Governor Inslee Ending Healthcare Related COVID Proclamations Effective October 27th

Governor Inslee Ending Healthcare Related COVID Proclamations Effective October 27th

On Friday, Governor Inslee announced he is rescinding 12 healthcare related COVID proclamations. Governor Inslee stated there would be 90 days before they are rescinded to allow for a smooth transition. The effective date will be October 27th. The following are the long-term care proclamations that will be going away.  

  • Proclamation 20-52 Statewide Proclamations Relating to Long-Term Care.
    This proclamation included 20-06, 20-10, 20-16, 20-17, 20-18. Which essentially restricted all visitors’ access in long-term care.  
  • Proclamation 20-32 Department of Health– Health Care Workers.

This proclamation waived the training and requirements for NACs, continuing education for HCAs, and licensing requirements for licensed nurses.  The Nursing Commission, Department of Health (DOH), and Residential Care Services (RCS) are working collaboratively on mass testing for nursing assistants. There are 18 community colleges participating in this testing, regionally located. We are also still seeking a federal solution requesting that CMS extend these waivers that govern skilled nursing facilities. If that effort is successful, the State WACs must also be extended through an emergency rule. RCS is also working on emergency rules to extend the time needed to successful test and obtain certification.  These rules will apply to NARs working in assisted living, adult family homes, and home care providing a glide path to certification. More information to follow.  

  • Proclamation 20-65 Long Term Care – Workers, Facilities, and Resources
    This proclamation suspended requirements for the construction of a new health care facility and requirements for the certificate of need review related to any expenditure for the construction, renovation, or alteration of a nursing home.  
  • Proclamation 20-66 Long-Term Care – Operations and Visitation
    This proclamation required LTCF to follow the LTC COVID Response Plan (also known as the Safe Start Plan) as well as recommendations from CDC, DOH, and the State Board of Health.  The COVID Response Plan will also terminate on October 27th, the effective date of the rescission of the waivers.

Many of the things waived in these proclamations are already covered by emergency rules prepared for the eventual termination of the public health emergency and repeal of the proclamations. State agencies will be getting more detailed information out to providers soon.  

Now, for the 10-million-dollar question, will face masks and eye protection go away when the COVID Response Plan ends?  According to Residential Care Services, face masks and eye protection during resident care will continue to be required through CDC for nursing homes.  For the NH program, F880 does require the SNF/NF to follow national standards.  This is recognized to mean CDC standards, so anything recommended by CDC will still apply to the NH program – including any recommendations for masking or eye protection.  As for AL and other settings, we are unclear how DOSH will interpret and apply the CDC recommendations and we will provide further information on this as soon as we obtain clarification.

On Friday, the Governor also announced that several initiatives will be implemented or continue to help alleviate hospital capacity that is over 100% in some cases and in recognition that LTC is facing the same workforce challenges as hospitals.  These include: 

  • Extend statewide rapid response teams through March 2023. These teams have been supporting our long term care systems for many months, but were scheduled to end this summer. Through our and partner advocacy efforts, DSHS will maintain 56 contracted staff state-wide through March 2023 to ensure long term care facilities have the capacity to accept transitions from acute care hospitals and support staffing as needed and able to satisfy requests. 
  • Mass certification examinations for long term care staff. We have asked DSHS and the Nursing Commission to enter an interagency agreement to rapidly meet the need to examine and certify nursing assistants by setting up mass examination sites. Because of federal waivers during the pandemic, there is a backlog of long term care staff that need to become certified to continue practicing. These staff are critical to our State’s long term care system and ensuring they can get all of the necessary credentials supports additional capacity in the community. 
  • Difficult to discharge incentives. Health Care Authority will provide a one-time incentive per patient for long term care providers to accept patients from hospital inpatient settings. These incentives have been in place for some time and on average result in 100+ additional discharges per month. 
  • Support for Harborview bed readiness program with Rapid Response Teams. UW Medicine and Harborview have made extensive efforts to care for the patients that come through their doors, including creating a critical bed readiness program to support their patients awaiting discharge into post-acute care settings. The State will partner with Harborview to expand this program by up to 40 beds by providing staffing support to the program through rapid response team staff. 
  • Additional staff to support transition of patients in the Harborview bed readiness program. The State will also expand the rapid response teams by 25 staff to specifically support transitions of patients from the Harborview bed readiness program to the community. 
  • Incentives for transition of specialty care patients. For patients with serious medical care or behavioral needs, finding placement can be challenging because of the staff and supports needed to ensure quality care upon discharge. This incentive will provide $300 per day for 180 days for 50 people transitioning from specific hospitals into assisted living or nursing facilities. The State will also make use of its Community Services and Supports contract in order to address complex medical and behavioral needs. Incentives will be available to discharges to assisted living and skilled nursing facilities only. 

The State will be sending out further information as they finalize details on these initiatives, including the criteria for receiving some of these incentives.. It is important to note: This is NOT the end of the Public Heath Emergency. That date still has not been released. We will also share more details as we receive them

 

Questions?

Contact:

Laura Hofmann, MSN, RN – Director of Clinical and Nursing Facility Regulatory Services
c: 425-231-4804

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