COVID-19 UPDATE #199
October 22, 2021
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LTC OMBUDS ADDRESSES VACCINATION STATUS |
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On October 19, 2021, the Long Term Care (LTC) Ombuds informed WHCA and other long term care associations that effective October 18, 2021, all LTC Ombuds who enter long term care facilities for the purpose of providing in-person services to residents have been fully vaccinated against COVID-19 and have provided proof of vaccination to the LTC Ombuds Program. WHCA and other long term care associations were informed that LTC Ombuds entering facilities will carry a letter with them in case they encounter facility access issues related to the vaccination mandate. The letter goes on to recount that when entering facilities, LTC Ombuds are not required to provide proof of vaccination in accordance with the DSHS Safe Start Plan. Accompanying the letter is a signed declaration from the State LTC Ombuds Patricia Hunter attesting to the fact that all LTC Ombuds entering facilities are fully vaccinated.
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STORM WARNING FOR POTENTIAL EXTREME WEATHER IN WESTERN WASHINGTON |
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The National Weather Service has issued notification of possible extreme weather in Western Washington throughout the weekend and into early next week. They also hosted a webinar earlier today to provide updates and insights on what to expect. Multiple storm systems over the next week may bring rain, wind, mountain snow, and the potential for high surf and thunderstorms. The most impactful system will occur Sunday into Monday. Persistent rounds of rainfall will lead to rising rivers, and some may approach flood stage. Gusty winds at times may cause localized power outages and tree limb damage. Significant wind gusts are possible on the coast. Additional and alternative information is available on the Cliff Mass Weather Blog.
Please be sure your emergency/disaster plans related to extreme weather and outages are reviewed and ready in case they are needed.
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BOOSTER DOSES NOW AVAILABLE FOR ALL THREE
COVID-19 VACCINE TYPES FOR CERTAIN INDIVIDUALS
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The Washington State Department of Health (DOH) is expanding the use of COVID-19 vaccine booster doses for certain individuals following recommendations from the U.S. Food and Drug Administration (FDA), the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices, and the Western States Scientific Safety Review Workgroup.
Last month, health care providers began offering booster doses of the Pfizer-BioNTech (Pfizer) vaccine to certain individuals. Since then, more than 345,000 additional doses (which is a combination of booster and third doses) have been given out across the state. Now, providers can also offer booster doses of the Moderna and Johnson & Johnson (J&J) vaccines to those who are eligible.
At least six months after completing the primary Pfizer or Moderna vaccine series, the following groups of people are eligible for a booster dose
At least two months after receiving the single-dose J&J vaccine, it is recommended that everyone 18 and older receive a booster dose. Pfizer and J&J’s boosters are both full doses, while Moderna’s booster is a half dose.
“Vaccination continues to be the safest and most effective tool we have to prevent serious illness, hospitalization, and death from COVID-19. Getting the unvaccinated their first shots remains a priority,” said Secretary of Health Umair A. Shah, MD, MPH. “A booster dose will further protect fully vaccinated individuals by increasing the vaccine’s effectiveness in their bodies, which otherwise may wane over time.”
According to the FDA and CDC, studies found “mixing and matching” boosters is safe and effective. This means your booster shot does not have to be the same COVID-19 vaccine type your primary vaccination was. For example, someone who received the J&J vaccine can receive a booster dose of J&J, Pfizer, or Moderna. Likewise, someone who received two doses of an mRNA vaccine (Moderna or Pfizer) can receive a Moderna, Pfizer, or J&J booster.
COVID-19 vaccines are proven to be safe and effective and are recommended for everyone 12 and older. Currently, there is plenty of vaccine available across the state for everyone who needs a dose. To find a vaccine near you, visit Vaccine Locator or call the COVID-19 Information Hotline at 833-VAX-HELP. Language assistance is available.
The DOH website is your source for a healthy dose of information.
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DEAR ADMINISTRATOR LETTER HIGHLIGHTS CRITICAL STAFFING MANAGEMENT IN LONG TERM CARE SETTINGS |
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In a Dear Administrator letter dated October 19, 2021, all providers are notified of procedures to manage resources and avert crisis when facing critical staffing levels. The letter addresses:
- Guidelines for critical staffing management and use of emergency preparedness plans;
- Department response, procedures, and assistance with critical staffing management; and Regulatory requirements for emergency preparedness in various LTC settings
The letter expands on each of these headings and provides many resources to support providers managing critical staffing. The letter reminds providers that all long term care settings are required to have an emergency plan in place to address a range of possible emergencies and those plans should include critical staffing management and protocols to monitor and manage staffing resources.
