Tom Butt
 
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  COVID-19 Update - March 23
March 24, 2020
 

Last night’s briefing from League of California Cities:

East Bay Mayors, Council Members & City Management:

Today, based on feedback we received from you about impacts to your cities, the League of California Cities made a request to Governor Newsom (see attached letter to Governor Newsom) to relieve cities from certain statutory requirements during the current COVID-19 public health crisis, so cities can focus on responding to the crisis and devoting the resources necessary to protect the health and safety of all Californians.  We do anticipate having additional requests, so please continue to send items to covid-19@cacities.org.  The League requested relief in connection with the following, specifically about mandated timelines:
·       Review and Approval of Development Projects
·       Housing Element Submission
·       Housing and Community Development (HCD) Grant Programs
·       California Environmental Quality Act (CEQA)
·       Transportation Funding
·       Public Records Act
·       Public Reform Act – Form 700
·       California Government Claims Act
·       Solar Permits
·       Wireless Telecommunication Facilities
·       Financial Reports
·       Police Department Registration

This afternoon, the Governor provided an update (briefing notes attached; highlighted areas may be of specific interest to cities).  One item to highlight from the Governor today is his announcement that State Parks is working with local jurisdictions to reduce access to state parks public parking lots. The specific press release is here and continue to check the State Parks COVID-19 webpage for additional information.

The Department of Housing and Community Development announced awards today for the $100 million emergency homeless funding allocation for cities and counties.  You can find the list here and also attached.  

On the federal side, we continue to work with the National League of Cities and our federal lobbyists to raise issues of concern on behalf of our cities.  I want to highlight that we are hearing that the small cell preemption regulations may be in play in the federal stimulus package.  Note the red font section under the “Federal Actions” section below and request that you contact your representatives to explain concerns about this.  Other items include:
·       The White House will have another briefing on Wednesday at 10am; register HERE but note that the call capacity is limited. Note: latest White House briefing document is also attached.  
·       The President announced today the October 1 deadline for REAL ID is being extended (no date given).  
·       Small Business Administration’s Administrator Jovita Carranza announced automatic deferments through December 31, 2020 for borrowers still paying back SBA loans from previous disasters.
·       FEMA has created a webpage titled “Coronavirus Rumor Control” which should help differentiate between rumors and facts. Additionally, procurement information from FEMA is attached.

Governor Actions and Announcements
Update from the Cal Guard's Humanitarian Response to COVID-19
COVID-19 Testing Guidance from DPH

Other California Information
COVID-19: Federal Actions Affecting California: The LAO recently launched a series of posts describing federal COVID-19 response actions and their effects on California. In the coming days, this series will include write ups on the federal emergency declaration, unemployment insurance, health care and public health, food assistance, and others. We will add to the series and update the posts as additional actions are taken and additional information becomes available. In some cases, these posts also will discuss actions the state could take in response to federal assistance.  The series is available here.

Federal Actions (Courtesy of NLC)

In another significant development today, the Senate again failed to end debate and begin moving to the CARES Act, the third stimulus bill, which was drafted by the Senate.

On the other side of the Capitol, House Speaker Nancy Pelosi released a draft bill. The move lays down a marker that will set the stage for negotiations with the Senate.  

NLC achieved a major victory by getting language inserted into Pelosi's bill that would provide tax credits to local governments who provide new mandated paid sick and paid emergency family leave under Public Law 116-127 (HR 6201). We need our members to call their House member and tell them how important this provision is, and encourage their member to make sure it is included in a final House-Senate third stimulus bill.

NLC has received word from offices on Capitol Hill that telecommunications industry advocates are pushing for inclusion of the STREAMLINE Small Cell Deployment Act in stimulus legislation. The STREAMLINE Act, which NLC has opposed since 2018, would enshrine in statute the Federal Communications Commission's small cell preemption regulations, as well as instituting a federal "deemed granted" penalty for shot clock overruns. This inclusion would permanently hamstring local decision making authority over small cell infrastructure and the ability of local governments to charge appropriate compensation for the use of local rights of way. We encourage you to reach out to congressional delegations in both chambers to oppose its inclusion. NLC has a template opposition letter that can be used at www.nlc.org/takeaction.

Finally, the House bill provides authority to the Federal Reserve to purchase municipal bonds. However, the definitions are not strong or clear enough. Those inclined to take action should act. They should call their representatives and Senators and ask that Senator Bob Menendez bill be included.

 Sam Caygill
Regional Public Affairs Manager | East Bay Division
League of California Cities
p. 916-402-7258 | e. scaygill@cacities.org

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Strengthening California Cities

Through Education & Advocacy
Coronavirus Briefing by the California Office of Emergency Services (CalOES), Health and Human Services (CHHS), and the Department of Public Health (CDPH) for State, Federal, Tribal Officials
Monday, March 23 at 1:00 pm
Call Overview:

CHHS, CDPH, and Cal OES hosted a briefing conference call for state, federal, and tribal officials regarding Coronavirus (COVID-19) developments.

Dr. Gil Chávez, CDPH

  • Current Statistics for COVID-19 in California:
    • 1,733 lab-confirmed positive cases in California;
    • 26,400 tests have been conducted in California;
    • 27 deaths reported in California, including one non-California resident;
  • Ages of all confirmed positive cases:
    • Hospitalized patients who have signs and symptoms compatible with COVID-19;
    • Residents and staff of long-term care facilities with signs and symptoms compatible with COVID-19;
    • Persons who are at higher risk for severe infection with signs and symptoms compatible with COVID-19;
    • Residents and staff of correctional facilities and other congregate settings with signs and symptoms compatible with COVID-19; and
    • Healthcare personnel with signs and symptoms compatible with COVID-19.
  • Not all patients who have signs and symptoms of COVID-19, need to be tested. Those who do not need medical attention should treat their symptoms at home.

