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Medical Rehab

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The Department of Human Services (DHS) has issued an updated stakeholder message regarding their actions in response to the COVID-19 crisis. Included in this message are updates to: 1135 Waiver, Appendix K Waiver, Residential Treatment Facility Visitation guidance, licensing, and Electronic Visit Verification (EVV). DHS also continues to work on updating a Frequently Asked Questions (FAQs) document, which is expected to be shared very soon. Members are encouraged to frequently check the DHS website for the most up-to-date information.

In addition, Secretary Miller will host a call for stakeholders on Wednesday, March 25, 2020 at 4:00 pm. Registration information for this call will be shared on March 23, 2020.

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OCR Issues Guidance on Telehealth Remote Communications Following Its Notification of Enforcement Discretion
March 20, 2020

On March 20, 2020, the Office for Civil Rights (OCR) at the U.S Department of Health and Human Services (HHS) issued guidance on telehealth remote communications following its Notification of Enforcement Discretion during the COVID-19 nationwide public health emergency.

The Notification, issued earlier this week, announced that effective immediately, OCR is exercising its enforcement discretion to not impose penalties for HIPAA violations against health care providers in connection with their good faith provision of telehealth using communication technologies during the COVID-19 nationwide public health emergency.

The new guidance is in the form of frequently asked questions (FAQs) and clarifies how OCR is applying the Notification to support the good faith provision of telehealth. Some of the FAQs include:

  • What covered entities are included and excluded under the Notification?
  • Which parts of the HIPAA Rules are included in the Notification?
  • Does the Notification apply to violations of 42 CFR Part 2, the HHS regulation that protects the confidentiality of substance use disorder patient records?
  • When does the Notification expire?
  • Where can health care providers conduct telehealth?
  • What is a “non-public facing” remote communication product?

“We are empowering medical providers to serve patients wherever they are during this national public health emergency,” said Roger Severino, OCR Director. “We are especially concerned about reaching those most at risk, including older persons and persons with disabilities,” Severino added.

  • The FAQs on telehealth remote communications may be found here.
  • The press release on telehealth remote communications may be found here.
  • The Notification of Enforcement Discretion on telehealth remote communications may be found here.

For more information on HIPAA and COVID-19, see OCR’s February 2020 Bulletin, use this link.

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EAST CENTRAL (Berks, Columbia, Luzerne, Montour, Northumberland, Schuylkill, Wyoming Counties) 717-561-5250

NORTH CENTRAL (Bradford, Clinton, Lycoming, Potter, Sullivan, Tioga, Union Counties)
717-561-5250

NORTHEAST (Carbon, Lackawanna, Lehigh, Monroe, Northampton, Pike, Susquehanna, Wayne Counties) 717-561-5257

NORTHERN TIER (Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Forest, Jefferson, McKean, Venango, Warren Counties) 717-561-5254

KEYSTONE (Adams, Bedford, Blair, Centre, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Juniata, Lancaster, Lebanon, Mifflin, Perry, Snyder, York Counties) 717-561-5255

SOUTHEAST (Bucks, Chester, Delaware, Montgomery, Philadelphia Counties)
717-561-5251

SOUTHWEST (Allegheny, Armstrong, Beaver, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Mercer, Somerset, Washington, Westmoreland Counties) 717-561-5252

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The Centers for Disease Control and Prevention (CDC) issued new guidance for healthcare providers that provides information on the best ways to conserve personal protective equipment (PPE), such as gowns, facemasks, N95 respirators, and eye protection as they experience supply shortages due to the outbreak of COVID-19.

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From RELIAS:

The well-being and safety of the individuals we serve is our top priority and will remain at the heart of every decision we make.

As you prepare for Coronavirus (COVID-19), Relias wants to directly support your efforts by providing accurate and impactful education on infection prevention and control. We are currently offering a free digital toolkit — How to Prepare for Coronavirus (COVID-19) and Influenza: Training & Resources, which contains unlimited access to courses and fact-driven information regarding COVID-19 preparedness and prevention.

This toolkit will continue to be updated with the latest resources; please check back often!

We encourage you to share this toolkit with colleagues, friends, and family to help combat coronavirus. At Relias, providing these types of resources is core to our mission to measurably improve the lives of the most vulnerable members of society and those who care for them.

Thank you for helping communicate this information. In times like these we listen, we learn, and we support each other.

Explore Our Toolkit

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Late this afternoon, the Governor ordered all businesses to close at 8:00 pm tonight (Thursday, March 19), except for those considered life-sustaining. For those businesses that are not considered life-sustaining and do not close, the state will begin to take enforcement actions on Saturday, March 21, at 12:01 am.

