Coronavirus Disease 2019 (COVID-19)

steps to obtaining ppe

NEWS UPDATES

COVID-19 Response Plans for ALFs

COVID-19 Response Plans for ALFs available here. HHSC advises this document is a “living” document with frequent updates as guidance changes. Links to vital information included. https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/assisted-living-facilities-alf

UT Center for Aging - FREE Specific Trainings

The Center for Excellence in Aging Services and Long Term Care for The University of Texas School of Nursing, is offering FREE education along with specific trainings on Infection Control via webinar.

Please visit their COVID-19 Resources page for more information at https://www.utlongtermcarenurse.com/covid-19-resources/

LTC Providers Required to Report COVID-19 to HHSC

Effective immediately, a provider must report every presumptive and confirmed case of COVID-19 in staff and individuals receiving services from the provider as a self-reported incident. A presumptive or confirmed case is considered a critical incident. Providers (other than HCS and TxHmL providers) must notify HHSC through TULIP or by calling Complaint and Incident Intake (CII) at 1-800-458-9858. HCS and TxHmL providers must notify HHSC at: [email protected].

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HHSC Waivers

The Health and Human Services Commission (HHSC) Long-term Care Regulatory (LTCR) has issued a Provider Letter for assisted living communities and related professions.

PL 2020-23 Guidance on COVID-19 Response in Assisted Living Facilities (ALF) Note: Replaces PL 20-13
PL 2020-21 Suspension of Certain LTCR Requirements during COVID-19 Outbreak

Restrictive Visitor Policies

Long-term care communities are under new direction to significantly limit visitors to their communities and any potential outings by residents. Assisted Living Providers received Provider Letter PL 20-23, and Governor Greg Abbott mentioned similar restrictions in his March 19th Executive Order #3. The provider letter invokes Texas Health and Safety Code, Chapter 247, Section 247.064(d), which says that a resident’s right to visitation can be restricted in order to protect the health and safety of residents.

If a resident leaves the community for any reason and then returns, the resident must be screened and temperature checked. If the resident fails any portion of the screen, the resident may be allowed to return but should be kept in isolation per the CDC’s protocol.

Requesting Personal Protective Equipment

Responding to COVID-19 has put an enormous strain on the country’s supply of personal protective equipment (PPE), including N95 masks, gloves and gowns. Because of the national shortage and prioritization of PPE to acute care settings, long-term care facilities are feeling the pinch. HHSC has an informative website (https://hhs.texas.gov/about-hhs/communications-events/news/2020/03/resources-ltc-providers-request-ppe) specifically for long-term care providers. All communities must attempt to purchase necessary PPE through private distributors. Save copies of emails and responses, because the documentation will be necessary for requesting any PPE from the strategic national stockpile.

The Department of State Health Services is utilizing the state’s 22 Regional Advisory Councils to manage PPE shortages. Assisted Living Communities may request PPEs from their local RACs (find contact information here: https://dshs.texas.gov/emstraumasystems/etrarac.shtm). Long-term care providers need to use the State of Texas Assistance Request (STAR) process, and prioritization for PPE distribution.

The Center for Disease Control put out advice for medical providers regarding the conservation of PPE. Find that information here: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html

Changes for Nurses

Governor Greg Abbott has announced several initiatives to increase the pool of nurses able to respond to COVID-19. The Texas Board of Nursing has a webpage dedicated to the changes (https://www.bon.texas.gov/COVID-19.asp).

The City of Austin has announced new control measures for all assisted living communities and nursing homes. Beginning immediately, communities will screen all residents, employees, visitors, and volunteers for elevated temperatures prior to entering the community. http://www.austintexas.gov/news/control-order-issued-combat-spread-covid-19-among-vulnerable-populations


To stay up to date on the Houston area:

City of Houston Health Department :

https://www.houstontx.gov/health/Epidemiology/2019-nCoV.html

Harris County Health:
http://publichealth.harriscountytx.gov/Resources/2019-Novel-Coronavirus 

NIH (National Institute of Health)

ADDITIONAL RESOURCE LINKS

Direct Links to COVID-19 Local Health Entities DSHS webpage: https://www.dshs.state.tx.us/regions/2019-nCoV-Local-Health-Entities/

