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SDSMA COVID-19 Update
What you need to know
March 31, 2020

The South Dakota State Medical Association is providing an e-newsletter to members at the end of each business day containing pertinent and essential information from key relevant resources, including the latest from the state government in South Dakota.

Confirmed Cases


As of Tuesday, 108 cases of COVID-19 have been confirmed in South Dakota with one death, according to the South Dakota Department of Health.

Coronavirus Response in Pierre During Final Day of Legislative Session


Yesterday in what was to be veto day, the South Dakota legislature introduced and acted upon a number of bills in response to COVID-19.  Bills include:

HB 1295, An act to revise provisions regarding contagious disease control and enforcement and to declare an emergency.  As proposed, any person infected with, or is reasonably suspected of having severe acute respiratory syndrome coronavirus, which causes the disease known as COVID-19, is considered to present a health threat to others.  Such determination grants the department of health the authority to pursue action to isolate the person to prevent further spread.
 
Similar authority is granted to the department in cases of tuberculosis any middle east respiratory syndrome (MERS), severe acute respiratory syndrome 10 (SARS), smallpox, and viral hemorrhagic fevers.
 
HB 1298, An act to provide for the postponement of certain elections and to declare an emergency. With the passage of HB 1298 and notwithstanding any other provision of law, any election scheduled to be held from April 14, 2020, through May 26, 2020, shall be postponed in the interest of public health and safety. Any candidate deadline associated with the original election date shall remain in place. The members of the governing body of the political subdivision holding the election shall choose any Tuesday in June 2020 as the alternate election date. 
 
If the governing body of the political subdivision chooses to hold the election on the primary election date of June 2, 2020, the following provisions are required: 

  1. The combined election is subject to approval by the county commission of any county in which the political subdivision is located; 
  2. Any expense from a combined election shall be apportioned in a manner agreed upon by the governing body of the subdivision and the county commission of each county in which the political subdivision is located; and 
  3. Any other obligation arising under state law for either election shall be handled as agreed upon by the governing body of the subdivision and the county commission of each county in which the political subdivision is located. 

SB 91, An act to provide emergency authority to counties, community improvement districts, and municipalities in the event of a public health crisis and to declare an emergency. As proposed, SB 91 would have granted the governing body for each county may, by ordinance, provide for the declaration of a public health emergency within the county's jurisdiction outside the corporate limits of any municipality. The ordinance shall take effect immediately upon passage and shall be published in full either as part of the minutes or separately. SB 91 failed to pass both branches.
 
The legislature will come together for a special session in June to discuss the FY2021 budget and the allocation/use of forthcoming federal funds as a result of the CARES Act.

AMA Letter to Trump: Stronger Federal Leadership is Needed to Buy, Distribute PPE

 

The AMA is calling on President Trump for stronger federal leadership to address the shortage of PPE. Many physicians and hospitals report that they are only days away from exhausting their supplies of the PPE.

“We continue to hear that lack of federal coordination of acquisition and distribution of PPE has created a situation where this equipment finds its way not to the areas where it is needed most, but to the highest bidder,” AMA Executive Vice President and CEO James L. Madara, MD, wrote in a letter to President Donald Trump. “In some cases, that bidder is the federal government, which wields bargaining power that states simply cannot match. This system of procurement not only leaves critical shortage areas without adequate supply, but has resulted in significant increases over normal prices and growth in the gray market as desperate buyers will do anything they can to ensure supply for their front-line workers. We simply cannot stand by while our physicians, nurses, and other health care workers continually risk their own health and well-being to treat COVID-19 patients because their state or facility was outbid for critical protective equipment,” Dr. Madara added. “We cannot ask overburdened state and local health departments and health care facilities to take on additional burdens of sourcing and bidding on basic PPE.”

What’s needed right now, Dr. Madara wrote, is “strong federal leadership to ensure our dedicated health care workforce can be kept safe and can keep working to fight the spread of COVID-19.”

The AMA is urging the Trump administration to “take a stronger role to coordinate a national effort of acquisition and distribution of PPE, ensuring that critical PPE no longer goes to the highest bidder and areas in urgent need can protect essential health care workers." The administration also should “do everything in its power to ensure that facilities capable of manufacturing PPE are doing so at the maximum possible capacity.”

The AMA also lauded the president’s decision to heed the advice of his scientific experts to keep national physical distancing guidelines in place through April 30. Given the lack of a vaccine and widely available point-of-care testing, Dr. Madara wrote, those guidelines should be kept in place “for so long as needed to flatten the curve.” Prematurely relaxing the guidelines would prolong the “devastating impacts of this pandemic” on the nation’s health system and economy.

Federal Government Requesting All Hospitals Report Data on COVID-19 Testing


In what the Centers for Medicare & Medicaid Services is calling an "unprecedented" exercise in information sharing, the federal government is calling on health systems to share daily updates from their in-house labs with federal agencies. Read more from CMS.
 

New Flexibility for Physicians During COVID-19 Emergency


Centers for Medicare & Medicaid Services has issued temporary regulatory waivers and new rules to allow healthcare systems flexibility to respond to the coronavirus pandemic. Made possible by the president's recent emergency declaration and emergency rule making, the temporary changes apply immediately across the entire U.S. healthcare system for the duration of the emergency declaration. Included is  Medicare coverage for telephone services, significant additions to the list of covered telehealth services such as emergency visits, and greater clarity on the use of remote patient monitoring for acute conditions.

The American Medical Associaiton released a statement applauding these actions, saying in part: “With physicians stretched thin in the fight against the COVID-19 pandemic, our health care workforce needs flexibility, reduced red tape, and immediate solutions to increase capacity and ensure access to care in every patient setting, including from home.

Read the announcement from CMS.

Additional background information on the waivers and rule changes
More information on the COVID-19 waivers and guidance and the Interim Final Rule

Quality Payment Program and Quality Reporting Program/Value Based Purchasing Program COVID-19 Relief

The Centers for Medicare & Medicare Services has announced relief for clinicians, providers, hospitals and facilities participating in quality reporting programs in response to the coronavirus. A fact sheet provides additional guidance to health care providers with regard to the announcement. CMS has extended the 2019 Merit-based Incentive Payment System (MIPS) data submission deadline from March 31 to April 30, 2020. This and other efforts are to provide relief to clinicians responding to the COVID-19 pandemic. In addition, the MIPS automatic extreme and uncontrollable circumstances policy will apply to MIPS eligible clinicians who do not submit their MIPS data by the April 30, 2020 deadline.
 

Resources


Physicians and others can access the most up-to-date resources in one place on the COVID-19 Resources page at sdsma.org.
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