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04/02/2021

Today's COVID-19 Report: Friday, April 2

Friday, April 2, 2021

Here are the latest need-to-know updates for Friday, April 2 regarding the COVID-19 pandemic and other topics of importance.


HOLIDAY BEST WISHES

Happy Passover and Blessed Easter wishes to all!

In Today's Report

  • Regional Rapid Response Assistance Program launched
  • CDC issues COVID-19 guidance for adult day centers, participants
  • Emergency Preparedness Plan updates for 2021
  • State supported testing schedule and long-term care facility visitation updates
  • Survey Tip of the Week: Visitor Signage and Education
  • You asked... We answered regarding exposure to COVID-19 outside a facility and quarantining
  • You asked... We answered regarding testing a fully vaccinated healthcare worker after exposure
  • LeadingAge Need to Know: Plan to build the national aging services infrastructure and the Collaborative Care HIT virtual summit

Regional Rapid Response Assistance Program launched

Yesterday the provider associations were encouraged to ensure members had learned of the launch of Ohio Department of Aging’s (ODA) Regional Rapid Response Assistance Program (R3AP, pronounced “RAP”). The program has been designed by ODA and the Ohio National Guard to help Ohio congregate care centers support and protect older Ohioans through the COVID-19 pandemic and beyond.

The program is intended to provide additional services to the Ohio’s congregate care settings, including senior housing, day centers, senior centers, assisted living and nursing facilities that have experienced major disruptions in service during the public health emergency. While the first phase of R3AP focused on administering COVID-19 vaccine clinics at affordable senior housing locations, there is now an expanded suite of services. Assistance provided by the R3AP includes, but is not limited to: vaccination, COVID-19 testing and contact tracing, temporary staff support, PPE distribution, infection control resources, and training.

The R3AP has assembled teams of experts located in each of the eight regions designated by the Department of Health. These experts will use a multidisciplinary approach to monitor data and identify facilities in need of support. Regional team members will analyze the issues to understand challenges and identify solutions specific to the provider. The R3AP will also work with local health teams to mobilize and deploy personnel to provide key services. Partners include local health departments and local emergency management agencies.

The R3AP will be operated and managed by the Department of Aging. The National Guard will support the initial roll-out of the program with a short-term work force while more sustainable resources are secured. Providers should have received an EIDC Notice earlier today regarding the program. Interested locations should contact the R3AP team by calling 1-855-R3AP-ODA (1-855-732-7632).

Any providers, particularly adult day centers, who continue to seek medical orders for testing should reach out to Susan Wallace at swallace@LeadingAgeOhio.org. LeadingAge Ohio will make the connection to the appropriate R3AP resource.

CDC issues COVID-19 guidance for adult day centers, participants

On March 31, the Centers for Disease Control and Prevention (CDC) issued guidance for adult day services centers operating during the COVID-19 pandemic. The guidance is designed specifically for adult day administrators, staff and volunteers and should be taken as supplemental to (and specifically not in replacement of) any guidance issued on the state or local levels.

In addition to the guidance for centers themselves, CDC also issued guidance for adult day services participants, which includes much of the same information in the provider guidance but written for consumer audiences. While written for adult day providers specifically, other providers who offer in-person services in a center, like PACE organizations or senior centers, may find the guidance helpful as well. 

The guidance is comprehensive and covers behavioral, operational and physical approaches to preventing COVID-19 spread within a day center. It likely reflects many of the strategies centers have taken as they have reopened and/or modified their operations through the pandemic.

Like previous general CDC guidance, this document advises on healthy behaviors that all staff and participants should follow, including getting vaccinated when possible, staying home if a person tests positive for the virus, exhibits symptoms or comes into close contact with somebody who has COVID-19. The guidance also instructs individuals in a day center to wear masks and to regularly wash their hands, and provides guidance on proper techniques for both actions.

The guidance also provides operational guidance specific to adult day centers, similar to what CDC has issued in guidance for community-based organizations and other entities. These include placing limitations on visitors, ensuring physical distancing and implementing screening protocols. The guidance covers health screening at length and includes considerations on privacy and the need to engage in masking, distancing and other healthy behaviors in addition to screening.

It also addresses messaging within the center itself, including recommending signage that reminds individuals on distancing, mask usage and other COVID-19 prevention behaviors, as well as markers on the floor to indicate six feet of distance.

The guidance advises day centers on ways to promote distancing, including how to arrange tables and chairs in common areas, minimizing foot traffic in typically crowded areas, separating entry and exit points, and establishing physical barriers like plexiglass windows at reception desks. And, it recommends protocols on transportation, isolating staff and participants who begin to exhibit symptoms, staggering meal and activity times, and creating pods or cohorts to minimize close contacts across all individuals in the center.

While the guidance is helpful, it comes while Ohio adult day providers are still awaiting updated guidance from the Department of Health related to testing and access to adult day and senior centers. LeadingAge Ohio continues to advocate for rapid release of the new orders, to offer clarify to providers still struggling to reopen. Adult day questions, including those related to obtaining physician orders for testing, may be directed to Susan Wallace at swallace@leadingageohio.org.

Emergency Preparedness Plan updates for 2021

The Centers for Medicare & Medicaid Services (CMS) QSO-21-15-ALL memo updates the Emergency Preparedness State Operations Manual Appendix Z. LeadingAge Ohio encourages members to update their emergency preparedness plan to include the updated emergent infectious disease guidance which incorporates best practices, lessons learned, and planning considerations. Additions should include hazardous vulnerability assessment of bio-hazardous waste, bioterrorism, pandemic flu, and highly communicable diseases (such as Ebola, Zika Virus, and SARS). Planning should include considerations of PPE needs, patient surge, staffing needs, plans for monitoring updates from the Centers for Disease Control and Prevention (CDC) and other sources, use of alternative care sites, and 1135 waivers.

