COVID 19: New and Updated Information and Resources
I would like to encourage everyone to read this e-blast, as new information is included. From now on our COVID e-blasts will have a date behind new information, to make it easier for centers to read what is new and breaking.
 
Today, the Governor issued Executive Order 109, directing the suspension of all elective surgeries and invasive procedures scheduled to take place after 5:00 PM on Friday, March 27.
While there has been a frenzy of speculation, this does not close ASCs. Indeed the Governor’s order closely resembles the recommendations that NJAASC sent to everyone last week.
It states that medical and dental operations that can be delayed without undue risk to the current or future health of the patient, as determined by the patient’s physician or dentist should be cancelled.
That allows procedures that fit within guidelines- as NJAASC recommended, to be performed.
 
Below, please find a synopsis from NJAASC and the Executive Order itself. I would urge all of you to read the Executive Order in its entirety.
 
While procedures can still be performed, there must be close scrutiny of cases, and each center must establish written guidelines to ensure adherence to the provisions of the Order.
This includes as stated in the Order: ‘ a process for consultation with the treating provider about a designation that the surgery or invasive procedure is elective under the terms of the Order.’
NJAASC is preparing a template that we will then submit to the Department of Health for comment. If they respond all centers can then utilize it with their blessing. If not, we will recommend it to all ASCs anyway- so stay tuned for further e-mails regarding this issue.
Remember, this is an internal guideline- a center policy and procedure so to speak, it would not have to be submitted for every case you perform
 
The Order also mandates that ASCs in possession of PPE, ventilators, respirators or anesthesia machines not required for the provision of critical health care services, should undertake an inventory and sent the information to the State.
OEM is to establish a process for submittal- to be determined.
Now I know NJAASC at the behest of the Department of Health asked all ASCs for this information last week- and thank you to all who responded, it was overwhelming.
However not everyone did so and that was a week ago, so while we are asking for clarification, my educated guess will be that we are all going to have to do this again.
 
The situation remains somewhat unclear and fluid, so stay tuned to e-blasts from NJAASC to further clarify the provisions of the Governor’s Order.
 
Jeff Shanton
President, NJAASC
201-795-0205 x241
C: 201-637-9889      


Governor Murphy’s Executive Order 109 and ASCs

     TRENTON -- As part of the state's effort to preserve the capacity of the health care system to respond to COVID-19, Governor Phil Murphy today signed Executive Order No. 109, directing the suspension of all elective surgeries and invasive procedures performed on adults that are scheduled to take place after 5:00 p.m. on Friday, March 27. The Governor's Executive Order applies to all medical and dental operations that can be delayed without undue risk to the current or future health of the patient, as determined by the patient's physician or dentist.

     "Our new reality calls for aggressive action to reduce the burden on our health care system and protect our frontline medical responders," said Governor Murphy. "Given the dramatic shortfall in personal protective equipment we face, it's imperative that we work with our partners in health care to strategically preserve supplies and equipment for emergency purposes only."

     In addition to the suspension outlined above, Governor Murphy's Executive Order also requires the following:

     * Protecting the capacity of hospitals: Physicians and dentists, who are planning to perform surgery or invasive procedures in their offices, must consider the potential burden of post-surgery complications on local hospitals prior to performing any operation.

     * Explicit exemption for family planning and termination of pregnancies: The order provides that it shall not be interpreted in any way to limit access to family planning services, including termination of pregnancies.

     * Inventory of personal protective equipment to be taken: Any business, non-hospital health care facility, or institution of higher learning in possession of PPE, ventilators, respirators, or anesthesia machines not required for the provision of critical health care services shall undertake an inventory of these supplies and send that information to the State by 5:00 pm on Friday, March 27. The Office of Emergency Management shall establish a process for affected entities to submit this information.

     The Order requires facilities to immediately notify patients whose operations have to be suspended.

EXECUTIVE ORDER NO. 109

     WHEREAS, through Executive Order No. 102 (2020), which I signed on February 3, 2020, I created the State's Coronavirus Task Force, chaired by the Commissioner of the New Jersey Department of Health ("DOH"), in order to coordinate the State's efforts to appropriately prepare for and respond to the public health hazard posed by Coronavirus disease 2019 ("COVID-19"); and

     WHEREAS, in light of the dangers posed by COVID-19, I issued Executive Order No. 103 (2020) on March 9, 2020, the facts and circumstances of which are adopted by reference herein, which declared both a Public Health Emergency and State of Emergency; and

     WHEREAS, in accordance with N.J.S.A. App. A:9-34 and -51, I reserved the right to utilize and employ all available resources of State government to protect against the emergency created by COVID-19; and

     WHEREAS, as of March 21, 2020, according to the Centers for Disease Control and Prevention ("CDC"), there were more than 292,000 confirmed cases of COVID-19 worldwide, with over 12,000 of those cases having resulted in death; and

     WHEREAS, as of March 20, 2020, there were more than 15,000 confirmed cases of COVID-19 in the United States, with at least 201 of those cases having resulted in death; and

     WHEREAS, as of March 23, 2020, there were at least 1,914 positive cases of COVID-19 in New Jersey, with at least 20 of those cases having resulted in death; and

     WHEREAS, in recognition that the CDC has advised that social mitigation strategies for combatting COVID-19 require every effort to reduce the rate of community spread of the disease and that COVID-19 spreads most frequently through person-to-person contact when individuals are within six feet or less of one another, I issued Executive Order No. 107 (2020) on March 21, 2020, the facts and circumstances of which are adopted by reference herein, which ordered steps to mitigate community spread of COVID-19 limiting the unnecessary movement of individuals in and around their communities and person-to-person interactions in accordance with CDC and DOH guidance and requiring all businesses or non-profits, wherever practicable, to accommodate their workforce for telework or work-from-home arrangements and reduce staff on site to the minimal number necessary to ensure that essential operations can continue; and