Eric Lamoureux, Cal OES

  • The State Operation Center remains activated;
  • Priority is continued ordering and distribution of personal protective equipment and medical health supplies;
  • Continue to work with local governments to ensure supplies are being distributed properly;
    • Supplies are sent to counties who then distribute the supplies within their region. Cal OES wants to make sure that these resources are properly distributed.
  • Another priority is to address hospital surges:
    • Need to continue building out capacity; and
    • Decompress existing hospital capacity and make sure there is adequate staffing to support those in need.
  • Continue to make requests to the federal government. There are currently eight federal medical stations throughout the state, and there are going to be more deployed soon.

Ryan Buras, Cal OES

  • Update on task forces:
    • 14 task forces in operation;
    • Task forces meet every day; and
    • There are a lot of overlapping issues within each of these task forces.

Col. Darrin Bender, California National Guard

  • 286 soldiers and airman available to assist counties in distributing food from foodbanks; and
  • 22 service members who have medical training and are helping with medical logistics and screening.

Casey Deshawn – Federal Emergency Management Agency (FEMA) Region 9

  • Continue to execute aggressive and proactive steps to address COVID-19;
  • Response is most successful when locally executed;
  • To help Californians differentiate between rumors and facts, FEMA has created a webpage titled “Coronavirus Rumor Control”;
    • Encourage local officials to share this information in order to dispel disinformation within their communities;
  • There are two community based testing sites in operation in the state, and there will be more online soon; and
    • These are state managed and locally operated.
  • The United States Navy Ship “Mercy” is en route to Los Angeles and will be able to provide more hospital beds to people in need.

  
Brian Ferguson, Cal OES

  • Priority is continued emphasis of “stay home, stay safe” message;
    • There continues to be pockets of the population that need additional education on this issue.
  • Continue to work to ensure that communities are prepared for a health care surge;
  • Working with private sector partners in filling gaps; and
  • Information on https://covid19.ca.gov/ 
    • Especially useful for essential employees and determining who are critical staff so Californians have the resources they need to stay home.

Questions and Answers:

  • Can we get more information on the status of distributing personal protective equipment (PPE)?

Continue to work through the logistics of distributing PPE as this event progresses. Also are working with private companies who are willing to produce resources or donate them and coordinating the procurement of those resources. Continue to receive shipments from the national stockpile.

Lori Nezhura, Cal OES

    • There are three things that health care facilities can do that will help in streamlining resource requests:
      • Do not submit duplicative orders;
      • Do not submit multiple requests per day (it is better for requests to be bundled in one request); and
      • Do not over order.
        • Starting to see facilities wanting to stockpile resources.
  • How can local governments aid in ramping up health care capacity?

Working to build this capacity every day. Specifically, have been working with local governments to establish locations for testing and other brick and mortar facilities. Also, coordinating with local governments to staff these facilities. The state workforce is also providing support. California Department of Human Resources is looking at staffing requirements, and building teams to support these operations. This continues to be a collaborative effort.

  • What is the state’s current testing capability? What is the ideal testing turnaround time? Is there a backlog in testing, and how can that be decreased?

Of those tested, half have received results, and half are still pending. However, this is changing daily. Currently, there are 22 labs conducting testing. Private partnerships continue to be important in increasing the state’s testing capacity. Also, looking for creative ideas to collaborate with the private sector to do point of care testing.

  • How do counties ask the National Guard to help with food distribution at food banks?

If a county has a need for the National Guard to help with foodbanks, those requests need to come from that county’s emergency services office or contact.

  • Can anything be done so that grocery stores are required to limit the number of people in their stores to protect against spread?

Yes, work is being done to educate grocery stores of best practices of reducing spread. People will need to continue to get groceries, but it is paramount that everyone maintains social distancing practices. Cal OES is working with Go-Biz on education and outreach to businesses on what social distancing in these types of establishments may look like--such as queuing the line so that each customer is 6 feet apart. There are challenges with implementing these practices, but work continues to be done to improve this issue.

  • Is there a plan to allow students to go back to campus this school year? Or will students be finishing out the academic year at home?

It remains uncertain if children will return to school this year. Hopefully, students can return, but it appears unlikely. This situation will continue to be monitored and re-assessed as more information is known. The California Department of Education’s website has more information on this issue.

State and Local Elected Officials –

On Wednesday, March 25, at 1:00 PM ET, please join the U.S. Surgeon General – Jerome Adams – and Senior Administration Officials for a briefing call on COVID-19 (coronavirus). The purpose of this call is to provide State and local elected officials with up-to-date information on COVID-19 and pertinent Administration and Task Force actions. Registration instructions are below – please read the RSVP instructions in their entirety before registering. We encourage you to share this invitation with your county and/or municipal colleagues as well as public health officials. If you have a particular question you would like addressed during the call, please flag those for our team.

We would also like to flag a recent op-ed from Peter Navarro, Assistant to the President for Trade and Manufacturing Policy, on President Trump and the Administration’s whole-of-government, all-of-America approach to addressing COVID-19. You can find that op-ed here: Coronavirus – How Businesses Are Stepping Up, Collaborating with Trump Administration. In addition, please find a Fact Sheet on actions the Administration has taken to support the Nation’s small businesses and owners – President Trump Is Committed to Supporting Small Businesses Impacted by the Coronavirus.

Briefing Call Registration
Date: Wednesday, March 25
Time: 1:00 PM ET (please note time zone)
Call-In Registration: CLICK HERE
Note: Call-in lines are limited. Please register only if you are able to join the call. State and local leaders (especially staff) working in the same office are encouraged to register once as a group and use one call-in line to maximize the number of people who can join. Upon successful registration, you will receive dial-in details to the email address you use to register. Note that multiple people cannot dial-in using the same registration information.

Below, please find additional information that we continue to update. It includes helpful information and videos around community mitigation (Up-To-Date Information), resources for sharing verified and trusted information (Local Preparedness & Response Tips), and an outline of important federal agency actions important to your communities (Federal Agency Programs & Action Overview). The White House Office of Intergovernmental Affairs (WH IGA) will continue to share pertinent information as it becomes available. Please do not hesitate to reach out to our office directly if we can be of assistance. As a reminder, WH IGA is the primary liaison between the White House and the country’s State and local elected officials and Tribal Governments.

