June 17 Pennsylvania COVID-19 Update

INSIDE THIS REPORT:

  • Tuesday’s COVID-19 numbers and links
  • Secretary Miller outlines DHS adjustments made possible under disaster declaration
  • Press Conferences to be limited in the future
  • Wolf says no more shelter in place orders

Tuesday’s Department of Health Data Report
On Tuesday, the Pennsylvania Department of Health confirmed that as of 12:00 a.m. June 15 there were 362 additional positive cases of COVID-19, bringing the statewide total to 79,483. Approximately 6,033 of our total cases are in health care workers.  County-specific information and a statewide map are available here.

DoH estimates that 53,215, or 75% of all Pennsylvanians testing positive have now recovered.

In nursing and personal care homes, there are 16,720 resident cases of COVID-19, and 2,955 cases among employees, for a total of 19,675 at 650 distinct facilities in 47 counties.

There are 6,276 total deaths attributed to COVID-19, an increase of 33 new deaths. Out of our total deaths, 4,279 have occurred in residents from nursing or personal care facilities. A county breakdown can be found here.

There are 523,609 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;
  • Nearly 25% are ages 50-64; and
  • 28% are ages 65 or older.

There are 630 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.

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.

For the latest information for individuals, families, businesses and schools, visit “Responding to COVID-19” on pa.gov.

Currently, all 67 counties are in the yellow or green phase of reopening.

Statewide – The Wolf Administration has since noon, June 15:

Secretary Miller outlines regulatory and operational adjustments under disaster declaration
DHS Secretary Teresa Miller today outlined regulatory suspensions and operational adjustments permitted under Governor Tom Wolf’s disaster declaration for the COVID-19 pandemic. These flexibilities and waivers are necessary to ensure continuity of services and operations while keeping people served by and working in the health care and social services systems safe from COVID-19, and they remain in effect until notification is issued by DHS.  The subtext is that elimination of the Governor’s executive disaster order could eliminate these adjustments.

“COVID-19 has been a challenge unlike anything DHS and our providers and partners have ever faced. We have completely lost our sense of normal, and with that, serious adjustments are necessary to keep people safe,” said Secretary Miller. “This would not be possible without Governor Wolf’s disaster declaration. The waivers and regulatory suspensions permitted under this declaration are still critical, and until directed otherwise by the Wolf Administration, they remain in effect.”

Since March, DHS’ offices have made numerous adjustments to operations and functions to help providers across the health care and social services spectrum continue to operate with necessary social distancing measures in place and responding to the evolving challenge of COVID-19. Many of these waivers are permitted by the federal government but require a state-level disaster declaration be in place. The following are among the regulatory suspensions and operational adjustments that remain in effect under Governor Wolf’s disaster declaration:

Office of Medical Assistance Programs (OMAP)
Without the disaster declaration, waivers of prior authorization and copay requirements that remove barriers to treatment for COVID-19 would be removed, and out-of-state providers and providers who normally do not participate in Pennsylvania’s Medicaid program would lose the ability to work with people covered by Medicaid, limiting access to care for the nearly 3 million Pennsylvanians covered by this program. Additionally, the following flexibilities would be lost:

  • Broader use of telehealth that reduces the need for people to receive care in a doctor’s office;
  • Expanded scopes of practice for nurse practitioners and physician assistances;
  • Continued eligibility for children enrolled in the Children’s Health Insurance Program (CHIP); and,
  • Permitting billing for services at alternate care sites such as drive-up testing facilities.

Office of Long-Term Living (OLTL)
OLTL licenses and oversees more than 1,200 personal care homes and assisted living residences that provide a home and care to more than 45,000 people, a group that often has pre-existing or chronic conditions that create a higher risk for a more serious case of COVID-19. Waivers and guidance in effect due to Governor Wolf’s declaration permit regulatory changes that help keep residents and staff of these facilities safe, including restricting visitation and suspending program requirements that include requirements for meals to be served in congregate settings and group activities.