     WHEREAS, Executive Order No. 107 (2020) required the closure of facilities where personal care services are performed that, by their very nature, result in noncompliance with social distancing guidelines, including but not limited to cosmetology shops; barber shops; beauty salons; hair braiding shops; nail salons; electrology facilities; spas, including day spas and medical spas, at which solely elective and cosmetic medical procedures are performed; massage parlors, tanning salons, tattoo parlors, and public and private social clubs, whether or not they serve alcohol; and

     WHEREAS, Executive Order No. 107 (2020) did not limit, prohibit, or restrict in any way the provision of health care or medical services to members of the public, and allowed to remain open health facilities that provide medically necessary or therapeutic services; and

     WHEREAS, even as we institute social distancing measures, the number of COVID-19 cases in New Jersey is likely to increase for the immediate future, and, consequently, requires the State to take additional steps to preserve our health care system's capacity to treat those who require emergency or intensive care; and WHEREAS, limiting exposure of healthcare providers, patients, and staff to COVID-19 and conserving critical resources such as ventilators, respirators, anesthesia machines, and Personal Protective Equipment ("PPE") are essential to combatting the spread of the virus; and

     WHEREAS, the Centers for Medicare and Medicaid Services have issued guidance to limit non-essential adult elective surgery and medical and surgical procedures, including all dental procedures, to assist in the management of vital healthcare resources (including PPE) during this public health emergency and to limit potential exposure of healthcare providers, patients, and staff to the virus; and

     WHEREAS, the United States Surgeon General has encouraged hospitals and healthcare systems to consider stopping elective procedures; and

     WHEREAS, limiting non-essential adult elective surgery and invasive procedures, whether medical or dental, will assist in the management of vital healthcare resources during this public health emergency; and

     WHEREAS, while certain surgeries and invasive procedures are medically appropriate, they are not time-sensitive and a postponement will not endanger the health of the patient, and at the same time, these procedures, whether undertaken in a hospital, ambulatory surgery center or provider office, necessarily draw upon the skill and time of critical health care professionals and involve the use of equipment and supplies that may be needed to treat those who are critically ill; and

     WHEREAS, the Constitution and statutes of the State of New Jersey, particularly the provisions of N.J.S.A. 26:13-1 et seq., N.J.S.A. App. A: 9-33 et seq., N.J.S.A. 38A:3-6.1, and N.J.S.A. 38A:2-4 and all amendments and supplements thereto, confer upon the Governor of the State of New Jersey certain emergency powers, which I have invoked;

     NOW, THEREFORE, I, PHILIP D. MURPHY, Governor of the State of New Jersey, by virtue of the authority vested in me by the Constitution and by the Statutes of this State, do hereby ORDER and DIRECT:

     1. Beginning at 5:00 p.m. on Friday, March 27, 2020, all "elective" surgeries performed on adults, whether medical or dental, and all "elective" invasive procedures performed on adults, whether medical or dental, are suspended in the State. An "elective" surgery or invasive procedure, for purposes of this Order, is defined as any surgery or invasive procedure that can be delayed without undue risk to the current or future health of the patient as determined by the patient's treating physician or dentist. An "elective" surgery or invasive procedure does not include the administration of vaccines.

     2. Providers planning or determining whether to perform surgery and invasive procedures in their offices must also consider any possible post-operation complications that may place additional stress on local hospitals that do not have the capacity to accept transfers and need to coordinate any possible postoperation admissions with local hospitals prior to performing surgeries or invasive procedures. Ambulatory surgery centers are to coordinate any possible post-surgery admissions with local hospitals prior to performing any surgery or invasive procedure.

     3. Each hospital or ambulatory surgery center shall establish written guidelines to ensure adherence to the provisions of this Order, a copy of which shall be provided to DOH. In establishing such guidelines, the hospital or ambulatory surgery center shall include a process for consultation with the treating provider about a designation that the surgery or invasive procedure is elective under the terms of this Order.

     4. Nothing in this Order shall be construed to limit access to the full range of family planning services and procedures, including terminations of pregnancies, whether in a hospital, ambulatory surgery center, physician office, or other location.

     5. The Commissioner of DOH shall have the authority to issue binding guidance, in consultation with the Director of the Division of Consumer Affairs, on any of the provisions contained in Paragraphs 1 through 4.

     6. All elective surgeries or invasive procedures, whether medical or dental, already scheduled for after 5:00 p.m. on Friday, March 27, 2020, are to be cancelled or postponed indefinitely. Facilities are to immediately notify all patients and providers that have scheduled elective surgeries or invasive procedures that these operations cannot proceed as scheduled under the terms of this Order.

     7. Any business or non-hospital health care facility, including but not limited to dental facilities, construction facilities, research facilities, office-based healthcare or veterinary practices, and institutions of higher learning, in possession of PPE, ventilators, respirators, or anesthesia machines that are not required for the provision of critical health care services should undertake an inventory of such supplies and send that information to the State by no later than 5:00 p.m. on Friday, March 27, 2020. The Office of Emergency Management shall establish a process by which entities subject to this provision can submit this information.

