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MARRCH COVID-19 Resource Page
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LEGISLATIVE UPDATE


March 18, 2020

Emergency Legislative Agenda:

Our Legislative Team has been in communications with MDH, DHS and State Legislative Leaders regarding the following issues; 

  1. Definition of Healthcare Worker (MDE/Childcare Benefits)
  2. Expanding Use of Telehealth  (SF 4200) 
  3. Emergency Grants and Loans  

Accomplishments:

We were able to secure SUD as part of the MDE language, which opened up access to childcare benefits.  We have been in conversation with DHS and Legislative leaders regarding Telehealth and hear a deal may get done as soon as Friday.  (I’ve attached the link to SF 4200)  We continue to work with the Governor/MDH/DHS to ensure SUD providers will have access to the Emergency Grants and Loans promised to shore up healthcare.  (Announced at press conference last Friday, March 13.)

Also, please see this announcement by the Otto Bremer Trust (OBT), who has created a $50 mil emergency fund for community organizations impacted by and responding to (COVID-19) outbreak. 

 

RECAP: ALL-MEMBER MEETING


March 16, 2020

Read Our Recap

SUD workers identified as Healthcare

This was confirmed on the MARRCH call. Staff in addiction treatment have been identified as being included in the Healthcare category. This means that staff with school age children WILL be eligible for daily childcare through the local schools. A specific hotline for this support should be available tomorrow and will be shared as soon as it is available. These other numbers are available now from 7 a.m. to 7 p.m. 651-297-1304 or 1-800-657-3504.

Front lines of healthcare

Inclusion in the healthcare spectrum speaks to the critical nature of the services we are delivering and should continue to be included in messaging to staff and clients who may be concerned or fearful about why we are open. If specific guidance emerges to change our service status we will adjust to that information as appropriate.

Program specific operations

Bullets below address specific strategies, actions & resources:

  • Staggered break times- should be implemented for groups to assist with social distancing
  • Safety reminders - a useful reminder regarding simple practices that should be followed such as not passing items around in group etc.

MN Department of Health

The best way to get the most up-to-date information is to check here. This site changes several times a day. 

MN Department of Human Services

This is the DHS landing page for COVID-19. 

Governor Tim Walz Executive Orders

The Governor and his team are evolving their plan daily as they learn more information about the virus and how the public is responding. What has become a pattern is that he will hold a press conference and discuss his most recent executive order. I provided a link where all the executive orders will be posted.  He indicated that Minnesotan’s should expect that there will be more to come in the future as they continue to firm up plans for public health management.

MN Legislature

The Legislative bodies and committees will meet in floor and committee session on an on-call basis from March 16 through April 14. This means there will not be standing floor and committee meetings.  Simply this means that legislators are not going to be conducting regular committee business.  They are largely focused on COVID-19 and any measures needed to manage through this period of time.  The rest of the legislative agenda is on-hold indefinitely.    For instance, this evening the House and Senate are both planning to pass a second COVID-19-related bill to provide some sort of support for Minnesota’s hospitals, though an agreement has yet to be reached on whether the bill will provide grant funding as well as loans.

Congressional action

President Trump on Friday signed an $8.3 billion aid package related to the COVID-19 pandemic. The Congressional House also a passed a second bill of relief; but the Congressional Senate has yet to take it up.

Trump Administration guidance on meeting in groups

The President recently used a new number of 10 or fewer when meeting as a group; however, that has been clarified.  Please see below for the conditions related to the number.
Events with more than 10 people where the majority of participants are at higher risk for severe illness from COVID-19, including gatherings such as those at:

  • Retirement facilities.
  • Assisted living facilities.
  • Developmental homes.
  • Support groups for people with health conditions.

 

MEMBER PREPAREDNESS RESOURCES


COVID-19 Preparedness & Response

Has your organization….?

