COVID-19 UPDATE #11
March 19, 2020
INSLEE ISSUES PROCLAMATION 20-18 GRANTING DSHS ADDITIONAL COVID-19 FLEXIBILITY
Governor Inslee continues to issue proclamations regarding the current COVID-19 outbreak, taking emergency measures, noting that strict compliance with identified laws will risk destabilizing the state's long term care system and prevent, hinder, or delay the response to COVID-19. To date, the Governor has released 19 proclamations related to this statewide emergency. This is a fluid situation, and additional laws and rules may require suspension. Given the focus on eliminating barriers for Washingtonians under the COVID-19 outbreak, operating requirements for providers are changing regularly.

We are tracking those rules, and will update you as there are changes. Click here for a synopsis of laws and rules that are rescinded through April 9, 2020.
DSHS WAIVER REQUESTS GRANTED
Last night, Governor Jay Inslee released an additional proclamation , 20-18, related specifically to DSHS waiver requests to address the COVID-19 pandemic. The guidance repealed a number of requirements for providers until April 9, 2020.

In short, the new proclamation allows the Department to further limit inspections and investigations in skilled nursing and assisted living centers, eliminates penalties for refusing visitors in nursing homes, and rescinds the requirement for federal fingerprint background checks for certain assisted living workers. Importantly, this proclamation also waives the current staffing requirements for skilled nursing facilities in RCW 74.42.360 (2),(3), and (4). The Department has also eliminated certain assessment requirements for Medicaid-eligible nursing home residents.

In addition to guidance related to DSHS, the Governor issued two other proclamations yesterday that may impact senior housing/care providers including a moratorium on evictions , and a waiver of the one-week rule for unemployment benefits . 
OMBUDS COMPILES SPIRITUAL/MENTAL HEALTH RESOURCES LIST
The Washington State Ombuds program is compiling an updated list of Chaplains, Mental Health Therapists, and Spiritual Care providers who will provide services either free or for a fee. Many are able and willing to do telepsych counseling by phone or Skype (or similar). Some are willing to go into facilities when restrictions are listed. All regional LTC Ombuds also have this list, and when they contact families if the need arises or there is a request, the Ombuds will provide the information. Click here for the list.
TOMORROW: WHCA WEBINAR TO FEATURE TIPS AND TOOLS FOR CRISIS COMMUNICATION DURING COVID-19
Please join us Friday, March 20, at 2 PM for a webinar presented by J. Vander Stoep. J.'s firm, Sound Counsel Crisis Communications, is assisting many long term care organizations as they navigate the COVID-19 outbreak. J. will share tips and tools for communicating with the media, families, and employees during a crisis. This webinar will be succinct and brief; it will last approximately 20 minutes. WHCA will record the webinar and post it to our website so that if you cannot join live, you can view it later. Click here to join the webinar tomorrow at 2 PM. No preregistration is necessary.
AHCA/NCAL GUIDANCE ON THERAPY SERVICES DURING COVID-19
This document provides guidance for therapists on how LTC Facilities (SNFs and ALs) can operationalize federal and state guidance to significantly restrict visitors and non-essential personnel, as well as restrict communal activities inside LTC facilities as part of the effort to prevent COVID-19 from spreading. When deciding if a therapist needs to enter a building (regardless of their being an employee or outside contractor), we advise LTCs to consider the intent of the federal and state guidance in deciding. The intent is to restrict entry of as many people as possible, as each additional person entering increases the risk of COVID-19 entering. 
 
Of course, this also needs to be balanced with trying to meet the needs of the resident. That risk-benefit trade off needs to be made on a case-by-case basis but should incorporate the high morbidity and mortality associated with contracting this virus in the elderly over 80 (estimated at 15-20% or more).
NEW COVID-19 FACT SHEET FOR RESPIRATOR AND FACEMASK PRACTICES FOR LONG TERM CARE
The Department of Labor & Industries has prepared guidance about respirator and facemask practices for health care workers, with a focus on long term care facilities. The fact sheet is available here.
ADDITIONAL RESOURCES
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.