     8. The Director of the Division of Consumer Affairs, which houses over fifty professional licensure bodies, is authorized and empowered in his or her sole discretion, but in consultation with the Commissioner of DOH, to issue orders restricting or expanding the scope of practice for any category of healthcare professional or veterinarian licensed by a board in the Division of Consumer Affairs, including but not limited to, orders restricting elective surgeries, procedures, and examinations, or for further limiting the scope of practice, or the location for the delivery of service of other licensees subject to regulation by any licensing board or committee within the Division of Consumer Affairs. The Director of the Division of Consumer Affairs is also authorized and empowered in his or her sole discretion, but in consultation with the Commissioner of DOH, to waive any restriction on the entry or reentry into practice (or any restriction on the prescription of controlled dangerous substances or on access to the prescription monitoring program) of any person who has received training for employment in a healthcare profession or who has retired from practice.

     9. Any actions taken by the Commissioner of DOH or the Director of the Division of Consumer Affairs pursuant to this Order shall not be subject to the requirements of the Administrative Procedure Act, N.J.S.A. 52:14B-1 et seq.

     10. Paragraph 17 of Executive Order No. 107 (2020) is hereby superseded to the extent it is inconsistent with this Order.

     11. It shall be the duty of every person or entity in this State or doing business in this State and of the members of the governing body and every official, employee, or agent of every political subdivision in this State and of each member of all other governmental bodies, agencies, and authorities in this State of any nature whatsoever, to cooperate fully in all matters concerning this Executive Order.

     12. Penalties for violations of this Executive Order may be imposed under, among other statutes, N.J.S.A. App. A:9-49 and -50. 

     13. This Order shall take effect immediately.

     GIVEN, under my hand and seal this 23rd day of March, Two Thousand and Twenty, and of the Independence of the United States, the Two Hundred and Forty-Fourth. 

/ s / Philip D. Murphy
Governor

Attest:

/ s / Matthew J. Platkin
Chief Counsel to the Governor


NJAASC has curated authoritative information and a list of resources for our Membership’s reference. We will continue to update this as more information becomes available.


ASC STAFFING & HOSPITALS -3/23/20
Q: If any ASCs have staff that want to assist and work in the hospital, how should they go about it?

A: The ASCs need to work with their local hospital. The ASCs should know which is their local hospital.
 
Stefanie Mozgai, BA, RN, CPM
Assistant Commissioner
Department of Health
Health Facility Survey & Field Operations


CMS ANNOUNCES QUALITY REPORTING RELIEF-3/23/20

FAQ FROM DEPARTMENT OF HEALTH- 3/23/20

NJAASC RECOMMENDATIONS FOR PERFORMING CASES IN ASCs


REPORTING GUIDANCE FOR ASCs REGARDING CHANGE OF SERVICE OR CLOSURE


FROM ICAR TEAM LEAD

Please see the below information for expansion of messaging that was previously sent out. Additionally, attached you will find NEW NJDOH Recommendations for Long-Term Care Facilities during COVID-19 Pandemic.

Given the congregate nature of long-term care facilities (LTCF) and residents served (e.g., older adults often with underlying chronic medical conditions), this population is at an increased risk of serious illness when infected with COVID-19. LTCF have experience managing respiratory infections and outbreaks among residents and healthcare personnel and should apply those outbreak management principles to COVID-19.
 
All LTCFs should remain vigilant with prompt detection, triage, and isolation of potentially infectious persons to prevent unnecessary exposures among residents, healthcare personnel, and visitors at the facility. Infection prevention measures include:
  • Implement active screening of residents and staff for fever and respiratory symptoms. Remember that older adults may manifest symptoms of infection differently and that other symptomology should also be. Vital signs should include heart rate, blood pressure, temperature, pain and pulse oximetry. These assessments should happen, at a minimum, daily. The facility staff should have a heightened awareness for any change in baseline in their residents.
  • Stop current communal dining and all group activities such as internal and external group activities.
  • Follow all current CMS guidance regarding the restriction of visitors and non-essential healthcare personnel, except in certain compassionate-care situations
  • Review the CMS Quality, Safety & Oversight (QSO) Group memo Ref: QSO-20-14-NH at https://www.cms.gov/files/document/qso-20-14-nh-revised.pdf for expanded recommendations.
 
Remember to:
  • Connect with your association and monitor NJDOH, CDC, and CMS announcements, at least daily.
  • Conserve personal protective equipment (PPE) in accordance with CDC’s Strategies for Optimizing the Supply of PPE - https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html.
  • Contact your local health department with any questions or concerns. Contact information is available via the local public health directory at http://www.localhealth.nj.gov/.
  • Report any new cases or persons suspected of COVID-19 occurring in or associated with your facility to your local health department.
 
In addition to actions described above and attached , facilities should consider the following immediate actions when there is a confirmed case of COVID-19 to prevent further spread to their residents and staff:
  • Close the unit to new admissions except as needed to cohort ill individuals or staff.
  • Consider closure of the facility to new admissions.
  • Consider implementing universal use of facemask for HCP while in the facility
  • Encourage residents to remain in their room.  If multiple cases are present restrict residents (to the extent possible) to their rooms except for medically necessary purposes.
  • Mask all residents (who can tolerate masks) who are symptomatic when providing direct care; if masks are limited or not tolerated use of a tissue to cover the nose and mouth is appropriate.
  • Adhere to internal environmental cleaning protocols to ensure appropriate measures are being taken to clean and disinfect where appropriate including high-touch surfaces and all shared medical equipment (e.g., lifts, blood pressure cuffs, medication carts). Consider increasing the frequency of cleaning in the facility.
  • Quarantine and monitor exposed contacts including healthcare workers and roommates
 
For more information and ongoing updates please visit:
NJDOH: General COVID-19 Information :  https://www.nj.gov/health/cd/topics/ncov.shtml
 
