Inslee signs health care licensing waivers and other COVID-19 related orders

Gov. Jay Inslee tonight announced several new proclamations and a directive aimed at opening up the healthcare and childcare workforce, reducing transmission between families and children in DCYF custody, and lengthening the deadline for local governments to file their annual fiscal reports.

“We must continue to adapt to the new challenges we face every day during this COVID-19 outbreak,” Inslee said. “We need to allow the rapid expansion of the health and childcare sectors and help communities and families adapt to the changing realities of everyday life in this pandemic to further prevent the spread of the virus.”

Visitation and Remedial Services

This proclamation waives requirements for in-person visitation by children in the custody of the state Department of Children, Youth, and Family (DCYF) with family and DCYF caseworkers. It also waives requirements for DCYF to provide parents and children in child dependency cases with remedial services, which include things like coordinating family visits. The order will help prevent COVID-19 transmission between the foster parents, relatives, group homes, and others caring for children in DCYF’s custody. 

Nothing in this order, or in the “Stay Home, Stay Healthy” order, is intended to prevent compliance with a private parenting plan.

The governor encourages parents who are co-parenting under a parenting plan to communicate with one another during this difficult time in order to both maintain family relationships and to protect the best interests and health of each child.

This proclamation is accompanied by a directive, instructing DCYF to immediately issue emergency rules to bolster video visitation services for children in DCYF’s custody, so that they may interact with family remotely by April 1. 

Waiving licensing requirements for healthcare workers

This proclamation waives requirements necessary for health care workers to remain licensed to practice in the state, including ongoing training and continuing education requirements. These waivers will deliver much needed relief to an increasingly taxed health care system, allowing workers to focus on providing care to Washingtonians during the COVID-19 outbreak.

Waiving requirements for child care and background checks

This proclamation waives several requirements for licensed childcare workers, including requiring federal fingerprint background checks before completing the licensing process. This responds to an increased need for childcare during the COVID-19 emergency, increasing availability by allowing workers to be more easily licensed to provide care to those who need it.

Waiving financial reports filing deadlines

This proclamation waives deadlines for local governments to file their required annual financial reports with the State Auditor’s Office, effective for thirty days. Specifically, this order waives a part of the law that requires local governments to file these financial reports no later than 150 days after the end of the fiscal year.

10th Anniversary of the Affordable Care Act

On its tenth anniversary, the Affordable Care Act (ACA) is helping our state provide health care during a pandemic.

Being at the center of the COVID-19 pandemic shows how critical it is for Washington State to have a strong health system. A virus does not discriminate, and we need everyone, regardless of their income, to be able to access health care to keep us all safe.

Passed by Congress 10 years ago this week, the ACA has helped 600,000 uninsured Washingtonians get health coverage and care. While there’s not a lot for health care providers to celebrate right now, we do want to honor this anniversary and stand strong to protect the ACA.

The Affordable Care Act enabled Washington State to significantly expand Medicaid coverage, greatly increasing health care access and resources. This has been particularly important for access to dental care as the number of Medicaid-insured adults accessing dental care each year has more than doubled since the state expanded Medicaid. In total, our state’s expanded health care safety net now provides health care to more than 1.7 million patients.

The ACA has also increased access to health services that are critical in addressing our state’s homelessness and opioid crises. The ACA created more funding for mental health and substance use treatment, and rural hospitals have been able to remain open thanks to Medicaid expansion. 

Better Health Together launched the Navigator network in 2013 with the audacious goal of enrolling 10,000 participants in qualified healthcare plans. Within the first two years, the Network dramatically exceeded this number, enrolling more than 100,000 participants. Because of this work, more than 96% of our Eastern Washington region now has insurance coverage.

Our network’s tremendous success comes from the web of diverse partners connected across our region. This vast network of partners, which represents many sectors has reached population segments including un/underinsured people, older adults, people with disabilities, low-income individuals and families, people experiencing homelessness, foster youth, prison and re-entry populations, people with limited English proficiency, migrant workers, small businesses, rural populations, and the region’s diverse racial/ethnic populations.

Unfortunately, the ACA has been under attack for the past several years. Federal threats to weaken it put millions of people at risk of losing access to health care. But the fact is that people depend on coverage provided by the ACA. Global health care emergencies such as the coronavirus show how much our health is connected to everyone around us. Washington State policymakers must protect the advances gained through the ACA to ensure that everyone in our state can access health care, keeping us all safer.

