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State Disaster Medical Advisory Committee: Contingency PPE + Testing Prioritization

Posted By Administration, Wednesday, March 25, 2020

Society PA,

In response to the COVID-19 pandemic, the Arizona Department of Health Services (ADHS) has convened the State Disaster Medical Advisory Committee (SDMAC).  On March 24, 2020,  guidance for personal protective equipment (PPE) preservation and testing prioritization was approved in accordance with the Arizona Crisis Standards of Care Plan.

Recommendation: Shift to Contingency PPE, Prepare for Crisis Measures

Standards for PPE use should be shifted from conventional to contingency measures; organizations should prepare for crisis measures.  Recommendations for contingency use of different elements of PPE include extended use strategies.  Further details can be found online under CDC’s Strategies for Optimizing the Supply of PPE.  

Recommendation: Set Testing Prioritization 

Given limited testing supplies, both reagents and swabs, and limited PPE, the SDMAC approved the following testing priorities.  The goal of testing should be to limit introduction of COVID-19 in healthcare and congregate settings and vulnerable populations.

  • Public health and healthcare professionals should prioritize testing among three specific groups until sufficient and consistent PPE, testing supplies and capacity are widely available:
    • Healthcare workers, first responders, and employer identified critical infrastructure personnel* with COVID-19 symptoms
    • Individuals living in congregate settings with symptoms of COVID-19
    • Individuals hospitalized with respiratory symptoms  
  • Community-based COVID-19 testing (drive-through, walk-up, etc.) should be focused on making tests available to the three priority groups above.
  • Healthy individuals and those with mild disease do not require testing. These individuals should practice social distancing and follow the recommendations of their local and state public health authorities. 

More information on the SDMAC and the guidance reported here can be found on the ADHS website for SDMAC.

Thank you,
Arizona Health Alert Network

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Avoid inappropriate prescribing in the COVID-19 epidemic

Posted By Administration, Wednesday, March 25, 2020

Society PA,

There is widespread social media reporting the efficacy of antimalarial and antibiotic medications for treatment of COVID-19.  The data to support this is preliminary and insufficient at this time and should not be applied on a population level.   

Over the past 48 hours, we have been made aware of several downstream effects:

1) Patients are inappropriately requesting prescriptions of antimalarial and certain antibiotic medications

2) Pharmacies are running out of antimalarial and certain antibiotic medications

3) Patients are self-administering antimalarial and certain antibiotic medications

4) Patients are self-administering non-FDA and household products (i.e. fish tank cleaner)

ARIZONA PROVIDERS: Please do not prescribe theorized “anti-COVID” medications and counsel patients against using inappropriate medications and household products to prevent or treat COVID-19.

Management of COVID-19 is currently supportive care for respiratory and pneumonia care.  For further resources on treatment guidelines, see the CDC clinical guidance and clinical trials.

Thank you,
Arizona Health Alert Network

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Governor Ducey Expands Telemedicine Coverage For Arizonans

Posted By Administration, Wednesday, March 25, 2020

Governor Ducey Expands Telemedicine Coverage For Arizonans

News Release

March 25, 2020

PHOENIX — Governor Ducey today issued an Executive Order requiring health care insurance companies to expand telemedicine coverage for all services that would normally be covered for an in-person visit. The order helps ensure that Arizonans who may be sick or under quarantine can access care from their homes and avoid potentially risky trips to a health care provider. It remains in effect until the termination of the declared public health emergency. 

“Access to health care is crucial at a time like this,” said Governor Ducey. “This order will ensure that Arizonans can access care without having to leave home while freeing up much needed capacity for our health care providers and hospitals. It’s commonsense and helps ensure our most vulnerable continue to have access to care in a way that protects them and public health.”

Yesterday, Governor Ducey took steps to free up physicians for other needed medical services and ensure access to health care for kids and vulnerable Arizonans receiving care through KidsCare and AHCCCS.

Today’s Executive Order prevents insurers from charging more for a telemedicine visit than they would for an in-person visit. In addition, the order:

  • Requires all Medicaid plans in the State of Arizona to cover all health care services that are covered benefits to be accessible by telemedicine to AHCCCS members, while prohibiting those plans from discounting rates for services provided via telemedicine;
  • Includes all electronic means of delivering telehealth including telephone and video calls;
  • Ensures that a patient’s home is considered an approved location to receive telemedicine services;
  • And prohibits a regulatory board from requiring a medical professional who is authorized to write prescriptions to conduct an in-person examination of a patient prior to the issuance of a prescription.