NJDOH: Key Messaging to Long-term Care Facilities (LTCF) for COVID-19:  https://www.nj.gov/health/cd/documents/topics/NCOV/NcOv_LINCS_LTCF_Key%20Messages_03032020.108103.pdf
 
CMS: Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in Nursing Homes (REVISED):  https://www.cms.gov/files/document/3-13-2020-nursing-home-guidance-covid-19.pdf
 
 
 
Jessica Arias, BSN, RN, CIC
Infection Control Assessment Response (ICAR) Team Lead | Infection Preventionist
Infectious and Zoonotic Disease Program | Communicable Disease Service
Division of Epidemiology, Environmental, and Occupational Health | New Jersey Department of Health
P.O. Box 369 Trenton, NJ 08625| Phone 609.826.5964 | Fax 609.292.5811
FROM NJDOH
DOH Stakeholder Guidance – Cmsr. Persichilli
a. Amplify DOH and CDC messaging 
b. Communicate regularly and effectively with employees, patients, families, and visitors/vendors 
c. Direct stakeholders to guidance and factual resources from DOH and CDC  

Q&A 
Resources 
• DOH COVID-19 Webpage: 
• NJ Coronavirus Hotline: 1-800-222-1222 
• CDC guidance for dialysis safety including infection prevention tools: https://www.cdc.gov/dialysis/index.html 
• Guidance for Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed COVID-19 in Outpatient Hemodialysis Facilities: 
• CDC Interim Guidance for Healthcare Facilities: 
• Handwashing flyers are available in high resolution in English and Spanish 

COVID-19 Information for Healthcare Professionals
 
Purpose: Due to their often extensive and close contact with vulnerable individuals in healthcare settings, NJDOH recommends a conservative approach to HCP monitoring and restrictions from work to quickly identify early symptoms and prevent transmission from potentially contagious HCP to patients, HCP, and visitors. Healthcare facilities (HCFs) should have a low threshold for evaluating symptoms and testing symptomatic HCP, particularly those who fall into the high- and medium-risk categories described in this guidance. HCFs, in consultation with public health authorities, should use clinical judgment as well as the principles outlined in this guidance to assign risk and determine need for work restrictions. 
 
To help HCFs document and assess HCP risk and exposure, NJDOH has developed the below series of tools and checklists:
 
 
  • This document can be used to assess the type of potential exposure HCP may have experienced while caring for the COVID-19 patient and assign risk level (High, Medium, Low or No Risk). It also provides guidance on the management of exposed HCP.
 
 
  • This tool can be used to assess HCP exposure risk prior to the patient being identified as having COVID-19.
 
 
  • This tool can be used to monitor and assess the appropriate use of personal protective equipment (PPE) for HCP caring for the COVID-19 patient after they have been identified in the facility. 
 
 
  • This tool can be used by a HCF or local health department (LHD) to assist HCP with daily symptom monitoring.
 
 
  • This tool can be used by a HCF or local health department (LHD) track HCP under active monitoring.



FROM HORIZON BLUE CROSS BLUE SHIELD

Protecting your health and well-being.

Your health and well-being are top priorities for Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ). That’s why, we’re taking the following steps for our fully insured members, as well as members enrolled in the State Health Benefits Program (SHBP) and School Employees' Health Benefits Program (SEHBP) health plans.

Effective immediately, Horizon BCBSNJ is:
  • Waiving cost sharing obligations (out-of-pocket costs) for all services associated with the diagnosis of COVID-19 per Centers for Disease Control and Prevention (CDC) guidelines. This includes:
  • Waiving cost sharing obligations for all charges associated with a visit to an in-network primary care doctor or urgent care center or an in-network or out-of-network Emergency Room (ER) for evaluation of symptoms identified by the CDC as possible indicators of COVID-19 infection (fever, cough and shortness of breath).
  • Waiving cost sharing obligations for all charges associated with a visit to an in-network primary care doctor or urgent care center or an in-network or out-of-network ER for COVID-19 testing for members who know they have been exposed to an individual diagnosed with COVID-19.
  • Waiving cost sharing obligations at in-network and out-of-network labs for charges associated with the delivery of services connected to CDC-approved lab studies or tests for COVID-19 for members who know they have been exposed to an individual diagnosed with COVID-19 or with symptoms identified by the CDC as possible indicators of COVID-19 infection (fever, cough and shortness of breath).  
This means your doctor or other health care professional should not collect your copay, coinsurance or deductible for care to diagnose COVID-19. 

Additionally, Horizon BCBSNJ is:
  • Waiving early medication refill limits on 30-day prescription maintenance medications (consistent with your benefit plan) and/or encouraging you to use 90-day mail order benefit. We will also ensure formulary flexibility if there are shortages or access issues, and not hold patients liable for additional charges stemming from obtaining a non-preferred medication resulting from shortages or access issues.
As an added resource for our members during this evolving public health crisis, Horizon BCBSNJ is providing at no cost  24/7 access to licensed nurses who can help members who have symptoms that are consistent with the suspected coronavirus 2019 infection.

Learn more about what Horizon BCBSNJ is doing to ensure our members have continued access to care.


FROM APIC
In response to COVID-19, APIC is providing  complimentary access  to our new  APIC Text Chapter Collection: Outbreak Preparedness and Response  now through Sept 30. Learn how to access this important resource  here .

Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents: 
 
Novel coronavirus is putting the whole world on alert


FROM PREMIER SAFETY INSTITUTE


FROM THE CDC


FROM JDJ CONSULTING
Drug Shortages and Backorders
Amid the health climate, JDJ Consulting has been watching the current drug shortages closely. What should you do if you're experiencing difficulties acquiring certain drugs?


