The spread of Covid-19 has disturbed life across the Golden State or California. On March 19, Governor Gavin Newsom passed an order that all individuals residing in California were to stay at home except for required activities like purchasing groceries or getting necessary healthcare. Schools, non-essential firms, like gyms and entertainment venues, and parking lots in state parks and beaches were closed.
While preparing for the COVID-19 pandemic, the healthcare industry, on the other hand, continues to serve patients. Health experts predict that the surge of California has not come yet.
The MD of the San Francisco Department of Public Health, Grant Colfax, said he thinks in a week or two to see a vast number of coronavirus patients that have to be hospitalized. Newsom lately increased the estimate of additional hospital beds required for Californians who become ill with COVID-19 from 20,000 to 50,000.
You will need to learn about how California is currently adopting policies related to workforce, telehealth, health care coverage, and palliative care to prepare for the COVID-19 pandemic.
Helping Californians Stay Covered
Covered California, the nation’s Affordable Care Act health insurance policy market, has started a particular enrollment period to ensure that the unemployed do not get bumped off their health coverage. Californians have to register for coverage until June 30. The California Department of Insurance and the California Department of Managed Health Care say the registration period also applies to health plans taken by people outside the exchange.
State subsidies are there to make health insurance affordable for Californians buying coverage. As per a Covered California news release, 576,000 users earning between 200% and 400% of the federal poverty level get a monthly average of $608 per family in federal tax credits and new state subsidies. The state subsidy to families is $504 per month for customers earning 400% to 600% of the poverty level.
The state has placed a 90-day hold on studies of Medi-Cal revisions to assure that people enrolled already do not find a gap in policy. The California Department of Health Care Services (DHCS), which governs Medi-Cal, “is trying to expedite applications for senior citizens and other inhabitants considered vulnerable to the disease,” Cathie Anderson reported in the Sacramento Bee. Medi-Cal registration isn’t subject to registration periods and is continuous year-round.
These collective activities are significant because being uninsured is”downright terrible during a public health crisis. To be able to get screened and tested, you should call your physician, but that presumes, you have a physician or usual source of care.
To encourage testing for Californians displaying COVID-19 symptoms, Covered California Executive Director Peter V. Lee” stressed that screening and testing for the coronavirus are free for anybody with coverage, whether during Medi-Cal, Covered California, or employer-sponsored insurance,” Erica Hellerstein reported for CalMatters.
COVID-19 Highlights Workforce Shortages
The crisis has exacerbated the country’s healthcare workforce shortage, and California hospitals are bracing for the worst. Across the nation,” hospitals are taking exceptional steps to bulk up the workforce, from calling retirees for aid to assigning medical students to answer the phones,” Rachel Roubein and Joanne Kenen mentioned in Politico.
In an attempt to lessen the challenges, the Trump government announced new rules that would let physicians practice across state lines without going through layers of recertification and licensing. Meanwhile, hospitals are working on contingency plans for freeing up their staff in the case of an influx of COVID patients.
Medical experts are concerned about the patient-to-provider spread of the coronavirus. Jenny Gold reported at California Healthline that one case of COVID-19 in Vacaville leftover 200 hospital employees under quarantine. It’s simply not sustainable to believe that each and every time a healthcare worker is exposed, they need to be quarantined for 14 days.
To free up more nurses and doctors, Newsom explores the possibility of loosening the state’s “scope of practice” legislation, which regulates the kinds of work that licensed healthcare employees can do, Sophia Bollag wrote in Sacramento Bee. “Our staffing will require more flex, it is going to require greater capacity as it relates to present ratios, as it pertains to the current scope of practice,” Newsom said during a news conference.
He also suggested that “fourth-year medical students and nursing students near the end of the training could be called on to take care of COVID-19 patients,” Bollag proclaimed. People no longer practicing medicine, and physicians might be encouraged back to deal with COVID-19 patients.