Sincerely,

The White House Office of Intergovernmental Affairs
              
William F. Crozer
Special Assistant to the President/Deputy Director
White House Office of Intergovernmental Affairs


COVID-19: Background & Additional Information

Background
Under the leadership of President Trump and Vice President Pence, the full weight of the U.S. Government is working to protect the health and safety of the American people. Since the beginning of the outbreak, President Trump has taken unprecedented steps – including prudent travel restrictions and an early containment strategy – to protect the health of Americans in response to the coronavirus. In January, the President formed a Coronavirus Task Force, led by Vice President Mike Pence and comprised of subject-matter experts, to organize a whole-of-government response (President Donald J. Trump Has Taken Unprecedented Steps to Respond To the Coronavirus and Protect the Health and Safety of Americans). The Coronavirus Task Force and broader Administration have and will continue to work with State-Local-Tribal officials and private sector and non-profit partners in preparing for and responding to the Coronavirus. It is important to note that the threat of serious illness to the average American remains low. All agencies are working aggressively to monitor this continuously evolving situation and to keep our stakeholders informed. We appreciate your partnership in this whole-of-government, all-of-America response.

Up-To-Date Information

  • The most up-to-date information and guidance can be found via the Centers for Disease Control and Prevention Coronavirus Disease 2019 website (here). You are also encouraged to follow HHS, CDC, and other agency social media channels for up-to-date information.
  • The Coronavirus Task Force holds frequent national briefings which can be viewed live (here)
  • Community Guidance
    • The President’s Guidelines for America: 15 Days to Slow the Spread (here)
    • HHS/CDC Community Framework for Mitigation (here)
    • Guidance for families, businesses, schools and others (here)
    • What is Social Distancing (video)
    • CDC Print Resources and Fact Sheets (here)
  • Informational Videos
    • President Donald J. Trump: Strong & United, We Will Prevail (here)
    • First Lady Melania Trump: A Message from First Lady Melania Trump (here)
    • U.S. Surgeon General: Urgent Need – Health Americans Should Continue Donating Blood (here)
    • U.S. Surgeon General: How Can Millennials Stop the Spread of Coronavirus (here)
    • U.S. Surgeon General: Is It Still Safe to Donate Blood? (here)
    • U.S. Surgeon General: How Can You Engage in Social Distancing? (here)
    • U.S. Surgeon General: How Can You Keep the Most Vulnerable Safe from Coronavirus (here)
    • U.S. Surgeon General: Message to Young People (here)
    • Dr. Deborah Birx: How Can Millennials Fight the Coronavirus (here)
    • Dr. Deborah Birx: What Should Schools Do About (here)
    • Dr. Deborah Birx: Where Can the Coronavirus Live? (here)
    • Dr. Deborah Birx: Who Needs to be Tested for Coronavirus? (here)
    • Dr. Deborah Birx: Protect the People Around You (here)

What You Need To Know (https://www.coronavirus.gov/)

  • What You Should Know - How COVID-19 Spreads, Symptoms, etc. (here)
  • Situation Summary (here)
  • Travel Information (here) – State Department: International Travel (here)
  • Avoid Scams (here)
  • Preventing COVID-10 Spread in Communities (here)
  • Higher Risk & Special Populations (here)
  • Healthcare Professionals (here)
  • Resources for Healthcare Facilities (here)
  • Resources for Health Departments (here)
  • Laboratories (here)
  • Communication Resources (here)

Local Preparedness & Response Tips

  • Response is locally executed, state managed, and federally supported. Local officials should coordinate requests through their State Emergency Management Agencies.
    • A list of State emergency management agencies can be found here.
    • FEMA guidance on public assistance for States, local governments, tribal governments, and eligible non-profits can be found here.
    • FEMA guidance on public assistance for tribal governments can be found here.
  •  Proactively sharing and disseminating verified and accurate guidance and information through social media, newsletters, and other avenues:
  • Ensuring clear, open lines of communication with the public and making information and guidance readily available.
  • Inventorying resources and proactively coordinating with State and local health authorities.
  • Reviewing and implementing local preparedness plans and strategies.

Agency Resources and Contact Information
Below, please find agency-by-agency information, guidance, and contact information.

Resources – Below, please find agency-by-agency resources and guidance.

  • U.S. Department of Health and Human Services (here)
  • Centers for Medicare and Medicaid (here)
  • Federal Trade Commission (here)
  • U.S. Food & Drug Administration (here)
  • U.S. Department of Education (here)
  • U.S. Department of Agriculture (here)
  • U.S. Small Business Administration (here)
  • U.S. Department of Labor (here)
  • U.S. Department of Homeland Security (here)
  • U.S. Department of State (here)
  • U.S. Department of Veterans Affairs (here)
  • U.S. Environmental Protection Agency (here)
  • U.S. Department of the Interior (here)
  • U.S. Department of Energy (here)
  • U.S. Department of Commerce (here)
  • U.S. Department of Justice (here)
  • U.S. Department of Housing and Urban Development (here)
  • U.S. Department of the Treasury (here)
  • Office of the Director of National Intelligence (here)
  • U.S. Election Assistance Commission (here)

 

Contact Information – Response to COVID-19 is locally executed, stated managed, and federally supported. Local elected officials should collaborate with and work through their local emergency management office up through the State Emergency Management Agency, which works in collaboration with FEMA and HHS. Should particular issues arise outside of these appropriate channels, please find contact information for our Intergovernmental Affairs colleagues across the federal family. As State and local elected officials, they are your primary points of contact.