Word of Mouth Vol. 3 March 2020 Newsletter

Word of Mouth Vol.3 March 2020 Newsletter

Eastern Washington Funders Launch COVID-19 Community Response Fund

Eastern Washington funders launch COVID-19 Community Response Fund to address immediate and long-term needs of communities 

A coalition of philanthropic, government, and business partners has joined together to create a COVID-19 Response Fund that will rapidly deploy resources to community-based organizations at the frontlines of the region’s coronavirus outbreak in Eastern Washington. The fund is designed to complement the work of public health officials, medical providers, businesses and governments to expand regional capacity addressing the outbreak as effectively as possible. 

In the coming weeks, the fund will rapidly deploy resources to community-based organizations working in communities who are disproportionately impacted by coronavirus and the economic consequences of the outbreak. 

Hosted by Innovia Foundation, the COVID-19 Eastern Washington Community Response Fund will provide funding to organizations that have deep roots in community and strong experience serving the elderly, homeless, residents without health insurance and/or access to sick days, communities of color, people with limited English language proficiency, healthcare, hospitality and gig economy workers, and low-wage employees, among others. 

Grants will be administered in partnership with a Regional Pandemic Community Advisory Group consisting of funding partners and community representatives. The Advisory Group will proactively identify potential grant recipients, solicit guidance on potential recipients from community advisors, and recommend final awards. In order to move resources quickly and not further burden organizations on the frontlines of the pandemic, we are not hosting a formal application process at this time. Funds will be released on a rolling basis as fundraising continues throughout the outbreak and recovery phases of the crisis, making it possible to move resources quickly and adapt to evolving needs in subsequent funding phases. The Fund expects to make an initial round of grants within the next few weeks. 

Individuals and organizations can donate and find additional information about the COVID-19 Response Fund via www.innovia.org/covid19. Innovia is working with philanthropy partners in North Idaho to establish a similar response fund in that region. 

“The coming days and weeks will reveal new and unforeseen challenges to our communities,” said Innovia Foundation CEO Shelly O’Quinn. “ This collective action by local funders will provide an immediate, local response to support those who are most vulnerable to the health and economic impacts of the COVID-19 pandemic.” 

The Fund is anchored by the following initial donations: $50,000 donation from Innovia Foundation; $50,000 from Avista Foundation; and $50,000 from Premera Blue Cross. Additional funders will include Spokane County United Way, Empire Health Foundation, Providence Healthcare, Women Helping Women Fund, and the Community Building Foundation. 

PARTNER STATEMENTS 

“There are many unknowns in this crisis, but we do know all our fund partners are fully committed to providing support to those at highest risk of health and economic challenges. A special thanks to our front-line workers who are risking their own health to keep the rest of use safe. This fund is here to assist you and your organization for as long as it takes.” 

-- Empire Health Foundation Interim President Jeffrey Bell 

“Today feels different because of the crisis we are all in, but I know together we can provide critical support to our community. We are proud to join with local foundations to find innovative ways to support people to ensure every family, child, and individual in our community has access to basic needs. Mobilizing volunteers and financial resources is always a necessity and I thank everyone for your willingness to give and support others in this critical time.” 

-- Spokane County United Way President and CEO Tim Henkel 

“The breadth and impact of this virus make this an unprecedented time, and collective action is our only solution. We’re committed to working with our many partners in eastern Washington and in all of our communities to help us all manage this health emergency.” 

-- Premera President and CEO Jeff Roe 

“Together, we’ve been through fires and storms, recessions and depressions, and our communities have always persevered. We recognize that times like these require compassion, connection and collective action. While the situation we’re facing right now will undoubtedly create a burden for many, we are encouraged by the strength and resilience of our communities. We recognize we have the opportunity to relieve some of this burden, and Avista is honored to be one partner in this collaborative effort.” 

-- Executive Director of the Avista Foundation Kristine Meyer 

Alien Emergency Medical COVID-19 Coverage Expansion (WAC 182-507-0115)

Alien Emergency Medical (AEM) clients can access care within the provider’s* office setting (outside of the emergency department, inpatient and other outpatient settings) to diagnose and treat COVID-19. *Includes MD/DO, ARNP, NP providers Includes coverage for testing and treatment in any office, mobile, non-hospital based setting. Medications, medical supplies and follow-up visits may be covered in the following situations:

1. Upon presentation for testing when medications or supplies are determined to be medically necessary for care while waiting for COVID-19 test results.

2. Following diagnosis of COVID-19 additional medications and medical supplies are covered.

3. Following discharge from an inpatient admission due to COVID-19 two (2) follow-up visits in any setting (office, outpatient etc) will be covered.