Annually the plan needs to be reviewed, trained on, and tested. The annual requirement applies to long-term care facilities. Other healthcare providers are required to update the plan every two years and upon changes. The QSO-21-15-All memo includes changes that would apply to all healthcare providers. CMS has provided a fact sheet on the Appendix Z updates.

State supported testing schedule and long-term care facility visitation updates

The Ohio Department of Health (ODH) has released the following state supported testing schedule for April 12 through May 7:

  • Per the amended orders, vaccinated staff should be tested once per week; unvaccinated staff should be tested twice per week; continue to report test results weekly;
  • The upcoming test schedule for April 12 through May 7 can be viewed here, including lab assignments as they may have changed;
  • All courier services will be directly coordinated through your assigned lab;
  • Supplies have begun shipping this week.

Important information about amended orders:

Please visit the ODH website to obtain resources, or reach out to COVIDTesting@age.ohio.gov with questions.

Survey tip of the week: Visitor signage and education

The Ohio Department of Health (ODH) has confirmed that annual surveys will begin this month and LeadingAge Ohio will be providing weekly tips to assist members. This week’s tip covers visitor signage and education from the newest visitation guidance. The Centers for Medicare & Medicaid Services (CMS) outlined specifics on visitor signage and education in the CMS QSO-20-39-NH memo. A facility must have instructional signage throughout the facility and proper visitor education on COVID-19 signs and symptoms, infection control precautions, other applicable facility practices (e.g., use of face covering or mask, specified entries, exits and routes to designated areas, hand hygiene). In all cases, visitors should be notified about the potential for COVID-19 exposure in the facility (e.g., appropriate signage regarding current outbreaks), and adhere to the core principles of COVID-19 infection prevention, including effective hand hygiene and use of face-coverings. Visitors should also be informed that those who are unable to adhere to the core principles of COVID-19 infection prevention will not be permitted to visit and will be asked to leave.

ODH highlights that social distancing according to the CMS memo should be followed. This would include instruction on CMS’ guidance that visits should be conducted using social distancing; however, if during a compassionate care visit, a visitor and facility identify a way to allow for personal contact, it should only be done following appropriate infection prevention guidelines, and for a limited amount of time. Also, if the resident is fully vaccinated, they can choose to have close contact (including touch) with their visitor while wearing a well-fitting face mask and performing hand-hygiene before and after. Regardless, visitors should physically distance from other residents and staff in the facility.

Additional guidance on the memo and links to signage that meets the requirement can be found in the LeadingAge Ohio FAQ on visitation, testing, and quarantine.

As the annual surveys begin, LeadingAge Ohio is sharing tips each week to assist members during the survey process. Send questions you’d like addressed in future Tips of the Week to Stephanie DeWees at sdewees@leadingageohio.org.

You asked... We answered regarding exposure to COVID-19 outside a facility and quarantining

You asked:

If a nursing home employee is exposed to COVID-19 outside of the facility; has been fully vaccinated over a month ago; and is not exhibiting any signs and/or symptoms of COVID-19, may they continue to work in the facility without quarantining at home? 

We Answered:

The employee can work and would not have to quarantine. The Centers for Disease Control and Prevention (CDC) notes that fully vaccinated health care personnel (HCP) with higher-risk exposures who are asymptomatic do not need to be restricted from work for 14 days following their exposure. Work restrictions for the following fully vaccinated HCP populations with higher-risk exposures should still be considered for:

  • HCP who have underlying immunocompromising conditions (e.g., organ transplantation, cancer treatment) might impact level of protection provided by the COVID-19 vaccine. However, data on which immunocompromising conditions might affect response to the COVID-19 vaccine and the magnitude of risk are not available.

You asked... We answered regarding testing a fully vaccinated healthcare worker after exposure

You asked:

Should a facility test a fully vaccinated healthcare worker who has had an exposure but is asymptomatic?

We Answered:

Yes, the Centers for Disease Control and Prevention (CDC) recommends testing in this scenario in the Interim Guidance on Testing Healthcare Personnel for SARS-CoV-2. Specifically, CDC suggests testing in the following four situations:

  1. Testing HCP with signs or symptoms consistent with COVID-19
  2. Testing asymptomatic HCP with known or suspected exposure to SARS-CoV-2
  3. Testing asymptomatic HCP without known or suspected exposure to SARS-CoV-2 as part of expanded screening
  4. Testing HCP who have been diagnosed with SARS-CoV-2 infection to determine when they are no longer infectious

LeadingAge Need to Know: Plan to build the national aging services infrastructure and the Collaborative Care HIT virtual summit

LeadingAge shares the latest coronavirus news and resources with members twice each weekday. This morning's Need to Know featured an item on LeadingAge's plan to build the national aging services infrastructure and the Collaborative Care HIT virtual summit.

Check out the full report here.


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Questions

Please send all questions to COVID19@leadingageohio.org. Additionally, members are encouraged to visit the LeadingAge Ohio COVID-19 Working Group facebook gro up to pose questions to peers and share best practices. LeadingAge is continuing its daily calls for all members.  To participate in these daily online updates, members should register here.  

LeadingAge Ohio is working to ensure that the information in our daily alerts, on our website, and all coronavirus-related communications is as accurate as possible. However, LeadingAge Ohio makes no guarantees about the accuracy of the information. 

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Our national partner, LeadingAge, is an association of 6,000 not-for-profit organizations dedicated to expanding the world of possibilities for aging. Together, we advance policies, promote practices and conduct research that support, enable and empower people to live fully as they age.