March 25 COVID-19 Update – Pennsylvania American College of Physicians

​March 25 Pennsylvania COVID-19 Update

​Current Situation
The PA Department of Health reported that as of midnight March 24, there were 276 additional positive cases of COVID-19 reported, bringing the statewide total to 1,127.  Positive cases have been identified in 44 of the state’s 67 counties.  And Governor Wolf issued Stay at Home orders for Lehigh and Northampton Counties this afternoon, bringing the total to 10 counties and more than 6 million people.  11,193 persons have tested negative.

To date, there have been 38 COVID-19 patients in ICUs and 18 on ventilators to date. Dr. Levine said the state will have the age breakdown for positive tests later this week.  There have been 11 total deaths in PA. Philadelphia has the most cases with 257, while Northampton has the most deaths with 3.
 
Capacity of the Health System
Dr. Rachel Levine, State Secretary of Health, said that Pennsylvania currently has 3,400 licensed ICU beds  with about 40% available.  There are about 3,000 ventilators available in use and in stockpiles with 75% available.  We had about 1,000,000 N-95 masks, at start, and getting more, purchasing whatever is available in terms of PPE.   Hospitals at the time are about 40 percent filled with various types of patients.

As for PPE stores – Dr. Levine said the Commonwealth just got some new stores from the federal government today, and is pushing the PPE out to hospitals, health systems, EMS and SNFs.

Levine was asked about the estimated time frame for the peak of cases, and said, “We are continuing to see an exponential rise in new positive cases – doubling every two to three days.  As the case counts double, they are getting very high, very fast.  Because 10% of new cases require hospitalization, we’re preparing for space, beds, and may even use hotel rooms or other spaces for convalescence.  We need to prepare staffing for physicians, CRNPs, PA,s RTs and RNs; deal with standards of care issues; and need PPE.”
 
PA-ACP Joins in Asking Governor and General Assembly for COVID-19 Medical Funding
The Chapter today joined HAP and other medical/professional organizations in asking Gov. Wolf and the General Assembly to create a state health care emergency fund to help the state’s providers and health systems deal with the surge of patients, while managing ongoing patient and disease issues. The letter requested significant and direct allocation of financial resources to support health care and human services workers on the front line.

This support is vitally important as we grapple with maintaining an adequate workforce, buy critical supplies, stand up additional infrastructure (including telehealth capabilities) to augment capacity, and keep our doors open to care for patients and our community during this emergency.
Later on Wednesday, the House and Senate did act, creating a $50 million emergency fund (See Legislative Action Below.)
 
State Suspends Some Requirements, Allowing Retired Physicians to Immediately Resume Work
This morning, the Department of State announced that In order to increase the number of health care practitioners available to respond to the COVID-19 emergency and to ensure continuity of patient care and services, Governor Wolf has granted the Department of State’s request to suspend some licensing and regulatory requirements that will allow individuals in the healthcare field who have inactive licenses or have allowed their Pennsylvania license to expire, to seek reactivation and immediately resume work within their scope of practice, provided their inactive or expired license is/was in good standing.
 
The Department requested these suspensions to allow retired practitioners to reenter the field more easily and without paying reactivation fees. These requests were granted by the Governor.

Board of Medicine:

  • MD licensees who are in active/retired status for less than four years can submit a reactivation application with a suspension of the continuing education requirements.
    • This allows these practitioners to become active unrestricted until Dec. 31, 2020.
    • If a licensee wishes to continue practicing beyond Dec. 31, 2020, the licensee would need to renew the active-unrestricted license and meet all current requirements at that time
    • This applies to Medical Doctors (MDs)
  • MDs who are expired/inactive for less than four years; and certain allied health professions integral to providing care during this state of emergency who are expired/inactive for less than four years, may apply for reactivation of their licenses with a suspension of their respective CE requirements.
    • This would allow those individuals to become active until December 31, 2020.
    • This applies to the following licensees:
      • Medical Doctors
      • Physician Assistants
      • Respiratory Therapists
      • Perfusionists 
  • For reactivations granted to the above professionals, all reactivation fees for the licensees are suspended by the Governor.

