Federal 100% Cost Share for COVID-19 Expenses Extended

The Federal Emergency Management Agency (FEMA) in February 2021 increased federal funding for COVID-19 pandemic expenses from 75% to 100%, retroactive to the beginning of the pandemic in January 2020. The agency has now extended the COVID-19 federal 100% cost share for an additional three months, from April 1 to July 1, 2022.

This extension allows FEMA to pay 100% federal funding for the costs of eligible COVID-19 expenses, which include COVID-19-related medical care, vaccination and testing efforts. Absent an additional extension from the Biden administration, the federal cost share will reduce to 90% after July 1.

Members with questions on the FEMA cost share extension may contact Renée Smiddy at the MHA.

FEMA Updates Interim Policy on Eligible Public Assistance Federal Cost Sharing

The Federal Emergency Management Agency (FEMA) has issued a new interim policy, Coronavirus (COVID-19) Pandemic: Safe Opening and Operation Work Eligible for Public Assistance. This interim policy supersedes version 1 that was published April 5, 2021.

This updated policy retroactively amends the applicable time period of eligibility to the beginning of the incident period of Jan. 20, 2020, and specifies that work conducted from the beginning of the incident period to Dec. 31, 2021, will be reimbursed at a federal cost share of 100 percent. Work conducted after Dec. 31, 2021, will be subject to the cost share established at that time.

This version of the interim policy maintains the same scope of work as Version 1, which includes COVID-19 diagnostic testing, purchase and distribution of face masks, cleaning and disinfection, screening and temperature scanning, and installation of temporary physical barriers and signage to support social distancing.

Member with questions on the interim policy may contact Renee Smiddy at the MHA.

FEMA Public Assistance Grant Agreements Updated, Applicant Trainings Planned

Hospitals and other organizations that have applied for Public Assistance (PA) from the Federal Emergency Management Agency (FEMA) will need to obtain updated grant agreements that reflect 100% federal reimbursement, updated from the previous agreements indicating 75% federal reimbursement and 25% local cost share. The Michigan State Police Emergency Management and Homeland Security Division is updating grant agreements for current grantees and will distribute final agreements as soon as possible. The division is currently experiencing a high volume of applicants due to the Wayne County floods and ongoing COVID-19 pandemic.

Any hospital that is seeking FEMA PA and has not attended a training is encouraged to join one of the upcoming trainings outlined on the state’s website. Any potential PA applicant must register at the FEMA Grants Portal and attend a virtual applicant training to be eligible for FEMA PA funds. The first round of PA applicant trainings was held in May 2020, and those who attended one of those sessions have satisfied their training requirement. However, some information may have been updated and hospitals may benefit from attending an upcoming training.

Members with questions should contact Renée Smiddy at the MHA.

FEMA Updates COVID-19 Interim Policy on Medical Care Eligible for Public Assistance

The Federal Emergency Management Agency (FEMA) has updated the COVID-19 Interim Policy on Medical Care Eligible for Public Assistance (PA). This interim policy is applicable only to eligible PA applicants and defines the requirements for determining eligibility of medical care work and costs under the PA program. This updated interim policy supersedes the May 9, 2020, policy. Highlights from the updated interim policy include:

  1. Federal Cost Share Increased to 100%, retroactive to Jan. 20, 2020, continuing through Sept. 30, 2021.
  2. FEMA requires PA funding to focus on the highest risk communities and underserved populations as determined by established social and economic disadvantage measures (e.g., the Centers for Disease Control and Prevention Social Vulnerability Index). Subrecipients must prioritize resources to ensure an equitable pandemic response and failure to comply may result in funding reductions. Prioritization of resources must be documented to ensure pandemic response and recovery efforts are conducted equitably.
  3. New eligibility of costs associated with COVID-19 vaccination. FEMA notes that, while the federal government provides the vaccine at no cost, there may be additional costs eligible for PA funding to support vaccine distribution and administration. COVID-19 vaccination eligible work and costs include:
    1. Community vaccination centers.
    2. Personal protective equipment, other equipment and supplies required for storing, handling, distributing/transporting and administrating COVID-19 vaccines.
    3. Facility support costs, including leases, utilities, maintenance and security.
    4. Additional staff, including medical and support staff not paid by another funding source.
    5. On-site infection control measures and emergency medical care for COVID-19 vaccination sites.
    6. Resources to support mobile COVID-19 vaccination in remote areas.
    7. Vaccine-related costs incurred by Federally Qualified Health Centers, Rural Health Clinics and Critical Access Hospitals that are not covered by another funding source.
    8. Communications to disseminate public information regarding vaccinations.
    9. Information technology equipment and systems for patient registration and tracking, vaccine-related inventory management, and/or analytics and reporting needs.
    10. Training and technical assistance on proper storage, handling, distribution and administration of COVID-19 vaccinations.
    11. Vaccination administration consistent with equitable pandemic response and recovery.

