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WVPCA Weekly Outlook
A Newsletter on Community Centered Healthcare
October 23, 2020
In This Issue...
Emergency Management News - WVPCA News - PCMH Corner
School-Based Health - O/E - State News - National News
Financial and Funding Resources
News Flash!
FDA approves first COVID-19 drug: the antiviral remdesivir
Read the entire article from WVNews here.

After 6-month wait, Justice unveils program to pay delinquent utility bills
Read the entire article from Charleston Gazette-Mail here.

Organizations share concerns about ‘Obamacare’ lawsuit ahead of oral arguments
Read the entire article from MetroNews here.
Pharmacy Week: October 18-24, 2020
Pharmacy Week, celebrated the third full week in October, acknowledges the invaluable contributions that pharmacists and technicians make to patient care in hospitals, outpatient clinics, and other healthcare settings. 

The WVPCA would like to acknowledge the many contributions of our community health center pharmacy teams. Our pharmacy teams play a critical role in educating patients, promoting safe and effective use of medications, and always making a difference . . .one patient at a time.
Medical Assistant Recognition Week (MARWeek)
Medical Assistants are at the heart of health care. Every year, Medical Assistant Recognition Week (MARWeek) is celebrated during the third full week in October. Medical Assistants play a vital role with patients, and the WVPCA would like to acknowledge the many contributions they make to our community health center teams. 

Thank you for making a difference, every day for every patient.
COVID-19 Lives Longer on Skin than Flu, Study Shows
Flu viruses tend to live on the skin for 1.8 hours. COVID-19 lives for more than four times that length.

A Japanese study published in Clinical Infectious Diseases journal found the virus is active on a person's skin for nine hours, which could increase the chance of contact transmission and also makes regular handwashing more important. 

Both COVID-19 and Influenza A were inactivated within 15 seconds by using hand sanitizer.
Vaccine Distribution Plan Submitted to CDC
West Virginia submitted its plan for COVID-19 vaccine distribution to the federal Centers for Disease Control and Prevention, Gov. Jim Justice announced during his COVID-19 news briefing last week.

The plan, which was not shared during the briefing, is supposed to provide guidance for how the state will organize its distribution of a forthcoming COVID-19 vaccine, though it’s still unclear when a vaccine will be available.
WVPCA News
2021 E/M Documentation Guidelines: 
Prepare for the Changes Webinar
Please join the WVPCA and Shellie Sulzberger for our 2021 E/M Documentation Guidelines: Prepare for the Changes webinar. During this presentation we will discuss the upcoming changes, how to document E/M services and utilize your staff to help streamline processes to be more efficient related to seeing the patient and documenting. Major changes to office and outpatient evaluation and management (E/M) codes will take effect Jan. 1, 2021.
Objectives of the Presentation:
  • E/M changes for 2021
  • Selection of new and established patient visit codes based on medical decision making (MDM) or time.
  • New guidelines for using time 
  • Revised MDM guidelines

Targeted Audience: Physicians, Non-Physician Practitioners (NP, PA), Psychiatrist, Psych NP, or Psych PA (if they are billing E/M codes 99201-99205 and 99212-99215), Any provider that bills Evaluation and Management (E/M) codes, Coding Staff, and Billing Staff.

This event is intended only for Community Health Center Staff at no cost for participants.

To maximize participation for health center staff this training is being offered on two separate dates. You ONLY need to attend one.

After attending one of these presentations health centers will have the opportunity to have a customized Learning Lab conducted by Shellie Sulzberger.
The Learning Lab will allow providers to send the presenter examples of patient encounters to discuss what level of service would be appropriate and what elements would not be required (unless the provider needed the information for clinical or other reasons). For example, the presenter can discuss how a new patient level 4 can be obtained without documenting a complete review of systems, PFSH and complete exam if not medically indicated.
This webinar will be interactive to help the providers understand how to select the appropriate E/M level based upon the work and complexity.
There will be a separate fee for health centers for the Learning Lab and this opportunity is only available to health centers after attending one of the above webinars. Please contact the WVPCA for more details.

