Coronavirus Disease 2019 (COVID-19)

steps to obtaining ppe

For a list of TALA Industry Partners who provided COVID-related services, please click here.

NEWS UPDATES

COVID-19 Response Plans for ALFs

HHSC To Allow Limited Visitation At Nursing Facilities And Long-Term Care Facilities

TALA President interview by Chris Fox with CBS News Radio. The story ran on KRLD in Dallas, and on Texas State Networks, which is 134 radio stations statewide including KLBJ in Austin and WOAI in San Antonio.

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

ALF Required Reporting Cases of COVID-19 to HHSC
HHSC has modified when AL communities should report positive COVID cases through the TULIP system. Beginning immediately, communities should report ONLY the first positive case(s) and ONLY the first positive case(s) after at least fourteen days of no cases. Essentially, HHSC would like for AL communities to notify the agency at the start of any potential outbreak but to cease reporting each new case identified as part of that reported outbreak.
Local health departments will likely have different reporting requirements. Many local jurisdictions continue to request significant information from ALs about COVID-19 outbreaks and any indication of spread. Changes to reporting requirement for HHSC does not impact the duty to report to your local health department.

COVID-19 Cases in LTC Facilities on Public HHS Website

Texas’ Attorney General sent a letter to HHSC at the beginning of July explaining that the agency was required to make public information about the presence of COVID-19 in all long-term care facilities, including nursing homes and assisted living communities. HHSC has complied with the letter, and almost immediately, TALA and its members noticed errors and discrepancies in the data. HHSC would like for all communities who notice errors in the reported data to reach out to their HHSC Regional Directors. The website has a disclaimer about the accuracy of the data, but each community should try to correct posted misinformation.
HHSC Website COVID-19 Cases in Long-Term Care

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

COVID-19 Emergency Rules - §553.2001 & §553.2003

Texas Department of Emergency Management - Interactive map for finding testing resources: https://tdem.texas.gov

As of 12/1/2020 ALF Provider Letters: 

CMS/CDC COVID-19 trainings are available:

*Note: Descriptions indicate trainings are geared toward NF staff, however, the key principles are also applicable to ALF staff.

Provider Letter 20-38: https://apps.hhs.texas.gov/providers/communications/2020/letters/PL2020-38.pdf

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

CDC Website Guidance for Health Care Providers (HCP) regarding Repeat Testing

https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html

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:

Types of Testing for COVID-19 - Texas Department of State & Health Services

Click here

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 6/23/2020

LTC Dallas - Link here

LTC Austin - Link here

LTC El Paso - Link here

LTC Harris County - Link here

General (with LTC Mentioned) Travis County - 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

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.