Hurricane & Pandemic Preparedness: Tropical Storm Cristobal is forecasted to make landfall on the Louisiana coast on Monday, June 8. Please review your hurricane response plans, and take into consideration, and adjust for, current COVID-19 pandemic guidelines, such as exposure and social distancing. In addition, make sure your facility operational metrics, including generator information and fuel status, are updated in the ESF-8 portal. The Louisiana EOC is expected to be activated soon; therefore, we encourage you to monitor communications from the LDH via the ESF-8 portal messaging system as landfall approaches and contact your hospital designated regional coordinator with questions or needs.
Remdesivir Distribution Update: This week, LDH will be receiving another shipment of remdesivir, which will be allocated to hospitals with 5 or more current COVID-19 inpatients. A reserve cache has been established for hospitals with less than 5 patients. Hospitals can contact Leah Michael, the director of pharmacy services for Louisiana, at email@example.com or Morris and Dickson for medication requests or for questions.
HHS Data Reporting: HHS has announced that the next deadline for submitting data to inform the agency’s distribution of its supply of remdesivir is Monday, June 8 at 7:00 p.m. CDT. HHS is once again requesting the number of currently-hospitalized COVID-19 patients, and of those hospitalized, the number requiring placement in intensive care units. This is a separate request from the daily data that Louisiana is providing to HHS on hospitals’ behalf. Hospitals should submit the data using the HHS TeleTracking web portal. Registered users of TeleTracking should have received an email Monday announcing this next round of data collection. See the American Hospital Association’s May 11 Special Bulletin for additional details on what specific data to submit and how to enter it into TeleTracking. For issues with accessing the TeleTracking portal or questions about the data, contact TeleTracking Technical Support at 1-877-570-6903.
Phase 2 for Louisiana: On June 1, Gov. John Bel Edwards announced that following continued improvement in Louisiana’s COVID-19 outlook and a significant increase in testing capacity and contact tracing, Louisiana is ready to move on June 5 to Phase 2 of the White House’s reopening strategy. In addition, he released a Roadmap to a Resilient Louisiana: Phase Two document that contains the data the Office of Public Health used to make the decision for Louisiana to move into Phase 2.
STATE PUBLIC HEALTH EMERGENCY DECLARATIONS
- Proclamation Number 38 JBE 2020: Additional Measures for Public Health Emergency that
temporarily suspend certain
licensure, scope of practice and certification requirements and offers guidance on funeral services. (03/31/20)
HEALTHCARE FACILITY NOTICES AND HOSPITAL WAIVERS
- Extension of LDH Notices and Orders: In an Emergency Order issued May 15, LDH extended the effectiveness of the following Notices and Orders impacting hospitals until June 5, 2020. This extension
maintains all the waivers and provisions currently in place for healthcare
providers. #2020-COVID19-ALL-002, issued March 13, regarding visitor restrictions for healthcare facilities; #2020-COVID-ALL-007, issued March 21, regarding restrictions on elective and surgical procedures; and #2020-COVID-ADC/ADHC/PACE-001, issued on March 13, regarding the closure of all adult day cares, adult day health care providers and PACE providers statewide. PACE centers may continue to operate as clinics following all applicable federal and state mandates relative to the COVID-19 public health emergency.
- Guidance Update on Disposition of Patients: On May 2, LDH issued revisions to interim guidance on “Changes to Strategies and Precautions for the Disposition of Patients with COVID-19 in Healthcare Settings” effective April 30, 2020.
- Temporary PASRR Suspension Extension: On April 28, LDH issued a Healthcare Facility Notice to all licensed hospitals and all Medicaid-certified nursing facilities extending the “Temporary Suspension of Pre-Admission Screening and Resident Review (PASRR)” until otherwise directed by LDH.
- LDH Relaxes Restrictions for Time-Sensitive Medical Procedures: On April 24, the LDH published clarifying information for revised order issued on April 20 #2020-COVID19-ALL-010 that allows certain medical and surgical procedures to resume on April 27, 2020.
- Discharges to Nursing Facilities: On April 24, LDH issued a new order restricting certain discharges to nursing facilities. The revised order is effective until May 31, 2020.
- Critical Care Collaborative: LDH and
providers at Our Lady of the Lake Regional Medical Center, Baton Rouge
General and University Medical Center created a pool of evidence-based resources for hospitals that are preparing for, or newly
providing, ICU-level care for patients with COVID-19.
