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August 14, 2020
  WVPCA Weekly Outlook Newsletter
    A Newsletter on Community Centered Healthcare

Read the entire article from The Wall Street Journal here.

Thomas Health plan to emerge from bankruptcy goes before judge       
Read the entire article from Charleston Gazette-Mail here.

Health care staff, communities honored during National Health Center week
Read the entire article from The Journal here.

As we end National Health Center Week, the WVPCA wants to take this time to thank you for your dedication and innovation in providing access to quality health care and support services in West Virginia.
Community health centers nationwide serve 27 million patients, and that number continues to grow along with the demand for affordable primary care. Collectively, our health centers provide services to more than 470,000 West Virginians, which means 1 in 4 West Virginians are health center patients.
Not only do our community health center's provide integrated and coordinated medical care, dental care, behavioral health services, affordable medications, health education, referrals to social services, and more for members of our community, but they also work to ensure that patient-centered care is provided and that all patients are treated with respect.   
 "Community Health Centers in our state are the foundation of the safety net for health care services.  During the past six months, health centers have been resolute in meeting the needs of their communities.  In responding to COVID-19, our health centers have helped lead the way, whether working alongside other health partners in providing testing services at community events, launching and expanding telehealth programs, or providing testing services and care at their sites, our health center staff have been on the front lines every day.  They do this because they believe in our mission of health equity - that everyone should have access to affordable health care."  
                                                                                                                                   Sherri Ferrell,  WVPCA CEO

This week was just a small salute to you and your efforts.  All of us at the WVPCA are shouting "We appreciate you and thank you for lighting the way for your patients and communities." 
Tell us how you are celebrated the future of Community Health by emailing your event details to  events@wvpca.org.  We will be showcasing these celebrations in our next ENews edition.
August is National Immunization Awareness Month 

National Immunization Awareness Month is an annual observance to highlight the importance of vaccination for people of all ages. COVID-19 has led to steep declines in routine immunization, making the need to improve childhood immunization especially urgent. Health centers play a critical role! Research shows the strongest predictor of whether a patient gets vaccinated is a recommendation from their health care professional.

To encourage patients and stakeholders to keep up with immunizations, the CDC has produced toolkits and resources to help health care professionals communicate with their patients about immunization. Find the following resources in the toolkit:
  • Key messages to help ensure patients stay up to date on their vaccines.
  • Sample social media to communicate the benefits of immunization during National Immunization Awareness Month.
  • Graphics for social media platforms and use on websites, newsletters, and other materials.
  • Educational resources.
CDC's recent "Interim Guidance for Immunization Services During the COVID-19 Pandemic" can also help your health center plan for safe vaccine administration during the COVID-19 pandemic.
COVID-19 News Alert: HHS Provider Relief Fund Phase 2 General Distribution Now Accepting Additional Applicants

Please see the below CMS News Alert.  Note - there is no new money for health centers; but as of 8/10/2020 health centers have the opportunity to submit their data to demonstrate they should potentially receive "new" money if they did not receive their full 2% of revenue to date. This is the only venue for health centers to "make their case" that HHS should have paid the health center more, based on the most accurate revenue data available.  The deadline to submit this information is August 28, 2020.  

HHS announced that certain Medicare providers would be given another opportunity to receive additional Provider Relief Fund payments. These are providers who previously missed the June 3, 2020 deadline to apply for additional funding equal to 2 percent of their total patient care revenue from the $20 billion portion of the $50 billion Phase 1 General Distribution, including many Medicaid, Children's Health Insurance Program (CHIP), and dental providers with low Medicare revenues. In addition, certain providers who experienced a change in ownership, making them previously ineligible for Phase 1 funding, will also be given an opportunity to apply for financial relief.
Starting August 10th, these eligible providers may now submit their application  for possible funds by August 28, 2020. This deadline aligns with the extended deadline for other eligible Phase 2 providers, such as Medicaid, Medicaid managed care, CHIP, and dental providers.

For the latest information on the Provider Relief Fund Program, visit: hhs.gov/providerrelief.
Youths who vape at higher risk of getting COVID-19, study finds

Teenagers and young adults who vape face a significantly higher risk of contracting COVID-19, a new study shows.

The study, published in the Journal of Adolescent Health, includes data from online surveys conducted in May. The surveys included responses from 4,351 participants, ages 13 to 24, from across the country. About half had used e-cigarettes, while the other half had never used nicotine products.

Researchers found that those who vaped were five times more likely to contract COVID-19 than those who did not use e-cigarettes. Those who vaped and smoked cigarettes were seven times more likely to contract the disease.

Youths who had vaped and smoked cigarettes in the previous 30 days were almost five times as likely to experience COVID-19 symptoms, such as coughing, fever and difficulty breathing as those who had never smoked or vaped.

