June 11 Pennsylvania COVID-19 Update

INSIDE THIS REPORT:

  • Senate files suit in Commonwealth Court to force terminating emergency declaration
  • Governor responds to House, Senate action
  • HHS - $25 billion in provider aid going out to MA Providers – Portal Link to Apply
  • Tuesday’s COVID-19 numbers and links
  • CMS says in-person care should resume
  • House Speaker announces resignation
  • Wolf updates outdoor recreation guidance
  • Wolf Administration Press Release on emergency order necessity

Senate goes to Commonwealth Court over termination of emergency declaration
Those legal actions included the Senate Republican Caucus filing on Wednesday, while Wolf was speaking to the press, in Commonwealth Court, to assert what they say is the Legislature’s right, under state law, to terminate disaster emergency declarations.

Also while Wolf on Wednesday afternoon was claiming his right to continue to operate under a disaster declaration, the state Senate passed a proposed Constitutional amendment to put a new process for disaster emergency declarations into the Pennsylvania Constitution. Currently that process exists in state law (Chapter 73, Subsection A of Title 35).

Governor Wolf responds to House, Senate and HR 836
While the Senate was at Commonwealth Court, Governor Wolf told the news media that “Ending the disaster declaration would not reopen anything.  It just won’t.  And anybody who says differently is wrong,” Wolf said.

“That wouldn’t reopen a single business that was closed and wouldn’t make anyone safer. It would end your doctor’s ability to provide telehealth.  Licensing changes would have to stop.  The millions of people who are on unemployment would lose that.  Rent deferrals would stop…

Asked what punishments a business could face if they open up in the time until the Court rules, Wolf said, “The disaster proclamation remains in effect and can only end if the Governor ends it.” He noted that ending the disaster declaration would not end any orders issued by the Secretary of Health that set guidelines for business operations.

Asked what he would do with the resolution, Wolf said, “I’m not sure.  Right now it’s not going to get to my desk.  Since I’m not a lawyer, the Constitution says it has to be signed into law and if vetoed by the Governor, I don’t know anywhere the Constitution says the legislature can pass a law without the Governor’s signature.

Wolf said he was going to go to court, to eliminate chaos.  He said “there doesn’t seem to be any other option, and we think any court hearing this would have no other option than to rule with us on this.”  He said there were a number of different things the Administration was considering, and that it’s not clear if this kind of dispute has ever arisen but that a court decision would establish that a Constitutional process is being followed.  When asked why he doesn’t just terminate the order and then sign a new one, Wolf said he would not, because that would be agreeing that the General Assembly has powers he believes they do not.

The Governor has emergency powers to navigate our way thorough a crisis, and we now have a pandemic, economic depression, and civil unrest…Government must function, respond quickly and effectively.”

Wolf said, “I want to make sure that we, as clearly and unambiguously as possible, make the case that under our constitutional democracy, no branch of government -- none, not the governor, not the General Assembly, not the courts -- have the unilateral right to do anything, to impose their will on the people of Pennsylvania. This is unprecedented as far as I know.”

Republicans almost uniformly responded that, for the last three months, the governor has been doing exactly what he and the Constitution say no branch of government has the right to do.

HHS - $25 billion in provider aid going out – MA providers to get payments
HHS is planning on paying out $25 billion in coronavirus aid to safety-net and hard-hit providers.  The department said Tuesday it’s expecting to allocate an estimated $15 billion to Medicaid and Children's Health Insurance Program providers that have yet to receive any federal aid during the pandemic. Another $10 billion would go to safety-net hospitals.

"Healthcare providers who focus on treating the most vulnerable Americans, including low-income and minority patients, are absolutely essential to our fight against COVID-19," said HHS Secretary Alex Azar. "HHS is using funds from Congress, secured by President Trump, to provide new targeted help for America's safety-net providers and clinicians who treat millions of Medicaid beneficiaries."

On Wednesday, HHS is launched an enhanced Provider Relief Fund Payment Portal that allows eligible Medicaid and CHIP providers to report their annual patient revenue, which will be used as a factor in determining their Provider Relief Fund payment. The payment to each provider will be at least 2 percent of reported gross revenue from patient care; the final amount each provider receives will be determined after the data is submitted, including information about the number of Medicaid patients providers serve.