Registration closes November 3 at noon.

IPHCA Announces All Virtual Leadership Conference
The Illinois Primary Health Care Association, representing the state's 51 community health centers, is one week away from their 2020 Annual Leadership Conference that will be held online Oct. 28-30 during the coronavirus pandemic.

IPHCA is using the virtual conference to connect its attendees with an outstanding roster of speakers:
  • Kareem Abdul-Jabbar, pro basketball's all-time leading scorer and Presidential Medal of Freedom Winner for his work to improve education in underserved communities
  • Regina Benjamin, the 18th U.S. Surgeon General
  • Maria Hinojosa, an Emmy-winning anchor and executive producer of NPR's "Latino USA"
Anyone interested is welcome to attend the virtual conference.
Modifications to PCMH Annual Reporting Requirements 
NCQA updates Recognition publications periodically to clarify guidance, revise resources and refine criteria expectations. Updates are now available for the PCMH Annual Reporting publication.

Recognition Programs publications are available for download by going to the My Downloads section of My NCQA. Log in using your email address and password. Refer to the information below to access the publication download. 

Program - PCMH Annual Reporting (2021)

The modifications made to PCMH Annual Reporting 2021 clarify expectations to reduce the number of returned submissions. The goal of these modifications is to expedite both your submission and NCQA’s review process.

Changes include:

  • Expanded the list of multiple-choice options and removing “other” as a multiple-choice option. 
  • Changed the AR-KM 2 “Denominator Definition” from a text answer to yes/no. 
  • Practices no longer need to enter the “Patients at the Practice—Definition” for AR-CM 1.  

Modifications
Removed “other” as an option from the following multiple-choice questions: 
  • AR-TC 1
  • AR-KM 1*
  • AR-KM 2*
  • AR-AC 1
  • AR-AC 2
  • AR-AC 3
  • AR-CM 2
  • AR-QI 4
*Additional answer choices added to provide a greater selection of options for practices

In addition, NCQA has added two new Annual Reporting 2021 resources, the Annual Reporting Preparation Guide for 2021 and a measure reporting tip sheet which is a new tab in the Quality Improvement Worksheet.

If you should have any questions, please contact Shannon Parker.
5 easy ways to prepare for 2020 Open Enrollment
How to get ready to enroll — quickly and easily!
  • Get familiar with the Marketplace by reading these quick tips. Find answers to your most common questions.
  • Download this checklist (PDF) to make sure you have everything you need. When you apply, you'll be asked about your household, income, and current coverage and may need to refer to specific documents, like W-2s, pay stubs, or tax returns. Gathering what you need now will save you time later.
  • Make a list of questions before it's time to choose your health plan. For example, "Can I stay with my current doctor?" or "Will this plan cover my health costs when I'm traveling?" Get tips on choosing a health insurance plan.
  • Set your budget. There are different types of health plans for different needs and budgets. You’ll need to figure out how much you’re able to spend on premiums each month, and how much you want to pay out-of-pocket for prescriptions or medical services. See how your total costs work together.
  • If you're planning to renew your current coverage for 2020, review your 2019 application to make sure it's still accurate. If it's not, update it with any income and/or household changes. This will save you time when you apply because your 2020 application will be pre-filled with your 2019 information.
The Power of Positive Attention
Mental Health America just released data showing the number of people reporting signs of anxiety and depression since the start of the pandemic hit an all-time high in September. They are also seeing alarming numbers of children with similar symptoms. Often, when children are having difficulties, they act out in order to get attention.

During this pandemic, even adults are struggling how to cope. One method of helping children cope is by providing them with positive attention. Positive attention can take many forms, such as verbal praise, hugs and kisses, or even fist bumps. Not only is positive attention great for kids, it is good for adults too, as it is something in their day that is good. 
State News
Flu season already ramping up in West Virginia
West Virginia is one of only two states reporting moderate flu activity, according to the most recent influenza surveillance report from the Centers for Disease Control and Prevention. Iowa is also seeing moderate spread of the virus. All other U.S. states are reporting only minimal flu activity, according to the report.

