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April 9, 2020
  WVPCA Weekly Outlook Newsletter
    A Newsletter on Community Centered Healthcare

Employers' Health Care Costs Expected to Rise Due to Coronavirus
Self-funded health plans could see their claims costs jump 7 percent this year as a result of the pandemic. Both self-funded and fully insured employer plans may see higher premiums in 2021, analysts predict.
Read the entire article from SHRM  here.

Can Community Health Centers Survive the Coronavirus Fight?
Read the entire article from  US News  here.

W.Va. Hospital Shut Down With 'No Warning,' Union Says 
Read the entire article from Law360   here

Coronavirus can live in your body for up to 37 days, according to new study
Read the entire article from the CBSNews  here.

The American Clinical Laboratory Association, whose members include Quest Diagnostics and LabCorp, is asking HHS to immediately begin accepting applications from commercial labs for a $100 billion fund created under the Coronavirus Aid, Relief, and Economic Security Act.
Read the entire article from HealthcareDive  here

Long-standing racial and income disparities seen creeping into COVID-19 care
Read the entire article from Modern Healthcare  here

 State and local public health departments will get $186 million in funding from the CDC to help track and test for COVID-19 in hotspots and soon-to-be hotspots.  Read complete article here.
When Face Mask Supplies are Limited or Depleted: CDC Recommendations

The CDC has released a set of strategies to maximize the use of face masks when supply is scarce or unavailable.

The agency recommends these strategies for face mask shortages:
1. Selectively cancel elective and nonurgent procedures for which healthcare professionals would usually wear a face mask.
2. Remove face masks for visitors in public areas.
3. Allow healthcare workers to use the same face mask for multiple patient encounters without removing the mask between encounters.
4. Only allow healthcare professionals to use face masks, asking patients with symptoms of respiratory infection to use tissues or other face coverings.

The agency recommends these strategies for face mask shortages during crises:
1. Cancel all elective and non-urgent procedures for which healthcare professionals would usually wear a face mask.
2. Allow healthcare workers to use face masks beyond the shelf life designated by manufacturers.
3. Allow healthcare workers to use the same facemask for multiple patient encounters, but ask them to remove the mask in between each encounter.
4. Prioritize face mask use for selected activities, including during essential surgeries and procedures and during patient care activities where splashes and sprays are anticipated.

The agency recommends these strategies when no face masks are available:
1. Allow use of a face shield that covers the entire front and sides of the face.
2. Allow use of homemade masks.
3. Keep healthcare workers at higher risk for severe illness from COVID-19 from direct contact with known or suspected COVID-19 patients.
4. If possible, designate healthcare workers who have clinically recovered from COVID-19 to provide care for patients with COVID-19.
5. Consider use of ventilated headboards that draws exhaled air from a patient in bed into a high-efficiency particulate air filter.
6. Consider use of portable fan devices with high-efficiency particulate air filtration that can help deliver clean air to patient rooms.

USDA Expands Provisions for Lenders to Offer Temporary Exceptions to Payment Deferrals for Agency Guaranteed Loan Programs

USDA Rural Development Deputy Under Secretary Bette Brand today announced that USDA is expanding servicing options for guaranteed lenders due to the COVID-19 pandemic. 


As you know, information on coronavirus is changing daily.  The WVPCA is working with Federal, State, and local health officials in emergency preparedness activities as well as disseminating appropriate and current information to our Community Health Centers.  This includes up-to-date resources and policies to ensure the continued health and safety of the communities we serve.  

Guidance and resource information can be found on the WVPCA website here and coronavirus.gov.
Telehealth/Telemedicine Billing and Coding in Response to COVID-19 Webinar

Please join the WVPCA and Shellie Sulzberger of Coding and Compliance Initiatives, Inc. for this educational webinar related to billing and coding guidelines for Telehealth and Telemedicine Visits in response to the COVID-19 pandemic on  Thursday, April 16, 2020 at 1PM to 2:30PM.
Attendees will participate in:
  • Discussion of key elements for COVID-19:  including definitions for virtual visits, remote patient monitoring,  etc. 
  • Discussion of reimbursement policies for major WV payers:  WV Medicaid, PEIA, Highmark, Cigna and Medicare.
  • Discussion of ICD-10 coding.
Target Audience:  Billing and Coding Staff, Providers and Financial Staff.