Clinicians that participate in state Medicaid and CHIP programs and/or Medicaid and CHIP managed care organizations who have not yet received General Distribution funding may submit their annual patient revenue information to the enhanced Provider Relief Fund Portal to receive a distribution equal to at least 2 percent of reported gross revenues from patient care. This funding will supply relief to Medicaid and CHIP providers experiencing lost revenues or increased expenses due to COVID-19. Examples of providers, serving Medicaid/CHIP beneficiaries, possibly eligible for this funding include pediatricians, obstetrician-gynecologists, dentists, opioid treatment and behavioral health providers, assisted living facilities and other home and community-based services providers.

To be eligible for this funding, health care providers must not have received payments from the $50 billion Provider Relief Fund General Distribution and either have directly billed their state Medicaid/CHIP programs or Medicaid managed care plans for healthcare-related services between January 1, 2018, to May 31, 2020. Close to one million health care providers may be eligible for this funding.

Before applying through the enhanced provider relief portal,   applicants should:
Read the Medicaid Provider Distribution Instructions - PDF*
Download the Medicaid Provider Distribution Application Form - PDF*

Tuesday Data Report from the Department Of Health
On Tuesday, the Pennsylvania Department of Health confirmed that as of 12:00 a.m. June 9 there were 410 additional positive cases of COVID-19, bringing the statewide total to 76,846. Approximately 5,837 of our total cases are in health care workers.  The Department estimates that 72% of all individuals who tested positive have recovered.

There are 6,062 total deaths attributed to COVID-19, an increase of 48 new deaths. Out of our total deaths, 4,199 have occurred in residents from nursing or personal care facilities.  County-specific information and a statewide map are available here.

There are 631 patients who have a positive serology test and either COVID-19 symptoms or a high-risk exposure, which are considered probable cases and not confirmed cases. There are 467,329 patients who have tested negative to date. Of the patients who have tested positive to date the age breakdown is as follows:

  • Nearly 1% are ages 0-4;
  • Nearly 1% are ages 5-12;
  • Nearly 2% are ages 13-18;
  • 6% are ages 19-24;
  • Nearly 37% are ages 25-49;
  • 25% are ages 50-64; and
  • 28% are ages 65 or older.

Most of the patients hospitalized are ages 65 or older, and most of the deaths have occurred in patients 65 or older. More data is available here.

In nursing and personal care homes, there are 16,309 resident cases of COVID-19, and 2,845 cases among employees, for a total of 19,154 at 623 distinct facilities in 45 counties. A county breakdown can be found here.  For the latest information for individuals, families, businesses and schools, visit “Responding to COVID-19” on pa.gov.

Statewide, the Wolf Administration has since noon, June 9:

CMS says in-person care should resume
The Trump administration released guides for patients and facilities on Tuesday, encouraging providers to resume deferred and non-emergent care in areas with declining COVID-19 cases.

The recommendations say facilities should only resume in-person services when they have adequate staff, testing, protective equipment and the ability to respond rapidly to new outbreaks. If possible, separate buildings or floors should be used for COVID and non-COVID patients, and facilities should avoid rotating staff between the two areas unless absolutely necessary.

The guidelines continue to recommend telehealth or virtual visits as an option, but stressed that patients should not delay care following signs of serious health conditions like chest pains or stroke symptoms. Patients should also continue receiving necessary preventive care such as immunizations and cancer screenings, according to the document.

Seema Verma : ‘Americans need their health care.’ “Those needing operations, vaccinations, procedures, preventive care, or evaluation for chronic .

House Speaker Mike Turzai to resign Monday, June 15
House Speaker Mike Turzai (R, Allegheny County) on Wednesday gave his farewell speech to the House, announcing that he would step down as speaker and would resign from the House on June 15.

“I’m a steward,” said Turzai referring to the speaker’s job. “Now it will be someone else’s turn. And that’s for the good.”  He said he expects the House to elect a new speaker during the week of June 22-24 to serve during the rest of the 2019-2020 legislative session.  In the short term, House Majority Leader Bryan Cutler (R, Lancaster) will serve as speaker until an election is held.  Cutler has not ruled out being a candidate for the position, saying that’s an internal discussion among the caucus members.

Appropriations Committee Chair Stan Saylor (R, York) and Majority Whip Kerry Benninghoff (R, Centre) have quietly been making their interest for the job known among members.

Turzai, 60, has been speaker since 2015. He announced in January that he wouldn’t seek reelection to the 28th House District seat that he has represented since 2001. Turzai is expected to take a senior position in the private sector.

Wolf updates outdoor recreation guidance
Governor Tom Wolf today released updated guidance regarding the types of outdoor recreation that businesses may offer during the yellow and green phases of reopening, and how they may do so safely, as the commonwealth continues to open its own public recreation facilities across the state.