What to do:
1. Monitor the FDA website for drug shortages. Here is the link to the FDA's Drug Shortage Database:

2. Use the Critical Drug Shortage Policy at your center to avoid throwing away expired medications that are unavailable to purchase. JDJ Consulting's SAMPLE Critical Drug Shortage Policy is available HERE .

* Fill out the form for each drug with an FDA Extended Date and keep on file. 
* No expired drugs can be in stock unless the medical staff approve.
* The FDA is not recommending the Extended Dates to be relabeled. When products become available, the facility should replace the extended date product.

PUBLIC ADVISORIES, UPDATES & FAQ FROM NJDOH

The Communicable Disease Service (CDS) is providing the following frequently asked questions specific to healthcare personnel and COVID-19 response. To assist healthcare facilities and public health officials with questions concerning exposed, symptomatic or confirmed cases who are also healthcare personnel. This document is meant to be a supplement to HCP exposure documents available on NJDOH website:


Please note this guidance may be updated as the information changes.





BUSINESS ISSUES
LABOR AND EMPLOYMENT ALERT FROM BRACH EICHLER

ALERT: NEW STATE WEBSITE DEVOTED TO COVID-19 BUSINESS CONCERNS
https://conta.cc/2WjLA2G

FROM BRACH EICHLER: NOW THE FEDS TAKE THEIR SWING AT HELPING EMPLOYERS AND EMPLOYEES

NEW JERSEY LEGISLATION REGARDING COVID

A3095 which provides county clerks with additional time to prepare mail-in ballots for the 2020 primary. Any additional mail-in ballots that have been approved before the 45th day before the 2020 primary election are required to be forwarded or delivered at least 38 days, instead of 45 days, before the day of the election. County clerks still are required to comply with federal guidelines and have military and overseas ballots mailed by April 18, 2020. The additional week provided under the amended bill is temporary and will only apply to the 2020 primary election.

A3813 which would allow a school district, county vocational school district, or county special services school district to meet the requirement that schools be open for 180 days in a year with an excessive number of unexpected school closures due to an epidemic, or a weather or other emergency through the use of virtual or remote instruction. Specifically, in the event that a district is required to close its schools for more than three school days due to an epidemic, or a weather or other emergency condition, the commissioner will allow the district to apply to the 180-day requirement one or more days of virtual or remote instruction provided to students on the day or days the schools of the district were closed if the program meets such criteria as may be established by the commissioner. All schools in NJ have been closed since yesterday although many districts had closed prior to the Governor mandating the closure statewide.

A3840 provides direction to school districts for the provision of school meals to students if the districts are directed by either the New Jersey Department of Health or the health officer of the jurisdiction to institute a public health-related closure due to the COVID-19 epidemic. Under these circumstances, the district is required to implement a program during the period of the school closure to provide school meals to all district students who are eligible for the free and reduced price school lunch and school breakfast programs. The school district must collaborate with county and municipal government officials to identify one or more school meal distribution sites that are walkable and easily accessible to students in the district. The bill lists possible sites including, but not limited to: faith-based locations; community centers, such as YMCAs; and locations in the school district where summer meals are available. The bill provides, however, that if there is high density housing in a school district, the district must make every effort to identify a school meal distribution site in that housing area. In cases where a site is not within walking distance the meals must be delivered the student's residence or to the student's bus stop as long as a parent or guardian is present at the bus stop to receive the food.

A3841 extends the time to file a New Jersey gross income tax or corporation business tax return if the federal government extends the filing or payment due date for federal returns. The bill also speaks to taxpayers that are required to make quarterly estimated payments around APril 15th. The bill would automatically grant an extension for those taxpayers if the federal government grants an extension and would not impose penalties or interest if the taxpayer files a return by the end of the extension. The extended due date would be no later than June 30, 2020.

A3842 establishes the “Bridging the Digital Divide in Schools Grant Program” in the Department of Education. for the purpose allocating grant moneys to school districts, charter schools, renaissance schools, and nonpublic schools to provide or expand access to technology and technological equipment, such as laptops, tablets, hot spot access devices, and other electronic mobile devices, for students who do not have the means to purchase such items or who do not have access to the Internet at home. No specific appropriation is attached to the bill

 A3843 requires health insurance carriers (health, hospital and medical service corporations, health maintenance organizations and insurance companies), as well as the State and School Employees’ Health Benefits Programs and the State Medicaid program, to provide coverage for expenses incurred in both the testing for coronavirus disease 2019, provided that a licensed medical practitioner has issued a medical order for that testing and the delivery of health care services through telemedicine or telehealth in accordance with the provisions of P.L.2017, c.117. The requirements of the bill remain in effect during the Public Health Emergency and State of Emergency declared by the Governor in Executive Order 103 of 2020. The bill requires the coverage to be provided to the same extent as for any other services under the health benefits plan, except that no cost-sharing may be imposed on the coverage provided pursuant to the bill. The bill takes effect immediately and applies to all health benefit plans currently in effect in the State, or that are delivered, issued, executed or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of the bill.