  • U.S. Department of Health & Human Services: Darcie Johnston (Phone – 202-690-1058 / Email – darcie.johnston@hhs.gov)
  • U.S. Department of Homeland Security: Cherie Short (Phone – 202-893-2941 / Email – cherie.short@hq.dhs.gov)
  • U.S. Department of State: Bill Killion (Phone – 202-647-7595 / Email – killionw@state.gov)
  • U.S. Department of Transportation: Sean Poole (Office – 202-597-5109 / Cell – 202-366-3132 / Email – sean.poole@dot.gov)
  • U.S. Department of Education: Susan Falconer (Phone – 202-320-6837 / Email – susan.falconer@ed.gov)
  • U.S. Department of Veterans Affairs: Thayer Verschoor (Phone – 202-461-7385 / Email – Thayer.verschoor@va.gov)
  • U.S. Environmental Protection Agency: Britt Carter (Phone – 202-440-0728 / Email – carter.brittanys@epa.gov)
  • U.S. Small Business Administration: Ryan Lambert (Phone – 202-615-6570 / Email – ryan.lambert@sba.gov)
  • U.S. Department of Agriculture: Lillie Brady (Phone – 202-845-3872 / Email - lillie.brady@usda.gov)

 

Recent Announcements

President Donald J. Trump Announces New Guidelines to Address COVID-19 – The President’s Guidelines for America: 15 Days to Slow the Spread
Monday, March 16, President Donald J. Trump announced new guidelines to address COVID-19, stop the spread, and protect health. The President’s Coronavirus Guidelines for America: 15 Days to Slow the Spread can be found here. “My administration is recommending that all Americans, including the young and healthy, work to engage in schooling from home when possible, avoid gathering in groups of more than 10 people, avoid discretionary travel and avoid eating and drinking in bars, restaurants, and public food courts," President Trump stated. “With several weeks of focused action, we can turn the corner and turn it quickly -- a lot of progress has been made."

FEMA Releases Guidance On Public Assistance for States, Local Governments, and Eligible Non-Profits
The Administration continues to place its full weight and resources behind the response to COVID-19. FEMA currently has over $500 million in available balances in the Disaster Relief Fund (DRF) Base to support all 56 States and Territories for COVID-19 response efforts, including for direct Federal assistance, temporary facilities, commodities, equipment, and emergency operation costs. State, Territorial, Tribal, local government entities and certain private non-profit (PNP) organizations are eligible to apply for Public Assistance. States, Tribal and Territorial governments do not need to request separate emergency declarations to receive FEMA assistance under this nationwide declaration. The emergency declaration will reimburse for eligible emergency protective measures taken to respond to the COVID-19 emergency at the direction or guidance of public health officials under Category B of FEMA’s Public Assistance program. FEMA will not duplicate assistance provided by the U.S. Department of Health and Human Services (HHS), to include the Centers for Disease Control and Prevention (CDC), or other federal agencies. More here.

Department of Homeland Security Releases Memorandum on Identification of Essential Critical Infrastructure Workers During COVID-19 Response
Functioning critical infrastructure is imperative during the response to the COVID-19 emergency for both public health and safety as well as community well-being. Certain critical infrastructure industries have a special responsibility in these times to continue operations.Thursday, March 19, the Cybersecurity & Infrastructure Security Agency released guidance on the identification of essential critical infrastructure workers during COVID-19 response. This guidance and accompanying list are intended to support State, Local, and industry partners in identifying the critical infrastructure sectors and the essential workers needed to maintain the services and functions Americans depend on daily and that need to be able to operate resiliently during the COVID-19 pandemic response. More here.

President Donald J. Trump Outlines Federal Support for Governors’ Use of the National Guard to Respond to COVID-19
Sunday, March 22, President Donald J. trump announced federal actions to ensure that the National Guard can effectively respond to the COVID-19 crisis. President Trump issued a memorandum providing for 100 percent federal funding through FEMA for the cost of Governors deploying National Guard units in their States to carry out approved missions. Governors remain fully in command of their National Guard units. The Presidential Memorandum can be found here.

President Trump Announces Approval of Existing Drugs to Test Treatments for Coronavirus
Thursday, March 19, President Donald J. Trump announced that the FDA is evaluating existing drugs that could serve as potential therapeutics for coronavirus patients. The drugs will be used in a clinical trial. "We have to remove every barrier or a lot of barriers that were unnecessary and they've done that to get the rapid deployment of safe, effective treatments and we think we have some good answers," the President said. The FDA continues to expand its work regarding therapeutic options and has a vaccine trial underway. More here. More here.

President Trump Signs Legislative Package Providing Extensive Assistance to Americans Impacted by the Coronavirus
Wednesday, March 18, President Trump signed the Families First Coronavirus Response Act, ensuring that American families and businesses impacted by the virus receive the strong support they need (more here). The President and Administration worked tirelessly with Congress to secure the legislative package, which includes the following:

  • Provides free coronavirus diagnostic testing for the American people, regardless of their economic circumstances or health coverage;
  • Establishes tax credits to provide paid sick and family leave for coronavirus-related employment interruptions;
  • Incentivizes States to ease access to unemployment benefits, assisting Americans who may be unemployed due to the impact of the virus;
  • Provides funding and flexibility for emergency nutritional aid for senior citizens, women, children, and low-income families.

President Trump Issues Executive Order Invoking the Defense Production Act
Wednesday, March 18, President Donald J. Trump issued an executive order invoking the Defense Production Act. Under the Defense Production Act, the President has the authority to determine that certain supplies are essential for the national defense during challenges like thisThe President’s action allows the Administration, if it becomes necessary, to order the distribution of health and medical supplies to where they are most needed. You can find the Executive Order here.

President Donald J. Trump Directs FEMA Support Under Emergency Declaration for COVID-19
The federal government continues to take aggressive and proactive steps to address the COVID-19 threat as the health and safety of the American people remain a top priority (President Donald J. Trump Has Mobilized the Full Resources of the Federal Government to Respond to the Coronavirus). On Friday, March 13, President Trump declared a nationwide emergency pursuant to Sec. 501(b) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121-5207 (the “Stafford Act”) (Letter from President Donald J. Trump on Emergency Determination Under the Stafford Act). This increases federal support to the Department of Health and Human Services (HHS) in its role as the lead federal agency for the ongoing COVID-19 pandemic response. As a result of the President’s decisive, unprecedented action, FEMA is directed to assist state, local, tribal, territorial governments and other eligible entities with the health and safety actions they take on behalf of the American public. FEMA actions will be in support of HHS and in coordination with state, tribal and territorial governments. Eligible emergency protective measures taken at the direction or guidance of public health officials in response to this emergency, and not supported by the authorities of another federal agency, will be reimbursed strictly under the FEMA Public Assistance program. FEMA assistance will be provided at a 75 percent Federal cost share. Reimbursable activities typically include emergency protective measures such as the activation of State Emergency Operations Centers, National Guard costs, law enforcement and other measures necessary to protect public health and safety. To note, the declaration does not make direct financial assistance available to individuals.. Municipalities and counties are encouraged to work directly with their local emergency management offices and through the State Emergency Management Agency for all requests for assistance.You can read more about the disaster recovery process here.