The state did not see moderate flu activity during the 2019-2020 flu season until the week of Dec. 15-21, according to CDC surveillance reports. By that time, more than a dozen states, including Kentucky and Virginia, had already reached high flu activity.

Public health officials have warned that it is possible to become infected with both influenza and COVID-19 at the same time, a situation that could lead to negative health outcomes.
Influenza vaccines are now available through medical providers, health departments and pharmacies.

It takes about two week after vaccination for the body to fully develop protective antibodies to protect against the flu, so public health officials recommend getting the vaccine as soon as possible.
Justice Appoints Christiansen to
Lead Office of Drug Control Policy
Dr. Matthew Christiansen will replace Bob Hansen, who retired this week, as the head the state Office of Drug Control Policy, Gov. Jim Justice announced during Friday’s COVID-19 news briefing. Christiansen’s appointment is immediate, according to a news release from the state Department of Health and Human Resources. He will spend the next month transitioning into his new role.

“Combating our state’s drug crisis has been a number one priority of this administration,” DHHR Secretary Bill Crouch said in the release. “I am pleased that Dr. Christiansen will offer a seamless transition to this most important position. We are very grateful for Bob Hansen’s service to the state and his countless efforts.”

Christiansen holds a bachelor’s degree from Denison University, and earned his medical degree and a Master’s in Public Health from Marshall University. He currently practices primary care and addiction medicine at Marshall Health, and works as an associate professor at the Department of Family and Community Health, Division of Addiction Sciences, at Marshall University’s Joan C. Edwards School of Medicine. Christiansen also heads Ebenezer Medical Outreach, a free clinic in Huntington, according to the release.
Evidence-Based Communication Strategies for Improving Child and Adolescent Vaccine Uptake
Effective communication is a critical component in ensuring that children are fully vaccinated. In 2019, the World Health Organization (WHO) listed vaccine hesitancy under its top ten threats to global health. Join this webinar on November 4, 2020 from 12:00pm to 1:00pm provide an overview of vaccine hesitancy and common communication pitfalls encountered in the clinical setting when attempting to address vaccination concerns. Alternative, evidence-based, communication strategies known to improve vaccine acceptance will be reviewed. Special considerations for potential future COVID-19 vaccines will also be addressed.

Objectives: 
• Identify common communication assumptions that undermine effective communication with vaccine-hesitant parents.
• Describe 4 evidence-based vaccine communication strategies that have shown to increase vaccine uptake among children and adults.
• Identify communication issues related to potential future COVID-19 vaccines that may need additional study.

Speaker:
Amanda Dempsey, MD, Ph.D.,MPH is a Tenured Professor of Pediatrics at the University of Colorado Denver, and Research Director for Pediatric Hospital Medicine at Children's Hospital Colorado. She has studied pediatric immunization delivery for the last 15 years with particular interests in vaccine hesitancy, and potential solutions to mitigate this problem.

Cost: Free

Continuing Education: 
Continuing Education Units for Physicians, Pharmacists, and Nurses are being applied for and pending approval.
Veteran's Mental Health Webinar - Free CEs
Veteran's Mental Health in 2020 featuring Perry Blankenship, M.A., M.DIV., MBA, M.Ed., ALPS webinar will take place on Friday, November 13, 2020 at 10AM.

The impact of trauma related issues is on the rise in our nation. This webinar will explore the impact of the current pandemic, civil unrest, lack of mental health and substance use disorder treatment services on veterans and their families. Less than half of the returning veterans who need mental health and addiction treatment services receive treatment. The prevalence of psychological and addiction challenges in the veteran population is an increasingly significant issue. Mental health clinicians need to understand the unique experiences and needs of this population, whether they are treating the veterans themselves or working with their partners and families. We will discuss how the events of 2020 contribute to post traumatic stress disorder (PTSD) and substance use disorder (SUD) triggers and explore practical clinical approaches to supporting veterans and their families including virtual resources. 