“As summer quickly approaches and all 67 counties are in either yellow or green phases of reopening, it was important to provide businesses with the guidance necessary to safely reopen or plan for reopening as they reach the green phase,” Gov. Wolf said. “I want all Pennsylvanians to remain active and to enjoy all the recreation the commonwealth has to offer, but we must do so safely and with social distancing top of mind.”

The new guidance allows outdoor activities like mountain biking, outdoor miniature golf, motorsports venues, go carts, rock climbing, disc golf, paintball, horse riding, tennis, archery or shooting, and other similar facilities that conduct operations outdoors to resume operation in yellow phase counties.

Businesses that operate these outdoor recreational activities may resume operations but may not operate indoor spaces for public or visitor use other than restrooms and ticketing and entry locations.

Online ticketing and timed or staged entry are strongly encouraged to manage occupancy rates and physical distancing. These businesses must ensure that visitors practice social distancing and do not congregate at entry gates, kiosks, concession stands, or similar locations.

The announcement comes as Pennsylvania’s own recreational facilities are reopening to the public, with facilities in state parks and forests such as cabins, cottages, lodges, and yurts opening statewide on Friday, June 12, and most state park swimming pools in yellow phase and green phase counties reopening as of Saturday, June 13. As of Saturday, June 6, all 58 state park beaches are open to swimming.

Capacity at beaches and pools will be limited to 50 percent of the normal facility capacity and mitigation measures, including restricting visitor parking, controlling facility access, ensuring social distancing and the wearing of face masks when not in the water, must remain in place. All Centers for Disease Control and Prevention (CDC) guidance remains in effect.

The updated guidance can be found here.

Wolf Administration Press Release on emergency order necessity
In a press release, the Governor said, “Last night, the General Assembly voted to end the disaster declaration with many members claiming their actions ended the business guideline orders. That is not true. Not only does any concurrent resolution need to come to the Governor for approval or disapproval, but the disaster declaration is separate from the orders signed by Secretary of Health Dr. Rachel Levine under the Disease Prevention Act that include provisions for business reopening and for worker and building safety. Those orders remain in place. The legislature did nothing to end those.

“Rather, the legislature chose to attempt to end the disaster declaration – a measure that would ostensibly end protections passed for businesses, workers, and residents.”

Wolf asserted that if the declaration were to end, these protections would go away:

  • Burdensome eligibility requirements for more than a million Unemployment Compensation claimants would immediately go back into effect, and employers across the commonwealth would no longer receive relief from charges.
  • Certification requirements under the public-school code and child protective services law would end.
  • A school meal eligibility waiver, which has allowed more than 300 meal sites to open for distribution of food to school-age children in need, would end.
  • Telehealth and other health care services provided by out-of-state providers for Pennsylvanians would end.
  • Utility assistance for thousands of families and individuals would end, leaving people without water or electricity.
  • Hospitals and alternative care sites would no longer be able to add capacity or repurpose facilities (i.e., beds) without having to abide by the 60-day notice requirement.
  • License renewal and training requirement suspensions for health care professionals, child care workers, direct care workers, direct support professionals, among other professional groups who provide life sustaining services to our children, seniors, and vulnerable residents would end, meaning all of these workers would need to choose between not returning to work until those credentials could be renewed or trainings completed and the option of returning to work with the understanding that they are practicing out of compliance with Pennsylvania law and regulation, very well opening themselves up to personal liability.
  • PennDOT waivers for commercial motor vehicle weight limitations and permitting requirements for the transport and delivery of agricultural feed, food, and dairy products, fuel, pharmaceuticals, and medical supplies to assist in supply chain challenges would end and motor carriers would be restricted in their ability to directly assist in supporting emergency relief efforts necessary to respond to the pandemic.
  • Mortgage foreclosure and eviction moratoriums that offer protection to vulnerable Pennsylvanians at risk of losing their homes during the pandemic would end.

In addition to these immediate waiver and legislative enactments being removed, ending the disaster declaration also would remove many practical aspects of the state’s response to this disaster, including the authority to activate the National Guard to help with nursing homes; deploying commonwealth personnel, services and distributing supplies and equipment; implementing emergency funding; suspending rules and regulations that would hinder or delay necessary action in coping with the emergency; and using all available resources of the commonwealth government and its political subdivisions to deal with the emergency.

The state could also lose federal public and individual disaster assistance, and any additional state funding sources available through transfer of unused General Fund dollars.

During a state of emergency declared by the governor, commonwealth agencies and departments may implement their emergency assignments without regard to procedures required by other laws pertaining to performing their work, entering into contracts, purchasing supplies and equipment, and employing temporary workers.