White House Announces New Partnership to Unleash U.S. Supercomputing Resources to Fight COVID-19
The White House announced the launch of the COVID-19 High Performance Computing Consortium to provide COVID-19 researchers worldwide with access to the world’s most powerful high performance computing resources that can significantly advance the pace of scientific discovery in the fight to stop the virus. This unique public-private consortium, spearheaded by The White House, the U.S. Department of Energy, and IBM, includes government, industry, and academic leaders who have volunteered free compute time and resources on their machines.

Federal Agency Programs & Action Overview

U.S. Department of Health & Human Services (HHS)

  • The Department of Health and Human Services is committed to providing as much information as possible to prepare communities for response to COVID-19. The Department, through the Centers for Disease Control and Prevention, the Food and Drug Administration, and other agencies, continuously provide guidance to healthcare providers, laboratories, communities, and state and local officials for dealing with suspected or confirmed cases of COVID-19. The most up-to-date information can be found at www.coronavirus.gov and https://www.cdc.gov/coronavirus/2019-nCoV/index.html
  • Guidance
    • CMS released two telehealth toolkits today to help practitioners understand the broadened access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their doctors without having to travel to a healthcare facility. Under this new waiver, Medicare can pay for office, hospital, and other visits furnished via telehealth across the country and including in patient’s places of residence starting March 6, 2020.  A range of providers, such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers, will be able to offer telehealth to their patients. The toolkit for General Practitioners can be found here and for ESRD providers here.
    • CDC released interim guidance to help prevent workplace exposures to acute respiratory illnesses, including COVID-19, in non-healthcare settings. The guidance also provides planning considerations if there are more widespread, community outbreaks of COVID-19. The guidance can be found here.
    • FDA issued a new policy that allows for expanded use of devices to monitor patients’ vital signs remotely. The devices include those that measure body temperature, respiratory rate, heart rate and blood pressure. The guidance can be found here.
    • CMS released recommendations to delay non-essential procedures in an effort to preserve personal protective equipment (PPE), beds, and ventilators for facilities as well as to free up health care workers to treat patients with COVID-19. The recommendations provide a framework for hospitals and clinicians to implement immediately to determine and identify non-essential and elective procedures. The recommendations and guidelines can be found here
    • CDC released PPE guidance that will provide guidance in PPE shortages, particularly for long-term care facilities, dialysis, and home health providers. The strategies include information specific to eye protection, isolation gowns, facemasks, and N95 respirators. The information can be found here
    • CDC’s Prepare to Care for COVID-19 is a resource with practical tools clinicians can use to care for patients with COVID-19, and will be regularly updated to help clinicians adapt as the outbreak unfolds. More information can be found here.
    • CDC released guidance for responding to Coronavirus Disease 2019 (COVID-19) among people experiencing unsheltered homelessness (more here).
  • The President’s emergency declaration gives HHS important powers to enhance state and local communities’ ability to respond to the outbreak, including flexibility around Medicare and Medicaid rules. 
    • Flexibility and Relief for State Medicaid Agencies: The national emergency declaration also enables CMS to grant state and territorial Medicaid agencies a wider range of flexibilities under section 1135 waivers. States and territories are now encouraged to assess their needs and request these available flexibilities, which are outlined in the Medicaid and CHIP Disaster Response Toolkit. Examples of flexibilities available to states under section 1135 waivers include the ability to permit out-of-state providers to render services, temporarily suspend certain provider enrollment and revalidation requirements to promote access to care, allow providers to provide care in alternative settings, waive prior authorization requirements, and temporarily suspend certain pre-admission and annual screenings for nursing home residents. To date, two states, Florida and Washington, have received approval for their waivers. For more information and to access the toolkit, visit here.  
    • Waivers and Flexibilities for Hospitals and other Healthcare Facilities:  CMS will temporarily waive or modify certain Medicare, Medicaid, and CHIP requirements. CMS will also issue several blanket waivers, listed on the website below, and the CMS Regional Offices will review other provider-specific requests. These waivers provide continued access to care for beneficiaries. For more information on the waivers CMS has granted, visit here.
    • Centers for Medicare & Medicaid Services (CMS) Guidance: CMS released updated FAQs that address issues raised by states over the prior few days. The document includes answers to questions related to the flexibilities CMS is affording to states in managed care, benefits, financing, 1115 demonstrations, and leveraging “1135” waivers offered as part of the President’s declaration of a national emergency. States may submit questions to CMS through their state leads. The FAQs can be found here.
    • Centers for Medicare & Medicaid Services (CMS) Nursing Home Guidance: As you know, nursing homes and their residents are vulnerable populations for COVID-19.  This week, CMS released updated guidance for infection control and prevention of COVID-19 in Nursing Homes which can be found here (3/9). The Press Release can be found here and all CMS guidance related to COVID-19 can be found here.
    • Expanded Telehealth Coverage (3/17): The Trump Administration announced expanded Medicare telehealth coverage that will enable beneficiaries to receive a wider range of healthcare services from their doctors without having to travel to a healthcare facility. More here.
  • Wednesday, March 12, CDC announced the imminent release of almost $600 million to support state and local authorities respond to the COVID-19 outbreak. Full funding amounts are here.
  • The CDC has been actively working to address the need for testing across the country. You can find more information about testing here. We encourage review of the Updated Guidance on Evaluating and Testing Persons for Coronavirus Disease 2019, as well as the recently updated the FAQ website for laboratories to determine best practices for testing.
  • The U.S. Public Health Service Commissioned Corps has deployed hundreds of officers to help with this response. As America’s Health Responders, the Commissioned Corps is currently very involved in assisting the CDC with airport screenings, deploying staff to support hospitals, among other important missions. Find out more about Commissioned Corps activities here.
  • Part of preparedness includes a robust blood supply. The current situation around COVID-19 heightens the need for a ready blood supply, please encourage your health community members to keep their appointments to donate blood.

