Federal Agency Programs & Action Overview
U.S. Department of Health & Human Services (HHS)
· The Department of Health and Human Services is committed to providing as much information as possible to prepare communities for response to COVID-19. The Department, through the Centers for Disease Control and Prevention, the Food and Drug Administration, and other agencies, continuously provide guidance to healthcare providers, laboratories, communities, and state and local officials for dealing with suspected or confirmed cases of COVID-19. The most up-to-date information can be found at www.coronavirus.gov and https://www.cdc.gov/coronavirus/2019-nCoV/index.html
· Guidance
· CMS released two telehealth toolkits today to help practitioners understand the broadened access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their doctors without having to travel to a healthcare facility. Under this new waiver, Medicare can pay for office, hospital, and other visits furnished via telehealth across the country and including in patient’s places of residence starting March 6, 2020. A range of providers, such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers, will be able to offer telehealth to their patients.
General Practinoner Toolkit
ESRD Toolkit
· CDC released interim guidance to help prevent workplace exposures to acute respiratory illnesses, including COVID-19, in non-healthcare settings. The guidance also provides planning considerations if there are more widespread, community outbreaks of COVID-19. Interim Guidance
· FDA issued a new policy that allows for expanded use of devices to monitor patients’ vital signs remotely. The devices include those that measure body temperature, respiratory rate, heart rate and blood pressure. Guidance
· CMS released recommendations to delay non-essential procedures in an effort to preserve personal protective equipment (PPE), beds, and ventilators for facilities as well as to free up health care workers to treat patients with COVID-19. The recommendations provide a framework for hospitals and clinicians to implement immediately to determine and identify non-essential and elective procedures. Recommendations and Guidelines
· CDC released PPE guidance that will provide guidance in PPE shortages, particularly for long-term care facilities, dialysis, and home health providers. The strategies include information specific to eye protection, isolation gowns, facemasks, and N95 respirators. More Information
· CDC’s Prepare to Care for COVID-19 is a resource with practical tools clinicians can use to care for patients with COVID-19, and will be regularly updated to help clinicians adapt as the outbreak unfolds. More Information
· CDC released guidance for responding to Coronavirus Disease 2019 (COVID-19) among people experiencing unsheltered homelessness. More Information
· The President’s emergency declaration gives HHS important powers to enhance state and local communities’ ability to respond to the outbreak, including flexibility around Medicare and Medicaid rules.
· Flexibility and Relief for State Medicaid Agencies: The national emergency declaration also enables CMS to grant state and territorial Medicaid agencies a wider range of flexibilities under section 1135 waivers. States and territories are now encouraged to assess their needs and request these available flexibilities, which are outlined in the Medicaid and CHIP Disaster Response Toolkit. Examples of flexibilities available to states under section 1135 waivers include the ability to permit out-of-state providers to render services, temporarily suspend certain provider enrollment and revalidation requirements to promote access to care, allow providers to provide care in alternative settings, waive prior authorization requirements, and temporarily suspend certain pre-admission and annual screenings for nursing home residents. To date, two states, Florida and Washington, have received approval for their waivers. For more information and to access the toolkit, visit here.
· Waivers and Flexibilities for Hospitals and other Healthcare Facilities: CMS will temporarily waive or modify certain Medicare, Medicaid, and CHIP requirements. CMS will also issue several blanket waivers, listed on the website below, and the CMS Regional Offices will review other provider-specific requests. These waivers provide continued access to care for beneficiaries. More information on the waivers CMS has granted
· Centers for Medicare & Medicaid Services (CMS) Guidance: CMS released updated FAQs that address issues raised by states over the prior few days. The document includes answers to questions related to the flexibilities CMS is affording to states in managed care, benefits, financing, 1115 demonstrations, and leveraging “1135” waivers offered as part of the President’s declaration of a national emergency. States may submit questions to CMS through their state leads. FAQs
· Centers for Medicare & Medicaid Services (CMS) Nursing Home Guidance: As you know, nursing homes and their residents are vulnerable populations for COVID-19. This week, CMS released updated guidance for infection control and p revention of COVID-19 in Nursing Homes which can be found here (3/9). The Press Release can be found here and all CMS guidance related to COVID-19 can be found here.
· Expanded Telehealth Coverage (3/17): The Trump Administration announced expanded Medicare telehealth coverage that will enable beneficiaries to receive a wider range of healthcare services from their doctors without having to t ravel to a healthcare facility. More Information
· The CDC has been actively working to address the need for testing across the country. More information about testing. We encourage review of the Updated Guidance on Evaluating and Testing Persons for Coronavirus Disease 2019, as well as the recently updated the FAQ website for laboratories to determine best practices for testing.
