MHA Today | February 21, 2020

February 21, 2020
MHA Today: News for Healthcare Leaders

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February 21, 2020

MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.


Insights


In early February, the Trust for America’s Health ranked Missouri among the “high performer” states for public health preparedness. The strength of the relationship between the state and the hospital community was essential to the top-level ranking.

None of this is an accident. For nearly two decades, the state — largely through the Department of Health and Senior Services — has partnered with hospitals and preparedness stakeholders to build a strong and integrated program designed around responding to all hazards. This week, I asked a member of the MHA team — Keri Barclay, MHA’s Manager of Clinical Preparedness — to pen this column. Last week, she was at the Center for Domestic Preparedness in Anniston, Ala., where in 2015, MHA and 150 Missouri hospital leaders participated in the nation’s best readiness training. Her insights follow.



Keri Barclay in PPE “The CDP is the nation’s premier site for hospital-specific training in disaster preparedness and terrorism response. The facility is ideal because, as a decommissioned hospital, it provides a realistic environment for simulations.

The goal is knowledge transfer. As a member of MHA’s emergency preparedness and response team, I am much better prepared to share best practices with Missouri hospitals and our statewide partners.

Last week’s highly infectious disease training focused on critical thinking around proper personal protective equipment. The majority of our time was spent learning to evaluate best practice and safe care for infectious disease patients while maintaining that same level of safety for front-line health care workers. These principles carry renewed importance given the U.S. and global public health emergency with coronavirus — now known as COVID-2019. The training included exercises designed to address care for Ebola, highly infectious disease and COVID-2019. Needless to say, these conditions underscore the importance of preparedness.

Patient Care in PPE Part of the training encompassed multiple aspects of highly infectious disease transport and patient care. This included preparing ambulance units for safe patient transfer, using an isopod or appropriate alternative, starting IVs, giving medications, and cleaning up spills. The culmination of nearly a week of training was a day full of exercise scenarios spent in maximum barrier PPE. The exercise included patient care — including work with live volunteers — and rotation through a variety of donning and doffing PPE exercises to create muscle memory for safe procedures. It would be hard to underestimate the value of repeated donning and doffing during training.

In my role as a preparedness manager, I often reflect on the words of Anthony Fauci, M.D., director at the National Institutes of Health. He said, “It’s folly to predict what a next pandemic might bring. We just need to be prepared.”

Hospitals and health care facilities must conduct regular training for infectious disease management and cultivate robust disease surveillance systems in their communities, among patients and at the staff level. These organizations must be able to quickly pivot from daily operational readiness for infectious patients to addressing an outbreak. And, it is essential that time and resources are dedicated to multidisciplinary health care teams — in the hospital and throughout health care coalitions.

The little things count! Hand hygiene, PPE, environmental services and engineering controls all are crucial to safe communities, safe patient care, and employee health and safety.

This experience extended a better understanding of infectious disease outbreaks — from influenza and measles to COVID-2019 or Ebola. I am excited to begin to deliver these tools to hospitals and our preparedness partners throughout the state.”

Keri Barclay, R.N., CHEP
MHA Manager of Clinical Preparedness
kbarclay@mhanet.com


In This Issue
Senate Committee Approves FRA Reauthorization Bill
APRN Licensure Bill Advances
State Senate Committee Considers Bill Of Rights For Sexual Assault Survivors
State Legislators Review Facility Fees Legislation
CMS Issues CJR Three-Year Extension
MHA Reports Medicare Pay-For-Performance Overview
MLN Connects Provider eNews Available
COVID-19 Informational Call Available, CDC Provides Direction On Expired PPE



Advocate
state and federal health policy developments


Senate Committee Approves FRA Reauthorization Bill

Staff Contact: Rob Monsees or Bill Anderson

The Senate Appropriations Committee unanimously approved legislation to reauthorize the hospital Federal Reimbursement Allowance and four other state provider taxes for an additional year, until Oct. 1, 2021.

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APRN Licensure Bill Advances

Staff Contact: Daniel Landon or Rob Monsees

A state Senate committee approved a new version of Senate Bill 714, which would create a separate system of licensure for advanced practice registered nurses who currently are licensed as registered nurses with an APRN certification.

