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COVID-19: State Updates & Guidance

STATE PUBLIC HEALTH EMERGENCY DECLARATIONS

  • State of Louisiana Extension: On July 23, Gov. John Bel Edwards signed a renewal of the current proclamation extending Phase Two in the state, which includes the statewide mask mandate and additional restrictions, until Aug. 7. In addition, the governor signed Proclamation Number 97 JBE 2020 that extends a number of suspensions of various licensure laws, rules, and regulations for medical professionals and personnel.
  • Proclamation Number 89 JBE 2020: Announces a mandatory mask requirement for Louisiana, which went into effect on July 13. The statewide mask mandate allows for parishes without high COVID-19 incidence to opt out if they choose. The governor also limited indoor social gatherings to 50 total people and ordered bars in the state closed to on-premises consumption. The new order is set to expire July 24, 2020, but it could be extended. (07/11/20)
  • Proclamation Number 74 JBE 2020: Extends the public health emergency until June 26, 2020. All the previously-issued waivers and guidance related to the Louisiana Board of Pharmacy and the Louisiana State Board of Nursing regarding this public health emergency have been extended to June 26, 2020 unless terminated sooner. (06/04/20)
  • Proclamation Number 52 JBE 2020Extends Stay at Home Order, along with several professional licensure requirements in Louisiana, until May 15. (04/30/20)
  • 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: On July 2, LDH issued an Emergency Order that continues the previously-issued #2020-COVID-19-ALL-020 for all licensed healthcare facilities and will remain in effect from July 5, 2020 until further notice from the State Health Officer.
  • LDH Reinstates PASRR Process for Nursing Home Placement: LDH issued a Healthcare Facility Notice lifting the temporary suspension of the PASRR waiver. Effective June 15, LDH is reinstating the regular nursing home admission process, which requires the PASRR Level 1, and if necessary, Level II, assessments to be completed by the hospital before a Nursing Facility admission. Providers can contact 337-262-1664 if they have any questions.
  • 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.

  • 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.

CLINICAL GUIDANCE

  • LA HAN Alert: On July 21, LDH issued a Louisiana Health Alert Network (LA HAN) message regarding an interim guidance update on the “Discontinuation of Transmission-Based Precautions, Disposition of Patients with COVID-19 in Healthcare Settings, and Updated Return to Work Guidance for Healthcare Workers.”
  • 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

  • Data Reporting: On June 18, LDH issued a Louisiana Health Alert Network (LA HAN) message regarding an update on COVID-19 data collection and reporting. All facilities performing testing for COVID-19 are required to report all results to LDH, much like they currently do for other communicable diseases. This includes rapid testing, point-of-care testing, antibody testing, or any other testing performed for COVID-19. For reporting results, the Department prefers electronic laboratory submissions in HL7 or CSV format. The message also included guidance on the data elements for reporting. Questions regarding laboratory data submission should be directed to ELR@la.gov.
  • 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 leah.michael@la.gov or Morris and Dickson for medication requests or for questions.

CONTACT TRACING

  • 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.

BEHAVIORAL HEALTH

  • 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.

RURAL HOSPITALS

  • 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 kandi.smith@la.gov.


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.

PATIENT PROTECTIONS


OTHER RESOURCES

  • 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.
Louisiana Hospital Association

9521 Brookline Avenue, Baton Rouge, LA 70809  Google Map
Phone: (225) 928-0026
Fax: (225) 923-1004