· The U.S. Public Health Service Commissioned Corps has deployed hundreds of officers to help with this response. As America’s Health Responders, the Commissioned Corps is currently very involved in assisting the CDC with airport screenings, deploying staff to support hospitals, among other important missions. More about Commissioned Corps Activities
· Part of preparedness includes a robust blood supply. The current situation around COVID-19 heightens the need for a ready blood supply, please encourage your health community members to keep their appointments to donate blood.
U.S. Small Business Administration (SBA)
· The U.S. Small Business Administration has approved all states and territories for low-interest federal disaster loans for working capital to small businesses suffering substantial economic injury as a result of the Coronavirus (COVID-19).
· Any such Economic Injury Disaster Loan assistance declaration issued by the SBA makes loans available statewide to small businesses and private, non-profit organizations to help alleviate economic injury caused by the Coronavirus (COVID-19).
· SBA’s Office of Disaster Assistance will coordinate with the state’s or territory’s Governor to submit the request for Economic Injury Disaster Loan assistance.
· Once a declaration is made, the information on the application process for Economic Injury Disaster Loan assistance will be made available to affected small businesses within the state.
· These loans may be used to pay fixed debts, payroll, accounts payable and other bills that can’t be paid because of the disaster’s impact. The interest rate is 3.75% for small businesses. The interest rate for non-profits is 2.75%.
· SBA offers loans with long-term repayments in order to keep payments affordable, up to a maximum of 30 years. Terms are determined on a case-by-case basis, based upon each borrower’s ability to repay.
· SBA’s Economic Injury Disaster Loans are just one piece of the expanded focus of the federal government’s coordinated response, and the SBA is strongly committed to providing the most effective and customer-focused response possible.
· SBA announced the option to defer payment on previous disaster loans until December 2020.
· For additional information, please visit the SBA disaster assistance website at http://sba.gov/Disaster.
U.S. Department of Education (DoED)
· The Department of Education has established a dedicated Coronavirus webpage, which includes resources for institutions of higher education and for K-12.
· The website includes guidance for students at institutions of higher education, and covers Coronavirus-related scenarios that could impact students who are enrolled in study abroad programs, students who meet full-time requirements but fall below 12 credit hours, students who are quarantined and miss class, campuses that have temporarily stopped offering ground-based classes to prevent the spread of Coronavirus, and foreign schools that serve Americans who receive Federal financial aid. Also see a letter from the Office for Civil Rights that addresses potential discrimination associated with coronavirus.
· On Friday, March 20, the Department of Education announced the suspension of federal student loan payments and waiving interest during the national emergency. All borrowers with federally held student loans will automatically have their interest rates set to 0% for a period of at least 60 days. In addition, each o f these borrowers will have the option to suspend their payments for at least two months to allow them greater flexibility during the national emergency. More here.
· The Department has provided additional information for families and communities including:
· Information regarding certain flexibilities under the Every Student Succeeds Act, or “ESSA;” (more here)
· Information regarding services to children with disabilities; (more here)
· A fact sheet from the Office for Civil Rights on the risk of Coronavirus in schools while protecting the civil rights of students; and a short webinar on Online Education and Website Accessibility;
· Information on the Family Education Records Privacy Act, or “FERPA,” as it pertains to K-12 and higher education students (more here);
· Information for Accrediting Agencies Regarding Temporary Flexibilities Provided to Coronavirus Impacted Institutions or Accrediting Agencies (more here);
· Guidance and resources for educating students with disabilities (more here).
· The Department will continue to update its website, ed.gov/coronavirus. Please direct education related questions to COVID-19@ed.gov.
U.S. Department of Transportation (DOT)
· The U.S. Department of Transportation, in its important supporting role, has and will continue to coordinate with transportation stakeholders, foreign counterparts and other federal agencies to manage the risk in the United States.
· The U.S. government’s travel restrictions and advisories have been a remarkably effective ‘first layer’ of containment. These travel requirements delayed the arrival of the virus to the United States, giving the nation precious time to prepare further measures, and plan for mitigation. This achievement took the cooperation of nearly 200 commercial airlines, a like number of overseas airports, and the Civil Aviation Authority of China.
