitted data since the reset can continue to submit using the update link.
Reminder: After submitting the initial survey, a confirmation email will be provided for a link to update your survey each day (instead of submitting a new survey). Submitting a new survey results in multiple surveys showing on the map with different bed numbers. This makes it difficult to know which totals are current. Please use the link emailed after the initial submission to edit facility bed availability. Please do not submit an “initial” submission more than once. If information does not change from day to day, the submitter can simply update the date and submit – the prior day’s information will populate.
The survey information will populate an accompanying dashboard that will be available to hospitals to use as a tool in finding placement for those patients who would be best served in a long-term care setting. This dashboard may be accessed at https://mophep.maps.arcgis.com/apps/opsdashboard/index.html#/f1e0745f93fe46b482d8ff4585f821bf. To view instructions on utilizing the dashboard, click on ‘Instructions’ under the map for information.
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, have been exhausted and providers have a supply of twenty-one days or less on hand.
Please be sure to describe the urgent need for PPE and your situation in the comments on the form.
https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/ppe.php
LTC Bed Availability Portal
The healthcare continuum is again becoming strained with the number of positive cases across the state. This portal was originally established in November to improve communication across the care continuum to assist in ensuring Missourians have access to the right care in the right setting.
We are renewing our request for long-term care communities to complete a brief survey each day in order to identify available beds for potential admissions. Participation in the bed availability survey is voluntary. The survey may be accessed at https://arcg.is/1rjKy8.
The dashboard is being reset and all previous data is being deleted, so all communities will need to submit an initial survey – old update links will no longer work.
Reminder: After submitting the initial survey, a confirmation email will be provided for a link to update your survey each day (instead of submitting a new survey). Submitting a new survey results in multiple surveys showing on the map with different bed numbers. This makes it difficult to know which totals are current. Please use the link emailed after the initial submission to edit facility bed availability. Please do not submit an “initial” submission more than once. If information does not change from day to day, the submitter can simply update the date and submit – the prior day’s information will populate.
The survey information will populate an accompanying dashboard that will be available to hospitals to use as a tool in finding placement for those patients who would be best served in a long-term care setting. This dashboard may be accessed at https://mophep.maps.arcgis.com/apps/opsdashboard/index.html#/f1e0745f93fe46b482d8ff4585f821bf. To view instructions on utilizing the dashboard, click on ‘Instructions’ under the map for information.
Abbott BinaxNOW Testing Supplies
To order Abbott BinaxNOW from the state (one time shipments):
Missouri Long Term Care Facilities (RCF, ALF, ICF, and SNF), private Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID), and Adult Day Care programs may order free Abbott BinaxNOW Testing Supplies from DHSS and SEMA via the following link: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/testing-resources.php.Then scroll down under BinaxNOW Testing to the BinaxNOW hub and click on that link – then scroll to the icon for long-term care facilities and click on that icon. It takes you to a gray colored page that says to click ‘here’ to re-order; from that re-order form, click on Facility Type in the upper right hand corner and choose LTCF from the drop down box; then click on the your facility’s name in the drop down box entitled Facility Name.
The re-order form should then auto populate your contact information into the form and you simply tell us how many tests you need toward the bottom of that form, then click submit.
To reinstate direct shipments of Abbott BinaxNOW from the federal government:
Providers should email their facility information, shipping address and the BinaxNOW delivery Point of Contact for the facility and request to be added back onto the direct shipment list to Binax.Team@hhs.gov. Please be aware this can take up to 2 weeks to begin receiving shipments again.
DHSS guidance related to COVID-19 outbreaks, visitation, reporting, waivers, etc.- can be found on our website:
COVID-19 Reporting Requirements
|
|
Reporting Process/Form |
System |
Purpose/Description |
Required? |
Time Frame |
|
1 |
REDCap: DHSS |
Reporting form for all positive case results, including staff and residents. This includes Point of Care (POC) and PCR testing. |
Yes, for all SNF, ICF, RCF, ALF, ICF-IID and Adult Day Care |
Within 24 hours of positive result |
|
|
2 |
Long Term Care Facility COVID-19 Outbreak Testing Data Reporting |
REDCap: DHSS |
Reporting portal for outbreak testing dates, number of residents and staff tested. |
Yes, for all SNF, ICF, RCF, ALF, and ICF-IID. |
Within 24 hours of testing |
|
3 |
Web Portal: Managed by NHSN |
NHSN-required fields solely for certified nursing homes (SNF/NFs). |
Yes, for all certified SNF/NF. Voluntary for any state licensed only facility (RCF/ALF/Adult Day Care) or ICF-IID. |
Weekly, with a preference for submission on the same day each week |
|
|
4 |
Web Portal: NHSN |
POC test reporting that includes both positive and negative POC test results (even if potentially a false positive). |
Yes, for any facility not reporting to DHSS in Row 5 |
Within 24 hours of result of POC test |
|
|
5 |
Secure File Transfer/CSV file: DHSS |
POC test reporting that includes both positive and negative POC test results (even if potentially a false positive). |
Yes, for any facility not reporting to NHSN in Row 4 |
Within 24 hours of result of POC test |
Archived Listserv messages can be found on our blog site: https://ltc.health.mo.gov/
Missouri Department of Health and Senior Services Recall Alert
To: Local Public Health Agencies
From: Dusty Johnson
Date: 07/06/2021
CLASS: Class I High Priority
This announcement is distributed to Environmental staff and LPHA Administrators.