View the Executive Order HERE.


https://azgovernor.gov/governor/news/2020/03/governor-ducey-expands-telemedicine-coverage-arizonans

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Coronavirus Disease 2019 (COVID-19): Reporting positive cases and isolation release recommendations

Posted By Administration, Wednesday, March 18, 2020

Arizona Health Alert Network

Society PA,

As of March 16, 2020, there are 18 confirmed cases of COVID-2019 in Arizona. Arizona case counts are updated on the ADHS COVID-19 webpage daily at 9AM. 

The Arizona Department of Health Services acknowledges that the situation, guidance, and testing capacity are constantly changing. The current guidance of reporting, testing, and isolation for Arizona providers are the following:

1. Call the local health department to report patients with laboratory positive COVID-19 if they have a high-risk occupation* OR live in a congregate setting†.

2. Counsel patients on the following isolation recommendations: 

  • If a patient has been tested for COVID-19 and is awaiting results:
    • Remain under home isolation precautions.
  • If a patient has tested positive for COVID-19:
    • Remain under home isolation precautions for 7 days from specimen collection OR until 72 hours after fever is gone and symptoms of acute infection resolve, whichever is longer.
  • If a patient has tested negative for COVID-19 and has compatible symptoms (fever, cough, SOB):
    • Stay home until 72 hours after all symptoms are gone without the use of medicine.
  • If a patient has not been tested for COVID-19 and has compatible symptoms (fever, cough, SOB):
    • Stay home away from others until 72 hours after fever is gone and symptoms of acute infection resolve.
  • If a patient has not been tested for COVID-19 and has other non-compatible symptoms: 
    • Stay home until 24 hours after all symptoms are gone without the use of medicine.
  • Individuals returning from travel within or outside of the U.S. who are not sick should be allowed to return to work unless otherwise indicated by public health. 

3. Testing is available through public health or commercial laboratories. At this time, specimens (NP swabs) can only be collected by a provider and the following commercial laboratories have COVID-19 testing available:

For up-to-date information for providers in Arizona, please visit the ADHS website and download the IDAZ mobile phone application. For general national information, visit the CDC website. Please call the Arizona Poison Control System for any COVID-19 questions: 1-844-542-8201.

*Healthcare personnel, school personnel, childcare worker, jail/prison personnel, or other similar occupation
†Jail/prison, long-term care facility or nursing home, university, or other similar setting.

Thank you,
Arizona Health Alert Network

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Microbiology specimens will require a barcode generating form starting on 3/9/2020

Posted By Administration, Monday, March 9, 2020

Society PA,

In order to enhance Arizona's COVID-19 response and in accordance with Arizona Management System directives, the Arizona State Public Health Laboratory will be fully implementing its microbiology barcode generating form as of Monday, 3/9/2020. Full implementation will ensure timely and accurate processing of all specimens during the COVID-19 surge event.  

All clinical microbiology specimens sent to the Arizona State Public Health Laboratory must be submitted with a barcoded Microbiology Submission Form beginning Monday, 3/9/2020.    

Submissions which do not have a barcode will not be processed until a barcode is provided.  

The barcode generating Microbiology Submission form is available on the Shipping and Receiving website. This web page also provides access to an instructional video and text instructions for using the form.   Please direct questions to the ASPHL Laboratory Chief of Laboratory Support Services, Joseph Manfrida, using the contact information below.   Thank you for assisting ASPHL in the statewide COVID-19 response by utilizing the barcode form.  

Joseph Manfrida, PhD

joseph.manfrida@azdhs.gov

(602)364-2359  

Thank you,
Arizona Department of Health Services

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Novel Coronavirus (2019-nCoV) Update: First Confirmed Case in Arizona

Posted By Administration, Tuesday, January 28, 2020

Arizona Health Alert Network

Society PA,

As of January 26, 2020, there has been one confirmed case of 2019-nCoV in Arizona. This is one of five confirmed cases (all travel associated) reported to date within the United States. This is a rapidly evolving situation, and information will be updated on the ADHS website as it becomes available.

Arizona clinicians are recommended to:

  • Mask and isolate patients presenting with acute respiratory illness and recent travel from Wuhan City, China in the last 14 days of symptom onset.
  • Immediately notify your healthcare facility’s infection control personnel and local healthdepartment.
  • Healthcare personnel encountering a suspect patient should use standard precautionscontact precautions, airborne precautions, and use eye protection (e.g., goggles or a face shield).
  • Obtain a detailed travel history for patients being evaluated with fever and acute respiratory illness.
  • Consider testing for seasonal respiratory illnesses, like influenza.
  • Coordinate with the local health department for specimen collection, transport, and testing for suspect cases.

The Arizona Department of Health Services and local health departments are coordinating surveillance, infection control, and communication with the Centers for Disease Control and Prevention regarding 2019-nCoV.