Molina Healthcare Services and Resources

Key Molina Washington Resources:   

• COVID-19 Specific Information for Molina Members

We are maintaining a coronavirus alert on the homepage of our website www.MolinaHealthcare.com that links to information and resources regarding services to address the COVID-19 pandemic, please check frequently for updates.  We also recently finalized a Member Flyer (English & Spanish versions attached) that include links to access Molina Virtual Urgent Care.  We would appreciate your help in making this information broadly available to community partners.

• Molina’s Virtual Urgent Care available at no cost to Molina Marketplace and Medicaid Members

Retroactive to March 1, 2020, Molina’s Marketplace members have 24/7 access to Molina Virtual Urgent Care services at no cost. Molina Washington Medicaid members already enjoy 24/7 access to Molina Virtual Urgent Care, these services cover more than 800,000 Molina Members.  We are working on launching a similar option for about 10,000 Molina Medicare DSNP members which is scheduled to go live on Friday March 20th. Please note that the URL and phone number for Molina virtual Urgent Care for MarketPlace and Medicaid members are different.

• Molina of Washington Medicaid Virtual Urgent Care: (844) 870-6821, TTY 711, or wavirtualcare.molinahealthcare.com

• Molina of Washington Marketplace (QHP) Virtual UC: 800 TELADOC (800) 835-2362, or  Teledoc.com/MolinaMarketplace

• Prescription Medications & Access to Mail Order Pharmacy Services

Molina is now allowing 90-day prescription volumes.  Members can receive an early refill for 30 days, plus two additional refills, up to a 90-day supply.  We are also encouraging all Molina Members to take advantage of our CVS mail order pharmacy with free delivery.  Please see attached Mail Order Rx Flyers in English and in Spanish, explaining how Members can access these services.

• Information and Communications for Providers

Molina has added Alerts on our Medicaid and Marketplace (QHP) Provider landing pages and Provider Portal linking to a new landing page: www.MolinaHealthcare.com/providers-wacovid19 that includes provider information and resources such as:

• Telehealth resources including how to bill for telemedicine services different than Molina Virtual Care

  • COVID-19 Telehealth Billing Molina is covering  all modalities of Telehealth (telemedicine, telephone, and online digital) as noted below:

    • Telemedicine (real time interactive, e.g. video-conferencing)  – Molina will pay for services rendered directly by providers who offer telemedicine services and is also making telemedicine services available through Molina Virtual Urgent Care.  For our Molina Marketplace or Medicare Members, we are waiving cost share for telemedicine services received through Molina Virtual Urgent Care.

    • Telephone – Molina is covering Telephone services.  For Medicaid, we are following HCA billing guidance. 

    • Online Digital (email; store and forward) – Molina is covering online digital services.  For Medicaid, we are leveraging HCA billing guidance.

• Coverage for COVID19 testing (with no cost share for testing for any Molina members)

• Authorization Extensions

• Allowance for 90 day Prescription volumes

Telephone numbers available to Molina Members:

Molina Member Services

• Medicaid – (800) 869-7165

• Marketplace (QHP) – (888) 858-3492

• Medicare – (800) 665-1029

• Member Services Fax – (800) 816-3778

• Member Enrollment – (866) 916-0916

Molina Nurse Advice Line (24-Hours a day, Monday to Sunday)

• (888) 275-8750 (English)

• (866) 648-3537 (Spanish)

Accessing Resources in a Home Rule State

As most of you may know, WA state has a home rule which means control of resources in an emergency or disaster are at the local level through Emergency Preparedness leadership at your local health department. This is also where most of not all state or federal relief funds will be disbursed. We have been advised that this person can elevate local issues up the statewide incident management team. We have offered you a link to that list.

https://www.doh.wa.gov/Portals/1/Documents/1000/SystemsTransformation/LocalHealth/DirectoryLocalHealthJurisdictions2020.pdf

If you identify issues for rural that you believe are statewide policy issues, I am willing to communicate those up through the DOH leadership at Incident Command, with an effort to limit such communication to the highest priority issues and needs at this time.

The Rural Health team at DOH is largely mobile now and is committed to being responsive. Our thoughts and hearts are with you as you care for the vulnerable members of your communities.

 
Pat Justis, MA
Executive Director
Rural Health/Office of Community Health Systems
Health Systems Quality Assurance
Washington State Department of Health

Patricia.justis@doh.wa.gov
360-236-2805 | www.doh.wa.gov
Mobile 360-338-2875

Relief for CMS Regulations

As part of President Trump's 3/13 Emergency Declaration CMS is waiving key regulations. The Fact Sheet lists all changes. Of particular relevance to rural are the CAH changes: 

Critical Access Hospitals

CMS is waiving the requirements that Critical Access Hospitals limit the number of beds to 25, and that the length of stay be limited to 96 hours.

There are additional provisions for skilled nursing beds, home health and more.