Necessary Information:
Tyson Foods Inc., a Dexter, Mo. establishment, is recalling approximately 8,492,832 pounds of ready-to-eat (RTE) chicken products that may be adulterated with Listeria monocytogenes, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.
The frozen, fully cooked chicken products were produced between December 26, 2020 and April 13, 2021. The products that are subject to recall are listed here. View the labels here.
The products subject to recall bear establishment number “EST. P-7089” on the product bag or inside the USDA mark of inspection. These items were shipped nationwide to retailers and institutions, including hospitals, nursing facilities, restaurants, schools and Department of Defense locations.
On June 9, 2021, FSIS was notified of two persons ill with listeriosis. Working in conjunction with the Centers for Disease Control and Prevention (CDC) and state public health partners, FSIS determined there is evidence linking the Listeria monocytogenes illnesses to precooked chicken produced at Tyson Foods Inc. The epidemiologic investigation identified three listeriosis illnesses, including one death, between April 6, 2021 and June 5, 2021. During routine sample collection, FSIS collected two precooked chicken samples from two establishments that are closely related genetically to Listeria monocytogenes from ill people. One of the samples was collected at Tyson Foods Inc. FSIS is continuing to work with federal and state public health partners to determine if there are additional illnesses linked to these products.
Additional information on the investigation may be found on the Centers for Disease Control and Prevention website.
Consumption of food contaminated with L. monocytogenes can cause listeriosis, a serious infection that primarily affects older adults, persons with weakened immune systems, and pregnant women and their newborns. Less commonly, persons outside these risk groups are affected.
Listeriosis can cause fever, muscle aches, headache, stiff neck, confusion, loss of balance and convulsions sometimes preceded by diarrhea or other gastrointestinal symptoms. An invasive infection spreads beyond the gastrointestinal tract. In pregnant women, the infection can cause miscarriages, stillbirths, premature delivery or life-threatening infection of the newborn. In addition, serious and sometimes fatal infections in older adults and persons with weakened immune systems. Listeriosis is treated with antibiotics. Persons in the higher-risk categories who experience flu-like symptoms within two months after eating contaminated food should seek medical care and tell the health care provider about eating the contaminated food.
FSIS is concerned that some product may be in consumer and institutional freezers. Consumers should not eat these products. Institutions should not serve these products. These products should be thrown away or returned to the place of purchase.
FSIS routinely conducts recall effectiveness checks to verify recalling firms notify their customers of the recall and that steps are taken to make certain that the product is no longer available to consumers. When available, the retail distribution list(s) will be posted on the FSIS website at www.fsis.usda.gov/recalls.
Members of the media who have questions regarding the recall can contact Derek Burleson, Communications Manager, Tyson Foods, at (479) 290-6466 or derek.burleson@tyson.com. Consumers who have questions can contact Tyson Foods customer relations, at (855) 382-3101.
Consumers with food safety questions can call the toll-free USDA Meat and Poultry Hotline at 1-888-MPHotline (1-888-674-6854) or live chat via Ask USDA from 10 a.m. to 6 p.m. (Eastern Time) Monday through Friday. Consumers can also browse food safety messages at Ask USDA or send a question via email to MPHotline@usda.gov. For consumers that need to report a problem with a meat, poultry, or egg product, the online Electronic Consumer Complaint Monitoring System can be accessed 24 hours a day at https://foodcomplaint.fsis.usda.gov/eCCF/.
Additional Information:
We have received questions regarding when communication with Engineering Consultation Unit (ECU) is needed. When completing any of the activities listed below, please reach out to the ECU for review.
When is ECU approval not required?
ECU does not charge any fees to review projects.
If uncertain whether a review is needed, please contact the ECU at ECU@health.mo.gov.
Please retain all ECU correspondence with other facility records.