RCPA members are considered life-sustaining businesses. For a complete chart of life-sustaining businesses, use this link.

Additional information regarding the Governor’s declaration can be found below:

Questions, please contact Jack Phillips.

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Protecting our staffs, our residents in our facilities, and our communities are paramount as we face this public health issue. VitalCore Health Strategies has created a protocol response plan that provides a very clear COVID-19 pandemic response plan and we hope you find this document beneficial for the health and safety of your facility.

The response plan is based on current guidance from the Centers of Disease Control and Prevention (CDC). It provides an outline for infection prevention and control information that should be considered for facilities related to a COVID-19 response. Please keep in mind that the CDC’s guidance may continue to change so this plan may require updating. Please continue to visit the CDC’s website for updates. If you have any additional questions, please contact your RCPA Policy Director.

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Text of March 18 press release.

Harrisburg, PA — Health care professionals licensed under any of the Department of State’s Bureau of Professional and Occupational Affairs (BPOA) licensing boards can provide services to patients via telemedicine during the coronavirus emergency.

“Telemedicine provides health care professionals flexibility to continue treating their patients while following best practices on social distancing as outlined by the Department of Health,” Secretary Boockvar said. “The department requested, and Governor Wolf granted us, the authority to allow health care professionals from out-of-state to treat Pennsylvania residents using telemedicine, when appropriate, due to COVID-19.”

This new guidance applies to the following boards:

o Chiropractic
o Dentistry
o Medicine
o Nursing
o Optometry
o Pharmacy
o Podiatry
o Psychology
o Osteopathic Medicine
o Nursing Home Administrators
o Occupational Therapy Education and Licensure
o Physical Therapy
o Social Workers, Marriage and Family Therapists, and Professional Counselors
o Examiners in Speech-Language Pathology and Audiology
o Veterinary Medicine

Currently, no Pennsylvania law prohibits the practice of telemedicine.

Additionally, the department is working with the Governor’s office, the Department of Health, and Department of Human Services to identify regulations and requirements that can be suspended to give medical providers and facilities the flexibility they need to respond to the crisis. We will publish these notifications on our website as they become available.

Governor Wolf also granted the department’s request for a suspension to allow licensed practitioners in other states to provide services to Pennsylvanians via the use of telemedicine, without obtaining a Pennsylvania license, for the duration of the emergency. Out-of-state practitioners must:

o Be licensed and in good standing in their home state, territory, or country.

o Provide the Pennsylvania board from whom they would normally seek licensure with the following information prior to practicing telemedicine with Pennsylvanians:
• their full name, home or work mailing address, telephone number and email address; and
• their license type, license number or other identifying information that is unique to that practitioner’s license, and the state or other governmental body that issued the license.

Please submit the information requested above to the appropriate board resource account listed on the BPOA website.

All practitioners using telemedicine in Pennsylvania must remain informed on all federal and state laws, regulations and guidance regarding telemedicine, including a practitioner’s obligations under the Health Insurance Portability and Accountability Act (HIPAA) and recent guidance provided by the U.S. Department of Health and Human Services.

Authorization to engage in telemedicine from a professional licensing standpoint is separate and apart from any insurance coverage/payment issues that fall under the Department of Health, the Department of Human Services, the Department of Insurance, or any other state or federal agency.

The Department of Human Services issued guidance for Behavioral Health Services Telemedicine here. The Department of Drug and Alcohol Programs released Telehealth guidance for their programs and providers here.

Questions, please contact Jack Phillips.

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RCPA has been hearing from members regarding supplies they need to combat the COVID-19 epidemic. We have heard from members that they are running short on masks/respirators, hand sanitizers, gloves, etc. Regarding masks/respirators, RCPA understands there is a shortage of these items. Providers are in need of masks/respirators to take care of residents in group homes, inpatient facilities, etc. If a resident in one of these facilities is stricken with COVID-19, then staff will have to follow CDC protocol and be required to use masks/respirators. If providers do not have any to give to staff, then providers will have to transport the resident to the hospital. We understand hospitals would rather keep individuals in their current location.

In most instances, providers are working with their local hospitals to get masks/respirators, but there are limited quantities, if any. To try and combat this shortage, providers should contact their County Emergency Management office. RCPA understands that the mask/respirator issue is a major concern for providers and we are working with our state partners for assistance.

If providers are experiencing any other shortages such as medicine, food, or other supplies, please contact a member of the RCPA staff as soon as possible or as needs arise, so we can inform the applicable state agency. Questions, please contact Jack Phillips.

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