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WVPCA Weekly Outlook
A Newsletter on Community Centered Healthcare
October 30, 2020
In This Issue...
Emergency Management News - WVPCA News - PCMH Corner
O/E - State News - National News - Financial and Funding Resources
News Flash!
Pandemic response sparks power struggle
Read the entire article from Charleston Gazette-Mail here.

Fauci tells WVU virtual panel he believes vaccine viability will be apparent by early December
Read the entire article from WVNews here.

As Halloween nears, trick-or-treaters urged to practice caution, safety
Read the entire article from WVNews here.
CDC Finds Nearly 300,000 "Excess Deaths" in the U.S. Amid Pandemic and 25- to 44-Year-Olds Hit Hard 
The Centers for Disease Control and Prevention (CDC) reports that COVID-19 has taken a disproportionate toll on Latinos and Blacks, as previous analyses have noted. But the CDC also found, surprisingly, that it has struck 25- to 44-year-olds very hard: Their "excess death" rate is up 26.5 percent over previous years, the largest change for any age group. It is not clear whether that spike is caused by the shift in COVID-19 deaths toward younger people between May and August or deaths from other causes, the CDC said.

"Excess deaths" is a calculation by researchers of the number of deaths overall during a particular period compared to how many people die during the stretch in a normal year. It is an importance calculation because some people who die might never have been tested for the disease, for example, and if people die at home without receiving medical care, they might not make it into the confirmed data. In the most updated count to date, CDC researchers found that nearly 300,000 more people in the United States died from late January to early October this year compared to the average number of people who died in recent years.
Trump Administration Acts to Ensure Coverage of Life-Saving COVID-19 Vaccines & Therapeutics
Under President Trump’s leadership, CMS is taking steps to ensure all Americans, including the nation’s seniors, have access to the coronavirus disease 2019 (COVID-19) vaccine at no cost when it becomes available. On October 28, the agency released a comprehensive plan with proactive measures to remove regulatory barriers and ensure consistent coverage and payment for the administration of an eventual vaccine for millions of Americans. CMS released a set of toolkits for providers, states and insurers to help the health care system prepare to swiftly administer the vaccine once it is available.

 These resources are designed to increase the number of providers that can administer the vaccine, ensure adequate reimbursement for administering the vaccine in Medicare, while making it clear to private insurers and Medicaid programs their responsibility to cover the vaccine at no charge to beneficiaries. In addition, CMS is taking action to increase reimbursement for any new COVID-19 treatments that are approved or authorized by the FDA.

“Under President Trump’s leadership, we have developed a comprehensive plan to support the swift and successful distribution of a safe and effective vaccine for COVID-19,” said CMS Administrator Seema Verma. “As Operation Warp Speed nears its goal of delivering the vaccine in record time, CMS is acting now to remove bureaucratic barriers while ensuring that states, providers and health plans have the information and direction they need to ensure broad vaccine access and coverage for all Americans.”
Promising Health Center Practices During COVID-19 Summary Document
The NACHC Quality Center has produced a promising practices document that compiles over six dozen entries NACHC received this summer in response to a Call for Best/Promising Practices Developed or Adapted During COVID-19.
 
This activity was designed to gather, synthesize, and share promising practices and transformation activities in response to the COVID-19 pandemic. 
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.

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.
Choosing A Marketplace Plan That
Meets Your Household's Needs
Things to think about when comparing Marketplace plans
  • There are 4 categories of health insurance plans: Bronze, Silver, Gold, and Platinum. These categories show how you and your plan share costs. Plan categories have nothing to do with quality of care.

  • HealthCare.gov offers health insurance plan quality ratings (or "star ratings"), that reflect member experience, medical care, and health plan administration. The ratings let you quickly compare plans based on quality.

  • When choosing a plan, it’s a good idea to think about your total health care costs. You pay a monthly bill to your insurance company (a "premium"), even if you don’t use medical services that month. You pay out-of-pocket costs, including a deductible, when you get care.

  • Some plan types allow you to use almost any doctor or health care facility. Other plans limit your choices or charge you more if you use providers outside their network.

State News
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
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.
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.
National News
Health Centers Sue HHS Over Drug Company Denials of 340B Pricing
The National Association of Community Health Centers (NACHC) has filed suit in response to recent moves by drug manufacturers to dismantle the federal 340B drug discount program that health centers and the patients they serve count on. The suit seeks to compel the Department of Health and Human Services (HHS) to implement a long-delayed dispute resolution process that would allow health centers to act against drug companies that are violating the 340B statute and have abruptly stopped shipping discounted drugs to health centers' contracted pharmacies. Across the country, millions of lives are at stake and health center operations and budgets face possible devastation amid an overwhelming public health pandemic. NACHC issued a news release with additional information.
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.
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
Today with Macrae: Health Center Program Updates 
Mark your calendar to join Jim for updates on COVID-19, funding and other topics.
Tuesday, December 1, 2020
2:00-3:00 PM EST
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 
Financial and Funding Resources 
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.