- OB Guidance: On March 16, LDH issued Interim Considerations for Infection Prevention and Control of COVID-19 in Inpatient Obstetric Healthcare Settings.
- Clinical Guidance for Individuals Returning to Normal Activity: On March 17, LDH updated the clinical guidance for returning to normal activity after being in isolation for suspected or confirmed COVID-19. The guidance, published in a Louisiana Health Alert Network (LA HAN) message,
now provides that it is acceptable to return to normal activity following a suspected or confirmed case of COVID-19 when: 1) at least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing
medications; 2) improvement in respiratory symptoms (e.g., cough, shortness of breath); and 3) at least 7 days have passed since symptoms first appeared. This guidance is consistent with the Discontinuation of Home Isolation Interim Guidance from the CDC.
TESTING & LABORATORY
- LDH Comprehensive Testing Plan: LDH has contracted with 11 partners as part of its comprehensive testing plan, which was submitted on May 30 to HHS. The plan outlines how LDH will increase statewide testing, especially in congregate settings where the risk of spread is high. On May 30, LDH posted on its website all materials submitted to HHS, including its contracts with providers.
- Remdesivir Distribution: OPH recently received a second shipment of Remdesivir. In addition to the allocations for those facilities that have five or more COVID-positive patients, a reserve cache of medication has been established for those hospitals that have an inpatient COVID-positive census of fewer than five patients. Hospitals can contact Leah Michael, the director of pharmacy services for Louisiana, at firstname.lastname@example.org or Morris and Dickson for medication requests or for questions.
- HAN Alert: On May 18, LDH issued a LA HAN message informing providers that the Department has implemented a plan for COVID-19 testing and tracking that is now underway. The plan involves hiring as many as 700 Louisiana residents who will serve as "contact tracers," interviewing and advising people who have tested positive for COVID-19 to determine who in their lives could also be at risk. LDH is working with two contractors, Accenture and Salesforce, to manage the contact tracing process. Two Louisiana-based call centers are being activated and will be based in the Lafayette and New Orleans areas.
HOSPITAL SERVICE DISTRICTS
- Open Meetings Law: On March 16, requirements under the Open Meetings Law were relaxed by Executive Order JBE 30-2020. The order provides that all state agencies, boards and commissions, and local political subdivisions of the state shall provide for attendance at essential governmental meetings via teleconference or video conference and such attendance
shall be allowed during the period of this emergency. All efforts shall be made to provide for observation and input by members of the public. Before any meeting conducted pursuant to this section, the state agency, boards and commission, or local
political subdivision of the state shall first provide a written certification that it will otherwise be unable to operate due to quorum requirements. On March 19, the Louisiana Attorney General has also issued guidance that is in accordance with the executive order.
- OBH Memo: On April 22, the Louisiana OBH issued a memorandum to inpatient psychiatric hospitals, distinct part psychiatric units and residential facilities, including residential substance use disorder treatment facilities, psychiatric residential treatment facilities and therapeutic group homes, regarding patients with COVID-19.
- SHIP Funding: On April 17, LDH announced that Louisiana qualified for COVID-19 SHIP funds to support rural hospitals that are seeing increased demands for clinical services and equipment, as well as experiencing short-term financial and workforce challenges related to meeting the needs of patients with COVID-19. The notice of award will be released April 22, which is also the program start date. A list was released in an April 2 LHA Alert. An FAQs document is available, and more information will be provided to these facilities from LDH. If you have any questions, contact LDH Rural Hospital Sustainability Manager Kandi Smith at email@example.com.
LOUISIANA DEPARTMENT OF INSURANCE (LDI)
- Medical Surge-Related Patient Transfers: In the April 20 issue of the Louisiana Register, the Office of the State Register will publish Emergency Rule 41
from LDI regarding medical surge-related patient transfers in Louisiana, effective March 31, 2020.
- Moratorium on Policy Cancellations: LDI issued Emergency Rule 40,
which “suspends any notice of cancellation, notice of nonrenewal, nonreinstatement or any other notice related to any of the kinds of insurance enumerated in §4003 that was in force and effect at 12:01 a.m. on March 12, 2020, and any such notice
shall be null and void and have no force of effect.” However, this Emergency Rule does not prevent an insurer from cancelling or terminating an insurance policy for fraud or material misrepresentation on the part of the insured.
- Telemedicine and Network Adequacy: On March 23, LDI issued Emergency Rule 37
that provides for telemedicine and network adequacy in health insurance during the COVID-19 outbreak. Emergency Rule 37 is effective until April 9, 2020 unless extended by the Department.