Offered by: Marshall University School Health TA Center, Community Health Division in partnership with Youth Health Services and McDowell County Schools with funding from the WV Bureau for Behavioral Health

Continuing education approved for:
2 hours in Veteran's Mental Health by the WV Board of Examiners in Counseling WVBEC Provider #529
2 hours Addictions approved by WVCBAPP
2 hours approved WV Board of Social Work Provider #490102
Electronic Influenza Toolkit Now Available for Healthcare Providers and Immunization Partners
The West Virginia Immunization Network launched EveryoneAddsUp, a statewide Influenza Vaccination Communication Campaign that features television and radio ads, billboards, Facebook and Instagram posts, and online targeted ads. Additionally, we have developed an electronic toolkit for healthcare providers and partners that provides suggested language, graphics, and shareable content for providers. View, download, or print these educational resources offering information about flu season 2020-2021.

Download the free toolkit which includes the following:
·   Printable flyers and posters for clinics
·   Waiting/exam room electronic display ads
·   Website buttons and banners
·   Social media content
National News
NACHC Announces Year of the Nurse 2020 Campaign
NACHC, in partnership with PCAs, HCCNs, and community health centers, will celebrate nurses' contributions by using the theme, "Nurses Leading with Care" and sharing stories of APRNs, RNs, and LPNs who provide care in health centers and communities. 

Throughout 2020, in honor of the Year of the Nurse and Midwife, NACHC is highlighting individual nurses, groups of nurses or specific nursing roles in health centers and their communities. Nominate a nurse and receive buttons for your health center’s nurses.

The WVPCA encourages you to identify nurses in your health centers who you would like to highlight by completing a few questions.   The nomination form asks that you complete your name and contact information, the name, role/title and contact information of the nurse you are recommending and a short description of the nurse's contribution to their community.  
 
Thank you, in advance, for your nominations!

For more information, contact Sarah Price, MSN-Ed, RN.
HHS Announces Phase 3 Provider Relief Funding
On October 1, 2020, the U.S. Department of Health & Human Services (HHS), through the Health Resources and Services Administration, announced $20 billion in new phase 3 provider relief funding. This funding is available to "frontline" providers -- including those who have already received the full amount they were eligible for under the General Distribution. (This amount was 2% of 2018 net patient revenues.) It is unclear how much any provider will be eligible for; it will likely depend on total requests received.  

Providers can submit their application from Monday, October 5, 2020, through November 6, 2020. HHS urges providers against waiting to apply until the last week of the application window, and to apply early to help expedite the review process and distribution of funds to as many providers as possible.
It's not too late to apply to the
NHSC S2S Loan Repayment Program
NHSC S2S LRP applicants may qualify for up to $120,000 in loan repayment for their medical, nursing and dental school student loans. Eligible health professional students in their final year of school receive the award in exchange for a three-year service commitment in a high-need (HPSA 14 or above) rural, tribal, or urban community. Read the 2021 Application and Program Guidance carefully before you start your application.

  • Students must be U.S. citizens or nationals and enrolled or accepted in an eligible medical (MD or DO), dental (DDS or DMD), NP or CNM degree program at a U.S. accredited school.
  • Installments are paid to students annually in a lump sum which, when applied to qualified health professional student loans, can significantly lower the overall debt by reducing accrued loan interest amounts.
  • NHSC S2S LRP award recipients are eligible to continue service through the NHSC Loan Repayment Program, and could potentially pay off all of their educational debt with continued service at an approved NHSC site.