Amid reports that shortages of medical supplies are forcing some healthcare workers to clean and reuse single-use personal protective equipment (PPE), the state issued 21 million N95 masks from its emergency supply. Individuals and companies throughout the country are coming forward to help. Direct Relief has donated PPE to over 1,000 community health centers and free clinics nationally.
PG&E is donating almost one million N95 and surgical masks to California hospitals and Tesla CEO Elon Musk bought over 1,000 ventilators to send to Los Angeles. Bay Area firms Falcon Spirits Distillery and Clean360 pivoted from making spirits and soap to creating hand sanitizer.
Hospitals in need of PPE can ask supplies by filling out a form on Job N95 — a new national clearinghouse for medical equipment. Government agencies and medical equipment providers may also visit the site to arrange bulk purchase orders and give stuff.
Telehealth May Transform The Way Care Is Delivered
The need for medical care has resulted in a spike in telehealth services, a development that could change the medical care landscape. Though medical care has been changed by technology, the adoption of telehealth has delayed, cardiologist Haider J. Warraich mentioned in the Los Angeles Times. “One of the principal reasons China has been able to reduce coronavirus spread has been a dramatic increase in virtual visits,” he wrote. “Promoting telemedicine on a level with [in-person] visits can protect patients and medical care staff and allow for considerably more efficacy in the system.”
To that end, The Trump administration declared on March 17 that it would instantly expand Medicare telehealth coverage nationally to assist elderly Americans access care from home at no extra price. To bring telehealth into the 13 million people covered through Medi-Cal, California asked for a national 1135 waiver that contained a request for flexibility for telehealth and virtual communications.
Part of this waiver request was approved, but portions, including telehealth, are still awaiting approval. Meanwhile, DHCS has taken immediate action to expand telehealth access, requiring Medi-Cal managed care programs (PDF) to pay providers the same rate for telehealth and phone visits as they do for in-person visits.
Many California hospitals have expanded their use of telehealth to control foot traffic. The American Medical Association reported that 21 Kaiser Permanente hospitals in Northern California served an average of 3,000 inpatients daily increased video visits for primary and specialty care by over 150 percent in a recent two-week period.
UCSF is reaching out to patients with a variety of conditions ahead of the scheduled in-person visits to determine whether they could convert them to telehealth visits. To stay up-to-date on telehealth coverage changes, bookmark the Center for Connected Health Policy’s living record of national policies and state-specific activities.
The California Medical Association compiled a running record of telehealth tools, and the Center for Care Innovations is upgrading a knowledge center for practicing virtual care during a pandemic.
Care at The End of Life
As hundreds of people are hospitalized due to COVID-19, are patients, healthcare systems, and families ready for decisions and conversations about medical interventions and healthcare preferences? Now providers must tap into palliative care’s tenets to direct patients and their families through uncharted waters.
Palliative care is a medical practice focused on suffering for individuals with severe illness and relieving stress, and it is provided as an additional layer of support alongside curative care. Some experts fear that a longstanding lack of palliative care experts”could leave many COVID-19 patients in distress.
This pandemic means that we’re going to be drawn to infrequent conversations with families, suddenly having to make tough decisions about life and death. As we take stock of gloves, masks, and ventilators, we must also be prepared to dig deep into our communication reserves, patience, and compassion.
In an article comment, Emily Aaronson, MD, an emergency physician, and assistant chief quality officer at Massachusetts General Hospital, encouraged households to participate in conversations about end-of-life. “You must know what would be important to them when they were at the last phase of the life — and what measures you and others might need to take to ensure those requirements are met,” Aaronson wrote. “These are discussions designed to guard against regrets.”
Many resources are available to assist medical care providers and families alike. Aaronson advocated the Conversation Project and Death Over Dinner to facilitate discussions. The Center to Advance Palliative Care coordinated a COVID-19 toolkit for clinicians, and VitalTalk, a nonprofit organization dedicated to helping clinicians develop communication skills for serious illness, published a guide to difficult conversations about the care of COVID-19 patients.