· DOT continues to ensure: an active air bridge remains in place for the safe return of Americans from affected areas; airlines are funneling passenger flights to one of the eleven designated U.S. airports equipped to health-screen Americans returning from affected areas; continued air and sea cargo traffic between the US and China; health protocols are established to protect the crews of aircraft continuing to fly between the US and foreign locations; and, dissemination of health messages about the virus, for airlines to use to inform their passengers.
· External Stakeholder outreach is being actively conducted throughout the modes of transportation in DOT. DOT has already hosted calls with stakeholders for the Federal Aviation Administration, Federal Transit Authority, Federal Motor Carrier Safety Adminis tration, and others. Additional calls are scheduled for outreach to additional stakeholders in all surface transportation, maritime, and labor.
· On March 13, USDOT issued a national emergency declaration to provide hours-of-service regulatory relief to commercial vehicle drivers transporting emergency relief to the nationwide COVID-19 outbreak. The declaration does not cover routine commercial deliveries, or transportation of mixed loads of essential supplies and/or persons and goods or persons not related to emergency needs. Effective immediately, the declaration will remain in effect for the duration of the emergency or until 11:59 P.M. (ET), April 11, 2020, whichever occurs sooner. Learn more here.
U.S. Department of Labor (DOL)
· The Occupational Safety and Health Administration (OSHA) developed COVID-19 planning guidance for employers to implement engineering, administrative, and work practice controls and personal protective equipment (PPE). The guidance is intended for planning purposes – employers and workers should use the planning guidance to help identify risk levels in workplace settings and to determine any appropriate control measures to implement.
· DOL announced new guidance outlining flexibilities that States have in administering their unemployment (UI) programs to assist Americans affected by the COVID-19 outbreak. Under the guidance, federal law permits significant flexibility for states to amend their laws to provide UI benefits in multiple scenarios related to COVID-19. Learn more here.
· On March 14, DOL issued new temporary enforcement guidance for respirator fit-testing in healthcare during the COVID-19 outbreak. The temporary guidance is aimed at ensuring healthcare workers have full access to needed N95 respiratory protection. OSHA recommends that employers supply healthcare personnel who provide direct care to patients with known or suspected coronavirus with other respirators that provide equal or higher protection, such as N99 or N100 filtering facepieces, reusable elastomeric respirators with appropriate filters or cartridges, or powered air purifying respirators. Learn more here.
· The Department of Health and Human Services is committed to providing as much information as possible to prepare communities for response to COVID-19. The Department, through the Centers for Disease Control and Prevention, the Food and Drug Administration, and other agencies, continuously provide guidance to healthcare providers, laboratories, communities, and state and local officials for dealing with suspected or confirmed cases of COVID-19. The most up-to-date information can be found at www.coronavirus.gov and https://www.cdc.gov/coronavirus/2019-nCoV/index.html
· Guidance
· CMS released two telehealth toolkits today to help practitioners understand the broadened access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their doctors without having to travel to a healthcare facility. Under this new waiver, Medicare can pay for office, hospital, and other visits furnished via telehealth across the country and including in patient’s places of residence starting March 6, 2020. A range of providers, such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers, will be able to offer telehealth to their patients.
General Practinoner Toolkit
ESRD Toolkit
· CDC released interim guidance to help prevent workplace exposures to acute respiratory illnesses, including COVID-19, in non-healthcare settings. The guidance also provides planning considerations if there are more widespread, community outbreaks of COVID-19. Interim Guidance
· FDA issued a new policy that allows for expanded use of devices to monitor patients’ vital signs remotely. The devices include those that measure body temperature, respiratory rate, heart rate and blood pressure. Guidance
· CMS released recommendations to delay non-essential procedures in an effort to preserve personal protective equipment (PPE), beds, and ventilators for facilities as well as to free up health care workers to treat patients with COVID-19. The recommendations provide a framework for hospitals and clinicians to implement immediately to determine and identify non-essential and elective procedures. Recommendations and Guidelines
· CDC released PPE guidance that will provide guidance in PPE shortages, particularly for long-term care facilities, dialysis, and home health providers. The strategies include information specific to eye protection, isolation gowns, facemasks, and N95 respirators. More Information
· CDC’s Prepare to Care for COVID-19 is a resource with practical tools clinicians can use to care for patients with COVID-19, and will be regularly updated to help clinicians adapt as the outbreak unfolds. More Information
· CDC released guidance for responding to Coronavirus Disease 2019 (COVID-19) among people experiencing unsheltered homelessness. More Information
· The President’s emergency declaration gives HHS important powers to enhance state and local communities’ ability to respond to the outbreak, including flexibility around Medicare and Medicaid rules.