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.
Financial Management PEP Report Webinar 

Please join the WVPCA and Jonathan Chapman, Chief Project Officer of Capital Link for this interactive 90 minute webinar to discuss Financial Management Performance Evaluation Profile (PEP) Reports.

How do you assess your health center's performance by looking at financial metrics? Which metrics are important? What do the peer benchmarks in your Performance Evaluation Profiles tell you? Why is benchmarking even more important today?  WVPCA's member health centers are invited to join us in this webinar training to find out how benchmarking data influences performance analysis. In this session, WVPCA member health centers will learn how to assess their financial and operational performance using benchmarking and comparative metrics in the ever evolving FQHC business model.  

The WVPCA has worked with Capital Link to create individual health center Performance Evaluation Profile Reports.  These reports have been provided to each health center in preparation for this webinar.

  • What is important to measure?
  • How to use your PEP report data to establish a foundation for assessing COVID-19 impact and Value-Based Care.
  • Review of WV health center specifics - how we read results.
  • Moving forward with next steps - continued financial management training on September 15th to have a deeper dive discussion about the "Health Center of 2025" and Value Based Care.
Target Audience: CHC CEOs, CFOs, COOs, Board Members, CHC Financial and Operational Staff.

There is no cost for health centers for this training event.

Tuesday, August 25, 2020 | 10:00 AM to 11:30 AM
Nurse-Led Diabetes Prevention Webinars

Please join the West Virginia Primary Care Association (WVPCA) as we have partnered with the National Nurse-Led Care Consortium (NNCC) to conduct a four-part ECHO peer learning series for West Virginia school and health center nurses. 

Session 1 - August 26th (Wednesday): Clinical Guidance | 12:00 PM - 1:00 PM
Session 2 - September 9th (Wednesday): Communication with Families and Children | 12:00 PM - 1:00 PM  

Session 3 - September 22nd (Tuesday): Childhood Trauma, Obesity, and Lifestyle Change | 12:00 PM - 1:00 PM
Session 4 - October 6 (Tuesday): Partnerships, Referrals, and Care Coordination | 12:00 PM - 1:00 PM

The WVPCA and the NNCC conducted a Town Hall in May to begin identifying issues in diabetes management and prevention in youth.  The information gathered has been used in the development of these four ECHO opportunities that support the care that is being provided to those with diabetes as well as diabetes prevention efforts. 

Participants are encouraged to attend all four sessions and submit cases from their clinical experience for discussion among the group.

Objectives for this Nurse-Led Diabetes Prevention ECHO:
  • Learners will improve communication between schools, school-based health centers, and community-based health centers.
  • Learners will identify tangible next steps to reduce prediabetes among elementary school-aged children.
  • Learners will develop a multi-disciplinary, nuanced approach to addressing diabetes risk that includes communication with patients, families, and fellow practitioners.
TARGET AUDIENCE: This event is intended for SBHC staff and school nurses.
Although federal guidance and local circumstances continue to evolve, NCQA is implementing the exceptions noted below for the March 1-September 30, 2020, time frame. This applies to all future surveys that include this look-back period. They will give updates as needed and when new information becomes available.  They suggest primary care practices consult and complete The Green Center's weekly COVID survey. While NCQA does not issue or manage this survey, they believe the information gathered is meaningful. The survey helps practices understand and report primary care's capacity to respond to COVID-19.

Practitioners Who Provide Care During a Public Health Emergency:
Organizations do not need to credential practitioners who are not part of their network or practice and are providing care to members/patients as part of a federal, state or local government emergency response team.

CMS 1135 Waivers for State Licensing:
CMS allows states to request a waiver that will temporarily allow out-of-state practitioners to provide services if they are licensed in another state. When credentialing these practitioners in a state that receives a waiver, NCQA will waive the requirement that the organization verify the license to practice for that state.

Health Care Organizations and Practices Whose Operations Are Affected:
NCQA understands that normal operations have been disrupted in many communities, which could affect organizations' ability to meet NCQA requirements. NCQA will be flexible in scoring organization performance during the March-September time frame. Organizations will need to provide documentation regarding the circumstances that interfered with meeting requirements.

Note: Recognition practices may show evidence from any time in the past year, so organizations may demonstrate that activities were routinely implemented before and after the March-September time frame.
Organizations with an upcoming survey or evaluation in 2020 should contact their Recognition account representative. NCQA will determine if additional accommodations (e.g., longer extensions, virtual surveys, shorter look-back periods) are necessary on a case-by-case basis. Please submit all other questions through My NCQA at my.ncqa.org.
Please contact Shannon Parker at Shannon.parker@wvpca.org should you have any questions.
NCQA updates Recognition publications periodically to clarify guidance, revise resources and refine criteria expectations. Updates are now available for the PCMH and PCSP Standards and Annual Reporting publications. Q-PASS access to the 2021 Annual Reporting Requirements will be available in August.