- Health Insurance: In the April 20, 2020 issue of the Louisiana Register, LDI issued Emergency Rule 36-Patient
Protections and Related Health Care Services Regarding Health Insurance
Matters Affecting Insureds in Louisiana Caused by the Outbreak of
COVID-19, effective March 17, 2020.
LOUISIANA STATE BOARD OF MEDICAL EXAMINERS (LSBME)
- Board Changes: Plain Language guidance document provides summaries of a number of regulations that have been suspended or relaxed by the LSBME to address the COVID-19 pandemic.
LOUISIANA STATE BOARD OF NURSING (LSBN)
- Louisiana State Board of Nursing Website
- Emergency Rules: LSBN has passed the following rules:
- Emergency rule to temporarily waive the
requirements for continuing education related to the reinstatement of
lapsed, inactive, or retired registered nurses’ licenses during a public
health emergency and went into effect on April 3.
- Emergency rule for
relaxation of collaborative practice agreements for APRNs
- Emergency rule for
extension of RN applicant (new graduate nurses) temporary permit
- Emergency Relief: On March 17, LSBN is granting emergency relief for
all RNs/APRNs in hospitals to allow them to do moderate clinical laboratory point of care testing.
LOUISIANA STATE BOARD OF PHARMACY (LSBP)
- Extension: On a May 15, the Louisiana State Board of Pharmacy distributed a notice extending its issued waivers and guidance to June 5.
- Pharmacist License Renewal: On April 2, the Louisiana Board of Pharmacy modified the continuing education requirements for pharmacist license renewal for Calendar Year 2021 such that a total of 15 hours of pharmacist-specific continuing education accredited through the Accreditation Council for Pharmacy Education will qualify for license renewal whether the CE is acquired through live presentations or home study methods.
- LSBP Guidance: On April 14, LSBP issued:
- guidance information on the temporary “5% rule” waiver mentioned above. The LSBP has also waived its similar rule for the same period of time;
- a guidance document, in collaboration with LSBME and LDH, for pharmacists contemplating therapeutic interchange procedures; and
- a guidance document in response to physicians issuing recommendations for therapeutic marijuana products, as well as marijuana pharmacies receiving such recommendations, both of whom have requested an alternative method of transmission of those recommendations.
- NABP Passport: On March 28, LSBP issued a memo
recognizing the NABP Passport as a valid service in Louisiana to allow pharmacists and pharmacy technicians temporary permission to practice in states where they are not licensed. To participate, pharmacists and pharmacy technicians should obtain an NABP Passport.
There is no cost to the applicant.
- Pharmacy Guidance: LSBP has issued guidance
relaxing certain rules regarding storage space for prescription drugs; centralized compounding capacity; and allowable quantities of extra outpatient prescription meds and waiving the restriction on hospital permits that limit hospital pharmacies
to dispensing medications to hospital patients only, for the duration of the public health emergency.
- Pharmacy Emergency Rule: LSBP will publish the following Emergency Rule
to limit the dispensing of chloroquine and hydroxychloroquine for COVID-19 by pharmacist.
- COVID Convalescent Plasma (CCP): CCP is in high demand at many medical facilities across the state to assist in the recovery of those gravely ill with COVID-19. CCP can only be collected from persons who are recovered from COVID-19. Qualified individuals can donate plasma at a LifeShare Blood Center facility. Medical discharge teams are asked to present the FAQs flyer and Physician’s Order Form to recovered COVID patients and their families during discharge instructions. To collect CCP, LifeShare requires a completed physician’s form for every donor. Recovered COVID patients are needed to help those still struggling with COVID-19. More information is available on the LifeShare FAQs webpage.
- Patient Communication Cards: LDH created a communication card for patients who are deaf or hard of hearing. In addition, Louisiana’s QIN-QIO Alliant Quality created an English and a Spanish communication card for patients who are deaf or hard of hearing.
- Certifying Deaths: On April 22, LDH issued updated guidance regarding proper cause-of-death certification for cases where confirmed or suspected COVID-19 infection caused or contributed to the death.
- Medical Monitoring Station Update: On April 9, LDH issued an updated Healthcare Facility Information Sheet regarding the Medical Monitoring Station in the Ernest N. Morial Convention Center in New Orleans to provide more information on which patients qualify for transfer to the MMS and the process to initiate transfer of these patients.