Registration information can be found here.
The Power of Positive Thinking
Image courtesy of time.com
If we open almost any self-help book, we'll find a writer talking about the power of "positive thinking." But in the real world, "positive thinking" rarely carries the same importance as words like "work ethic" or "persistence" or, for that matter, "decision-making" and "skills." Don't get us wrong, no one prefers feeling negative over positive, and we certainly don't like being around negative people. It's just that "positive thinking" is viewed as a soft, fluffy term and is easily dismissed as "nice to have, but not necessary for optimal productivity." Yet, leadership research is making it more and more difficult to dismiss positive thinking.
Play along with us for a moment. Let's say that we're walking through the park, and a bear steps onto the path ahead of us. When this happens, our brains record a negative emotion-fear. Researchers have long known that in moments like this our mind is programmed to narrow its focus by shutting down the outside world and limiting the options we see. This is a valuable instinct if we're trying to save life and limb because nothing else really matters in that moment.
The challenge comes in other moments when our actual physical safety isn't at risk. For example, when we're in a verbal conflict with a colleague or when our to-do list gets longer and longer. In those moments, our brain's natural wiring will lock in on the anger, frustration, fear, and stress. And, just like it did with the bear, those negative emotions will prevent our minds from seeing any options other than our "fight or flight" survival instincts (neither of which are the healthiest ways to address our colleague or our to-do list). Researchers refer to this as an "amygdala hijacking" and it keeps us from seeing the other options and choices that surround us.
Here's the thing: positive emotions have been shown to do the opposite. They open our sense of possibilities and broaden our minds, which allows us to think creatively and critically. Positive thinking provides more than a temporary decrease in stress and the addition of a few smiles, it impacts overall performance. Given the abundance of negative emotions in our world right now and the need for leaders to raise their performance because of global challenges, we should seek to enhance our positive emotions by doing things that sparks feelings of joy, contentment, and passion. 

Here are two methods we use:
  1. Meditation and Prayer. Research has shown that people who meditate and/or pray display more positive emotions than those who do not. It's also been shown that meditation increases mindfulness, purpose, and social support, while decreasing signs of illness. Applications like Headspace, Calm, and Balance provide guided meditations that can help reduce stress, improve sleep quality, and increase focus.
  2. Play. Having fun is no less important than our Wednesday meeting, and yet, many of us rarely give it time and space to live on our calendars. At Ethos, one of the things our founder and CEO expects is that we work hard, but that we play frequently. "Set goals, don't obsess over them," James says. Research indicates that joy, laughter, and play refresh the mind. We need to give ourselves permission to embrace the getaways and schedule time for fun and adventure. It may be one of the most helpful things we can do to improve our leadership.
How to Keep Your Zoom Chats Private and Secure

Trolls. Prying bosses. Zoom's a great video chat platform, but a few simple steps also make it a safe one.

With so many  people stuck inside, Zoom has become the default video chat platform for millions. Its simple, accessible interface makes keeping in touch with family, friends, and coworkers a cinch. At the same time, many have found Zoom's default privacy and security features lacking, exposing users to trolls and unwanted oversight. 

This article goes over the basics of how to keep your Zoom chats private and secure.   There are plenty of settings you can tweak to make Zoom a safer place for you and everyone else on the line.

Click here to read more.
State NewsStateNews
WVCTSI announces COVID-19 funding opportunity 

In response to the ongoing COVID-19 pandemic, the West Virginia Clinical and Translational Science Institute has released a request for applications (RFA) for research projects related to enhancing understanding of this public health crisis.
The Pop-Up COVID-19 funding opportunity will provide up to $30,000 for projects that show significant scientific merit and will enhance the understanding of the COVID-19 pandemic. Funding received must be utilized within a 12-month project period. Detailed instructions, eligibility information, and a complete RFA can be found on the Pop-Up COVID-19 funding opportunity webpage.
Applications will be accepted on a rolling basis until April 21, 2020. Questions related to this funding opportunity should be directed to Camille Charlier, MS, WVCTSI pilot grant program coordinator, at ccharlie@hsc.wvu.edu.
WV Project ECHO beginning weekly sessions on COVID-19 pandemic

WVCTSI's WV Project ECHO will be hosting weekly sessions in April devoted to combating the ongoing COVID-19 pandemic. These remote sessions will allow healthcare providers from across the state to ask patient questions and learn best practices from a panel of expert hub members. Sessions will take place from 12:15 to 1:15 p.m. every Thursday in April. 
Interested participants can email Jay Mason , assistant director of WV Project ECHO, at  jdmason@hsc.wvu.edu with any questions. 