In addition to waiving requirements for long-term care facilities, OLTL’s waivers permitted under the disaster declaration include guidance for increasing beds at nursing facilities and continuity of services for people served in the community by Community HealthChoices.

Office of Developmental Programs (ODP)
ODP provides oversight and support for approximately 35,000 people with intellectual disabilities and autism living in communities around Pennsylvania and 681 residents of four state centers run by DHS. Under the disaster declaration, service providers are able to reconfigure facilities’ physical space, use alternate space, adjust staffing to allow for quarantine and isolation areas, and make other operational adjustments to keep both residents and staff safe and ensure continuity of operations during the pandemic.

Office of Mental Health and Substance Abuse Services (OMHSAS)
Because of the pandemic and the need for social distancing, many behavioral health counseling and substance use disorder treatment programs have been able to transition to telehealth under Governor Wolf’s disaster declaration. This declaration and the subsequent waivers are necessary both to allow telehealth and so providers are able to bill for services and sessions administered through telehealth. In addition to this, the disaster declaration also allows a waiver permitting take home medication for people using medication-assisted treatment. These waivers have been critical to keep people safe while ensuring continuity of behavioral health and substance use disorder treatment in a manner that keeps staff and patients safe. If these services were disrupted, it could create a serious threat to a person’s well-being, sobriety, recovery, and health.

Office of Children, Youth, and Families (OCYF)
OCYF oversees Pennsylvania’s child welfare system, which is administered by counties at the local level. State regulations govern the foster care system, and the disaster declaration permits flexibility for foster families entering the system so children can continue to be placed into care if necessary. Additionally, OCYF licenses residential providers for children, and the disaster declaration is necessary to enable operational adjustments to keep staff and children safe from the virus.

Office of Income Maintenance (OIM)
Under Governor Wolf’s disaster declaration Pennsylvanians who qualify for the Supplemental Nutrition Assistance Program (SNAP) but do not receive the maximum benefit for their household size are able to receive an additional payment to total the monthly maximum benefit. This federally funded payment is authorized under the Families First Coronavirus Relief Act and brings an additional $100 million to individuals and families that then gets returned to grocers, farmers markets, and other small businesses and local economies around Pennsylvania.

Additionally, the disaster declaration permits operational adjustments that helps keep public assistance recipients and applicants as well as DHS staff in County Assistance Offices safe by allowing interviews for programs to take place over the phone rather than face-to-face in an office.

As needs and circumstances change, DHS may begin to rescind certain waivers or flexibilities. Notification on changes to or suspensions of current guidance or waivers will come from DHS. Until and unless notified, waivers remain in effect.

Secretary Miller said, “DHS is closely monitoring circumstances for our providers and the people we serve, and the disaster declaration allows us to continue to be responsive to developing needs and rise to the challenge of this pandemic.”

State Press Conferences will be limited in future
On Tuesday, the Governor’s Office said that press conferences by Gov. Wolf and state Health Secretary Levine will now only be held if there is something new to announce. The Governor had already limited his press conference availability to live questions and follow ups from the news media, having had just four such events since March.  Over the last ten days, even Dr. Levine’s press availabilities have become fewer, as the virus data has continued to improve and more counties moved into the green phase.

Some members of the House have suggested their Counties will be announced this week as moving to green on Friday, June 26.  The Wolf administration has repeatedly noted that even though it now publishes county level metrics and data dashboards, it considers many other things isn making the decisions on easing virus mitigation activities in PA Counties.

Wolf: No return to shelter in place rules
Governor Wolf told KDKA Radio’s Morning Show that there can be no return to “shelter in place” rules, even if the state experiences a second wave of COVID-19 this fall.  The Governor said the order he imposed in March was so the state could buy time to avoid overrunning hospital and healthcare systems.

“We’re in a different place now then we were and I think that you have to recognize that the economic and social, personal toll of having to shelter in place and all those things, we just can’t do that.” Wolf said expanded coronavirus testing and contact tracing will help, even if there is a fall resurgence.

He noted that now, hospital systems are better prepared.  “In Pennsylvania, we have 6,000 about ventilators, I think 230 are being used right now for COVID-19 patients.”