To download the publications, go to the My Downloads section of My NCQA. Log in using your email address and password. If you have not previously downloaded NCQA publications, refer to the table below for quick access. 

Publication by Program

Notable Changes
  • There is no longer a New York State-specific PCMH publication; you can find all New York State publication information directly in the main PCMH Standards and Annual Reporting publication.
  • In response to the COVID-19 pandemic, NCQA has limited changes to Annual Reporting for 2021. PCMH and PCSP Annual Reporting Requirements for reporting period January 1-December 31, 2021, remain nearly identical to the preceding reporting year.
  • NCQA has expanded and clarified PCMH program guidance for use of telehealth to ensure that practices can continue to meet PCMH requirements. Read our recent blog post to learn more. 
A table of updates summarizing changes to the publications is available in the FAQ section of NCQA.org. Click here for the PCMH FAQ and here for the PCSP FAQ. Updates to PCMH and PCSP Transforming Standards go into effect for all enrolled and Recognized practices on August 1, 2020. 

August is National Immunization Awareness Month (NIAM). CDC will host two upcoming NIAM events highlighting the importance of vaccination for people of all ages.

WEBINAR: Strengthening Vaccine Confidence in Pediatric and Family Practice Offices During the COVID-19 Pandemic - August 19, 2020 from 3:00-4:00pm EDT
This webinar will discuss how to strengthen vaccine confidence among parents and ensure safe well visits.  Register here.

Instagram Q&A for Parents: Childhood Vaccination - August 24, 2020 at 12:00pm EDT
CDC experts will provide near real-time answers to questions about staying up to date on childhood vaccines during the COVID-19 outbreak.  Tune into CDC's Instagram feed to join the conversation.

Additional resources to assist you with communicating to health care professionals, parents, and patients about immunizations during August and throughout the year can be found here.

August is Children's Eye Health and Safety Month. The National Center for Children's Vision and Eye Health at Prevent Blindness just released a new report inclusive of current data on vision testing and the social determinants of health and an expanded section on equity matters in vision. Access the report at of "Children's Vision and Eye Health: A Snapshot of Current National Issues 2nd Edition." During the month of August, the National Center for Children's Vision and Eye Health and the National Optometric Association ask you to help raise awareness of children's vision and eye health. Especially during the pandemic, while children are learning at home, parents and caregivers can their educational materials to help them observe possible vision problems and get eye care for their children when needed.

School-Based Health Alliance COVID Survey.  Fall is quickly approaching. Prior to the COVID 19 pandemic, the schools you serve would be preparing for the influx of students returning to school after summer vacation. For the School-Based Health Alliance (the Alliance), this would have marked the launch of the 2019-20 National SBHC Triennial Census. But not this year.
The pandemic changed the SBHC landscape and it continues to do so. As a result, the Alliance decided to postpone administering the 2019-20 SBHC Census. Instead, we will gather data related to pandemic's impact on the current SBHC landscape and the SBHC response during these uncertain times. Please complete this brief, 10-minute survey about your current SBHC operations by Thursday, August 20, 2020. Take the survey here.
We will use the data collected to represent and support the needs of SBHCs and the field during these unprecedented times; to advocate for local, state, and national program and policy initiatives; and to provide targeted technical assistance.
If you have questions or need assistance regarding this survey, send an email to research@sbh4all.org.

The National School-Based Health Alliance's partner, the National Center for School Mental Health, is offering West Virginia 10 scholarships to participate in School Health Interdisciplinary Program Conference.  Included in the scholarship is up to 33 free CEU's. 
The School Health Interdisciplinary Program (SHIP) conference is a multi-faceted approach to continuing education. SHIP providers comprehensive training on coordinated school health. This conference focuses on topics vital to school professionals. SHIP is committed to advancing quality and sustainability in school health, with this year's theme of Addressing the Needs of the Whole Child: What Works in School Health and Wellness. Training will focus on helping school-based professionals understand core concepts in the school health field, including best practice strategies and policies.
The target audience for the conference includes: school nurses, school social workers, school psychologists, school-based health center staff, administrators, after-school program providers, alternative program staff, child advocates, health educators, school teachers and support staff, community and faith- based representatives, child serving agency staff, mental health practitioners, substance use providers, pediatricians, occupational therapists, psychologists, psychiatrists, pupil personnel workers, school counselors, school resource officers, social workers, and special educators.
Professional continuing education hours will be complimentary for counselors, nurses, psychologists, and social workers. The University of Maryland School of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
View the website  for more information on registration and the conference program
If you are interested in registering, please email John Kennedy, to receive the actual code to use for the registration to receive the scholaship. There are only ten scholarships available and first come basis.   Each person must request an individual code. If you are not one of the ten scholarships, this is still a great opportunity for $50!
State NewsStateNews
Brigadier General Russell Crane appointed Deputy Secretary of West Virginia DHHR 

West Virginia Department of Health and Human Resources (DHHR) Cabinet Secretary Bill J. Crouch announced Wednesday the appointment of Brigadier General Russell Crane as deputy secretary of DHHR, effective Aug. 17, 2020.
According to a press release, Crane most recently served as assistant adjutant general (Army) of the West Virginia National Guard, and as deputy commanding general, Training Support Division (East), First United States Army. After a highly decorated military career, including being awarded the Bronze Star Medal, Crane concluded his First Army duties in April 2019.