Cases can be submitted online here.
(This session is temporarily replacing the Chronic Pain and HCV/HIV sessions normally held on Thursdays, so please disregard any information about chronic pain on submission form.)
Coronavirus Makes Participating in The 2020 Census More Important Than Ever

As we are making historic measures to slow the spread of the coronavirus, no one stands alone. We are all one community working toward the common goal of staying safe and healthy.

Times like these make participation in the 2020 Census even more meaningful for the State of West Virginia. Census data is used to fund research and programs that provide essential information for our public health system.

The 2020 Census is already in full swing. The largest civic engagement operation in the United States, the Census, happens once every ten years. The task requires counting every single person currently living in the country regardless of immigration status, living situation, or financial position.

Each person not counted could bring a loss of $2,000 per year for 10 years. Over 10 years, that is $20,000 per person lost. And it's not just about the money. The Census also determines how many congressional seats each state gets, as well as the distribution of 1.5 trillion in federal spending.

The Census is especially important in a region as geographically and demographically diverse as West Virginia. Barriers such as language capacity, poverty, homelessness, sexual orientation, citizenship status, race, and age can lead to low response rates making communities hard to count. Only 74% of West Virginia's residents completed the previous census in 2010. The data collected during the 2020 Census will be used to make decisions for the next 10 years.

Now, more than ever we need to make sure people understand the importance of being counted. Everyone should know that Census data is secure, and their privacy is protected by law. Completing the census is easy, and there are multiple ways to fill out the census form. It can be submitted easily online or by phone by calling 844-330-2020.

While we are doing our duty to stay safe and healthy, let's take 10 minutes to complete the Census. It's easy, safe, and adds real dollars for our state. We can all do something to help the community and ensure a strong foundation for the recovery of our region.
Important Changes to NCQA's Recognition Process in Response to COVID-19 Crisis