A press release outlining CMS announcement can be found here:  https://www.cms.gov/newsroom/press-releases/cms-takes-action-nationwide-aggressively-respond-coronavirus-national-emergency

A fact sheet outlining these actions can be found here: https://www.cms.gov/files/document/covid19-emergency-declaration-health-care-providers-fact-sheet.pdf

Pat Justis, MAExecutive Director
Rural Health/Office of Community Health Systems
Health Systems Quality Assurance
Washington State Department of Health

Patricia.justis@doh.wa.gov
360-236-2805 | www.doh.wa.gov
Mobile 360-338-2875

Temporary Practice Permit Applications for RNs

The Nursing Care Quality Assurance Commission completes the licensing for all nurses in our state, including RNs, LPNs, ARNPs and Nursing Technicians.         

The Nursing Commission is giving top priority to the temporary practice permit applications for nurses to assist with the urgent and critical care needs in King County during this COVID-19 crisis. Nurses may volunteer as an Emergency Volunteer Health Practitioners. Complete the Emergency Volunteer Health Practitioners Application (Word) Applications will be screened to ensure the potential volunteer’s health license is in good standing in each state of licensure. The volunteer’s name will be entered into a database of approved emergency volunteer health practitioners. The Washington State Department of Health will activate approved volunteers as needs arise while an emergency proclamation is in effect. This process allows out of state nurses without a Washington State license to work in Washington for the duration of the emergency.

If your facility is in need of emergency staffing and is planning on hiring nurses from out of state, the nurses may apply and be licensed in Washington. Please send an email to nurselicensing@doh.wa.gov with a list of applicant names. Please indicate the urgency of this request based on one or more of the following criteria:

·         intensity of patient care

·         lack of current staffing to provide patient care

·         staff unable to continue to provide patient care due to illness

·         existing nursing vacancies that are currently unfilled due to the COVID 19 situation

Our office will expedite the applications and issue temporary practice permits if the applicants meet all the licensure requirements. Once we receive the application, our office will send a fingerprint card packet. Applicants must complete an FBI criminal background check and submit their fingerprints as soon as possible. The temporary practice permit allows the nurse to practice in Washington while awaiting the results of the criminal background check.

For the application and directions to the online nursing application, please go to https://www.doh.wa.gov/Portals/1/Documents/6000/669419.pdf

Our office needs a list of nurses from your facility who are applying for positions in King, Snohomish and Pierce Counties to expedite the process.

Thank you.

Paula R. Meyer MSN, RN, FRE

Executive Director

Nursing Care Quality Assurance Commission Washington State Department of Health

Pay-for-Equity Menu Released

On March 5th, BHT finalized our Pay-for-Equity Menu. Organizations who completed our Equity Assessment now have the opportunity to commit to a Pay-for-Equity item that they will implement in their organization. Committing to an activity earns additional financial assistance from BHT, as well as 8 hours of free Technical Assistance from our Equity TA Bank, made up of consultants who can offer trainings and facilitation to support your equity work. 

Partners will be invited to select an activity via survey in early April. As a reminder for Partnering Providers, this is a requirement in your contract. 

BHT will be updating our website soon to add an Equity page where we can list resources and information about our TA partners – stay tuned for that reveal!

Noise Ordinance to Protect Health Care Facilities - Letter of Support

BHT wrote the Spokane City Council members in support of the changes to the noise ordinance being considered on Monday, March 2, 2020. Please see the letter, copied below.

RE: Proposed Noise Ordinance to Protect Health Care Facilities

Dear City Council Members:

We support the proposed changes before City Council give the City of Spokane greater authority to enforce the City’s noise ordinance and protect health care patients and staff.

As the Accountable Community of Health (ACH) organization responsible for the Medicaid Transformation efforts in Eastern Washington, BHT is charged with implementing efforts to improve the health of our region. For the past five years, we’ve connected, convened, and financially supported health care providers in our region to accomplish this goal.

We strongly believe that reproductive health care is health care. Better Health Together is proud to partner with Planned Parenthood of Greater Washington and North Idaho to improve the health of our Spokane community. In addition to the critical work they do for reproductive health, in the last year Planned Parenthood of Greater Washington and North Idaho has expanded to offer mental health services, a severe shortage in our community, as well as increased primary care services.

City Council member Lori Kinnear’s ordinance to address noise at health care facilities will help protect the health and safety of our community members accessing health care in Spokane. The proposed changes before City Council give the City of Spokane greater authority to enforce the City’s noise ordinance and a private right of action for impacted staff and patients.

Thank you for your consideration,

Alison Poulsen
Executive Director
Better Health Together