In The News

Emergency Rules Expand Healthcare Workforce, Aid New Graduates During COVID-19 Crisis

May 2, 2020

The Division of Professions and Occupations (DPO) has been granted authority to promulgate emergency rules for multiple professions under Executive Order D2020 038, which prioritizes essential healthcare services during the ongoing Novel Coronavirus (COVID-19) emergency. These rules were implemented today, and this communication and the attached Q and A document provide details on what, and why, these emergency measures were enacted.

Since healthcare professionals are statutorily required to work within a defined scope of practice, inpatient facilities previously were unable to use readily available personnel to fill healthcare service gaps. Temporarily relaxing these restrictions -- in conjunction with the expansion of delegation for certain medical personnel --  affords hospitals the flexibility to plug readily available healthcare staff into non-traditional roles and alleviate workforce shortages at hospitals and inpatient facilities.

The suspension of certain nursing and nurse aide education requirements is another major piece designed to reinforce the state’s healthcare system.  Minus these changes, nursing students would have forfeited tuition and in many cases been unable to enter the workforce in May. The emergency actions remove regulatory barriers that will provide nursing and nurse aide students in educational programs throughout Colorado avenues towards spring and summer graduation and allows newer students to progress through their education. It also enhances the ability of nurses and certified nurse aides to enter or remain in the workforce.

The temporary transfer of emergency rulemaking authority to DPO also allowed the Director to issue temporary licenses for a number of healthcare professions regulated by the following boards and programs: Dental, Medical, Nursing, Chiropractic, Occupational Therapy, Optometry, Physical Therapy, Podiatry, Respiratory Therapy, Speech-Language Pathology, and Veterinary.

New graduates within these professions have been unable to test due to the indefinite postponement of exams or limited testing site availability due to the Coronavirus. Temporary licensure now allows these new graduates to work under the supervision of a Colorado licensee until testing centers open and they have the opportunity to sit for the examination or complete approved postgraduate training.

Additionally, temporary licensure will be available to international medical graduates who are eligible for licensure as a physician but for completion of approved post-graduate education.  Temporary licensure allows these physicians, many of whom have practiced in foreign countries for years, to temporarily enter the workforce during the pandemic under the supervision of a Colorado licensed physician.

Temporary licenses are valid from the date of issuance through Dec. 31, 2020.  Applications will be available shortly on individual board and program webpages. Please continue to check the website for those applications relating to your profession. These licenses are non-renewable, and temporary license-holders must pass an exam prior to year’s end in order to obtain full licensure and continue practicing.

Information on emergency rules changes for specific professions are available here. And please watch the in-depth PowerPoint presentation on Executive Order D 2020 038 on YouTube that preceded today’s actions for more details. Please e-mail [email protected] with any other outstanding questions.

 

Governor Polis COVID-19 Update April 29, 2020

Topline Update

We currently have 14,758 cases, 766 deaths, and 2,621 hospitalizations out of 69,449 completed tests. We are thinking of these families and communities during these trying times.

This case data is broken down by various categories, is updated daily and can be found here. 

Daily growth in cases has declined. As of yesterday, the growth rate is down to 2.8%. We are continuing to see positive results on the hospitalization side. The daily growth in hospitalizations as of yesterday was 0.4%.

But we need to keep these numbers moving in the right direction. And that means continuing to stay home, wear masks, and adhere to the “Safer-at-Home” order that went into effect on Monday.

Colorado Testing Goals

Today the Governor provided an update on the state’s testing capability and infrastructure, and our plans to scale up our epidemiological work.

When this crisis began, we could only run 160 tests a day. Today we are running 3,000 tests per day. Our goal, between public and private partners, is to grow our daily capacity in early May to 5,000 and continue to scale up from there from 8,500+ tests/day if needed by the end of May.

How do we meet this goal?

  1. Increase testing supplies

  2. Increase availability of testing to the public

  3. Increase epidemiological capacity to make tests meaningful in preventing further outbreaks.

Testing Supplies Update

The Governor provided an update on where we are in terms of testing supply numbers. Keep in mind that this is a snapshot of a constantly changing situation because as soon as we get our hands on equipment, it is distributed to ensure more testing.

Right now we have:

  • 15,000 Swabs / Viral Media

  • 20,000 Extraction Reagents

  • 100,000 Detection Reagents which we have secured from South Korea.


Yesterday, the Governor was on a call with the White House where we were promised:

  • 195,000 swabs / viral media

  • Guaranteed a purchase order from private companies to purchase the extraction and detection reagents

By May 11, we expect to have secured

  • 147,000 Swabs / Viral Media -- that includes part of the federal commitment.

  • 117,000 Extraction Reagents

  • 147,000 Detection Reagents


And by the end of may, we expect to have secured

  • 195,000 Swabs / Viral Media -- this includes the full federal commitment.

  • 195,000 Extraction Reagents

  • 195,000 Detection Reagents

We want to thank our innovation response team for their incredible work. There is fierce competition in this market to get this equipment and everyone in the world is trying to get it. And in a matter of weeks we have stepped up to fill the gap on both sourcing and distribution which has allowed us to make significant progress. We expect that over time, supply chain issues will be resolved, and the supply of testing equipment will be able to keep up with the demand.