Members with questions should contact Renée Smiddy at the MHA

Combating the Novel Coronavirus (COVID-19): Week of March 8

MHA Covid-19 update

MHA COVID-19 UpdateThe president signed the American Rescue Plan March 11, establishing as law the latest legislation to address the many areas of loss the country has suffered due to the COVID-19 pandemic. It includes $8.5 billion in funding for eligible rural healthcare providers to offset expenses and lost revenues attributable to the pandemic (see related article). The MHA continues to keep members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

Mass Vaccination Site to Open at Ford Field as Vaccination Eligibility Expands

In a March 11 address, President Joe Biden instructed states to open vaccine eligibility to all adults no later than May 1. The federal government expects a significant increase in vaccine doses in the coming weeks and will make a website available to help anyone find a vaccine appointment near them.

In response to the president’s directive, Gov. Gretchen Whitmer announced that Michigan will open eligibility to adults ages 16 through 49 with certain preexisting conditions March 22 and to any adults 16 and older April 5. This is in addition to all adults ages 50 through 64 becoming eligible March 22. This news is reflected in the state’s official Prioritization Guidance document posted on its vaccine webpage. Officials expect weekly allocations to continue to increase to help meet the increased demand. The MHA will keep members apprised of any additional information relating to the expanded eligibility.

Members are encouraged to prepare for increased calls and website traffic as vaccine eligibility broadens and to provide their communities with details on who they will be able to vaccinate and how to make appointments.

The governor also announced that a mass vaccination site will open March 24 at Ford Field in Detroit. It will have the capacity to administer 6,000 vaccine doses each day to serve residents in the broader southeast Michigan region. The Biden administration, in partnership with the Federal Emergency Management Agency (FEMA), selected southeast Michigan for this major new community vaccination site.

The site, which was selected according to the Centers for Disease Control and Prevention’s priority tool to help those hardest hit and most vulnerable, will operate from 8 a.m. to 8:30 p.m., seven days a week, for eight weeks under the federal government’s vaccination pilot program. The facility will be managed by the state of Michigan with support from FEMA, Wayne County, the City of Detroit, Ford Field, Meijer, Henry Ford Health System and the Detroit Lions.

Federal efforts under development also include a Centers for Disease Control and Prevention (CDC) “equity index” that will rank states based on equity of access/administration of the vaccine in addition to the existing rankings that are based on doses given, speed, etc.

In addition, the CDC will be sending allocations directly to a list of federally qualified health centers across the nation, including those in the Michigan cities of Inkster, Pontiac, Brimley, Gladwin, Flint, Saginaw, Cassopolis, Kalamazoo, Centreville, Ann Arbor and Detroit.

CDC Issues COVID-19 Recommendations for Fully Vaccinated People

The CDC issued new recommendations March 8 for individuals who have been fully vaccinated against COVID-19. The agency considers people to be fully vaccinated two weeks after their second dose of the Pfizer and Moderna vaccines or two weeks after Johnson & Johnson’s Janssen single-dose vaccine.

The recommendations state that those meeting the full vaccination parameters may gather indoors with other fully vaccinated individuals without wearing a mask. In addition, they can gather indoors with unvaccinated people from one other household without masks, unless any of those people or anyone they live with has an increased risk for severe illness from COVID-19.