A3845 authorizes the New Jersey Economic Development Authority to provide grants during periods of emergency declared by the Governor, such as the declaration regarding the Coronavirus disease 2019, and for the duration of economic disruptions due to the emergency. The bill gives the authority the power to offer grants for the planning, designing, acquiring, constructing, reconstructing, improving, equipping, and furnishing of a project, including, but not limited to, grants for working capital and meeting payroll requirements, upon such terms and conditions as the authority deems reasonable, during such period of time. The bill also extends the uses of the economic growth account in the Economic Recovery Fund to the planning, designing, acquiring, constructing, reconstructing, improving, equipping, and furnishing by small and medium-size businesses and not-for-profit corporations of certain projects, including, but not limited to, grants for working capital and meeting payroll requirements, upon such terms and conditions as the authority deems reasonable, during such periods of time. The bill further provides that, for projects that were approved by the authority under the Grow New Jersey Assistance Program, if the Governor declares an emergency, then the chief executive officer of the authority has the discretion to grant a business documentation submission extension for the duration of the emergency and the board of the authority, upon recommendation of the chief executive officer, may grant two additional six-month extensions; provided that (i) the extensions are due to the economic disruption cause by the emergency; (ii) the project is delayed due to unforeseeable acts related to the project beyond the eligible business's control and without its fault or negligence; (iii) the eligible business is using best efforts, with all due diligence, to proceed with the completion of the project and the submission of the certification; and (iv) the eligible business has made, and continues to make, all reasonable efforts to prevent, avoid, mitigate, and overcome the delay. No specific appropriation is attached to the bill.

A3846 creates the “Temporary Lost Wage Unemployment Program” to allow individuals affected by the coronavirus disease 2019 pandemic to recoup actual lost wages due to the absence from work under certain circumstances and to assist employers who pay wages to workers who are ordered under quarantine by a licensed healthcare practitioner as a result of coronavirus disease 2019. Specifically, the program will provide, to the extent funds are available, monetary relief to individuals for actual lost wages in an amount that is equivalent to the individual’s average weekly rate of compensation from the past calendar year, if the individuals do not have fully paid leave. The Department of Labor and Workforce Development will use moneys in the fund, in an amount not to exceed $10,000,000, to pay the lost wages of individuals due to: the individual’s absence from work due to the need to care for a family member; the individual’s absence from work due to the illness of the individual; the individual’s absence from work due to school or childcare facility being closed; and for such other purposes as determined by the commissioner.  No moneys shall be paid to an individual for any period or wages for which the individual receives benefits pursuant the "unemployment compensation law."  Moneys in the fund may be supplemented or replaced, or both, by any amounts received from the federal government for the same purposes as provided in the bill. Finally, the department will use moneys in the fund, not to exceed $10,000,000, to assist employers who pay wages to workers who are ordered under quarantine by a licensed healthcare practitioner as a result of coronavirus disease 2019.

A3848 prohibits an employer, during the Public Health Emergency and State of Emergency declared by the Governor in Executive Order 103 of 2020 concerning the coronavirus disease 2019 pandemic, from terminating or refusing to reinstate an employee if the employee requests or takes time off from work based on a written or electronically transmitted recommendation from a medical professional licensed in New Jersey that the employee take time off work for a specified period of time because the employee has, or is likely to have, an infectious disease which may infect others at the employee’s workplace.

A3849 provides that during a state of emergency, public health emergency, or state of local disaster emergency, a custodian of a government record for a public agency will be required only to make a reasonable effort to respond to a request for a government record within seven business days, or as soon as possible thereafter, as the circumstances permit.

A3850 allows public bodies to conduct meetings by electronic means during periods of emergency. The provisions of the bill explicitly authorize a public body to conduct a meeting and public business, cause a meeting to be open to the public, vote, and receive public comment by means of communication or other electronic equipment during a state of emergency, public health emergency, or state of local disaster emergency. The bill also allows a public body to provide notice of meetings electronically through the internet during that time, but requires that public bodies who exercise this option limit, to the extent practicable, the public business conducted at that meeting to matters necessary for the continuing operation of government and that relate to the applicable emergency declaration. 

A3851 would expand the current authority of the Director of the Division of Local Government Services, in the Department of Community Affairs, to extend the statutory dates for the introduction and approval, and for the adoption, of county and municipal budgets when the Governor has declared a Public Health Emergency or State of Emergency. The bill permits the director to extend those dates unilaterally whenever a Public Health Emergency or a State of Emergency, or both, has been declared by the Governor and is in effect.

A3852 allows the conduct of State business and legislative sessions at locations other than Trenton during periods of emergency or other exigency. The bill also allows the Legislature to use any technology or electronic means to conduct its business, to carry out its purposes, or to comply with the requirements of certain provisions of the New Jersey Constitution during a period of emergency that is determined to exist by the Governor or the Legislature. This may be utilized for the conducting of hearings on the Governor's proposed budget in the coming weeks.   
 
 A3854 provides that, for the duration of the public health emergency declared in connection with the coronavirus disease 2019, all licensed health care facilities and clinical laboratories will be authorized to collect specimens for the purposes of testing for COVID-19. Nothing in the bill will abrogate the authority of the Commissioner of Health to require a health care facility to provide services or the use of its facility to respond to the public health emergency as authorized under the “Emergency Health Powers Act.” The bill also expressly authorizes the Commissioner of Health, during a public health emergency, to waive mandatory staffing ratio requirements for health care facilities, which is likely to be critical moving forward.

A3855 requires the Statewide 2-1-1 system and all executive branch departments to prominently display information concerning food access programs and resources through their main websites and social media throughout the duration of any declared public health emergency. The 2-1-1 system and the departments may further disseminate the information using any other means deemed appropriate to reach as many individuals and population groups in the State as possible.

