We continue to understand the difficulty of attaining FBI fingerprint clearances due to the limited number of available sites. We are working on multiple efforts to alleviate this situation.
We are working with legislative staff to prepare language to provide a temporary reprieve for some individuals who are required to be certified or recertified under the Child Protective Services Law. This reprieve would still require individuals to complete available state clearances, sign an attestation where the individual confirms in writing that they have not been convicted of certain offenses, and complete the FBI clearance within certain timeframes following the lifting of the Governor’s orders.
As we are awaiting this temporary reprieve, DHS has supported temporary mobile sites to help alleviate the current needs. Our first mobile site was earlier this week. During the call, we mentioned that a second site would take place on Thursday, April 23 in Allegheny County. Earlier this evening, we received word that this site was canceled and will be rescheduled. We apologize for any inconvenience. While we are doing what we can, these mobile sites will in no way meet the full demand or lessen the need for the legislative solution, which we continue to work towards.
Preventive Efforts in Congregate Settings
As we fight this pandemic, we remain keenly focused on doing all we can to protect vulnerable populations under DHS’ care and oversight.
Long-term and residential care facilities serving older adults, people with disabilities, and people with mental illness are feeling particular strain and pressure due to the circumstances we’re facing. People served in these settings often have co-occurring disabilities and chronic medical conditions like heart or lung disease and diabetes, putting them at greater risk of a more aggressive case of COVID-19 and serious complications if they do test positive. This time creates serious risks and challenges, but these populations are care-dependent, so we cannot lose sight of our obligation to ensure both DHS staff and providers in the community are able to continue these services while keeping residents and staff as safe as possible.
DHS is following all guidance issued by the Pennsylvania Department of Health and the Centers for Disease Control and Prevention in our state-run intermediate care facilities, hospitals for people with mental illness, and youth development centers and forestry camps. We have also directed all congregate care providers operating in communities across Pennsylvania – groups homes serving people with intellectual disabilities, personal care and assisted living facilities, and private intermediate care facilities, among others, to closely heed these recommendations as well. Specifically, we are working closely with licensed providers to adhere to the CDC’s long-term care facility guidance that speaks to screening for COVID-19 and visitation restriction as we try to limit the spread of COVID-19.
Long-term care providers are in an extremely precarious situation in this pandemic, and we are doing all we can to allow necessary operational adjustments and provide support from the state level. We continue to issue new guidance as necessary and make additional requests to the federal government to support the flexibility we all need to properly respond as the pandemic evolves. We’re also facilitating support networks between long-term care providers, health systems, and health care quality units to help assist with preparedness, mitigation, and infection control efforts. This week, the majority of personal care homes and assisted living residences have been reached by a health system partnering with DHS to provide educational support and clinical coaching to help prevent the spread of COVID-19.
We know that there are concerns around availability of personal protective equipment for community providers. PPE distribution is centralized through a process overseen by the Department of Health and the Pennsylvania Emergency Management Agency. This process is prioritizing hospitals and nursing facilities. For other congregate care settings, including person care homes, assisted living residences, intermediate care facilities, and licensed community homes, they are doing their best to be responsive to other needs as resources become available. Facilities with active cases are prioritized. We also know that COVID-19 testing for these long-term care facilities is also a concern. DHS is currently following the guidance of the CDC as well as DOH when determining when it is appropriate to test long-term care residents.
We know this period is difficult, but we need our care providers to know that they are not alone, and we are doing what we can to listen to your needs and support you through this difficult period. Care providers around Pennsylvania are heroes every day in normal times, and during times of great challenge like we face now, that heroism comes at great personal risk. On behalf of the Wolf Administration, I want to thank everyone working in direct and long-term care. We are with you, and we will overcome this challenge in the coming months together.
State-Run and Licensed Facility Data
I wanted to give an overview of what we are experiencing in our DHS-run facilities – our state centers, state hospitals, and our youth development centers and forestry camps.
As mentioned previously, we are paying meticulous attention to guidance and following protocols to mitigate the risk of COVID-19. Protecting the health and safety of people receiving care and services and our staff who provide these critical services is our utmost priority. We have published and discussed guidance related to changes in admissions and visitation policies to protect residents and staff during the public health crisis.
As the pandemic progresses, we want to be transparent about the status of our state-run facilities. This week, we started publishing data on cases of COVID-19 among staff and people served in these facilities. This information is accessible through the “DHS Data” section of our COVID-19 landing page at www.dhs.pa.gov and will be updated every weekday. The data reflects active cases of COVID-19 among staff and people served, so as individuals recover, they will not be reflected in active case counts.
Currently, positive cases are found among both staff and residents at Norristown, Wernersville and Torrance State Hospitals. Hospital staff and leadership in the Office of Mental Health and Substance Abuse Services have made numerous adjustments to limit further spread as much as possible.