· Flexibility and Relief for State Medicaid Agencies: The national emergency declaration also enables CMS to grant state and territorial Medicaid agencies a wider range of flexibilities under section 1135 waivers. States and territories are now encouraged to assess their needs and request these available flexibilities, which are outlined in the Medicaid and CHIP Disaster Response Toolkit. Examples of flexibilities available to states under section 1135 waivers include the ability to permit out-of-state providers to render services, temporarily suspend certain provider enrollment and revalidation requirements to promote access to care, allow providers to provide care in alternative settings, waive prior authorization requirements, and temporarily suspend certain pre-admission and annual screenings for nursing home residents. To date, two states, Florida and Washington, have received approval for their waivers. For more information and to access the toolkit, visit here.
· Waivers and Flexibilities for Hospitals and other Healthcare Facilities: CMS will temporarily waive or modify certain Medicare, Medicaid, and CHIP requirements. CMS will also issue several blanket waivers, listed on the website below, and the CMS Regional Offices will review other provider-specific requests. These waivers provide continued access to care for beneficiaries. More information on the waivers CMS has granted
· Centers for Medicare & Medicaid Services (CMS) Guidance: CMS released updated FAQs that address issues raised by states over the prior few days. The document includes answers to questions related to the flexibilities CMS is affording to states in managed care, benefits, financing, 1115 demonstrations, and leveraging “1135” waivers offered as part of the President’s declaration of a national emergency. States may submit questions to CMS through their state leads. FAQs
· Centers for Medicare & Medicaid Services (CMS) Nursing Home Guidance: As you know, nursing homes and their residents are vulnerable populations for COVID-19. This week, CMS released updated guidance for infection control and p revention of COVID-19 in Nursing Homes which can be found here (3/9). The Press Release can be found here and all CMS guidance related to COVID-19 can be found here.
· Expanded Telehealth Coverage (3/17): The Trump Administration announced expanded Medicare telehealth coverage that will enable beneficiaries to receive a wider range of healthcare services from their doctors without having to t ravel to a healthcare facility. More Information
· The CDC has been actively working to address the need for testing across the country. More information about testing. We encourage review of the Updated Guidance on Evaluating and Testing Persons for Coronavirus Disease 2019, as well as the recently updated the FAQ website for laboratories to determine best practices for testing.
· The U.S. Public Health Service Commissioned Corps has deployed hundreds of officers to help with this response. As America’s Health Responders, the Commissioned Corps is currently very involved in assisting the CDC with airport screenings, deploying staff to support hospitals, among other important missions. More about Commissioned Corps Activities
· Part of preparedness includes a robust blood supply. The current situation around COVID-19 heightens the need for a ready blood supply, please encourage your health community members to keep their appointments to donate blood.
U.S. Small Business Administration (SBA)
· The U.S. Small Business Administration has approved all states and territories for low-interest federal disaster loans for working capital to small businesses suffering substantial economic injury as a result of the Coronavirus (COVID-19).
· Any such Economic Injury Disaster Loan assistance declaration issued by the SBA makes loans available statewide to small businesses and private, non-profit organizations to help alleviate economic injury caused by the Coronavirus (COVID-19).
· SBA’s Office of Disaster Assistance will coordinate with the state’s or territory’s Governor to submit the request for Economic Injury Disaster Loan assistance.
· Once a declaration is made, the information on the application process for Economic Injury Disaster Loan assistance will be made available to affected small businesses within the state.
· These loans may be used to pay fixed debts, payroll, accounts payable and other bills that can’t be paid because of the disaster’s impact. The interest rate is 3.75% for small businesses. The interest rate for non-profits is 2.75%.
· SBA offers loans with long-term repayments in order to keep payments affordable, up to a maximum of 30 years. Terms are determined on a case-by-case basis, based upon each borrower’s ability to repay.
· SBA’s Economic Injury Disaster Loans are just one piece of the expanded focus of the federal government’s coordinated response, and the SBA is strongly committed to providing the most effective and customer-focused response possible.
· SBA announced the option to defer payment on previous disaster loans until December 2020.
· For additional information, please visit the SBA disaster assistance website at http://sba.gov/Disaster.
U.S. Department of Education (DoED)
· The Department of Education has established a dedicated Coronavirus webpage, which includes resources for institutions of higher education and for K-12.