 

For up to date information for providers, please visit the ADHS website. For general national information, visit the CDCwebsite. If you have any questions, please contact your local health department.

Thank you,
Arizona Health Alert Network

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Arizona Vaccine News from the AZ Dept. of Health Services

Posted By Administration, Thursday, October 31, 2019

Society PA,

Please see the attached below “Arizona Vaccine News.”

The intent of “Arizona Vaccine News” is to summarize local, national, and international vaccine information that affects Arizona. 

Thank you,
Arizona Department of Health Services

 Attached Files:

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Guidance for Providers Caring for Patients with Suspected Vaping-Related Respiratory Illness

Posted By Administration, Monday, October 21, 2019

Arizona Health Alert Network

Society PA,

As of October 17th, 1,479 cases of vaping-related respiratory illness have been reported nationally, with 33 deaths.  

Based on these cases, CDC has provided Interim Guidance for health care providers who are evaluating and managing patients with vaping-related respiratory illness.

With this new guidance, Arizona providers are requested to do the following:

  • Report suspected cases of vaping-related respiratory illnesses (VRRI) in hospitalized patients to the Arizona Poison & Drug Information Systems at 1-800-222-1222.
  • Ask patients with acute pulmonary illnesses about vaping or e-cigarette use, including use of non-nicotine substances.
  • Reassess outpatients with suspected VRRI within 24-48 hours to manage possible worsening illness.
  • Admit patients with suspected VRRI if their O2 saturation <95%, and initiate steroid treatment promptly.
  • Determine if any remaining product (including devices and liquids) are available for testing and notify the Arizona Poison & Drug Information Systems.
  • Provide patients with clear and consistent messaging:
    • If you are a child, you should not use vape products;
    • If you are pregnant, you should not use vape products;
    • If you are an adult who vapes, you should stop if you have concerning symptoms;
    • Do not buy vape-related products from informal sources (e.g. friends, family, “off the street”) and do not modify the device or add non-manufacturer substances.
    • If you are an adult using e-cigarette, or vaping, products to quit cigarette smoking, do not return to smoking cigarettes. Use evidence-based treatments, including healthcare provider counseling and FDA approved medications.
  • Refer patients, as appropriate, to the Arizona Smokers’ Helpline (ASHLine) at 1-800-55-66-222 for vaping and smoking cessation support.

Resources:

Thank you,
Arizona Health Alert Network

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Happy PA Week! 2019 State of AZ Proclamation

Posted By Administration, Thursday, October 10, 2019

Happy PA Week to you! 

Thank you for all you do for the profession and your patients!

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Legislative Update

Posted By Jen Feirstein, ASAPA Legislative Committee Chair, Tuesday, June 18, 2019
Updated: Monday, June 17, 2019
ASAPA Legislative Update – June 15, 2019

On May 10, 2019, Governor Ducey signed
HB 2519, which increases the physician to PA ratio from 1:4 to 1:6.  Accordingly, as of the general effective date of August 28, 2019, physicians will be able to supervise up to six PAs at any given time.  The original language and intent of HB 2519 was to change the term ‘supervision’ to ‘collaboration’ in Arizona PA legislation.  However, due to multiple stakeholder meetings, which included ASAPA leadership, physician professional organization leadership, malpractice insurance representatives, and legislators, and with the advisement of our association lobbyist, ASAPA opted to support a strike-everything amendment that changed the intent of the bill to that of increased physician to PA ratios.


ASAPA believes that the increased physician to PA ratio demonstrates progress toward the key elements of model PA legislation, which includes unlimited physician to PA ratios.  Additionally, it may decrease barriers to hiring PAs in large hospitals or medical organizations that utilize multiple physicians and PAs that all cross-collaborate.  The process of working on HB 2519 throughout the last Arizona legislative session was critical for the re-introduction of ASAPA and the PA profession to Arizona legislators.  It also allowed for incredible insight into the priorities and goals of our physician colleagues and their professional organizations.  This will be highly important as we start to plan and strategize for future legislative efforts that impact Arizona PAs.

Please reach out to the legislative committee or the Board of Directors of ASAPA with any questions about this legislative update.  We also encourage you to provide any support you can with regard to ASAPA’s future legislative efforts.  One of the most effective ways you can support legislative efforts is through your continued membership in ASAPA, and by promoting membership to your PA colleagues that may not be current members.  Membership applications can be found on the ASAPA
website.

Sincerely,


Jennifer Feirstein, MSPAS, PA-C, DFAAPA
Chair, Legislative Committee
Arizona State Association of Physician Assistants

Tags:  Legislative 

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