Coronavirus Response Newsletter

Vaccine Updates: CHA Issues Primer, CDPH to Host Hospital Calls, Statewide Advisory Committee Announced

  • Vaccination Primer for Hospitals: A COVID-19 vaccine could be available for hospitals to offer their employees and staff — and, if the hospital volunteers, to other front-line health care workers — as early as mid-December, assuming the Pfizer vaccine candidate is authorized for emergency use by then. The Moderna candidate, which can be refrigerated rather than stored at ultra-low temperatures, is expected to follow within a few weeks; however, hospitals may be asked to use the Pfizer candidate since they have greater ability to manage the ultra-low temperature storage and handling requirements than other vaccinators. To help hospitals get ready, CHA has prepared a five-page COVID-19: Vaccination Primer for California Hospitalssummarizing the latest information from the California Department of Public Health (CDPH) and the steps that hospitals will need to take to participate as vaccinators.
  • CDPH Calls for Hospitals, Vaccination Websites: At CHA’s request, CDPH will host two all-hospital calls on COVID-19 vaccination planning — on Dec. 4 and Dec. 18, both from 9 to 10 a.m. (PT) — and will distribute the call-in number and meeting materials via the California Health Alert Network. CHA will distribute the number via Coronavirus Response. CDPH is also posting information on two areas of its website: the California COVID-19 Vaccination Program and the COVID-19 Vaccine Planning sections. Hospitals can direct questions to CDPH on these upcoming calls or to their local health departments.
  • Vaccine Advisory Committee: CDPH has established a Community Vaccine Advisory Committee, on which CHA is represented by President & CEO Carmela Coyle. The committee will provide input and feedback for CDPH’s ongoing planning and engagement efforts to ensure equitable vaccine distribution and allocation. According to CDPH, it will build on the Scientific Safety Review Workgroup and the California COVID-19 Drafting Guidelines Workgroup. Information on how to listen to meetings, which begin Nov. 25, will be posted here.

Regeneron Treatment Receives Emergency Use Authorization

The Food and Drug Administration has authorized the use of monoclonal antibodies casirivimab and imdevimab together to treat COVID-19 outpatients at risk of developing severe disease. Weekly allocations to state and regional health departments will begin immediately and are anticipated to continue through January 2021. Doses will be delivered to acute care hospitals, as determined by the regional Medical Health and Operational Area Coordinator. 

Patient criteria for this infusion treatment is similar to that of the previously approved monoclonal antibody treatment, bamlanivimab; both treatments have been demonstrated to be most beneficial for outpatients with certain conditions who are at high risk for disease progression. As compared to bamlanivimab, the newly authorized regeneron treatment is more complex to administer, requiring one dose of each of two antibodies and more extensive preparation by the pharmacist prior to infusion. Additional information about the recent approval is available here, and more information about monoclonal antibodies and their administration can be found in the Operation Warp Speed playbook issued on Nov. 23.

Process for Requesting Staffing Waivers from CDPH Has Not Changed

Many hospitals have asked if the process for requesting nursestaffing ratio waivers has changed; it has not. The same process for requesting waivers of nursestaffing ratios that has been in place since June 30 continues. Hospitals should continue to submit requests individually via CDPH form 5000A and email it to [email protected]. Hospitals should mark it urgent if they need approval within eight hours. For more details, see All Facilities Letter (AFL) 20-26.3.

The increase in hospital inquiries about this issue underscores why CHA has requested that the waiver be reinstated statewide. CHA is in active discussions with CDPH and the Administration about this and will continue to keep hospitals updated.

CDPH Releases Guidance on SNF Admissions from Hospitals

CDPH has issued AFL 20-87, which provides guidance on admission and readmission of skilled-nursing facility (SNF) residents following hospitalization. The AFL, which was requested by CHA and developed by CDPH with input from CHA and the California Association of Health Facilities , also provides guidance on working in coordination with local health departments to ensure appropriate and safe care transitions from hospital to SNF. 

The new AFL will be the topic of the Dec. 2 webinar conducted in coordination with the Health Services Advisory Group (HSAG), from 3 to 4 p.m. (PT). For additional information and to register, visit the HSAG website. A recording will be available the day following the webinar.