NCQA would like to express their support of everyone affected by the coronavirus (COVID-19) outbreak, especially the care teams who are on the front lines.
They recognize that patients are your priority during this time and that you might need to temporarily pause certain activities associated with your work as a Certified Content Expert (CCE). Although the situation is still evolving, NCQA is extending the March, June and September 2020 certification renewal terms into the fall.  
  • All CCEs with March 2020 certification end dates, regardless of their current status, will be given a new temporary end date of October 31, 2020.
  • All CCEs with June 2020 certification end dates will be given a new temporary end date of November 30, 2020.
  • All CCEs with September 2020 certification end dates will be given a new temporary end date of November 30, 2020. 
During this extension, affected CCEs will maintain active status with all access and benefits associated with certification.
If you are a CCE with an end date that falls within the affected period, your new certification renewal window will open ninety days prior to the temporary end date. Once you are within the renewal window and have met the MOC requirements, the My CEC Certification Renewal window will allow you to renew certification. Upon initial renewal, the system will assign you a certification end date of December 31, 2022. After renewal, they will adjust your end date back to align with your original renewal cycle.
NCQA will notify you when your certification end date has been updated, so you can download your new PCMH Content Expert Certification certificate from My CEC with your correct start and end dates.
Please see NCQA's coronavirus response page to learn how changes to their Recognition process in response to the COVID-19 crisis could affect your NCQA Recognition activities.
If you have any questions or if you would like to renew your certification before the new adjust renewal window, please contact them through  My NCQA  so they can adjust your account.
Coronavirus and NCQA
Based on ongoing updates from the CDC and other authorities, NCQA has enacted new policies for NCQA staff, contractors and events.
NCQA is prepared to conduct all business activities virtually, if necessary. They will continue to deliver all systems, surveys, support services, contract and grant-related services. Also, they are assessing large meetings, events and conferences with the goal of converting them to virtual events.
NCQA will update policies as new information about COVID-19 becomes available.
They will continue to follow the COVID-19 situation and make decisions accordingly.
They will continue to keep staff, colleagues and partners informed as they learn more.
Click here for the latest updates. 
 Announcing 2017 Standards Training 
The West Virginia Primary Care Association (WVPCA), the District of Columbia Primary Care Association (DCPCA), and the Mid-Atlantic Community Health Centers (MACHC) and are excited to provide our members with the National Committee on Quality Assurance's (NCQA)  Patient-Centered Medical Home (PCMH) 2017 Standards Training Tuesday, July 14 - Thursday, July 16, 2020. The training will be conducted in-person by NCQA's own expert staff members. Our PCAs have worked collaboratively to bring this special training opportunity to our members.
During this 2 ½-day training, we are offering two classes: Introduction to PCMH 2017: Foundational Concepts of the Medical Home (1½ days) and Advanced PCMH 2017: Mastering the Medical Home Transformation (1 day). Both these classes are an essential component to understanding all the components of the new PCMH 2017 standards and earning the official NCQA PCMH "Certified Content Expert" designation. For those who do not intend to pursue certification, the training is extremely valuable for implementing PCMH, earning PCMH 2017 recognition and sustaining PCMH status through annual reporting.  
This training is being offered to WVPCA, DCPCA, MACHC and at a  greatly-reduced cost of only  $200 per person. For comparison, similar trainings administered by other entities normally costs almost $2,000. We recommend you send 1-3 key people from your health center to the training. Breakfast, lunch, and continuing education are included as part of the registration fee.
Please see the "HRSA-Supported NCQA PCMH Training Fact Sheet" for additional information about this training such as training description, agenda, Continuing Education Credit, and benefits of PCMH.
WVPCA members please use the coupon code: WVPCA2020
We ask that all WVPCA members register before Thursday April 30th 2020, as we want to ensure that all PCA members are registered before we share this training invitation to non-members.
Additional details on registration:  
  • If staying overnight, the Kellogg Conference Hotel will be offering a special rate of $139  for registrants. In order to obtain the special $139 discounted rate, you will need to call the Kellogg Conference Hotel directly at  (202) 651-6000 and request the rate using DCPCA as a group code. Overnight parking will be available for $40 a night and daily parking will be free for all attendees.
  • Two weeks before the training you will receive a welcome email from NCQA with instructions on how to complete NCQA's portion of your registration for the training. This message will contain links and information directing you to register with NCQA's system in order to receive the training's e-materials, evaluation and certificate distributions. COMPLETE your registration for the training by following the links to NCQA's website and register in their system. There are no additional fees associated with registering on NCQA's system. They will only use the information to manage the training's e-materials, evaluation and certificate distributions.
  • Several weeks before your training date, NCQA will send out a welcome email that contains all PowerPoint presentations from both training which include the 2017 standard for this training. It is the responsibility of each register to download and/or print out these materials prior to the training. No training materials will be made available during these trainings.
National NewsNationalNews
HHS to use coronavirus relief funds to pay for care for uninsured

HHS Secretary Alex Azar Friday said that the Trump administration will use a $100 billion hospital and provider relief fund to reimburse hospitals at Medicare rates for uncompensated  COVID-19  care for the uninsured. 

Azar said the funds will be distributed through the Public Health and Social Services Emergency Fund, which supports the National Disaster Medical System.

Azar did not specify how much of the $100 billion of Congress' so-called "Marshall Plan" for hospitals would be set aside for reimbursement. The department is still weighing how to distribute the rest of the money.

Read complete article here.
Watch Out for Fake Office of Civil Rights Investigators

HHS alerted hospitals and health systems of someone posing as an Office for Civil Rights investigator to get patient health information, the American Hospital Association warned.

In a notice, the association said HIPAA-covered entities should notify their staff. All OCR investigators have email addresses end with @hhs.gov. If staff receive a phony email, they should ask for a confirming email from the hhs.gov email account.