Staff at all state hospitals have their temperature checked and are screened with four standard questions that evaluate risk of exposure to COVID-19 at the beginning of every shift. Anyone who works a shift longer than eight hours is screened again before the overtime shift begins. Staff who work in the isolation units have temperature taken every four hours. All staff have a final temperature check at the end of their shift before leaving the facility.
Staff with a temperature higher than 100 degrees are directed to go home. Any staff who call off sick are asked to report their reasons to the hospital’s Infection Control Nurse so they can be properly counseled on next steps. Staff with possible symptoms of COVID-19 are required to provide documentation from their physician or meet with an infection control professional before returning to work.
Currently, our state hospitals are requiring all residents to wear masks in compliance with the recent guidance from the Department of Health and Governor Wolf. Additionally, residents have their temperature checked every eight hours. Anyone with a temperature over 100 degrees has temperature checks every four hours, and if their temperature does not drop, residents are moved to isolation in the infirmary unit for closer observation.
Both residents and staff who demonstrate high risk for exposure or symptoms of COVID-19 are tested. Residents awaiting test results are also isolated to mitigate risk of further exposure. Presently, test results take several days. DHS is in the process of acquiring testing equipment and supplies to enable a higher volume of tests to be performed with faster test results at multiple locations in the commonwealth, and Norristown State Hospital will be a testing site. Staff are being trained in the proper use and maintenance of the equipment so that testing may begin on site in the near future.
All state hospital staff are utilizing PPE according to Centers for Disease Control and Department of Health guidelines. The kinds of PPE utilized may vary based upon the risk of exposure per area to which staff are assigned, but some level of PPE is mandatory and being provided for all staff on the campuses. Hospital housekeeping staff are using Electrostatic Disinfection Process regularly in all buildings to enhance the cleaning and disinfection processes.
We are monitoring these situations closely and at all other DHS-run facilities should circumstances begin to change. We are working on a method to provide data on our licensed facilities as well, so look for an update in the future on that data.
LIHEAP Recovery Crisis
As the pandemic progresses, we are working to support access to vital public assistance programs and establish new opportunities to support Pennsylvanians through this difficult period and the months of recovery ahead. The 2019-2020 Low-Income Home Energy Assistance Program (LIHEAP) season closed on April 10, 2020. Before the season ended, there were numerous suggestions to extend the season, expand services, or increase benefit amounts due to the pandemic.
There has been significant interest in this important program and we value the suggestions countless stakeholders have made over the last several weeks. We appreciate all the input we have received and are making adjustments to our proposed LIHEAP Recovery Program in light of those recommendations that will provide utility and energy assistance for households affected by COVID-19’s economic challenges. This program will be funded through LIHEAP funds contained in the Coronavirus Aid, Relief, and Economic Stimulus Act – also known as the CARES Act. However, it has not yet been made clear to us exactly how much funding will be received for LIHEAP. Requests for information to the federal government have been denied, so we cannot move forward until we know how much funding we will receive.
Once funding becomes available, DHS intends to operate a Recovery Crisis program beginning in mid-May and running through August 31, or until funds are expended. Parameters for the Recovery Crisis program will be the same as the normal LIHEAP Crisis program with a few adjustments that take into account circumstances created by COVID-19.
We are ironing out final details on this program, but as soon as we are ready to move forward, we will be asking for your help in making sure the people who need to know about this opportunity can apply and receive assistance. Thank you, as always, for your support and partnership in connecting the people you serve to DHS programs that can help.
SNAP Online Ordering
Over the past several weeks, there has been significant interest in how Pennsylvania can join in the United States Department of Agriculture’s pilot program to allow SNAP recipients to purchase groceries online. We share an interest in helping SNAP recipients access this resource and option to help SNAP participants mitigate risk of being exposed to COVID-19, but this is not a program we can simply opt into.
The USDA’s Food and Nutrition Services (FNS) is responsible for approving both states and retailers for participation in the pilot. In Pennsylvania, only Amazon, Walmart, and ShopRite would be available through the pilot. If other retailers want to join this pilot, they would need to work through FNS directly. DHS does not have authority to add retailers. I also want to caution that in some states where the program currently exists, SNAP recipients face higher prices and difficulties accessing delivery or pick-up times that other customers are experiencing right now. DHS would not have any authority to address these issues or make accommodations for customers paying with SNAP. Additionally, SNAP funds would not be able to be used for delivery fees. DHS cannot waive this federal requirement, but we would be open to partnering with stakeholders and legislators to suggest that these fees be waived for SNAP customers.