Online Q & A Sessions 
Monday, October 26 | 10:00 AM - 5:00 PM ET

For additional information, including a program fact sheet, visit the NHSC website. Find NHSC-approved sites on the Health Workforce Connector.
October is Domestic Violence Awareness Month
1 in 4 women and nearly 1 in 10 men have experienced some form of intimate partner violence (IPV) in their lifetime. IPV is a form of domestic violence perpetrated by a current or former partner or spouse. It may include physical violence, sexual violence, stalking, or psychological harm. During the COVID-19 public health emergency, increases in IPV have been reported across the U.S.

Health centers are uniquely positioned to address IPV, as 1 in 11 people nationwide rely on a health center for care.

Here are some resources to help your health center address IPV.

  • Futures Without Violence, a HRSA-funded National Training and Technical Assistance Partner (NTTAP), offers health centers training in trauma-informed services, partnerships and policy development, and the integration of processes designed to increase the identification and referral to treatment of individuals experiencing or surviving IPV and human trafficking.
  • The IPV Toolkit they developed specifically for health centers now includes a resource page related to COVID-19.
  • Request technical assistance (TA) from Futures Without Violence.

  • The Health Information Technology, Evaluation, and Quality (HITEQ) Center (a HRSA-funded NTTAP) and Futures Without Violence are hosting a webinar on addressing interpersonal violence and human trafficking in the health center setting.
  • HITEQ Highlights: Addressing Interpersonal Violence and Human Trafficking in the Health Center Setting
  • Thursday, November 12 | 1:00-2:30 p.m. ET Register here

HRSA and the HHS Administration for Children and Families hosted a webinar in May on "Sheltering in Place, Violence and the Healthcare Response.” You can register to access the archived webinar.
HRSA: Guidance for Health Centers
 to Promote Flu Vaccination  
In a bulletin last week, HRSA shared some important reminders and resources for health centers to keep in mind to encourage your patients to get flu vaccinations.

For example, your health center can use social media messages and graphics from the CDC Digital Media Toolkit: 2020-21 Flu Season. The toolkit also includes a vaccine finder, print-ready materials, and other resources about the importance of flu vaccinations.

The CDC and Medscape are hosting a free continuing education credit activity that updates clinicians on the Advisory Committee on Immunization Practices influenza vaccination recommendations for the 2020-21 season. This activity is intended for health care personnel involved in influenza vaccination. The training activity is available from Medscape (free registration is required).

The National Association of Community Health Centers (NACHC), a HRSA-funded NTTAP, interviewed a diverse group of health center leaders to ascertain issues being considered in light of the urgent need for expansive flu vaccine coverage in the face of the COVID-19 pandemic. Check out their report.
Upcoming National Training Opportunities
Assessing Your Community Using the UDS Mapper 
Attend this session to learn how to leverage the UDS Mapper tool to further understand the communities and populations you serve.

The UDS Mapper is a collaboration between the Health Resources and Services Administration (HRSA) and the American Academy of Family Physicians (AAFP) and is part of the HealthLandscape online mapping platform.

Friday, November 6, 2020
2:00 PM EST
Physical Activity & Diabetes Prevention in the COVID-19 Landscape 
Though the connection between physical exercise and diabetes prevention is well established, individuals experiencing homelessness or unstable housing often do not have access to safe locations for physical activity. These challenges have become especially pronounced in the era of COVID-19, which make public facilities, parks, and venues of activity even less accessible. This national webinar will explore approaches to fostering physical activity for improving physical health of individuals unstably housed. Housing providers and health centers who serve this population will benefit from a conversation led by experienced guest speakers on strategies to best connect clients to community resources that are safe, healthy, and appropriate in the COVID-19 landscape.

Wednesday, Nov 11, 2020
1:00 PM EST
Provider Recruitment and Retention Training for Health Centers: Addressing Issues with Staffing, Recruiting, and Retention in the Face of a Pandemic
Tuesday, October 27, 2020 
3:00 PM EST
Call in: 888-323-9689
Passcode: 7945934
Diabetes Continuum of Care: Raising the Pillars for Community Engagement 
This is the third of four webinars in our Fall 2020 Diabetes in Special & Vulnerable Populations: A National Learning Series.