The letter explains the emergency plans for long term care settings will include continuum of care decisions for critical staffing management. Long term care settings will activate emergency plans to substantially change usual operations or levels of care when they identify:
- Resources are exceeded by demand or depleted AND
- Functionally equivalent care is no longer possible to address all requirements AND
- There is a risk to patient/resident or provider
Long term care setting providers are encouraged to contact the RCS Field Manager to discuss options for adjusting operations and standards of care to preserve and effectively allocate limited resources. All long term care settings can use the RCS document “ Continuum of Care Decisions for Critical Staffing Management in Long-Term Care Settings Guide” to track which contingency and crisis standards have been put into effect by the setting. The document contains possible decisions or protocols LTC settings can use when faced with critical staffing shortages.
All long term care settings must seek help and notify the department when contingency care levels are not sufficient to meet resident/care needs and any crisis standards to manage critical staffing shortages are initiated. This request for assistance and department notification will be done using the established rapid response team email and process:
The letter explains the response, procedures, and assistance with emergency preparedness plans and crisis management that RCS will take. The letter also provides the regulatory requirements for emergency preparedness. Questions can be directed to Katherine Ander. |
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PROPER FIT TESTING CONTINUES TO PROVIDE SUPERIOR PROTECTION |
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The Delta variant has proven that at any time, COVID-19 cases can dramatically increase. Providing your workforce with respiratory protection (N95) against respiratory hazards, such as the virus that causes COVID-19, is a safety standard regulated and enforced by the Washington Department of Labor and Industries (L&I). Fit testing ensures the N95 respirator will filter out 95% of the airborne virus when used correctly. Keep your employees working by getting them fit tested and ready to properly use a respirator.
The DOSH Directive 11.80 Temporary Enforcement Guidance was updated September 21, 2021. L&I will begin enforcing the requirement of annual fit testing on January 1, 2022. This means, for example, if your employees were fit tested on 11/1/2020, they will need to be fit tested again before 11/1/2021. If they are not, your facility may be cited on January 1, 2022, for not providing annual fit testing.
Now is the time to take advantage of the services DOH is offering for your caregivers that care for residents/clients in isolation or quarantine – FREE medical evaluation and fit testing for respirator use. This offer will expire at the end of 2021. Visit the DOH Respiratory Protection Program website for more information at Respiratory Protection Program, or email HAI-FitTest@doh.wa.gov.
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THURSTON COUNTY ISSUES COMMUNICABLE DISEASE UPDATE FOR LTC |
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On October 22, 2021, Thurston County Public Health and Social Services Department issued a Communicable Disease Update titled Long Term Care Facility COVID-19 Guidance for Outbreaks and New Admissions. The update informs providers that new admissions who are fully vaccinated, asymptomatic and have not been determined to be close contacts are no longer required to quarantine. The update also provides additional updated guidance regarding quarantine, testing, and cohorting when a positive COVID-19 case is identified in your facility. |
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DOH PROVIDES UPDATED MEDICAL SURGE CATALOG AND REQUEST FORM |
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The Department of Health (DOH) has provided an updated Medical Surge Catalogue and Equipment Request Form for all healthcare providers. Pulse oximeters have been added to the catalogue along with many other items. If you have questions, please reach out to DOH via the information provided on the Equipment Request Form. |
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DSHS AND DOH EMERGENCY RULES STATEMENT FOR LTC WORKERS |
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The Department of Social and Health Services (DSHS) and the Department of Health (DOH) continue to prioritize the need for a stable, trained long term care work force in the wake of the COVID-19 public health emergency (PHE). The departments have held several joint stakeholder listening sessions and recognize that emergency rules must be put in place to meet this goal.
Working in tandem, DOH and DSHS have identified four critical areas to be addressed through either emergency or permanent rules:
Under Authority of DSHS:
- Set dates for completion of training to absorb the backlog of workers hired during the pandemic
- Provide an avenue to grant credit for on-the-job training for those employed during the COVID-19 PHE who were not able to meet the CE renewal requirements
Under Authority of DOH:
- Set policies around credentialing dates that will complement and support the timelines set by DSHS
- Address the need to re-set the date of hire for workers who failed to renew or whose credential fully expired
While these rules may not be set in place at the same time due to differences in agency processes, DSHS and DOH are fully committed to jointly implementing these critical rules to support the long term care workforce. Here is the link to the DSHS Emergency Rule Filing regarding training, certification and CE training deadlines.
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AHCA UPDATES ITS 3-DAY STAY AND BENEFIT PERIOD WAIVER GUIDANCE FOR SNFs |
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This week, AHCA/NCAL updated the guidance document titled 3-Day Stay and Benefit Period Waivers for Medicare Part A SNF PPS. The two specific updates include:
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WHCA continues to post resources and information as it becomes available on our website. If you have questions or need additional information, please call the WHCA office at (800) 562-6170.
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