Fully vaccinated individuals who have been near someone who has the disease are no longer asked to avoid others or get tested unless they have symptoms. However, vaccinated people who live in a group setting and have been in contact with someone who has COVID-19 should quarantine for 14 days and get tested, even if they don’t have symptoms.

Because authorities do not yet know the extent to which vaccines mitigate the transmission of COVID-19, the CDC continues to recommend precautions that include wearing a mask, staying at least six feet apart from others, and avoiding crowds and poorly ventilated spaces. Anyone who has symptoms of COVID-19 should be tested and stay away from others.

The MHA will keep members apprised of any changes in these recommendations. Questions on the COVID-19 vaccine may be directed to Ruthanne Sudderth at the MHA.

COVID-19 Variants in Michigan More Transmissible than Original Virus

The Michigan Department of Health and Human Services (MDHHS) Bureau of Laboratories identified on March 8 the first Michigan case of the COVID-19 variant B.1.351 in a male child living in Jackson County. Case investigation is underway to determine close contacts and whether additional cases are associated with this case.

Cases caused by this variant, which originated in South Africa, were first reported in the United States at the end of January. It is believed to be more contagious, but there has been no indication that it affects the clinical outcomes or disease severity compared to the SARS-CoV-2 virus that has been circulating across the United States for the past year. Scientists are evaluating how well COVID-19 vaccines work against this newer variant, which has been identified in at least 20 other states and jurisdictions in the U.S.

The MDHHS has also provided information about the characteristics of the B.1.1.7 variant that was first discovered in the United Kingdom. This variant has now been identified in multiple Michigan communities after having first been detected in an isolate from a Washtenaw County case Jan. 16. It is approximately 50 percent more transmissible, leading to faster spread of the virus and potentially increasing numbers of cases, hospitalizations and deaths. Members should refer to the MHA’s COVID-19 alert sent Friday, March 12, for details and recommendations on managing variants.

The MHA and the MDHHS are closely monitoring case numbers, positivity rates and hospitalizations. The association will keep members apprised of any concerning data trends related to the variants. Members with data questions may contact Jim Lee at the MHA.

New Regulatory Flexibility Approved for Sharps Containers

The Department of Environment, Great Lakes, and Energy March 9 approved an MHA request to provide regulatory flexibility for hospitals facing a shortage of sharps disposal containers. State regulation currently requires hospitals to replace sharps containers every 90 days or when full, whichever is sooner. Through July 31, 2021, hospitals will now be exempt from the 90-day rule, meaning sharps containers will only be required to be replaced when full. The shortage is due to a production facility fire and increasing demand for the containers due to vaccinations; some MHA members had already received similar exemptions. The MHA will work with state government if additional flexibility is needed. Members with questions may contact Sean Sorenson-Abbott at the MHA.

State Provides Vaccine Communication and Administration Materials

A variety of vaccine materials are available for hospitals and other providers on the MDHHS Provider and Partner webpages for communication and administration purposes. These include toolkits for communicating with patients and communities regarding the safety and effectiveness of the vaccines, which are in the “COVID-19 Vaccine Communication Materials” section of the Partner page; Johnson & Johnson materials, including a Standing Order form for this vaccine; and more.

MDHHS Announces 22 Awardees in State’s Vaccine Pilot Program

The MDHHS and the Protect Michigan Commission have awarded 35,800 doses of COVID-19 vaccine to 22 pilot projects to help enhance the state’s vaccine equity strategy. Three of the awards went to Henry Ford Health System, MidMichigan Health and Schoolcraft Memorial Hospital, and the remainder went to health departments, community-based clinics, agencies on aging and other vaccinators.

The pilot program is designed to help remove barriers to vaccine access for Michiganders ages 60 and older who live in communities with a high Social Vulnerability Index (SVI) and high COVID-19 mortality rates. Participating providers that have additional capacity in their projects may expand vaccination to include people ages 50-59 with disabilities or underlying conditions. The awardees were chosen from more than 70 applications. Additional details on the program are available in the MDHHS news release.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC).