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Bracing for coronavirus, hospitals call for more funding

Extra $1 billion needed to help with problems tied to pandemic, they say

Hospitals are seeking more funding as they brace for more patients with COVID-19 infections and potential shortages of workers and supplies.

Groups representing hospitals, doctors, and nurses are seeking an extra $1 billion to help build up temporary hospital capacity, protect workers and deal with other problems tied to the coronavirus pandemic. Leading hospital groups also want Congress to temporarily boost Medicare payments and are warning against any blanket guidance on deferring nonemergency care.

Their requests come on the heels of President Donald Trump’s national emergency declaration Friday afternoon, which should provide more financial support and offer flexibility for health care providers to address the rapidly spreading virus. Health care officials expect the number of reported cases to rise this week, as they say testing will become available in up to 2,000 labs after patients have struggled to get tested.

On Monday, the leading advocacy groups for hospitals, doctors and nurses sent a letter to congressional leaders asking for the additional $1 billion in emergency funding to build new facilities to handle an influx of potential patients, obtain more personal protective equipment and pay for increased staffing. The groups said staffing needs are likely due to increased patient load or staffing shortages.

“Our health care workers are as likely to contract the coronavirus disease as anyone else in the community, so that’s a concern to us,” Nancy Foster, vice president of quality and patient safety policy at the American Hospital Association, said Friday in a separate interview with CQ Roll Call.

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The hospital and provider groups also raised the possibility of hospitals needing to provide solutions for their employees who face school and child care closures.

“As schools and childcare facilities shut down during community spread of coronavirus, hospitals may need to provide alternatives so that physicians, nurses and other staff with young children can come to work,” said the letter from the American Hospital Association, the American Medical Association and the American Nurses Association.

AHA and the other provider groups said the $1 billion would be needed in part to address the potentially “devastating implications” of cancellations due to shortages of protective equipment for workers, other medical supplies and the need to reserve beds for COVID-19 patients, “as well as patient cancellations due to fear of COVID-19 in health care facilities.”

Hospital groups are also urging Congress to consider suspending for as long as the pandemic continues a 2 percent Medicare payment cut that is in effect under the sequester required by the 2011 budget control law.

“This action alone will provide immediate, significant relief across-the-board, and will signal continued Congressional support for the hard work that lies ahead for all of us,” the AHA, Federation of American Hospitals and Association of American Medical Colleges said in a separate letter to congressional leaders.

Hospitals are also worried about the impact of patients deferring care that’s unrelated to COVID-19. The Centers for Disease Control and Prevention suggested that when possible, some procedures that normally require a hospital stay should be considered being done on an outpatient basis.

Washington Democratic Gov. Jay Inslee said last week that the state might require delaying some procedures so that capacity is maintained for emergency needs, according to Seattle’s KUOW. Several hospitals in Washington state, New York and elsewhere are already rescheduling surgeries.

The AHA and other leading hospital organizations on Sunday night urged Surgeon General Jerome Adams not to ban elective surgeries and other health care needs that patients may have at this time.

“A blanket directive to cancel elective and non-urgent procedures usurps the proper role of the physicians caring for patients and their families, collaborating closely with the hospital, to determine what is in the patient’s best interests,” the groups wrote.

Meanwhile, states are urging federal officials to do more to boost hospital capacity and are looking at actions of their own.

New York Democratic Gov. Andrew M. Cuomo, in an open letter to the Trump administration, suggested directing the Army Corps of Engineers to start building temporary hospital facilities at places like military bases or in college dormitories.

Maryland Republican Gov. Larry Hogan ordered health officials to work with health care providers to increase the state’s number of hospital beds by 6,000, suggesting reopening closed hospital facilities.

Limiting exposures

In a Sunday news conference, Health and Human Services Secretary Alex Azar acknowledged that the health care system could be overwhelmed as the virus, which the World Health Organization has declared a pandemic, spreads.

“Any pandemic like this runs the risk of exceeding our health care system capacity, and we must acknowledge that,” he said.

He added that the administration is working to acquire additional supplies for hospitals, calling the pandemic an “unprecedented challenge.” He declined to say exactly how many ventilators the country has on hand, although Anthony Fauci, the director of the National Institute for Allergy and Infectious Diseases, said on ABC’s “This Week” that the national stockpile is about 13,000.

Azar also raised the possibility of grouping patients who test positive for COVID-19 together, similar to what was done in China, which he said would be more efficient for the health care system.

“This gives us reduced burden on personal protective equipment, but it also can give us greater capacity as we put field medical shelters up, as we consolidate into single facilities, as we don’t need individual rooms, negative airflow, isolation, et cetera,” he said.

Ali Khan, dean of the College of Public Health at the University of Nebraska Medical Center and a former director of the CDC’s office for health preparedness and response, said in an interview that cities experiencing community spread should consider designating certain hospitals for those with respiratory illnesses, while sending those with other needs to other hospitals.

He also said hospitals should start taking steps like restricting access to emergency rooms and limiting the number of workers a patient might interact with.

“I’ve been in ERs where there are hundreds of people roaming in and out,” he said. “Health care staff, the students, everybody. Can we think a little more rationally about how many people should interact with a single patient? Can we think more rationally about visitors coming to hospitals or nursing homes?”

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