 
State Board of Osteopathic Medicine

  • DO licensees who are in active/retired status for less than four years can submit a reactivation application with a suspension of the continuing education requirements.
    • This allows these practitioners to become active unrestricted until Oct. 31, 2020.
    • If a licensee wishes to continue practicing beyond Oct. 31, 2020, the licensee would need to renew the active-unrestricted license and meet all current requirements at that time
    • This applies to Doctors of Osteopathic Medicine (Dos)
  • Dos who are expired/inactive for less than four years; and certain allied health professions integral to providing care during this state of emergency who are expired/inactive for less than four years, may apply for reactivation of their licenses with a suspension of their respective CE requirements.
    • This would allow those individuals to become active until October 31, 2020.
    • This applies to the following licensees:
      • Doctors of Osteopathic Medicine
      • Physician Assistants
      • Respiratory Therapists
      • Perfusionists
  • For reactivations granted to the above professionals, all reactivation fees for the licensees are suspended by the Governor.

 
Medical Assistance for COVID-19 testing and treatment for immigrants
The Department of Human Services has established immigrant eligibility for Medical Assistance, and addressed some common concerns around privacy and public charge. It also included two important pieces of new information specific to COVID-19:

  • No one in PA should be denied Medical Assistance for COVID-19 testing, diagnosis or treatment because of their immigration status!  COVID-19 is an emergency medical condition in Pennsylvania, so Pennsylvania Emergency Medical Assistance will include coverage of COVID-19 testing, diagnosis, and treatment. 
  • Using Medical Assistance for COVID-19 testing, diagnosis and treatment creates no public charge risk.  The very large majority of people who are eligible for Medical Assistance can receive Medical Assistance without any public charge risk.  In addition, USCIS announced last week that COVID-19 testing, diagnosis and treatment (including a vaccine if/when one becomes available) will not be considered during public charge tests, even if MA is used to access these services.

LEGISLATIVE UPDATE
The House and Senate approved four bills impacting businesses and health care, including legislation creating a special fund for health care equipment and supplies to deal with COVID-19.

HB1232, moved by the Senate, authorizes up to $50 million of additional funding to be made available for the Commonwealth’s COVID-19 response efforts within the state’s health care system, with those funds to be transferred by the state Budget Secretary to a restricted account in the General Fund from current special funds under the Governor’s jurisdiction.

The bill stipulates that the funds can only be used to buy medical equipment and supplies for healthcare entities to meet urgent patient and staff needs to address surge demand, and that money can only be transferred after all available federal funding and any funding made available through the Governor’s disaster proclamation is used for the COVID-19 response – with the authority to transfer those funds to expire on Sept. 30, 2020.

The legislation prohibits the state Budget Secretary from making any transfer that will result in a deficit in any of the respective special funds and requires the Secretary to provide notice of any transfers to the restricted account 24 hours prior to making the transfer, with the Secretary also required to provide the General Assembly with monthly reports of the spending activity for the Commonwealth’s COVID-19 response.

The legislation also authorizes the Department of Community and Economic Development to coordinate with local political subdivisions to extend filing and payment deadlines for the local Earned Income Tax.  These deadlines have been extended to July 15, 2020.

In addition, the bill would extend temporary regulations related to Pennsylvania’s medical cannabis industry until November 2021.

The House and Senate also concluded work on legislation to push the state’s primary election back to June 2, ease eligibility requirements and access to unemployment compensation for workers who have been directly impacted by the coronavirus, and waive the requirement that all public schools must be open at least 180 days per school year. 
​
Small Business Program Announced
The Governor announced a new COVID-19 Working Capital Access (CWCA) Program, that will be administered through PIDA using $60 million to provide small businesses of less than 100 employees to get working capital with a 0% interest rate at a term of three years.  They will be awarded on a first-come, first-serve basis. All PIDA loan applications must be submitted through a Certified Economic Development Organization (CEDO). To find your CEDO, click here.