A3856 makes a FY 2020 supplemental appropriation of $10 million for health care and residential facility sanitation due to the coronavirus disease 2019 outbreak. The funds are to be used to provide financial assistance to certain health care and residential facilities in meeting the sanitation demands imposed by the coronavirus disease 2019. These facilities are limited to: nursing homes; long-term care facilities; Program of All-inclusive Care for the Elderly, or PACE, facilities; federally qualified health centers; urgent care facilities; retirement centers; senior centers; intermediate care facilities; State developmental centers; group homes for individuals with medical needs; State psychiatric hospitals; post-acute rehabilitation centers; medical day care centers; residential schools for children with complex medical needs; group homes for individuals with mental health, substance use, or behavioral health conditions; and homeless shelters. The bill provides that the Director of the Division of Budget and Accounting, in collaboration with Commissioners of Health, Human Services, Children and Families, and Community Affairs, shall determine the methodology for allocation of the funds across the applicable facilities no later than five days after the effective date of the bill. And the Director of the Division of Budget and Accounting shall transfer such funds to the applicable departments and divisions for distribution to the facilities no later than 10 days after the effective date of the bill. 

A3857 supplements the FY 2020 appropriations act by appropriating $15 million for grants to the Community Food Bank of New Jersey, the Food Bank of South Jersey, and Fulfill Monmouth & Ocean to provide food assistance to households in need as follows: $10.8 million to the Community Food Bank of NJ, 2.4 million to the Food Bank of South Jersey and $1.8 million to Fulfill.

A3858 directs the Commissioner of Human Services, in collaboration with county welfare agencies, to issue supplemental cash assistance payments to eligible recipients of the Work First New Jersey program in addition to the standard benefits issued under the program during a public health emergency declared by the Governor, in which the commissioner determines that the standard benefits issued under the Work First New Jersey program are not sufficient to support the needs of recipients in the State. The payments shall be in an amount equal to a recipient’s monthly benefit amount for the most recent complete month. Following the initial determination to issue supplemental cash assistance payments, the commissioner is required to make all subsequent determinations on a monthly basis until the supplemental cash assistance payments cease. Furthermore, the bill directs the commissioner to distribute the supplemental cash assistance payments via the State’s electronic benefit transfer program.  

A3859 provides that, whenever a public health emergency or a state of emergency is declared by the Governor and is in effect, the Governor may issue an executive order to declare that a lessee, tenant, homeowner or any other person would not be removed from a residential property as the result of an eviction or foreclosure proceeding. This executive order would remain in effect for no longer than two months following the end of the public health emergency or state of emergency. The bill would permit eviction and foreclosure proceedings to be initiated or continued during the time of the executive order, but enforcement of all judgments for possession, warrants of removal, and writs of possession would be stayed, unless the court determines on its own motion or motion of the parties that enforcement is necessary in the interest of justice. The bill would require sheriffs, court officers, and their agents to refrain from acting to remove individuals from residential properties through the eviction or foreclosure processes during the time of the executive order, unless the court determines on its own motion or motion of the parties, that removal is necessary in the interest of justice. Governor Murphy announced during his press briefing today that he would sign this bill immediately and will then issue an Executive Order.

A3860 provides that, for the duration of the public health emergency declared in response to the coronavirus disease 2019, any health care practitioner will be authorized to provide and bill for services using telemedicine and telehealth, regardless of whether rules and regulations concerning the practice of telemedicine and telehealth have been adopted. The services authorized under the bill will include the full range of services set forth in the definitions of telemedicine and telehealth in existing law. A practitioner who is not licensed or certified to practice in New Jersey may provide health care services under the bill using telemedicine and telehealth, provided that: (1) the practitioner is licensed or certified to practice in another state or territory of the United States or in the District of Columbia, and is in good standing in that jurisdiction; (2) the services provided by that practitioner are consistent with the practitioner’s authorized scope of practice in the jurisdiction that issued the practitioner’s license or certification; (3) unless the practitioner has a preexisting provider-patient relationship with the patient that is unrelated to COVID-19, the services provided are limited to services related to screening for, diagnosing, or treating COVID-19; and (4) in the event that the practitioner determines that a telemedicine or telehealth encounter with a patient located in New Jersey will not involve screening for, diagnosing, or treating COVID-19, and the practitioner does not have a preexisting provider-patient relationship with the patient that is unrelated to COVID-19, the practitioner advises the patient that the practitioner is not authorized to provide services to the patient, recommends that the patient initiate a new telemedicine or telehealth encounter with a health care practitioner licensed or certified to practice in New Jersey, and terminates the telemedicine or telehealth encounter. The bill requires that any amount charged for services provided under the bill be reasonable and consistent with the ordinary fees typically charged for that service. If a health care practitioner who is not licensed to practice in New Jersey is required to terminate a telemedicine or telehealth encounter because the encounter does not involve the provision of services related to screening, diagnosing, or treating COVID-19, the practitioner will be prohibited from billing for any services provided during the encounter.

A3861 permits corporations to hold shareholders' meetings in part or solely by means of remote communication to the extent the board authorizes and adopts guidelines and procedures governing such a meeting. The bill also provides that shareholders participating in a meeting by means of remote communication are deemed to be present in person and are entitled to vote at the meeting, regardless of whether the meeting is held at a designated place or solely by means of remote communication.

A3862 allows the director of the Division of Consumer Affairs, with the approval of the Attorney General, to expedite the professional and occupational licensing process for out-of-state individuals when the Governor has declared a state of emergency. The individual applying for a specific license, certificate of registration, or certification in New Jersey must have a corresponding license, certificate of registration or certification in good standing from another jurisdiction. The bill gives the director and applicable boards the ability to waive certain requirements normally required in the licensure process, such as a criminal history record background check of an individual and payment of certain fees for the license, certificate of registration or certification.