4 types of testing

The Governor spoke about increasing the availability of testing. To hit our goal -- we need to provide a variety of sites across the state and meet people where they are.

There are four types of testing sites in Colorado where you can get COVID testing:

  • Private sector hospitals and health care facilities

    • These facilities are currently testing health care workers and patients, and the tests are covered by insurance.

    • Hospitals:

      • Children’s Hospital

      • National Jewish

      • UC Health

      • Centura - Western slope locations

    • Community Health Centers:

      • Stride

      • Clinica Tepeyac

      • Other Community Health Centers

    • Other providers

      • Kaiser Permanente, who are expanding testing to healthcare workers and first responders outside their network

    • As we move forward, we’re going to be asking these facilities to step up more testing for the general public.

  • Local community-based testing sites, most of them headed up by local public health agencies

    • We are helping local public health agencies stand these up across the state.

    • Two weeks ago, we distributed a playbook to local public health agencies to support them in their work, and asked them to submit a request to the state.

    • So far, 51 counties have requested a site. 

    • The state lab has completed readiness assessments and approved plans for 34 sites.

    • We have sent supplies to 26 of these testing sites and as more come on line, we will be sending supplies to these as well to meet people where they are.

    • We will be announcing a list of sites in the coming days.

  • State collaborations with private-sector partners.

    • For one example, we’re working with Kroger grocery stores like King Soopers to administer hundreds of tests in Denver and Boulder

  • Targeted testing for outbreaks and at-risk populations

  • We’re working with the CO National Guard and local agencies to ramp up testing at nursing homes -- we know these facilities are particularly vulnerable to contagion.

  • Here’s an update on that effort:

    • 4 of the state’s largest facilities have been tested and one is ongoing

    • 1,171 total tests

    • 99 total positive -- 55 symptomatic, 33 asymptomatic, and 11 unknown levels of symptoms.

    • 30 tests pending.

  • We’re proud to announce a new partnership with CSU which will provide 45,000 tests on nursing home workers during May and June, and we will also be sending extra personal protective equipment like masks and gloves to our senior care facilities to ensure staff and residents are more protected.

  • For particular communities and areas where there is a large number of symptomatic cases relative to population, such as Weld County, we’re doing specialized testing sites.

    • We tested 882 people in Weld County over the last four days 

      • 123 positives -- 88 symptomatic, 34 asymptomatic -- which underscores our challenge, not everyone who has it shows symptoms.

      • 140 tests still pending.

      • And we left additional kits with Weld County Public Health to continue to meet the high need for testing and containment in Weld County.

    • We’ve also had dedicated sites in Pueblo (484 tested), Mesa (482 tested), El Paso (1769 tested) and the Denver Metro Area


Who can get tested?

Right now here’s who can get tested:

  • Symptomatic healthcare and frontline workers

  • Symptomatic hospital and nursing home patients

  • Symptomatic workers and others in outbreak areas (i.e. JBS)

  • Some symptomatic community members

    • Depends on availability in your community

    • And how at-risk you are: older coloradans & those with underlying health conditions.

By mid-May, we want to continue to test all of these groups:

  • Symptomatic healthcare and frontline workers

  • Symptomatic hospital and nursing home patients

  • Symptomatic workers and others in outbreaks

And we want to be able to test ALL symptomatic community members who want it, and have the capacity for broader outbreak testing.

Finally as we continue to scale, we will build a robust program to prevent hotspots in senior, long term care, and congregate care facilities, and other vulnerable populations like people experiencing homelessness.


Epidemiological Update

In order for this strategy to be successful, we need to ramp up our epidemiological capacity. That starts with bringing in more trained professionals to do this important work. CDPHE has grown its COVID-19 epidemic response team from 31 staff to 56, a near doubling of the staff.

This includes:

  • Epidemiologists -- the scientists needed to analyze the data

  • Contact tracers -- conduct follow-up interviews with contacts of infected individuals

We are building a first in the country COVID Navigator Program, to establish wrap-around supports for those who are sick. We are hiring staff for this effort as well. All of the epidemiological staff at the state level will work in collaboration with local public health agencies and their epidemiological teams. But if we want the best epidemiological response that we can have -- it requires more than just staff. We need to bring all of the technological tools we can to bear.

In partnership with Google + MTX, we’ve launched a new symptom tracker to help you determine if you need to seek out a test or medical help, to guide you on next steps, and to help our epidemiologists determine if there’s an outbreak in your area and respond accordingly. 

This sort of self-reporting is happening across our state and it’s helping to save lives. We have already had over 1,000 entries into the tracker that’s providing us with valuable information. The tracker consists of a short survey on covid19.colorado.gov where you submit your symptoms. You can opt into text message support which will direct you to various resources, from telemedicine to behavioral health support. We’re also collecting data from ERs on patient symptoms so we can track which communities are the most impacted.

All of these things working in concert will help us achieve success in this next phase:

  • More testing supplies

  • More test sites

  • And more epidemiological capacity.