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State Senate Committee Considers Bill Of Rights For Sexual Assault Survivors

Staff Contact: Rob Monsees or Bill Anderson

A state Senate committee held a hearing on legislation that would create a Sexual Assault Survivor’s Bill of Rights. Senate Bill 812 is sponsored by Senator David Sater. This legislation enumerates a number of rights that accrue to a victim of sexual assault during any medical evidentiary or physical exam, or during any interview with law enforcement and prosecuting or defense attorneys. The proposal also places responsibilities on these parties to inform the victim of these rights and to obtain signed confirmation of receipt. A new cause of legal action would be created against parties who fail to make reasonable efforts or intentionally fail to comply with their responsibilities under this legislation. MHA opposes this legislation.

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State Legislators Review Facility Fees Legislation

Staff Contact: Rob Monsees or Bill Anderson

A state House committee held a hearing on House Bill 2311, sponsored by Representative Mike Haffner. This legislation prohibits the charging, billing and collecting of facility fees for any provider-based facility that operates under the ownership, administrative and financial control of a hospital or health system and bills as an outpatient department. Craig Thompson, CEO of Golden Valley Memorial Hospital, and Paula Littleton, reimbursement director for MU HealthCare, testified in opposition of the bill and described the legislation’s adverse impact on access to health care in local communities. MHA also testified in opposition to this proposal.

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Regulatory News
the latest actions of agencies monitoring health care


CMS Issues CJR Three-Year Extension

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services announced a proposed rule that would extend the Comprehensive Care for Joint Replacement model for three years ending Dec. 31, 2023. CMS also proposes to change the definition of a CJR episode of care to include both inpatient and outpatient services and revises the target price calculation. MHA published an issue brief with additional details.

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MHA Reports Medicare Pay-For-Performance Overview

Staff Contact: Andrew Wheeler

As the Centers for Medicare & Medicaid Services continues to tie payments to quality, the mandatory pay-for-performance programs continue to evolve. MHA released an analysis that includes details about the Hospital Readmissions Reduction, Hospital-Acquired Conditions and Value-Based Purchasing programs. The analysis details the weighting, hospital performance and financial impact for program years 2018, 2019 and 2020. MHA has free, on-demand webinars about the Medicare pay-for-performance programs.

Policy and analytic studies are available for download to authorized users of HIDI Analytic Advantage®. If you need a user ID and password or have questions about accessing these reports, please contact HIDI.

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MLN Connects Provider eNews Available

Staff Contact: Andrew Wheeler

Updates to MLN Connects Provider eNews were issued by the Centers for Medicare & Medicaid Services. eNews includes information about national provider calls, meetings, events, announcements and other MLN educational product updates. The latest issue provides updates and summaries of the following.

  • Bill correctly for Medicare telehealth services
  • CMS develops new code for coronavirus lab test
  • CMS program statistics: 2018 data

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Quality and Population Health


COVID-19 Informational Call Available, CDC Provides Direction On Expired PPE

Staff Contact: Jackie Gatz or Keri Barclay

Yesterday, MHA, in partnership with the Missouri Department of Health and Senior Services, hosted its second joint informational call on the current coronavirus outbreak to provide a situational update and outline guidance for more than 300 participants. A recording is available on MHA’s website.

Today, DHSS asked MHA to distribute the following message regarding personal protective equipment stockpiles to Missouri hospitals. “The Assistant Secretary for Preparedness and Response and the Centers for Disease Control and Prevention are aware of the health care system concern over PPE supply chain shortages and questions about storage and use of expired N95 masks and other PPE. The CDC is encouraging grant recipients, public health agencies and health care providers to maintain any stockpiles of PPE that is expired or past its normal shelf life until further guidance can be provided. The National Institute for Occupational Health and Safety is working with both the Occupational Safety and Health Association and the Food and Drug Administration to determine additional guidance on expired PPE past its intended shelf life.”

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Did You Miss An Issue Of MHA Today?


February 17, 2020
MHD Announces Funding For Hospitals Connecting To HIEs
MHA, DHSS To Host Joint Call On Coronavirus

February 19, 2020
State House Advances PDMP Legislation
Committee Advances Higher Standard For Health Constitutional Amendments
MHA Releases Analysis Of Medicare Spending Per Beneficiary
St. Alexius Hospital Names New CEO



Consider This ...

This season, the flu vaccine has been 45% effective against both types of flu across all ages. Overall, flu vaccine averages around 40% effective.

Source: AP/PBS News Hour