U.S. Small Business Administration (SBA)

  • The U.S. Small Business Administration has approved all states and territories for low-interest federal disaster loans for working capital to small businesses suffering substantial economic injury as a result of the Coronavirus (COVID-19).
  • Any such Economic Injury Disaster Loan assistance declaration issued by the SBA makes loans available statewide to small businesses and private, non-profit organizations to help alleviate economic injury caused by the Coronavirus (COVID-19).
  • SBA’s Office of Disaster Assistance will coordinate with the state’s or territory’s Governor to submit the request for Economic Injury Disaster Loan assistance.
  • Once a declaration is made, the information on the application process for Economic Injury Disaster Loan assistance will be made available to affected small businesses within the state.
  • These 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 is 3.75% for small businesses. The interest rate for non-profits is 2.75%.
  • SBA offers loans with long-term repayments in order to keep payments affordable, up to a maximum of 30 years. Terms are determined on a case-by-case basis, based upon each borrower’s ability to repay.
  • SBA’s Economic Injury Disaster Loans are just one piece of the expanded focus of the federal government’s coordinated response, and the SBA is strongly committed to providing the most effective and customer-focused response possible.
  • SBA announced the option to defer payment on previous disaster loans until December 2020.
  • For additional information, please visit the SBA disaster assistance website at SBA.gov/Disaster.

U.S. Department of Education (DoED)

  • The Department of Education has established a dedicated Coronavirus webpage, which includes resources for institutions of higher education and for K-12.
    • The website includes guidance for students at institutions of higher education, and covers Coronavirus-related scenarios that could impact students who are enrolled in study abroad programs, students who meet full-time requirements but fall below 12 credit hours, students who are quarantined and miss class, campuses that have temporarily stopped offering ground-based classes to prevent the spread of Coronavirus, and foreign schools that serve Americans who receive Federal financial aid.  Also see a letter from the Office for Civil Rights that addresses potential discrimination associated with coronavirus.
  • On Friday, March 20, the Department of Education announced the suspension of federal student loan payments and waiving interest during the national emergency. All borrowers with federally held student loans will automatically have their interest rates set to 0% for a period of at least 60 days. In addition, each of these borrowers will have the option to suspend their payments for at least two months to allow them greater flexibility during the national emergency. More here.
  • The Department has provided additional information for families and communities including:
    • Information regarding certain flexibilities under the Every Student Succeeds Act, or “ESSA;” (more here)
    • Information regarding services to children with disabilities; (more here)
    • A fact sheet from the Office for Civil Rights on the risk of Coronavirus in schools while protecting the civil rights of students; and a short webinar on Online Education and Website Accessibility;
    • Information on the Family Education Records Privacy Act, or “FERPA,” as it pertains to K-12 and higher education students (more here);
    • Information for Accrediting Agencies Regarding Temporary Flexibilities Provided to Coronavirus Impacted Institutions or Accrediting Agencies (more here);
    • Guidance and resources for educating students with disabilities (more here).
  • The Department will continue to update its website, ed.gov/coronavirus. Please direct education related questions to COVID-19@ed.gov

U.S. Department of Transportation (DOT)

  • The U.S. Department of Transportation, in its important supporting role, has and will continue to coordinate with transportation stakeholders, foreign counterparts and other federal agencies to manage the risk in the United States.
  • The U.S. government’s travel restrictions and advisories have been a remarkably effective ‘first layer’ of containment. These travel requirements delayed the arrival of the virus to the United States, giving the nation precious time to prepare further measures, and plan for mitigation. This achievement took the cooperation of nearly 200 commercial airlines, a like number of overseas airports, and the Civil Aviation Authority of China.
  • DOT continues to ensure: an active air bridge remains in place for the safe return of Americans from affected areas; airlines are funneling passenger flights to one of the eleven designated U.S. airports equipped to health-screen Americans returning from affected areas; continued air and sea cargo traffic between the US and China; health protocols are established to protect the crews of aircraft continuing to fly between the US and foreign locations; and, dissemination of health messages about the virus, for airlines to use to inform their passengers.
  • External Stakeholder outreach is being actively conducted throughout the modes of transportation in DOT. DOT has already hosted calls with stakeholders for the Federal Aviation Administration, Federal Transit Authority, Federal Motor Carrier Safety Administration, and others. Additional calls are scheduled for outreach to additional stakeholders in all surface transportation, maritime, and labor.
  • On March 13, USDOT issued a national emergency declaration to provide hours-of-service regulatory relief to commercial vehicle drivers transporting emergency relief to the nationwide COVID-19 outbreak. The declaration does not cover routine commercial deliveries, or transportation of mixed loads of essential supplies and/or persons and goods or persons not related to emergency needs.  Effective immediately, the declaration will remain in effect for the duration of the emergency or until 11:59 P.M. (ET), April 11, 2020, whichever occurs sooner. Learn more here.