  • Ensured that your infection control policies are consistent with the CDC’s and MDH’s guidance?
  • Reviewed your policies and procedures for screening and possible work restrictions for staff?
  • Developed a contingency staffing plan for staffing shortages (e.g. what about staff who self-quarantine, refuse to come to work, have school age children under 12, etc.)?
  • Activated a response team that keeps your senior leadership updated, and prepared for communication with public health officials and dissemination of information to other staff, and campuses?  Provides accurate and continuous updates to clients and staff?  Are you controlling messaging so as to reduce or eliminate inaccurate and unnecessary communication?  Do you have a “hotline” process for clients to communicate their concerns to your assigned/responsible staff?
  • Confirmed the local or state health department contacts for reporting COVID-19 cases and confirmed reporting requirements?
  • Provided education and refresher training to staff regarding COVID-19 diagnosis, and appropriate Personal Protective Equipment (PPE) use?  Evidence based self-care, voluntary self-quarantine, social distancing, etc.?
  • Assessed the availability of PPE and other infection control supplies (e.g., hand hygiene, cleaning supplies) that would be used for both staff and clients?  CDC recommends 60%+ alcohol mix for hand sanitizer. 
  • Researched contingency plans if the demand for PPE or other supplies exceeds supply?
  • Inventoried and stocked up in the case of a multi-week facility quarantine on food and necessary supplies? 
  • Assured uninterrupted client medications supply and delivery?
  • Provided education/refresher training to staff for cleaning. Assess effectiveness of environmental cleaning procedures?
  • Actively following the federal and state agencies who are in charge of the national and state Corona Virus response?  CDC and MDH (see attached links)
  • Modified procedures for screening and intake. Adopt CDC screening questions and protocols for accessing evaluation and testing.
  • Limited intakes to prevent crowding and virus spread?
  • Used protocols for isolation and observation for new intakes (within the limits of our means to do so)? 
  • Deployed self-screening, client and staff screening, intake screening (first tier); community based health screening (second tier); testing as directed by community based doctors upon positive screen and recommendation? What are your community testing sites?
  • Developed plans for visitor restriction?  When?  COVID-19 is already present in the Community. 
  • Enacted plans for when to suspend home visits/passes for clients?
  • Enacted plans for controlling for/restricting outside vendors, mentors, contractors, volunteers, etc.?
  • Adopted a rigorous cleaning regimen (see example attached) including recommended cleaning supplies?
  • Limited group sizes to less than 50 (as well as events); canceled outside events of more than 50 people? 
  • Designed “program in place” protocols for organizations with multiple facilities/sites? Limited interaction of different programs/houses/facilities?
  • Encouraged canceling of elective/non-emergency medical procedures per CDC and MDH recommendations?
  • Identified at risk and medically compromised staff and clients and follow medical advice for isolation vs. exposure?
  • Planned for clients who are contained or isolated--humane and comprehensive programming, service and activity schedule?
  • Ran worst case scenarios and backward mapped to phased responses based on the level of emergency communicated by the responsible federal, state and local officials?  For instance, who will be essential staff that may need to provide direct care to clients during a quarantine of a facility or site?
  • Tasked state agencies to obtain necessary variances to provide treatment services, using these preventative approaches, as well as billing and payment?
  • What is MARRCH’s communication and coordination strategy with members/providers?  How are SUD clients and group/congregate care clients, as well as SUD staff, being included in pending legislation, funding, resources and supply plans?  How are these vulnerable adults, who are at risk due to their medical conditions and SUD history being prioritized?
  • Joined other SUD providers in sharing recommended practices?
General Communication to Staff and Clients
  • Wash your hands with soap and water for minimum of 20 seconds, multiple times throughout the day.  Use hand sanitizer frequently.  Hand sanitizer 60%+ alcohol is recommended.  Make sure to scrub under your nails.
  • If you are sick, STAY AT HOME or in an isolated area to avoid spreading germs
  • Cough into your elbow, NOT into your hands.
  • Take extra care to clean common surfaces – especially including doorknobs, stair rails, light switches – each day.
  • Get in the habit of NOT touching your face.
  • Forgo shaking hands or even fist pumps in the workplace – wave or offer a friendly smile
  • If you or someone you know tests positive for COVID-19 or if you believe you may have been exposed to the virus, please let us know so we can find a way to help, pray for everyone involved, and take any necessary precautions here at _______
  • If you have to be in a larger group, try to practice “social distancing”—6 feet minimum is recommended.  The CDC recommends to not gather in groups larger than 50 people.
General Cleaning Protocols
  • Each staff person will wipe down all surfaces of desk, phone, keyboard, and other commonly touched surfaces within their personal offices morning and afternoon.
  • Front entry vestibule and foyer areas copiers and all entry doors into buildings disinfected with bleach solution hourly.
  • Gloves will be worn to take out all garbages
  • All cleaning with bleach solution to be done with gloves and paper towels.           
    • Spray bleach solution and let sit for 10 seconds
    • Wipe each handle or new surface with a NEW papertowel.
  • House laundry for both men’s and women’s program must be done daily.
  • Mop heads to be washed 2x daily- after morning and evening tighten up.
  • Clients to wash personal bedding at least 1x weekly.
  • Clinical staff and CD Tech staff to monitor each client cleaning time. Correct and demonstrate proper cleaning methods.
  • Each client will spray and wipe down all surfaces in their personal space/rooms 1x daily in the evening.
  • Weight room- each machine or weight must be disinfected after each individual use with bleach spray and papertowel.
  • Everyone will wash hands after any cleaning duty.
  • Lysol spray all chairs 3x/day (for as long as we have Lysol supply).
  • Use bleach solution and papertowels to disinfect all surfaces in building 3x daily.