The OCR has halted many investigations. In March, President Donald Trump announced that his administration would not be enforcing HIPAA penalties.
Upcoming Training OpportunitiesUpcomingNationalTraining

Join the HITEQ Center, in collaboration with the National Council for Behavioral Health, for a webinar on understanding from a beginner perspective, how to integrate HIV prevention, screening into integrated behavioral health services, including how to identify patients at risk for HIV with a focus on SUD, facilitate screening, and prompting for rescreening at appropriate intervals.

Useful for: C-suite staff, information technology (IT) leadership and staff, and clinical staff

Thursday, April 23, 2020
3:30 PM - 4:30 PM ET

Flattening the COVID-19 Curve: Latest Update
This weekly webinar series hosted by NACHC, a HRSA -funded NCA will feature leadership from Federal partners such as the Centers for Disease Control and Prevention, Health Resources and Services Administration's Bureau of Primary Health Care and NACHC. Additionally, webinars will highlight presentations from community health centers across the country who are on the front lines dealing with COVID-19.  

Thursday, April 16
1:00-2:00 p.m. ET

Many upcoming 
trainings and events 
have been canceled 
or postponed due  to the COVID-19 emergency. 
It is best  to call 
ahead or check 
with the organizer's websites and contacts to verify the status 
of ALL events
 and trainings

COVID-19 Webinar Series: Resource Sharing and Discussions with the Frontline

Please join the National Center for Farmworker Health for this webinar series. As health centers across the country are being impacted by this current crisis, there is a need amongst health center staff to share how service delivery, such as outreach strategies and enabling services, are being adjusted to maintain patient care. Addressing Social Determinants of Health and linkages to available resources and Webinar. Webinar participants will have an opportunity to share ideas and strategies with peers on the front line and identify promising practices to help them stay safe and continue providing effective patient care. 

Wednesday, April 15, 2020
2:30 PM - 3:30 PM ET
 __________________________ _____
Join this webinar to learn more about how your telehealth and remote communication can be a long tern solution to maximizing your impact on the Quadruple Aim.  

Virtual Communication involves using a communication tool to allow proactive communication to go out to your patients with specific messages to positively impact staff and patient safety and outcomes!

This webinar will focus on how to make telehealth and other virtual communication service lines sustainable post COVID.

Sustaining Telehealth and Virtual Communication Post COVID-19
Wednesday, April 22, 2020 |3:00 PM ET

COVID-19 is Birthing Another Crisis

Out of necessity many governors have requested residents to self-quarantine at home and businesses to allow employees to work from home as an intervention to flatten the curve and shorten this crisis. Many individuals have been laid off of their jobs, are working hard to honor the social distancing mandate and trying to redefine what normality actually is.   

All these challenges are creating a new crisis.   This crisis is the direct result of trying to limit the spread of COVID-19.  People's mental and emotional health are being challenged.  

To find out more about this crisis in the context of COVID-19 click here.
Funding and Financial Resources
Small Business Administration Loans

Health centers experiencing substantial economic distress as a result of COVID-19 can apply for the U.S. Small Business Administration's (SBA's) Low-Interest, Federal Economic Injury Disaster Loans.  SBA's Economic Injury Disaster Loans offer up to $2 million in assistance. Loans may be used to pay fixed debts, payroll, accounts payable and other bills that can't be paid because of the disaster's impact. The interest rate for non-profits is 2.75% and repayment terms are flexible up to 30 years. 
Capital Link COVID-19 Funding & Financing Resources

Capital Link has added a COVID-19 Resources page to their website with a collection of organizations and lenders that are providing funding for health centers in immediate need of financial assistance. Their upcoming webinars and learning collaborative sessions  that are scheduled over the next few weeks will include information that is tailored to the current circumstances health centers are currently experiencing in this pandemic, in-line with resources and guidance from NACHC and HRSA. 
CommunityHealthCenterResourceCommunity 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:

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 and Communications Coordinator 
To sign up to receive the WVPCA Weekly Newsletter, click HERE
West Virginia Primary Care Association
  1700 MacCorkle Ave. Charleston, WV 25314| (304) 346-0032 | WWW.WVPCA.ORG
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.