· The website includes guidance for students at institutions of higher education, and covers Coronavirus-related scenarios that could impact students who are enrolled in study abroad programs, students who meet full-time requirements but fall below 12 credit hours, students who are quarantined and miss class, campuses that have temporarily stopped offering ground-based classes to prevent the spread of Coronavirus, and foreign schools that serve Americans who receive Federal financial aid. Also see a letter from the Office for Civil Rights that addresses potential discrimination associated with coronavirus.
· On Friday, March 20, the Department of Education announced the suspension of federal student loan payments and waiving interest during the national emergency. All borrowers with federally held student loans will automatically have their interest rates set to 0% for a period of at least 60 days. In addition, each o f these borrowers will have the option to suspend their payments for at least two months to allow them greater flexibility during the national emergency. More here.
· The Department has provided additional information for families and communities including:
· Information regarding certain flexibilities under the Every Student Succeeds Act, or “ESSA;” (more here)
· Information regarding services to children with disabilities; (more here)
· A fact sheet from the Office for Civil Rights on the risk of Coronavirus in schools while protecting the civil rights of students; and a short webinar on Online Education and Website Accessibility;
· Information on the Family Education Records Privacy Act, or “FERPA,” as it pertains to K-12 and higher education students (more here);
· Information for Accrediting Agencies Regarding Temporary Flexibilities Provided to Coronavirus Impacted Institutions or Accrediting Agencies (more here);
· Guidance and resources for educating students with disabilities (more here).
· The Department will continue to update its website, ed.gov/coronavirus. Please direct education related questions to COVID-19@ed.gov.
U.S. Department of Transportation (DOT)
· The U.S. Department of Transportation, in its important supporting role, has and will continue to coordinate with transportation stakeholders, foreign counterparts and other federal agencies to manage the risk in the United States.
· The U.S. government’s travel restrictions and advisories have been a remarkably effective ‘first layer’ of containment. These travel requirements delayed the arrival of the virus to the United States, giving the nation precious time to prepare further measures, and plan for mitigation. This achievement took the cooperation of nearly 200 commercial airlines, a like number of overseas airports, and the Civil Aviation Authority of China.
· DOT continues to ensure: an active air bridge remains in place for the safe return of Americans from affected areas; airlines are funneling passenger flights to one of the eleven designated U.S. airports equipped to health-screen Americans returning from affected areas; continued air and sea cargo traffic between the US and China; health protocols are established to protect the crews of aircraft continuing to fly between the US and foreign locations; and, dissemination of health messages about the virus, for airlines to use to inform their passengers.
· External Stakeholder outreach is being actively conducted throughout the modes of transportation in DOT. DOT has already hosted calls with stakeholders for the Federal Aviation Administration, Federal Transit Authority, Federal Motor Carrier Safety Adminis tration, and others. Additional calls are scheduled for outreach to additional stakeholders in all surface transportation, maritime, and labor.
· On March 13, USDOT issued a national emergency declaration to provide hours-of-service regulatory relief to commercial vehicle drivers transporting emergency relief to the nationwide COVID-19 outbreak. The declaration does not cover routine commercial deliveries, or transportation of mixed loads of essential supplies and/or persons and goods or persons not related to emergency needs. Effective immediately, the declaration will remain in effect for the duration of the emergency or until 11:59 P.M. (ET), April 11, 2020, whichever occurs sooner. Learn more here.
U.S. Department of Labor (DOL)
· The Occupational Safety and Health Administration (OSHA) developed COVID-19 planning guidance for employers to implement engineering, administrative, and work practice controls and personal protective equipment (PPE). The guidance is intended for planning purposes – employers and workers should use the planning guidance to help identify risk levels in workplace settings and to determine any appropriate control measures to implement.
· DOL announced new guidance outlining flexibilities that States have in administering their unemployment (UI) programs to assist Americans affected by the COVID-19 outbreak. Under the guidance, federal law permits significant flexibility for states to amend their laws to provide UI benefits in multiple scenarios related to COVID-19. Learn more here.
· On March 14, DOL issued new temporary enforcement guidance for respirator fit-testing in healthcare during the COVID-19 outbreak. The temporary guidance is aimed at ensuring healthcare workers have full access to needed N95 respiratory protection. OSHA recommends that employers supply healthcare personnel who provide direct care to patients with known or suspected coronavirus with other respirators that provide equal or higher protection, such as N99 or N100 filtering facepieces, reusable elastomeric respirators with appropriate filters or cartridges, or powered air purifying respirators. Learn more here.