COVID-19 Resources for Rehabilitation Professionals
Supporting you and your hard work during the pandemic
In light of the current unprecedented health challenge with the spread of the coronavirus (COVID-19) and the additional stressors it has brought, ARN would like to support you in your practice and personal life. We have already extended deadlines for conference abstract submissions and applications to become a fellow of ARN, and will be waiving the late fee for upcoming CRRN renewals. Currently we expect to still hold our annual meeting, REACH, in October.
Materials and Resources for Addressing Coronavirus (COVID-19)
- CMS, Current Emergencies page
- CMS, COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers
- COVID-19: Preparing for the Surge with Dr. Lee Fleisher--webinar will be held on Wednesday, April 1 from 3–4 pm EDT
- Resources from Lippincott Nursing Center (journal publisher)
- ANA Crisis Standards of Care
ANA is issuing guidance related to crisis standards of care. In a pandemic, nurses can find themselves operating in environments demanding a balance between time-limited crisis standards of care and longstanding professional standards of care. This guidance applies to decisions about care made during extreme circumstances such as those resulting from emergencies, disasters or pandemics like COVID-19. ANA recommends that this guidance be used to inform discussions at the regional and facility level, while also informing nurses about crisis standards of care.
- ANA: two guidance documents--guidance related to nurses who are interested in volunteering and guidance related to consumers who want to help.
- AMRPA Resources
- National Quality Forum, Dr. Leana Wen on COVID-19 Public Health and Patient Advocacy Challenges
- Centers for Disease Control and Prevention (CDC), COVID-19 Update: Optimization Strategies for Healthcare Personal Protective Equipment (PPE)
- Centers for Disease Control and Prevention (CDC), Underlying Medical Conditions and People at Higher Risk for Coronavirus Disease 2019 (COVID-19)
- Centers for Medicare & Medicaid Services, CMS Announces Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19
- Centers for Disease Control and Prevention, Information for Health Care Professionals
- World Health Organization, Health Workers – Training Materials and Resources
- Centers for Medicare & Medicaid Services, Guidance for Infection Control and Prevention Concerning Coronavirus Disease (COVID-19)
- CMS has made changes to make it easier to provide care, for example, expanding telehealth options
- The WHO has designed a tool to promote trusted information channels, including a section for healthcare workers
- (Illinois specific) COVID-19 Testing Decision Matrix--Persons Under Investigation (PUIs) for Testing at IDPH Laboratories
- Family Caregiver Alliance, Articles for Family Caregivers
- Policy Brief: U.S. Nursing Leadership Supports Practice/Academic Partnerships to Assist the Nursing Workforce during the COVID-19 Crisis.
- Join the ANA to advocate for our health care workforce by encouraging Congress to do everything possible to increase PPE prioritization and distribution to nurses. View the ANA link for action.
- Letter the American Medical Rehabilitation Providers Association (AMRPA) sent to DHHS and congress
Senate Approves Third Coronavirus Relief Package
On Wednesday, March 25 the Senate approved the third coronavirus relief package.
Late last night (Wednesday, March 25) the Senate approved the third coronavirus relief package by a vote of 96 to 0. Action on the package was delayed due to efforts of Senators Lindsay Graham, Tim Scott, Ben Sasse, and Rick Scott to change the unemployment benefits provision of the bill. They wanted to reduce the benefits, claiming that some would choose to stay on unemployment rather than return to their jobs with lower wages than the benefits. They secured agreement to offer an amendment on unemployment benefits, which failed on a vote of 48 to 48.
The bill moves to the House, where action is expected on Friday. Majority Leader Steny Hoyer announced on Wednesday evening that the House would pass the package by voice vote on Friday morning.
Many of the Nursing Community priorities were part of this bill, including:
- Requires Strategic National Stockpile to include certain types of medical supplies, such as PPE;
- Reauthorizes Title VIII Nursing Workforce Development Programs;
- Authorizes NPs and CNS' to certify home health care for their patients;
- Includes United States Public Health Service Modernization - Ready Reserve Corps to respond to public health and national emergencies.
CMS Waivers for Health Care Providers
On March 13, the Centers for Medicare and Medicaid Services (CMS) announced a series of regulatory flexibilities, temporary waivers, and other actions to help health care providers respond to the ongoing coronavirus crisis. The national emergency declaration made on March 13 allows the Secretary of Health and Human Services (HHS) to authorize waivers of certain Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) program requirements under the Social Security Act, Section 1135. These actions include waivers and flexibilities for hospitals and other health care facilities, provider enrollment flexibilities, relief for state Medicaid agencies, and suspension of non-emergency enforcement activities, such as survey inspections.1
A full outline of the blanket waivers being instituted by CMS. Among other flexibilities, CMS is waiving a number of post-acute care requirements, including the requirement for a three-day prior inpatient hospital stay before covering admission to a skilled nursing facility (SNF); waiving maximum bed limits and length of stay caps for critical access hospitals (CAHs); allowing Durable Medical Equipment contractors to waive replacement requirements, such as the face-to- face visit and new physician order requirements; and waiving the “60 percent” rule for inpatient rehabilitation hospitals and units (IRFs) to allow IRFs to exclude patients from the inpatient population for 60 percent rule calculations, if the patient is admitted solely due to the emergency.
Additionally, state and territorial Medicaid agencies are permitted to apply for additional, facility-specific waivers under section 1135. More information regarding Medicaid and CHIP flexibilities can be found at CMS’ Disaster Response Toolkit.
Lastly, CMS has announced specific new measures for infection control in nursing homes to protect vulnerable populations, including significant restrictions on all visitors, cancellation of group activities and communal dining, and implementation of active screening for residents and health care personnel for coronavirus symptoms. Details on the new nursing home requirements.
- The “emergency area” is defined by the Act as a geographical area in which “there exists the public health emergency declared by the Secretary pursuant to section 319 of the Public Health Service Act on January 31, 2020, entitled ‘Determination that a Public Health Emergency Exists Nationwide as the Result of the 2019 Novel Coronavirus.’” See also, HHS Press Release, stating that “Health and Human Services Secretary Alex M. Azar II declared a public health emergency for the entire United States to aid the nation’s healthcare community in responding to 2019 novel coronavirus (emphasis added):” https://www.hhs.gov/about/news/2020/01/31/secretary-azar-declares-public-health-emergency-us-2019-novel-coronavirus.html The declaration is retroactive to January 27: https://www.phe.gov/emergency/news/healthactions/phe/Pages/2019-nCoV.aspx
Mental Health Resources
- WHO, Mental Health Considerations
- CDC, Managing Stress Anxiety
- Know your hospital/employer's plans for handling COVID-19 as it continues to spread. The Academy of Medical-Surgical Nurses recommends
- ASK: Ask your manager and/or administration what the plan is for suspected or confirmed COVID-19 patients.
- ENCOURAGE: Encourage and maintain proper handwashing technique in your unit
- UTILIZE: Utilize resources from the CDC, Johns Hopkins, the WHO, and nursing associations around the world—and continue to check for new resources as more information becomes available
- CHECK IN: Check in with your colleagues and staff about their mental health, stress, and the psychological toll that the coronavirus, preparedness, and information may be taking on them
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