Ready to print public awareness materials are available on the TxDSHS and CDC websites.

https://www.cdc.gov/coronavirus/2019-ncov/images/infographic-symptoms.jpg

https://dshs.texas.gov/coronavirus/docs/CoronavirusAlert-English.pdf

https://dshs.texas.gov/coronavirus/docs/CoronavirusSymptoms-English.pdf

https://dshs.texas.gov/coronavirus/docs/StopSpreadofGerms-English.pdf

CDC example signs for use outside resident room doors for Contact Precautions, Droplet Precautions, and Airborne Precautions

https://www.cdc.gov/infectioncontrol/basics/transmission-based-precautions.html#anchor_1564058318

Texas.gov has posted a link to help Front Line workers find child care and support in their area. Please click on this link to access: https://frontlinechildcare.texas.gov/index.html

Other Resources:

Texas Department of State Health Services - Coronavirus 2019 (COVID-19)

https://dshs.texas.gov/coronavirus/

Texas HHSC Emergency Preparedness rules & regulations for Licensed Assisted Living Facilities

https://texreg.sos.state.tx.us/public/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=26&pt=1&ch=553&rl=44

COVID-19 Healthcare Planning Checklist

https://www.phe.gov/Preparedness/COVID19/Documents/COVID-19%20Healthcare%20Planning%20Checklist.pdf

CDC guidance on implementing recommended infection prevention practices FREE online course - The Nursing Home Infection Preventionzist Training: https://www.cdc.gov/longtermcare/training.html

World Health Organization Coronavirus disease (COVID-19) outbreak: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

Health Care Coalitions across the US for emergency disaster response:

https://www.phe.gov/Preparedness/planning/hpp/Pages/find-hc-coalition.aspx

Child Care Options for Frontline Workers: https://frontlinechildcare.texas.gov/index.html

Activities and Program Resources during COVID-19

Virtual Resources for your Residents
If you are looking for other unique and inspirational ideas of engaging activities to do with residents, see the links below shared from the Engagement Team at Civitas Senior Living, a TALA member.
Virtual Tours
Other Resources:

LONG TERM CARE SPECIFIC ORDERS

As of 4/23/2020 (7:00 AM)

LTC Dallas - Link here

LTC Austin - Link here

LTC San Antonio - Link here


OPEN TEXAS DOCUMENTS

As of 4/27/2020

Open Texas Report

Executive Order GA-18

Executive Order GA-19

Executive Order GA-20

Preparation Checklist: Assisted Living Community

Know the facts: 1

Coronavirus Disease 2019 also known as COVID-19 was first identified in Wuhan, China. It is classified as a severe acute respiratory syndrome that has since spread globally with confirmed cases in various states of the US.  The Centers for Disease Control & Prevention (CDC) recommends similar strategies to prevent the spread of COVID-19 in Long Term Care settings as used to detect and prevent the spread of other respiratory viruses such as influenza (flu).

For up to date news on cases in the U.S. visit the CDC website below:

https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html

1 https://www.cdc.gov/coronavirus/2019-ncov/summary.html

How it spreads: 2

Person-to-person spread

The virus is thought to spread mainly from person to person. Such as when people are in close contact with one another (about 6ft) and through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land on or be breathed in by people near by.

Spread from contact with infected surfaces

CDC states it may be possible to obtain COVID-19 virus from touching a surface or object contaminated by an infected person and then touching your own mouth, nose or eyes.

2 https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html

Symptoms of respiratory infections including COVID-19: 3

  • Fever
  • Cough
  • Shortness of breath

People are thought to be most contagious when exhibiting active symptoms. It is possible the virus may spread prior to showing symptoms. “Symptoms may occur 2-14 days after exposure.”

 Be aware of recent travels to areas with confirmed cases and/or recent contact with an infected person.

3 https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html

PRINTABLE SUMMARY
GUIDANCE CHECKLIST

TALA will continue to monitor and provide updates to state, large county and large city orders. However, things are changing at a very rapid pace. We implore providers to follow the posted links to check for updates and to check for orders in smaller counties and cities.