A3864 would allow notaries public to perform certain notarial acts remotely. A remotely located individual would be allowed to use communication technology to appear before a notarial officer remotely located individual is located. The bill sets forth the specific circumstances during which notarial acts may be preformed.

A3865 makes it an unlawful practice for a retail food store to accept the return, with limited exceptions, of any groceries and other foodstuffs purchased during, and for 30 days following, a state of emergency declared in response to COVID-19. However, a retail food store may accept the return of groceries and other foodstuffs if it determines, in its sole discretion, that the purchased items are unsafe for use or otherwise adulterated as a result of any manufacturing error or defect. Any groceries or other foodstuffs accepted for return by a retail food store are not to be offered for resale. 

ACR165 urges the Department of Human Services to apply for any federal waivers available to increase and extend access to Supplemental Nutrition Assistance Program benefits, and ease any administrative barriers to accessing benefits that arise from the nationwide outbreak of the coronavirus disease 2019.

AJR158 urges the Federal Communications Commission to take temporary measures to secure broadband access for those affected by the COVID-19 public health emergency. 

A3852 which allows the conduct of State business and legislative sessions at locations other than Trenton during periods of emergency or other exigency. The bill also allows the Legislature to use any technology or electronic means to conduct its business, to carry out its purposes, or to comply with the requirements of certain provisions of the New Jersey Constitution during a period of emergency that is determined to exist by the Governor or the Legislature. This may be utilized for the conducting of hearings on the Governor's proposed budget in the coming weeks.   

 A3859 which provides that, whenever a public health emergency or a state of emergency is declared by the Governor and is in effect, the Governor may issue an executive order to declare that a lessee, tenant, homeowner or any other person would not be removed from a residential property as the result of an eviction or foreclosure proceeding. This executive order would remain in effect for no longer than two months following the end of the public health emergency or state of emergency. The bill would permit eviction and foreclosure proceedings to be initiated or continued during the time of the executive order, but enforcement of all judgments for possession, warrants of removal, and writs of possession would be stayed, unless the court determines on its own motion or motion of the parties that enforcement is necessary in the interest of justice. The bill would require sheriffs, court officers, and their agents to refrain from acting to remove individuals from residential properties through the eviction or foreclosure processes during the time of the executive order, unless the court determines on its own motion or motion of the parties, that removal is necessary in the interest of justice. Governor Murphy announced during his press briefing today that he would sign this bill immediately and will then issue an Executive Order.

 A3860 which provides that, for the duration of the public health emergency declared in response to the coronavirus disease 2019, any health care practitioner will be authorized to provide and bill for services using telemedicine and telehealth, regardless of whether rules and regulations concerning the practice of telemedicine and telehealth have been adopted. The services authorized under the bill will include the full range of services set forth in the definitions of telemedicine and telehealth in existing law. A practitioner who is not licensed or certified to practice in New Jersey may provide health care services under the bill using telemedicine and telehealth, provided that: (1) the practitioner is licensed or certified to practice in another state or territory of the United States or in the District of Columbia, and is in good standing in that jurisdiction; (2) the services provided by that practitioner are consistent with the practitioner’s authorized scope of practice in the jurisdiction that issued the practitioner’s license or certification; (3) unless the practitioner has a preexisting provider-patient relationship with the patient that is unrelated to COVID-19, the services provided are limited to services related to screening for, diagnosing, or treating COVID-19; and (4) in the event that the practitioner determines that a telemedicine or telehealth encounter with a patient located in New Jersey will not involve screening for, diagnosing, or treating COVID-19, and the practitioner does not have a preexisting provider-patient relationship with the patient that is unrelated to COVID-19, the practitioner advises the patient that the practitioner is not authorized to provide services to the patient, recommends that the patient initiate a new telemedicine or telehealth encounter with a health care practitioner licensed or certified to practice in New Jersey, and terminates the telemedicine or telehealth encounter. The bill requires that any amount charged for services provided under the bill be reasonable and consistent with the ordinary fees typically charged for that service. If a health care practitioner who is not licensed to practice in New Jersey is required to terminate a telemedicine or telehealth encounter because the encounter does not involve the provision of services related to screening, diagnosing, or treating COVID-19, the practitioner will be prohibited from billing for any services provided during the encounter.

A3862 which allows the director of the Division of Consumer Affairs in the Department of Law and Public Safety, with the approval of the Attorney General, to expedite the professional and occupational licensing process for out-of-state individuals when the New Jersey Governor has declared a state of emergency. The individual applying for a specific license, certificate of registration, or certification in New Jersey must have a corresponding license, certificate of registration or certification in good standing from another jurisdiction. The bill gives the director and applicable boards the ability to waive certain requirements normally required in the licensure process, such as a criminal history record background check of an individual and payment of certain fees for the license, certificate of registration or certification.



NJHA NEWS CLIPS
  1. Coronavirus update: Hospital capacity concerns as cases rise to 267; Murphy closes malls; 1st day of full school shutdown. What you need to know (03/18/2020)
  2. Murphy requests Trump’s help building hospitals as COVID-19 cases mount
  3. Local hospitals move to protect patients against the spread of the coronavirus
  4. Murphy orders closure of malls, amusement parks effective Tuesday evening (updated)
  5. As the coronavirus spreads, Pa. and New Jersey race to add hospital beds, testing
  6. Drive-thru testing available at Hudson Regional Hospital
  7. Elective surgeries canceled at Meridian Health hospitals for 2 weeks
  8. 5 steps to help make room for patients in your hospital
  9. CMS expands Medicare telehealth services to fight COVID-19

CMS Adult Elective Surgery and Procedures Recommendations

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Questions? Contact Jeff Shanton at  jshanton@jssurgctr.com