And together, with Safer-at-Home for most of the population, Stay-at-home for vulnerable populations, wearing face coverings, and other distancing and hygienic steps -- we can continue to make progress in our fight against this deadly virus and hopefully, begin to remove even more barriers in our society and our economy.


COVID Health Equity Response Team

The racial data that we are releasing shows that some communities of color are more likely to suffer from COVID and the impacts of the disease. This is likely a proxy for other societal inequities because historically people of color have unequal access to health care, economic opportunity, and benefits, all of which impact their ability to deal with COVID and the surrounding crisis.

So a couple of weeks ago we announced that we would be setting up a COVID health equity response team to:

  • Ensure equity as a factor in decision-making around logistics and resources,

  • Increase access to testing and care services,

  • Ensure racial and ethnicity COVID-19 data are accessible, transparent and used in decision-making,

  • And share time-sensitive information about how Colorado communities are experiencing particular challenges related to the COVID-19 response.

  • This team will be headed by Web Brown, the Director of the Office of Health Equity at CDPHE. And today we are glad to announce the task force members:

  • Congressman Joe Neguse, CD-2 

  • Farduus Ahmed, Hope Communities

  • Harry Budisidharta, Asian Pacific Development Center

  • Lizeth Chacon, Colorado People's Alliance

  • Eudelia Contreras, Lake County Build a Generation

  • Maggie Gomez, Center for Health Progress

  • Joline Dorce, Dawn Clinic

  • Rudy Gonzales, Servicios de la Raza

  • Amanda Henderson, Interfaith Alliance

  • Deidre Johnson, Center for African American Health

  • Adrianne Maddux, Denver Indian Health and Family Services

  • Denise Maes, ACLU 

  • Kenny Maestas, Colorado Cross-Disability Coalition

  • Omar Montgomery, Center for Identity and Inclusion-University of Colorado Denver 

  • Priscilla Montoya Vitello, Latino Community Foundation

  • Michelle McHenry-Edrington, Colorado Cross-Disability Coalition

  • Rosemary McDonnell-Horita, Atlantis Community, Inc. 

  • Rosemary Lyttle, NAACP

  • Ricardo Perez, Hispanic Affairs Project

  • Alex Sánchez, Roaring Fork Latino Network and Voces Unidas

  • Carmen Stevens, San Luis Valley Immigrant Rights Center, 

  • Representative from the Ute Mountain Ute Tribe

  • Representative from the Southern Ute Tribe

Click here to learn more about the Health Equity Response Team. 

 


 

 

 

ANA Updates COVID-19 April 28, 2020

ANA is dedicated to supporting our members and advocating for your needs during this global pandemic. One important way is the expansion of our COVID-19 Resource Center. This digital resource pulls together information from trusted sources such as the CDC and highlights clinical informationethical considerations, and features the COVID-19 work that the ANA is doing.

 Here you can:

We are making updates every week as ANA continues to advocate for clear, evidence-based guidelines and resources to ensure our nation's registered nurses can safely and effectively respond to COVID-19 and protect the public. Visit our new site today!

 

Joint Commission Statement on Universal Masking of Staff, Patients, and Visitors in Health Care Settings

April 24, 2020

The Joint Commission supports the Centers for Disease Control and Prevention’s (CDC) revised infection prevention and control recommendations related to COVID-19. 

Issued on April 13, the CDC stated that to address asymptomatic and pre-symptomatic transmission , health care facilities should “implement source control for everyone entering a healthcare facility (e.g., healthcare personnel, patients, visitors), regardless of symptoms.” Source control involves having people wear a cloth face covering or face mask over their mouth and nose to contain their respiratory secretions — reducing the dispersion of droplets from an infected individual. This will decrease the possibility that anyone with unrecognized COVID-19 infection will expose others and will allow organizations to forgo contact tracing if a case is identified. For source control to be effective, it requires that everyone wear a mask within health care buildings to prevent droplet and (to a lesser degree) aerosol spread of respiratory viruses, such as COVID-19. 

The Joint Commission believes that universal masking within health care settings is a critical tool to protect staff and patients from being infected by asymptomatic and pre-symptomatic individuals and should be implemented in any community where coronavirus is occurring. Even a single case of community spread of COVID-19 means that health care facilities and staff are at risk because other asymptomatic and pre-symptomatic patients may come in for care and inadvertently infect staff. 

 

CMS Releases Toolkit To Navigate State Workforce Flexibility

April 22, 2020

The Centers for Medicare & Medicaid Services (CMS) and the Assistant Secretary of Preparedness and Response (ASPR) released a new toolkit to help state and local healthcare decision makers maximize workforce flexibilities when confronting 2019 Novel Coronavirus (COVID-19) in their communities. This toolkit includes a full suite of available resources to maximize responsiveness based on state and local needs, building on President Trump’s commitment to a COVID-19 response that is locally executed, state managed, and federally supported. This work was developed by the Healthcare Resilience Task Force as part of the unified government’s response to COVID-19.

COVID-19 Workforce Virtual Toolkit: Resources for Healthcare Decision-Makers Responding to COVID-19 Workforce Concerns

 
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