David East and Carrie (Brixey) Schaumburg
ECU@health.mo.gov
We are currently in the planning phase to host a virtual provider meeting this year and are considering the best topics to provide the most beneficial information. We would like to hear from you about what LTC related topics and info you believe would be helpful and educational!
Please take a moment to answer complete a short questionnaire by July 15, 2021 at https://www.surveymonkey.com/r/83YX6GZ.
The Department of Health and Senior Services, Section for Long-Term Care Regulation has drafted emergency and proposed amendments affecting the nursing assistant training program referenced in regulation sets 19 CSR 30-84.010 and 19 CSR 30-85.042.
The emergency amendment for 19 CSR 30-84.010 was filed on June 14, 2021, with an effective of June 28, 2021 and expiration of December 24, 2021. The emergency amendment can currently be viewed at: https://www.sos.mo.gov/adrules/EmergenciesforInternet/emergency. The proposed amendment covering this same material will also be published in the same issue of the Missouri Register. The Register publication date is July 15, 2021 for the emergency and proposed amendments and can be found at: http://www.sos.mo.gov/adrules/moreg/moreg.asp.
NOTE: The public comment period for the proposed amendments will be from July 15, 2021 – August 14, 2021. The Department will be accepting comments during the comment period by mailing the comments to: Carmen Grover-Slattery, Regulation Unit Manager, Section for Long-Term Care Regulation, Division of Regulation and Licensure, PO Box 570, Jefferson City, MO 65102-0570 or by emailing to: RegulationUnit@health.mo.gov.
The emergency and proposed amendments can be reviewed on our website at: https://health.mo.gov/about/proposedrules/.
Missouri is experiencing a rise in individuals contracting the Delta variant (B.1.617.2, first detected in India) of the virus that causes COVID-19, SARS-CoV-2. It was announced by the Centers of Disease Control and Prevention yesterday that the Delta variant has been reclassified as a “variant of concern” in the United States. The Missouri Department of Health and Senior Services (DHSS) has been closely monitoring these developments and has been on the national leading edge of aggressive wastewater testing for variants of concern.
The Delta variant joins the B.1.1.7 (Alpha), B.1.351 (Beta), P.1 (Gamma), B.1.427/B.1.429 (Epsilon) variants circulating in the United States which are already classified as variants of concern.
Deemed highly transmissible, the Delta virus has been already detected in over 70 countries of the world, and is projected to become dominant worldwide. It is also causing more serious illness and hospitalizations among those who have not been vaccinated.
Monitoring the spread of emerging variants in the United States relies on widespread, rapid sequencing. While this national effort is still somewhat limited, it is clear that the variant has become prevalent in communities throughout Missouri. In February, the Missouri Department of Health and Senior Services (DHSS) began testing wastewater samples to look for the presence of these variants. These testing results are displayed in a new layer of the COVID-19 sewershed surveillance StoryMap.
The unpredictability of emerging variants is cause for continuation of infection prevention precautions.
“Our greatest concern in Missouri is areas with lower vaccine uptake,” said Robert Knodell, Acting Director of the Missouri Department of Health and Senior Services (DHSS). “With this variant being easier to spread and possibly causing more severe illnesses among unvaccinated people of all ages, vaccinations are the best way to stop this virus in its tracks.”
This recent rise of the highly transmissible Delta variant underscores the importance of continued testing for COVID-19 of all those with related symptoms, as well as those who have been exposed to the virus but may not have symptoms.
Social distancing and appropriate masking remain important and effective public health countermeasures. Vaccination is the most effective and long-lasting tool for protection from this infection. DHSS continues to encourage anyone age 12 and up to get vaccinated against COVID-19. Get the facts about COVID-19 vaccines and where to get vaccinated at MOStopsCovid.com.
The Health Education Unit is excited to announce our new changes to the CNA Rules – COMING SOON!
Along with the new implementation of the new CNA testing process, our rules are being updated and include proposed changes to the curriculum, reciprocity for out of state CNA’s coming to work in Missouri, and the requirement for our instructors to attend a four-hour update training every five years, as well as several others.
We invite you to attend one of our Q and A sessions to learn more about these changes. Our third party test administrator, Headmaster, will also join and be available to answer questions. Please access our website at https://health.mo.gov/safety/cnaregistry/ for log in information.
The scheduled dates and times are listed below:
June 16, 2021: DHSS/D & SDT Headmaster Q & A Webex Meeting
Time: 12:00 p.m.