We are planning to join this pilot and are preparing to submit the plan to FNS. If approved, there would be necessary system changes required by our EBT contractor and other business partners to make implementation possible. We have already had conversations with Amazon, Walmart, ShopRite and FIS, the third-party processor and all have agreed to provide commitment letters. We are now working with our EBT contractor to determine the timeline for the required changes that would allow us to make both SNAP and cash benefits available through the EBT card online. As soon we finalize these details, we will submit our plan to FNS. We will provide additional updates as we receive them.
There are options, though, for retailers to create flexibility for SNAP recipients looking to utilize delivery or pick-up options without having to join the federal pilot program or seek approval from anyone. The pilot establishes a way for SNAP recipients to pay online for groceries, but if a retailer already has mobile EBT processing equipment, they can allow SNAP customers to pay when groceries are delivered or picked up. Wireless point of sale devices can be purchased at any time, and we are working with the Pennsylvania Food Merchants Association so their members are aware of this on-going opportunity to create flexibility for customers paying with SNAP.
We also received a grant prior to the pandemic to provide EBT processing equipment to farmers markets. Interested markets would have to be an approved SNAP retailer through FNS, but once approved, a free mobile point of sale device can be obtained through our EBT vendor, Conduent. These grants also cover setup costs and one year of SNAP transaction fees. We are working with our partners to make farmers markets and their vendors aware of this option.
SNAP Emergency Allotments
We also received updated guidance from FNS regarding the issuing of additional emergency SNAP allotments. States have been granted approval to continue issuing emergency allotments each month until such a time as the Secretary of Health and Human Services rescinds the public health emergency declaration. This means that beginning in mid-May and thereafter, we will issue additional payments to current SNAP households for the difference between what they received in their regular scheduled benefit in the previous month and the maximum SNAP amount for their household size. Current SNAP households that already receive the maximum benefit are not eligible for the additional emergency allotment.
We are drafting a letter to the United States Congress expressing our concern about FNS’s interpretation of the Families First Corona Virus Relief Act as it relates to the issuance of the SNAP emergency allotment and requesting additional resources for the 40 percent of SNAP households that do not benefit from this change.
DHS and the Department of Education did submit our Pandemic EBT plan to FNS on Monday. If approved, this plan would provide SNAP to students who are eligible to receive free or reduced-price meals through the National School Lunch Program. This would provide an approximate benefit of $365 per child for approximately 958,000 Pennsylvania school-aged children.
We are still awaiting approval, and will keep you all in the loop when this hopefully moves forward. If approved, the first round of payments will be issued 14 days after approval.
Child Care Updates
On April 21, OCDEL released an updated policy announcement to child care and the Early Learning Resource Centers that Child Care Works (CCW) payments will continue to all providers. Payments will be made based on CCW enrollments for the month of May regardless of whether the provider remained open or closed. The policy continues the suspension of CCW co-payments charged to families if their children are not actively attending child care due to COVID-19 or if the child care is closed.
Last week, we mentioned the receipt of the CARES Act Stimulus funds released through the Child Care Development Fund. OCDEL is continuing to review data and consider stakeholder input to develop a plan to best direct these funds.
The Department of Labor and Industry’s website for COVID-19 Employment Opportunities has linked directly to the DHS COVID-19 Child Care map, allowing Pennsylvanians seeking to find work in an open life sustaining business the ability to review available child care near the job or their home. We continue to share available resources with individual families, employers, and associations regarding the availability of child care during COVID-19. Early Learning Resource Centers can connect families with open child care in their communities. The easiest way to identify which ELRCs serve a community is to visit www.raiseyourstar.org.
Stimulus Funding Update
We and the entire Wolf Administration realize the financial strain that the COVID-19 pandemic has placed upon providers. Over the past several weeks, DHS has been collecting data from providers on the impact of COVID-19 and are working closely with the Governor’s Budget and Policy Offices to develop plans to help stabilize our provider community to ensure they are there and able to serve participants once the pandemic is over. Part of these plans include accelerating some fourth quarter payments to hospitals so they will receive them in May instead of August. Retainer payments and alternative payment arrangements are another way DHS is providing relief.
Like many of our providers and partners, the state also has been put under a financial strain due to decreased sales tax revenue, payroll tax, and several other income sources – with an estimated $3 to $5 billion in projected revenue loss. However, under the CARES Act, Pennsylvania will receive approximately $2.7 billion, with another $2.2 billion going to local governments. These funds are intended to be used to address the needs throughout the state due to the impact of COVID-19. While we have begun to receive some of the CARES Act funding, federal guidance is not yet available on how these funds may be used.
The Governor’s Office will need to work closely with the legislature to determine the most appropriate way to distribute these funds to assist you with your financial needs, and as we have more information to share, we will keep you all in the loop. Thank you all for your patience as we navigate this process.