HHS Clarifies Provider Relief Fund Reporting Requirements

On Nov. 18, the U.S. Department of Health and Human Services updated its FAQs for the Provider Relief Fund and clarified two key points related to reporting requirements:

  • Expenses for capital equipment, inventory, and facilities projects may be fully expensed if the purchase was directly related to preventing, preparing for, and responding to the coronavirus. Examples of these types of equipment and inventory expenses, as well as facilities projects, can be found here.
  • Providers should not include payments received from or made to third parties related to care provided outside the reporting period (2019-20) when reporting net patient revenue. 

Cal/OSHA Adopts Emergency COVID-19 Standard

On Nov. 19, the California Occupational Safety and Health Board (Cal/OSHA) adopted an emergency temporary standard focused on COVID-19 in the workplace. This new, extremely broad regulation is in addition to the employee notice requirements encompassed in Assembly Bill (AB) 685, COVID supplemental paid sick leave adopted in AB 1867, and Senate Bill 1159’s workers’ compensation presumption requirements.

Before it goes into effect, the emergency temporary standard must be approved by the Office of Administrative Law (OAL) and was expected to be filed on Nov. 20. The OAL has 10 days to review the regulatory package. If approved, it would go into effect when it is filed with the Secretary of State and would remain in effect for 180 days, unless it is extended. Additional details about the emergency temporary standard are here.

OSHPD Clarifies Grace Period for Temporary Work for COVID-19 Until March 1

The Office of Statewide Health Planning and Development (OSHPD) has posted to its COVID-19 Resources web page the clarification that an OSHPD permit is not required for temporary changes or use of modifications to the physical environment for COVID-19 during the period of CDPH AFL 20-26.3, which is in place until March 1, 2021, unless extended. Hospitals only need to notify the OSHPD compliance officer responsible for their hospital. To determine the OSHPD compliance officer responsible for your hospital, select your hospital on OSHPD’s Facility Detail web page. Examples of the types of temporary work done by hospitals to date without prior OSHPD permit approval include erecting surge tents, repurposing rooms, and installing temporary barriers.

New CDPH Guidance Requires a Mask When Outside the Home

CDPH guidance issued Nov. 16 explains that Californians are now required to wear a mask, including at all times when outside their homes, and even if they are more than six feet apart when they are indoors. See the guidance for limited exceptions. Hospitals may want to review these requirements, as they relate to mask requirements for their break rooms, cafeterias, and other indoor spaces.

CMS Urges SNFs to Complete Free On-Demand COVID-19 Training

The Centers for Medicare & Medicaid Services (CMS) has issued an urgent call to action, encouraging SNFs to take advantage of free training designed to help staff combat the spread of COVID-19. CMS reports that over 125,000 individuals from 7,313 nursing facilities have completed the training, which represents about 12.5% of the nursing home staff in the country.  

The on-demand training, developed in coordination with the Centers for Disease Control and Prevention, includes multiple modules with emphases on topics such as infection control, screening and surveillance, personal protective equipment (PPE) usage, nursing home disinfection, and cohorting and caring for individuals with dementia. It also includes separate sets of modules for front-line staff and management staff. Instructions on how to create an account and take the training are available here.

CHA Continues Advocacy for Hospitals on New PPE Stockpile Law

CHA recognizes that with the Jan. 15, 2021, reporting requirement for Assembly Bill 2537 and its accompanying April 1, 2021, PPE stockpile deadlines right around the corner, hospitals are struggling with how to meet the new law’s obligations. More information about CHA’s advocacy efforts with Cal/OSHA, which began shortly after the bill was signed, is available here.   

Next CDPH Call for Health Care Facilities: Dec. 1, 8-9 a.m. (PT)  

Dial: (844) 721-7239  
Passcode: 7993227 

Save the Date: CDPH COVID-19 Vaccination All-Hospitals Call — Dec. 4, 9-10 a.m. (PT)

Call-in number to be determined.

Summary of Nov. 17 CDPH Call

CDPH has provided a summary of its recent weekly call with health care facilities.