Evaluating Environmental Cleaning

 

Criteria to Guide Evaluation and Laboratory Testing for COVID-19 (CDC)

Clinicians should continue to work with their local and state health departments to coordinate testing through public health laboratories. In addition, COVID-19 diagnostic testing, authorized by the Food and Drug Administration under an Emergency Use Authorization (EUA), is becoming available in clinical laboratories. This additional testing capacity will allow clinicians to consider COVID-19 testing for a wider group of symptomatic patients.

Clinicians should use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. Most patients with confirmed COVID-19 have developed fever1 and/or symptoms of acute respiratory illness (e.g., cough, difficulty breathing). Priorities for testing may include:

  1. Hospitalized patients who have signs and symptoms compatible with COVID-19 in order to inform decisions related to infection control.
  2. Other symptomatic individuals such as, older adults and individuals with chronic medical conditions and/or an immunocompromised state that may put them at higher risk for poor outcomes (e.g., diabetes, heart disease, receiving immunosuppressive medications, chronic lung disease, chronic kidney disease).
  3. Any persons including healthcare personnel2, who within 14 days of symptom onset had close contact3 with a suspect or laboratory-confirmed4 COVID-19 patient, or who have a history of travel from affected geographic areas5 (see below) within 14 days of their symptom onset.

There are epidemiologic factors that may also help guide decisions about COVID-19 testing. Documented COVID-19 infections in a jurisdiction and known community transmission may contribute to an epidemiologic risk assessment to inform testing decisions. Clinicians are strongly encouraged to test for other causes of respiratory illness (e.g., influenza).

Mildly ill patients should be encouraged to stay home and contact their healthcare provider by phone for guidance about clinical management. Patients who have severe symptoms, such as difficulty breathing, should seek care immediately. Older patients and individuals who have underlying medical conditions or are immunocompromised should contact their physician early in the course of even mild illness.


Resources from National Council

Understanding the implications of the coronavirus can be challenging, especially as conflicting updates abound. Use these resources to learn about the current state and scope of the pandemic:

Resources for Behavioral Health Organizations

Keeping your doors open is essential during this time of need. To help limit disruption of services, while protecting your patients and staff from infection risk, consider the following guidelines:

Behavioral Health Care Resources

In addition to the potential risk to physical health, the threat of COVID-19 also affects us emotionally. Here are some behavioral health care resources that can help:

 

ADDITIONAL RESOURCES


Essential links to Federal and State Agencies

  • MDH Hotline: If you are a health professional evaluating a patient for suspected coronavirus disease 2019 (COVID-19), or have clinical questions, please contact the Minnesota Department of Health hotline immediately at 651-201-5414.

Governor’s Executive Orders/Peacetime Emergency Declarations

 

If you have additional questions not addressed by the above links, please leave comments by clicking HERE. MARRCH is gathering common questions in the industry in order to better serve the organization and determine additional needs.

Submit Your Additional Questions

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1000 Westgate Drive,
Suite 252
St. Paul, MN 55114
P: 651.290.7462
F: 651.290.2266

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