U.S. Department of Labor (DOL)

  • The Occupational Safety and Health Administration (OSHA) developed COVID-19 planning guidance for employers to implement engineering, administrative, and work practice controls and personal protective equipment (PPE). The guidance is intended for planning purposes – employers and workers should use the planning guidance to help identify risk levels in workplace settings and to determine any appropriate control measures to implement.
  • DOL announced new guidance outlining flexibilities that States have in administering their unemployment (UI) programs to assist Americans affected by the COVID-19 outbreak. Under the guidance, federal law permits significant flexibility for states to amend their laws to provide UI benefits in multiple scenarios related to COVID-19. Learn more here.
  • On March 14, DOL issued new temporary enforcement guidance for respirator fit-testing in healthcare during the COVID-19 outbreak. The temporary guidance is aimed at ensuring healthcare workers have full access to needed N95 respiratory protection. OSHA recommends that employers supply healthcare personnel who provide direct care to patients with known or suspected coronavirus with other respirators that provide equal or higher protection, such as N99 or N100 filtering facepieces, reusable elastomeric respirators with appropriate filters or cartridges, or powered air purifying respirators. Learn more here.
  • On March 18, DOL announced availability of up to $100 Million in National Health Emergency Dislocated Worker Grants (DWGs) in response to COVID-19.  The DWGs are intended to provide eligible participants with both disaster-relief employment and employment training services.  These participants can include dislocated workers, workers who were laid-off as a result of the disaster, self-employed individuals who are unemployed or underemployed as a result of the disaster, and long-term unemployed individuals.  Learn more here.
  • The Office of Federal Contract Compliance Programs (OFCCP) issued a National Interest Exemption Memorandum to further facilitate response efforts for COVID-19.  OFCCP will grant a limited, three-month exemption and waiver from some requirements of the laws administered by the agency.
  • The Wage and Hour Division (WHD) has developed frequently asked questions documents highlighting application of the Fair Labor Standards Act and Family and Medical Leave Act during a public health emergency.  Learn more here.

U.S. Department of Housing & Urban Development (HUD)

  • The health and well-being of our country’s most vulnerable citizens is Secretary Ben Carson’s highest priority. At the direction of Secretary Carson senior HUD, officials have developed an Infectious Disease Toolkit for Continuum of Care homeless shelters (CoC). This includes specific documents addressing preparedness in shelters and encampment settings. More here.
  • On Wednesday, March 18, Secretary Carson, in consultation with the Coronavirus Task Force, announced the suspension of all foreclosure and evictions for single family homeowners with FHA-insured mortages for 60 days. The guidance applies to homewoekrs with FHA-insured Title II Single Family forward and Home Equity Conversion (reverse) mortgages, and directs mortgage servicers to:
    • Halt all new foreclosure actions and suspend all foreclosure actions currently in process; and
    • Cease all evictions of persons from FHA-insured single-family properties.
  • HUD has sent communication to CoC and Housing Opportunities for Persons With AIDS (HOPWA) grantees, highlighting the importance of infectious disease preparedness and linking to CDC and Healthcare for the Homeless resources: Infectious Disease Preparedness Among Homeless Assistance Providers.
  • HUD released a quick guide to CDBG eligible activities to support infectious disease response. Grantees should coordinate with local health authorities before undertaking any activity to support State or local pandemic response. The guide can be found here.
  • HUD is coordinating with the CDC, Healthcare for the Homeless, United States Interagency Council on Homelessness (USICH) on messaging and cross-promoting resource materials. This will continue on an ongoing basis. Also, the Department is reaching out to Health Resources and Services Administration (HRSA) and Substance Abuse and Mental Health Services Administration (SAMHSA) for future coordination.
  • HUD has plenty of resources for your communities including: 
    • Communities can use their unspent Emergency Solutions Grants and Continuum of Care Program funds to help address needs related to coronavirus. Additionally, a portion of CDBG funds are also available for public services, including health care.
    • Technical Assistance is available for ESG and CoC Program recipients if requested.  Additionally, communities that want to amend their CDBG plans, can reach out to their CPD representative if they need assistance.

U.S. Department of Agriculture (USDA)

  • USDA Secretary Sonny Perdue announced proactive flexibilities to allow meal service during school closures to minimize potential exposure to the coronavirus. During an unexpected school closure, schools can leverage their participation in one of USDA’s summer meal programs to provide meals at no cost to students. Under normal circumstances, those meals must be served in a group setting. However, in a public health emergency, the law allows USDA the authority to waive the group setting meal requirement, which is vital during a social distancing situation.
    • USDA and President Trump have been in communication with Food and Grocery Stakeholders and Executives to discuss the impact COVID-19 has on America’s food supply chain. Morehere.
    • USDA announced a collaboration with the Baylor Collaborative on Hunger and Poverty, McLane Global, PepsiCo, and others to deliver nearly 1,000,000 meals a week to students in rural schools closed due to COVID-19. Morehere.
    • Businesses or groups interested in helping should email: feedingkids@usda.gov.
  • USDA intends to use all available program flexibilities and contingencies to serve program participants across our 15 nutrition programs. USDA has already begun to issue waivers to ease program operations and protect the health of participants. USDA is receiving requests for waivers on an ongoing basis.
  • The food supply chain remains strong. Critical services, including Food Safety Inspections Services (FSIS), Animal Plan Health Inspection Service (APHIS), and Food and Nutrition Service (FNS), continue to serve the American people. More here.
  • For more information about the coronavirus response across USDA, please visit: www.usda.gov/coronavirus.

U.S. Department of Veterans Affairs (VA)

  • The Department of Veterans Affairs has implemented an aggressive public health response to protect and care for Veterans in the face of this emerging health risk. We are working directly with the Centers for Disease Control and Prevention (CDC) and other federal partners to monitor the outbreak of the virus. These measures include outreach to Veterans and staff, clinical screening at VA health care facilities, and protective procedures for patients admitted to community living centers and spinal cord injury units.
  • Any Veteran with symptoms such as fever, cough or shortness of breath should immediately contact their local VA facility. You can find the closest VA facility here. VA urges Veterans to call before visiting. Veterans can sign into My HealtheVet to send a secure message to VA or use telehealth options to explain their condition and receive a prompt diagnosis.
  • On March 22, the VA announced Veterans’ GI Bill benefits will continue during COVID-19 pandemic.
  • The VA has setup a website for veterans here: https://www.publichealth.va.gov/n-coronavirus/

U.S. Department of Homeland Security (DHS)

