As the House and the Senate come to a deal for an $8.3 billion spending package to combat the coronavirus, the Department of Health and Human Services has released its own emergency measures.
HHS, through the Centers for Disease Control and Prevention, is awarding an initial $25 million in a cooperative agreement to states and local jurisdictions which have so far borne the largest burden of response and preparedness activities.
The funds are for immediate assistance for activities such as monitoring of travelers, data management, lab equipment, supplies, staffing, shipping, infection control and surge staffing, HHS said.
Another $10 million is being released for the implementation of coronavirus surveillance across the U.S., building on existing influenza activities and other surveillance systems.
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In addition, HHS said it intends to purchase 500 million N95 respirators over the next 18 months for the Strategic National Stockpile.
The House bill provides more than $3 billion for developing treatments for the virus and allocates $2.2 billion for the Centers for Disease Control and Prevention to contain the outbreak, among other measures, according to The Wall Street Journal. More than $1 billion will go overseas, while $20 million will be made available to fund administrative expenses for loans to U.S. small businesses.
Originally, lawmakers were looking for $2.5 billion to fight COViD-19. President Trump then said he would be willing to sign a measure for more.
In addition to funding, the Centers for Medicare and Medicaid Services has announced several actions aimed at limiting the spread of the novel coronavirus, and specifically mentioned nursing homes.
CMS has announced that, effective immediately and until further notice, State Survey Agencies and Accrediting Organizations will focus their facility inspections exclusively on issues related to infection control and other serious health and safety threats, like allegations of abuse – beginning with nursing homes and hospitals.
CMS is also issuing a call to action to healthcare providers across the country, including nursing homes, to ensure they are implementing their infection control procedures.
WHY THIS MATTERS
Six residents of the Life Care Center outside of Seattle in Washington State have died from the virus.
There are now an estimated 162 cases of COVID-19 and 11 deaths nationwide.
CMS said its approach, announced by Vice President Mike Pence, who is overseeing COVID-19 efforts, will allow inspectors to focus their energies on addressing the spread of the virus.
Inspections will also continue in the 15,000 nursing homes across the country using the approximately 8,200 state survey agency surveyors.
The CMS memorandum includes protocols for the inspection process in situations in which COVID-19 is identified or suspected. These protocols include working closely with CMS regional offices and coordinating with CDC and other relevant agencies at all levels of government.
The other two memoranda provide critical answers to common questions that nursing homes and hospitals may have with respect to addressing cases of COVID-19. For example, the memoranda discuss concerns like screening staff and visitors with questions about recent travel to countries with known cases and the severity of infection that would warrant hospitalization instead of self-isolation.
It details the process for transferring patients between nursing homes and hospitals in cases for which COVID-19 is suspected or diagnosed. CMS also describes the circumstances under which providers should take precautionary measures (like isolation and mask wearing) for patients and residents either diagnosed with COVID-19 or showing signs and symptoms of COVID-19.
Finally, the agency is announcing that it has deployed an infection-prevention specialist to CDC's Atlanta headquarters to assist in real-time in guidance development.
In other efforts, the American College of Emergency Physicians has sent Congress recommendations around three main objectives: providing access to care for those infected or suspected to be infected, securing an adequate healthcare workforce and ensuring adequate resource allocation.
Among its recommendations, ACEP wants assurances of full coverage of testing and diagnosis by payers without patient cost-sharing.
On March 2, the U.S. Food and Drug Administration granted a request from the CDC for an emergency-use authorization to allow healthcare personnel to use certain National Institute for Occupational Safety and Health-approved respirators -- not currently regulated by the FDA -- during the coronavirus outbreak.
THE LARGER TREND
As anticipation grows for more widespread community transmission of COVID-19 in the U.S., emergency physicians are on the frontlines of caring for those affected, ACAP said.
ON THE RECORD
"Today's actions, taken together, represent a call to action across the healthcare system," said CMS Administrator Seema Verma. "All healthcare providers must immediately review their procedures to ensure compliance with CMS' infection control requirements, as well as the guidelines from the Centers for Disease Control and Prevention."
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