Public Health Emergency - Leading a Nation Prepared
In response to COVID-19, CBOs throughout the country have developed partnerships and implemented new practices to ensure that the access and functional needs of at-risk individuals are considered. A few examples are below.
Promote Food Security: To combat food insecurity, FEMA created guidance that highlights promising practices and successful capacity building examples that are working to sustain nutritional needs for at-risk individuals during the pandemic. ASPR also created an informational tool for case managers to more easily match clients and families with nutritional services. Specifically, the tool provides
information on federal programs to sustain nutrition needs for at-risk individuals. For example, In Arizona, emergency federal funding from the Families First Coronavirus Response Act and the CARES Act enabled the Pima Council on Aging to increase home delivery of meals from 5 to 7 days a week and switch to grab-and-go meals for participants of a congregate meal program. CBOs can refer to these resources if their clients are still struggling with access to meals and nutrition supports.
Leverage Buying Power to Obtain PPE: In response to COVID-19, many CBOs have leveraged their position in the community to obtain more protection. In Florida, for example, Area Agencies on Aging (AAAs) have come together to leverage their collective buying power in order to obtain more personal protective equipment (PPE). Similarly, public-private partnerships in the state of Ohio led to large donations of PPE as well as hand sanitizer for Ohio’s 12 AAAs.
Ways to Implement Alternative Care Sites: In order to appropriately respond to COIVD-19, many community-based buildings and facility structures have been repurposed into Alternate Care Sites (ACS) including National Guard armories, local community centers, and sporting arenas. There are many logistical, operational, and physical considerations for communities if they are considering creating an ACS in order to meet the access and functional needs of clients. The Alternate Care Site (ACS) toolkit was developed by ASPR to help state, local, tribal and territorial (SLTT) entities address potential shortages in medical facilities during the pandemic and can be helpful for SLTTs when identifying CBO sites to put an ACS into operation.
Funding is available for SLTTs that are interested in operating an ACS in the community. SLTTs that choose to operate an ACS may be eligible for funding under FEMA’s Public Assistance (PA) Program. For more information, FEMA developed a Fact Sheet: Coronavirus (COVID-19) Pandemic: Emergency Medical Care. The fact sheet provides information on the types of allowable expenses and covered costs that are associated with emergency medical care activities throughout COVID-19.
Telehealth Uptake Opportunities and Solutions: The Centers for Medicare and Medicaid Services (CMS) expanded the list of services that can be provided by telehealth during the public health emergency to include emergency department visits, initial nursing facility and discharge visits, and home visits. It also developed a number of
telehealth toolkits to support providers. ASPR released
behavioral health-specific telehealth guidance and
recommendations for using 911 during telehealth sessions if clients need immediate care. The
HHS Office of Civil Rights (OCR) has indicated that covered health care providers may use popular applications for video chat such as Facetime, Facebook Messenger video chat, Google Hangouts, Zoom or Skype to provide telehealth without risk of federal penalties for noncompliance with the Health Insurance Portability and Accountability Act (HIPAA) during the COVID-19 emergency. These flexibilities when coupled with reimbursement waivers can pave the way for continued utilization of telehealth.
While telehealth can provide increased access to health care, not all telehealth is accessible for those in most need. Telehealth solutions should be evaluated to meet an individual’s functional and cognitive needs. Promising practices are emerging such as integrating American Sign Language (ASL) interpreters for the deaf and hard of hearing with virtual platforms, but more work is needed. Additional barriers in certain geographic regions include lack of access to broadband and internet connections.
State, regional, and local
Health Information Exchanges Organizations (HIEs) or community information exchanges (CIEs) may serve as a resource for CBOs wanting more information about individuals they are supporting through telehealth. These organizations support health care and community-based organizations seeking to coordinate care by working within communities to promote secure electronic exchange of medical, behavioral and social service information. Examples of services that may be available include alerts (e.g. admission, discharge, transfer notifications), e-referral services, and secure health information exchanges. CBOs can consider exploring HIE and CIE services in their geographic area for opportunities to engage.
As CBOs resume operations, it is important to consider the real possibility that clients may want to continue utilizing telehealth services after the pandemic has passed, and that they may have difficulty doing so given limited access to broadband and internet services. This is particularly true in rural areas. CBOs may want to consider communicating with their clients about the continued use of (or options for) remote telehealth services. CBOs can alert clients to low-cost broadband and internet service opportunities like the Federal Communications Commission’s (FCC)
Lifeline Program in order for clients to more easily maintain the use of telehealth services.
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