Department of Human Services (DHS) Secretary Teresa Miller today discussed support the Wolf Administration is providing for long-term care facilities through the Regional Response Health Collaborative (RRHC) program, a statewide program providing clinical, operational, and educational support to long-term care facilities preparing for or facing outbreaks of COVID-19 at their facility. The secretary was joined by Dr. David Nace from UPMC and Dr. Emily Jaffe from Allegheny Health Network (AHN), who lead the UPMC-AHN RRHC, and leadership from DHS overseeing the RRHCs to discuss UPMC and AHN’s work supporting facilities in Southwest Pennsylvania and why the program must continue to be supported beyond its December 1, 2020 end date.
“We know how dangerous COVID-19 can be in congregate care settings, particularly in settings that serve people who are medically fragile or have other health vulnerabilities that make them more likely to experience additional complications from COVID-19, as often is the case for residents of long-term care facilities,” said Secretary Miller. “The unfortunate reality of this pandemic is that outbreaks can and will happen because these facilities and their staff cannot exist in a bubble. What matters most is how we catch and respond to outbreaks when they occur, and the RRHC program is strengthening our response at the state level and making local facilities better equipped to respond. This collaborative approach is saving lives.”
“The Department of Health is pleased with the RRHCs’ work to assist in ensuring facilities have the resources they need to respond to COVID-19 in these vulnerable settings,” Secretary of Health Dr. Rachel Levine said. “As we are in the midst of a fall resurgence, the RRHCs will become even more important. The introduction of COVID-19 into a long-term care facilities is a reflection of the number of cases in the community, which is why all Pennsylvanians have a role in helping protect these facilities.”
Pennsylvania’s long-term care system serves more than 127,000 people living in nursing homes, personal care homes, assisted living residences, and private intermediate care facilities. Due to the congregate nature and because they often serve individuals who are older or have co-occurring medical conditions that make them more vulnerable to an acute case of or complications from COVID-19, constant vigilance is necessary to avoid a serious outbreak at these facilities.
The RRHC program was designed to bolster Pennsylvania’s support for long-term care facilities and their residents and staff. Launched in late July, the RRHC program was established to provide clinical support, technical assistance, and education to long-term care facilities as they work to prevent and mitigate spread of COVID-19. The RRHCs are available 24/7 to support the nearly 2,000 nursing facilities, personal care homes, assisted living residences, and private intermediate care facilities in Pennsylvania and the residents they serve. Eleven health systems were selected to serve six regions across Pennsylvania. Southwest Pennsylvania’s RRHC is a partnership between UPMC and AHN.
Each RRHC is required to make a minimum of two on-site visits to each facility in their region, including an initial on-site assessment that will help the RRHC evaluate a facility’s COVID-19 prevention and mitigation strategies and their preparedness to respond to an outbreak if that were to occur. Based on this assessment, the RRHCs will help those facilities implement best practices in infection control, implement contact tracing programs in facilities, support clinical care through on-site and telemedicine services, and provide remote monitoring and consultation with physicians. RRHCs are in regular communication with DHS, the Department of Health (DOH), and the Pennsylvania Emergency Management Agency (PEMA) to report on experiences interacting with facilities, trends experienced by facilities, and potential challenges.
When a RRHC engages with a facility or is called in to help with a concern identified from collaboration between DHS, DOH and PEMA daily calls, these efforts are classified as missions. A mission could be anything from assistance with testing, assessing a facility’s preparedness, staffing support, rapid response deployment to facilities, PPE support, testing to ensure PPE is properly fitted, and questions or concerns requiring consultation. Since launching, the RRHCs have been assigned more than 6,800 missions, primarily covering testing, consultations, facility assessments, and support with PPE. The RRHCs are also working with the Jewish Healthcare Foundation to operate a statewide learning network available to all long-term care facilities. This network holds regular webinars on topics related to infection control and the latest guidance for responding to and mitigating spread of COVID-19. These webinars have reached more than 5,200 participants since the start of the RRHC program.
The administration can also deploy rapid response teams staffed by the RRHCs when an outbreak is suspected or confirmed at a long-term care facility. These rapid response teams consist of clinical and infection control professionals from the RRHCs to evaluate the situation, ensure proper cohorting of patients based off COVID status, facilitate resident transfers and additional staffing if necessary, and coordinate safe continued care for residents who are not COVID-positive. The rapid response teams can also provide emotional support to both residents or staff to help with the stress and fear associated with an outbreak. Rapid response teams are designed to stabilize potential or confirmed outbreaks, and assistance from RRHCs is not withdrawn until the situation is stabilized and there is no immediate risk to staff and residents.
The UPMC-AHN RRHC serves 11 counties in Southwest Pennsylvania. Since July, the UPMC-AHN RRHC has participated in 2,120 missions covering facility assessments, testing assistance, PPE support and fit testing, training and consultation, and staffing assistance, among others. UPMC and AHN have assisted with 83 rapid response deployments across the Southwest Region.
“This collaborative program has been a crucial and essential partner to providing facility support, consultations, testing assistance, provision of personal protective equipment and successful outbreak management services. It really is a model program for the rest of the country,” said Dr. David Nace, chief medical officer for UPMC Senior Communities and clinical chief of geriatric medicine at the University of Pittsburgh. “We know most long-term care facilities, even if they have funds, could not implement this type of operational and clinical undertaking independently. This program really proves the value of public-private partnerships between academic health centers and the Department of Health and Human Services.”
“We are extremely pleased to be part of this collaboration which has brought together the region’s leading healthcare resources for the benefit of seniors and others who are at most risk for COVID-19,” said Emily Jaffe, MD, MBA, vice president and executive medical director, HM Home and Community Services and post-acute medical director, AHN. “Together with Highmark Health, AHN’s patient-centered, community-focused mission lends exceptionally well to this critical effort.”
The RRHC is funded through Pennsylvania’s Coronavirus Aid, Relief, and Economic Security (CARES) Act award, the program is currently scheduled to end on December 1. The Wolf administration recently sent a letter to President Trump requesting funding to extend the program so it may continue to be a resource throughout the winter. Governor Wolf urged President Trump to work with Congress on a new stimulus package that would support the RRHC program and other resources crucial to protecting the lives, health and safety of Pennsylvanians.
“The last eight months have been a period of great learning. We’re now at a point where we have a system that is working and helping to stabilize and prevent outbreaks. As the country works to get a vaccine that is effective in market and available, we need to do all we can to protect people who are most vulnerable to this virus,” said Secretary Miller. “The RRHC program cannot stop COVID altogether, but it is undoubtedly making us better at fighting it. We cannot lose this resource.”
For more information on guidance to DHS’ providers related to COVID-19, visit www.dhs.pa.gov.