  • Actions by DHS and the administration are decreasing the strain on public health officials by screening incoming travelers, expediting the processing of U.S. citizens returning from China, and ensuring resources are focused on the health and safety of the American people. It is important to recognize, that while there is a significant focus on containing and mitigating the spread of COVID-19, all departments and agencies of DHS are continuing to perform their regular duties with no impact on their mission.
  • DHS is working to recognize, detect, and assist individuals attempting to enter the U.S. through our, airports, land ports, or waterways who may be carrying the virus: Cruise Lines International Association, CDC, USCG, and CBP. DHS is working with the Department of State, HHS, and the senior public health leadership with the Government of Mexico to prepare for any COVID-19 cases identified along the South West Border. This effort includes coordination with state, and local Public Health Officials to develop reporting and response courses of action.
    • On Thursday, March 12, President Donald J. Trump signed a Presidential Proclamation, which suspends the entry of most foreign nationals who have been in certain European countries at any point during the 14 days prior to their scheduled arrival to the United States. These countries, known as the Schengen Area, include: Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, and Switzerland. This does not apply to legal permanent residents, (generally) immediate family members of U.S. citizens, and other individuals who are identified in the proclamation
    • In furtherance of Presidential Proclamations 998499929993, and 9994, which bans the entry of non-U.S. citizens who are from or recently been in China, Iran, or certain European countries, the Department of Homeland Security issued a Notice of Arrival Restrictions requiring American citizens, legal permanent residents, and their immediate families who are returning home to the U.S. to travel through one of 13 airports upon arrival to the U.S., submit to an enhanced entry screening and self-quarantine for 14 days once they reach their final destination. More here.
    • On March 21, President Trump announced agreements with both Canada and Mexico to limit all non-essential travel across borders. More information is here.
  • The Cyber & Infrastructure Security Agency issued guidance and an accompanying list intended to support State, local, and industry partners in identifying the critical infrastructure sectors and the essential workers needed to maintain the services and functions Americans depend on daily and that need to be able to operate resiliently during the COVID-19 pandemic response. More here.
  • The Countering Weapons of Mass Destruction Office, which contains the National Biosurveillance Integration Center and the Chief Medical Officer, has maintained close coordination with DHS Components and U.S. Government partners regarding the status of the outbreak and associated U.S. Government response actions.

Notes from Governor’s Address to Californians – March 23, 2020, 4:30pm
** Information transcribed and truncated for audience;
notes may not fully capture all information provided **

Governor Gavin Newsom:

  • USNS Mercy navy hospital ship being made ready and will depart for Los Angeles;
    • Will take a number of days to be outfitted and before it arrives in the Los Angeles Port.
  • $100 million emergency homeless grants funds are going out to cities and counties;
  • Good things are happening on procuring hotel and motel rooms for homeless individuals across the state;
  • Update on the state’s emergency operations center:
    • Looking at what is happening in real time in the state of California;
    • Modeling - trying to bend the curve and using best practices around the world to inform our decision making;
    • Gaming out best and worst case scenarios on the virus and how to stop it; and
    • Looking to significantly increase the state’s inventory of beds.
  • Update on the state of hospitals in California:
    • California currently has 416 hospitals, with 75,000 beds;
    • Needs 50,000 additional beds;
    • Hospital system alone will provide for 30,000 of those beds;
    • Typically, hospitals have a surge plan of 15-20% of their capacity;
      • Are announcing today a surge plan of 40% capacity.
    • Externally, they are looking to provide 20,000 beds;
      • Announced three major acquisitions of hospitals.
    • 17,000 beds are still needed;
      • Looking at fairgrounds, hotels/motels etc.
    • Once resources are identified, want to make sure they are properly staffed and with the proper resources, included person protective equipment (PPEs).
  • Trying to ramp up procurement of PPEs:
    • For example, buying a billion gloves.
  • A three month surge capacity within our hospital system alone, would require 200 million sets of PPEs - Gloves, masks, shields;
  • Applauded the federal government for going after people hoarding and price gouging;
    • Local and state governments also need to go after folks that price gouge and hoard resources.
  • California and other states need to coordinate their procurement;
    • Need to bring down the cost curve;
    • Wants to work with other governors on this; and
    • Need to centralize procurement.
  • 6 California companies have said they plan to repurpose their manufacturing to make gowns;
  • Elon Musk delivered 1,000 ventilators to Los Angeles today;
  • 2 of 8 field medical stations have arrived from the federal government;
    • When all 8 arrive, will have a total capacity of two thousand beds.
  • Some Californians need to better practice social distancing;
  • Shutting down all state parking lots for state parks and beaches and all state campgrounds;
    • Calling it "soft closures;"
    • Had record numbers of people at state parks in southern California, cannot see what we saw this weekend again; and
    • Can go to www.parks.ca.gov to see which parks are better for those to visit and which have closures.
  • When will this end?
    • Need to bend the curve. The sooner we do that, the sooner things can get better.

Questions and Answers

  • Are you thinking about increasing enforcement? Or will social pressure be enough?

There are some businesses that are abusing this. We can put pressure through licensing and through regulations. Stepping up park patrols to remind folks of social distancing. Fining people if they are not comply. Will not have checkpoints around the state. Law enforcement at the local level have stepped up enforcement

  • Seven day average for unemployment insurance claims is 106,000. We typically average 2,000 cases. Will the state exhaust its unemployment dollars?

The state needs to get block grants from the federal government, and if it doesn’t it could exhaust its funds. Serious problem and need federal help to solve it.

  • Can you clarify that all homeless individuals will be moved to hotel rooms or only those that show symptoms? If not, how will you test homeless individuals?

This is a work in progress. The state is working with local health officials to prioritize homeless seniors and those with underlying conditions.

  • Can you provide more guidance on the closure of state parks and beach parking lots?

The Department of Parks and Recreation should be coming out with new guidance very soon. Can visit www.parks.ca.gov for more info.

  • How do you measure success? What are they thresholds you are looking for to let things go back to normal?

We must see an increase the number of tests available and tests being processed; Must have community surveillance of the outbreak; People must practice social distancing and stick to it. This will last at least 8 weeks but no firm date on when this will be over.

 

 

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