Major Gen. James Hoyer, adjutant general, assigned Crane to assist Secretary Crouch with the COVID-19 pandemic in March 2020.

"I greatly appreciate Major Gen. Hoyer for loaning Russ to DHHR to serve as a key advisor during this public health crisis," Secretary Crouch said in a press release. "With General Crane's deployment to Africa, Afghanistan, and Europe, as well as his service to the United States and his home state of West Virginia, he brings a plethora of experience, enthusiasm and strong leadership and management expertise to the table, especially during this worldwide pandemic of COVID-19."
Crane holds a bachelor's degree in criminal justice from Marshall University and was commissioned from the Reserve Officer Training Corps as an infantry officer in 1987. He holds a master's degree in strategic leadership from Mountain State University and master's degree in strategic studies from the Army War College.

"I look forward to continuing my service to West Virginia as part of this tremendous organization under Secretary Crouch's leadership," Crane said.

Crane joins Jeremiah Samples, who has served as a deputy secretary to Crouch since 2017.
National NewsNationalNews
Executive Order and Medicare Physician Fee Schedule Address Telehealth Continuation 

President Trump signed an Executive Order on Improving Rural Health and Telehealth Access, aiming to expand rural health access and many of the telehealth policies put into place during the COVID-19 pandemic. It is important to be aware, however, that Congressional action is needed to extend telehealth services for FQHCs beyond the public health emergency declaration, a fact emphasized in the annual Medicare Physician Fee Schedule proposed rule issued shortly after the executive order. There are a number of efforts in Congress to address the need for an extension of Medicare telehealth services for FQHCs. The proposed rule does include a provision to add Principal Care Management services for FQHCs and RHCs and to rebase the Medicare FQHC market basket.
Upcoming Training OpportunitiesUpcomingNationalTraining
HHS Telemedicine Hack Learning Community

Although telemedicine use has grown exponentially during the COVID-19 pandemic, many ambulatory providers still lack the knowledge and skills needed to implement video-based telemedicine into their practices. To support wide adoption of telemedicine, the U.S. Department of Health and Human Services (HHS), Assistant Secretary for Preparedness and Response is partnering with the ECHO Institute at the University of New Mexico and the Public Health Foundation's TRAIN Learning Network to deliver a 10-week, virtual peer-to-peer learning community called Telemedicine Hack.  

Key components of Telemedicine Hack include: 
  • Five teleECHO sessions on key topics (e.g., workflows, documentation, reimbursement) highlighting best practices and case studies from the field 
  • Five virtual "office hour" discussion panels with case presenters, government agencies, topical experts, and stakeholder associations responding to your questions
  • Inter-session peer-to-peer learning facilitated via virtual discussion boards and ad hoc interest groups
  • CME/CEU credits are available for attending, at no cost to participants
For more information about this series and to register, please click here for the flyer or contact c19ECHO@salud.unm.edu.

There is no cost to join the Telemedicine Hack initiative. All ambulatory providers (e.g., primary care, surgical, rural/urban, dental, mental health, solo practitioners) are invited to participate.

Wednesdays, July 22 - Sept 23, 2020 | 12:00 PM to 1:00 PM
FinancialAnchorFinancial and Funding Resources
HC Requests for Carryover of Unobligated Balances 

In recognition of the impact of COVID-19, HRSA will consider approving carryover of unobligated balances for any Health Center Program (H80) funding originating from more than one prior budget or project period-for example, unobligated balances from fiscal year (FY) 2018 that have already been carried over into FY 2019, and which your health center now needs for FY 2020 in-scope activities.
Note that any carryover funds, regardless of amount, must be used for the original approved purpose(s) of the award. In accordance with 45 CFR Part 75.403-405, you must use federal award funds only for allowable costs that are:
  • Consistent with the terms and conditions of the federal award and the Federal Cost Principles (45 CFR Part 75 Subpart E), including any supplemental award requirements (e.g., patient targets, FTE hiring and timelines);
  • Allocable to the purposes of the Health Center Program project; and
  • Reasonable.
See the  Health Center Program Carryover of Unobligated Balances Frequently Asked Questions (FAQs) for additional information. For specific questions about appropriate use of carryover funds, contact your Grants Management Specialist.
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.