After this webinar, participants will be able to:
1. Demonstrate key components of successful community engagement to address diabetes amongst special and vulnerable populations
2. Identify ways to adapt and strengthen community engagement strategies to address diabetes during public health emergencies (i.e. COVID-19)
3. Highlight tools and resources to assess readiness for fostering community engagement

NTTAP Collaborating Partners:
- Association of Asian Pacific Community Health Organizations (AAPCHO)
- Migrant Clinicians Network (MCN)
- National Nurse-Led Care Consortium (NNCC)


 Tuesday, November 10, 2020
2:00 PM - 3:00 PM ET 
Community Health Center Resources
Jackson Kelly attorneys provide limited consultation to all members of the WVPCA at no charge, as part of the WVPCA contract. There is no limit to the number of calls which any member may make. All inquiries within the scope of professional competence of firm attorneys will be addressed. Inquiries which require expertise not available through the firm will be promptly identified and, when requested, Jackson Kelly will assist in referring the matter to accounting firms, insurance agents, or others as circumstances warrant.

All inquiries, responses and consultation services provided by the firm lawyers will be provided without additional charge beyond the retainer amount, except for matters which require formal opinions, representation of record in litigation, transactional work, e.g. the purchase or sale of real property, or matters which require continued representation, research or consultation beyond a single inquiry or document review.

Justin M. Harrison is a labor & employment lawyer with Jackson Kelly PLLC. He is available for consultation through a special retainer relationship with the WVPCA. Justin can be reached at 304.340.1358 and via email at justin.harrison@jacksonkelly.com.
Risk Management Manual for Health Centers Now Available!
The Risk Management Manual for Health Centers is now available on the ECRI Institute Clinical Risk Management Program website! Designed to support a proactive approach to risk management at health centers and free clinics, the Manual provides background, tips, and how-tos in a manageable format.
Specific areas that are covered include:
Risk Management Programs & Plans
Claims and Lawsuits
Role of the Risk Manager
Patient Grievances and Complaints
Communication with Patients
Credentialing and Privileging
Communication among Providers, Staff, and Community Partners
Tracking Systems for Diagnostic Tests, Referrals, and Hospitalizations

View an archived webinar that provides a guided tour of the Manual and key features. For access to the ECRI Institute Clinical Risk Management Program website or any other questions, email clinical_rm_program@ecri.org.
COVID-19 Resources for Health Centers
ECRI Institute 
Federally qualified health centers and free clinics are on the front line in testing and treating patients who may have been exposed to COVID-19. Use these resources to keep your staff and patients safe:

In addition, ECRI's COVID-19 Resource Center includes free resources addressing the provision of clinical care and managing the supply chain. Updated several times per week, highlights include:


Additional guidance is available directly from the Health Resources and Services Administration (HRSA), including:
WVPCA Staff
Sherri Ferrell, MBA | Chief Executive Officer
Debra Boyd | Chief Financial/Chief Operations Officer
Staci Arnold, MBA | Data Service & Integration Specialist
Jennifer Boyd, PA-C, PCMH-CCE | Clinical Consultant
John Kennedy, MA | School-Based Health/Behavioral Health Coordinator
Pam Moore | Member Relations Coordinator
Shannon Parker, MBA, PCMH-CCE | Director of Health Center Operations
Amanda West | Staff Accountant
Emma White, RN | Clinical Quality Improvement Coordinator
Paula Beasley | Education & Communication Coordinator
Ruby Piscopo| Outreach & Enrollment Coordinator
To sign up to receive the WVPCA Weekly Newsletter:
1700 MacCorkle Avenue, SE
Charleston, WV 25314
Phone: 304.346.0032
Toll Free: 1.877.WVA HLTH
This project is/was supported partially/fully by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U58CS06834 State and Regional Primary Care Associations. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.