Meeting number (access code): 177 675 4909 Meeting password: urUBZCPC265
Join from a video system or application
Dial 1776754909@stateofmo.webex.com
You can also dial 173.243.2.68 and enter your meeting number. Tap to join from a mobile device (attendees only)
+1-650-479-3207, 1776754909## Call-in toll number (US/Canada)
+1-312-535-8110, 1776754909## United States Toll (Chicago)
Join by phone
1-650-479-3207 Call-in toll number (US/Canada)
+1-312-535-8110 United States Toll (Chicago)
Global call-in numbers
June 22, 2021: DHSS/D & SDT Headmaster Q & A Webex Meeting
Time: 3:30 p.m.
Meeting number (access code): 177 961 7383 Meeting password: VHvmrBY3Z83
Join from a video system or application
Dial 1779617383@stateofmo.webex.com
You can also dial 173.243.2.68 and enter your meeting number. Tap to join from a mobile device (attendees only)
+1-650-479-3207, 1779617383## Call-in toll number (US/Canada)
+1-312-535-8110, 1779617383## United States Toll (Chicago)
Join by phone
1-650-479-3207 Call-in toll number (US/Canada)
+1-312-535-8110 United States Toll (Chicago)
Global call-in numbers
June 30, 2021: DHSS/D & SDT Headmaster Q & A Webex Meeting
Time: 10:00 a.m.
Meeting number (access code): 177 278 8445 Meeting password: 3fdQsTPs8X2
Join from a video system or application
Dial 1772788445@stateofmo.webex.com
You can also dial 173.243.2.68 and enter your meeting number. Tap to join from a mobile device (attendees only)
+1-650-479-3207, 1772788445## Call-in toll number (US/Canada)
+1-312-535-8110, 1772788445## United States Toll (Chicago)
Join by phone
1-650-479-3207 Call-in toll number (US/Canada)
+1-312-535-8110 United States Toll (Chicago)
Global call-in numbers
The Missouri Department of Health and Senior Services (DHSS) along with the Missouri Developmental Disabilities Council released a new resource, the “Missouri Plain Language Guide for People with Disabilities, their Families and Caregivers,” on COVID-19 and the vaccine.
Through this partnership, the new guide will ensure that important information related to COVID-19 and vaccine access is more accessible to people with intellectual and developmental disabilities, and others with disabilities affecting reading, comprehension and other cognitive functions.
“After reading this new Missouri Plain Language Guide, I was very impressed with two very important things: 1) the amount of important and vitally necessary information that it contains; and 2) how plain and understandable the format is, that was used to present it, without diluting any of the valuable information that it conveys to the reader. I believe that this will prove to be a very valuable tool for persons with disabilities and many others,” said Cathy Enfield, Chairperson and Self-Advocate, Missouri Developmental Disabilities Council.
“There is so much information available about COVID-19 and vaccines, that it could be hard to navigate through the information. We value the collaboration with DHSS, to provide accurate information in a plain language format that is accessible to so many who experience disabilities. We look forward to continuing this important work to ensure the disability community has information to make decisions about their health,” said Vicky Davidson, Executive Director, Missouri Developmental Disabilities Council.
People with disabilities, their family members and caregivers have been eligible to receive the COVID-19 vaccine in the earliest phases of Missouri’s vaccine rollout. Currently, any Missourian age 12 and older is eligible to receive the COVID-19 vaccine. Since the beginning of 2021, DHSS and the Missouri Advisory Committee on Equitable COVID-19 Vaccine Distribution have been focused on deploying new strategies and resources to meet the disability community where they are – this new guide is a resource to support Missouri’s disability community and those individuals, family members and caregivers who support them.
“Since day one at DHSS, our goal has been to ensure Missouri’s most vulnerable, people with disabilities and those who support them (i.e., their families, caregivers and disability service providers) were at the front of the line to receive the free vaccine throughout our vaccine roll-out process. Throughout the year, we have also been working to deploy new strategies and resources to meet the disability community where they are. Our new plain language guide is an additional resource for Missourians with disabilities and those who support them,” said Sara Hart Weir, co-chair of the Missouri Advisory Committee on Equitable COVID-19 Vaccine Distribution.
Enfield added, “We simply need information to be supplied in a clear, plain and understandable way. As Chair of the Missouri Developmental Disabilities Council, I am proud of the work that our members and staff did on the document. I applaud their efforts and the efforts of all those who were involved.”
If you or someone you know is unable to visit a COVID-19 vaccination clinic without assistance, please call the COVID-19 Hotline at 877-435-8411 and press option 4 to be routed directly to your local Area Agency on Aging to make a vaccine appointment. You can also register individuals for the vaccine by visiting Missouri’s COVID-19 website, MOStopsCovid.com. COVID-19 Hotline hours of operation are Monday-Friday 7:30 a.m.-5:30 p.m. and Saturday 8 a.m.-2 p.m. (Hotline is open on Saturdays through until June 11.) Individuals are encouraged to call soon to ensure their names are added to the list.