Board Report delivers HASC’s most up-to-date and comprehensive information briefing to the association’s Board of Directors.

As we approach autumn, HASC is encouraged by the trajectory of COVID-19 cases across the region. However, we remain vigilant and like your teams, are not letting our guard down. With the flu season upon us, an influenza surge could have a double impact on health care and threaten to compete for coveted health care resources. Our region is also experiencing a historic wildfire season and HASC remains engaged in ongoing communication with Southern California Edison (SCE) to mitigate the impacts of potential Public Safety Power Shutoff (PSPS) events.

As a result of the decline in COVID-19 cases, we’ve decided to decrease the frequency of Board Report to monthly – but as the need for information changes we will adjust accordingly. We aim to provide you with a monthly information briefing throughout the six counties we serve.

Contact HASC President/CEO George W. Greene (below) with questions or comments.

Los Angeles County
9/17/20 Bi-weekly COVID-19 Public Health/EMS/Hospitals Call

• The county had been seeing decreases in COVID-19 testing which may be attributed to poor air quality and high temperatures.
• The county is now starting to see testing increase – it was below 15,000 tests a day, now testing is above 20,000 a day.
• The county is hovering around 1,100 positive cases daily.
• Seven-day average is down to 8.1% positivity.
• Los Angeles County is in the purple tier for re-openings. The county would need to get to 7% or below to move to next tier.
• Los Angeles County Department of Public Health (LADPH) is monitoring the impact of Labor Day weekend activities — more conclusive results should materialize over the next week.  
• LADPH has been in discussion with the state about flu shot promotion and education on the eventual COVID-19 vaccine in coordination with federal guidance on prioritization.
• LADPH has been receiving applications from schools regarding re-openings. There are currently close to 100 re-openings.
• LADPH is requesting that hospitals submit additional data variables for inpatients related to COVID-19.
• New data requirements include entry fields for demographics, place of residence, admission, disposition, discharge, intubation and extubation. New fields also survey for pregnancy status, homelessness and whether a patient has had a recent influenza test.
• LADPH verified that new data variables submitted through EHRs can be transmitted to LADPH.
• EMS was involved with distributing the first 38,000 vials of remdesivir but now hospitals can receive directly from AmerisourceBergen.

Ventura County
9/17/20 Ventura County Public Health COVID-19 Hospital Conference Call

• There has been an outbreak at the Ventura County Jail with 89 inmates testing positive for COVID-19. Only one individual has been hospitalized and they believe that the spread has been contained.
• COVID-19 testing at the county’s testing centers has decreased by 29% over the last week. However, Ventura County continues to test at levels significantly above the state-requested levels.
• Flu vaccination centers in the county will be opening and 49 community events have been scheduled to reach residents with vaccinations.

San Bernardino County
9/17/20 Bi-weekly San Bernardino County COVID-19 Call with DPH, EMS, Hospitals

• COVID-19 cases increased by 3.4% since last week.
• COVID-19 pregnant mother cases are up 27% last week to 330 cases. The rate of increase continues to be significant.
• PCR tests are at a 9.24% positivity rate. Up only 5% at 9,000. The decrease is due to demand rather than availability of supply.
• ED overflow patients continue to decrease but are up 13% last week compared to 16% the previous week.
• Ventilated patients up 23%. Unsure if increase is data-related or clinically-related. Will continue to track.
• COVID-19 hospitalized patients ranging 25-30%.
• COVID-19 ICU patients are below 20% as it was back in May.
• Hospital census continues to trend lower than projections.
• Hospital COVID-19 cases trending in the three regions continues to decline across all hospital facilities.
• The El Dorado fire has the potential to impact Bear Valley Community Hospital and Mountains Community Hospital. Trigger points have been identified for activation of evacuation.

Orange County
9/16/20 Orange County Emergency Medical Services Medical Health Operational Area Coordination (MHOAC)

• Total COVID-19 cases to date: 51,259.
• Total COVID-19 deaths to date: 1,111.
• There are currently 9 COVID-19 outbreaks at SNFs, 8 at elderly assisted living facilities.
• Current Average APOT is: 13m54s / Current 90th Percentile APOT is: 26m44s.
• Currently have 67 confirmed COVID-19 patients hospitalized and 17 PUIs.
• Emergency transport volume continues to average about 15% below normal.
• Non-emergency ambulance transports are still averaging about 20% below normal.
• Emergency transport volume of patients with a primary or secondary impression of cold/flu/ILI/COVID-19 has been at or near baseline for at least a couple weeks.

Santa Barbara
9/10/20 COVID-19 Health Care and EMS Partners Weekly Call

• There has been a decrease in the number of COVID-19 positive cases and hospitalizations, including Santa Maria where the numbers have been the highest.
• Some schools have been granted waivers to reopen.
• Public Health is currently working with 14 SNFs with outbreaks, which is down from more than 30 facilities just a few weeks ago.
• Public Health is working on creating some guidelines for visitation at SNFs.
• Public Health is surveying health care facilities about their ability and interest in offering flu vaccinations, and possibly COVID vaccinations in the future.

Riverside County
9/8/20 Bi-weekly COVID-19 Call with Riverside County Healthcare Coalition

• EMS is conducting daily 5150 census assessments. As of 9/8, 57 patients were holding in acute care EDs.
• AMR is pairing up behavioral health with law enforcement and fire for the deployment of 5150 transfer mitigation strategies.

• COVID-19 cases are trending back to the normal baseline.
• COVID-19 cases have significantly reduced in SNF and assisted living facilities.
• Community care licensed facilities are trending to below 100 cases.
• Inpatient and ED COVID-19 cases have stabilized.
• Ambulance transports are stabilizing.
• August ended with the lowest number of APOD hours. Starting to see upward trend – typically related to 5150 bed holds.
• There has been a significant drop in remdesivir usage.

• The SOS team has been working on testing frequency of staff and antigen testing devices sent to SNFs.
• SNFs continue to be required to test staff weekly.
• The SOS team has been providing training to substance use facilities and peds and adolescent care facilities.

• There is a need to ensure more tests are done in facilities, including antigen and PCR methods.
• Projection models predict a rise of COVID-19 cases in the fall and expect to see results of Labor Day by end of week.

• 19 schools have received waivers for in-class learning which is roughly 1,000 to 2,000 students. The county intends to be strict regarding infection control measures with schools. Schools have not yet appeared as a signal of transmission during any contact tracings.

Other HASC Advocacy and Activities

CARES Act Funding

Orange County
On Tuesday, Sept. 15, the Board of Supervisors approved a $30 million CARES Act allocation for 29 Orange County hospitals. Contracts will be distributed during the week of Sept. 22 with hospital checks to follow contract execution. Hospitals must expend CARES Act funds by Dec. 31, 2020.

Riverside County
On July 7, the County Executive Office allocated $34 million in hospital reimbursements for expenses incurred as a response to the pandemic, as well as preparation for future COVID-19 coordination with the county’s Emergency Operations Center. The Executive Office, with the Emergency Management Department, is currently coordinating with the regional hospitals to explain the CARES funding eligibility criteria and compile supporting documentation for reimbursement purposes.

Los Angeles County
HASC has been engaged with the Board of Supervisors in a request for $75 million in hospital reimbursements for expenses. HASC has provided hospitals with a template letter to assist in our advocacy efforts by sending their individual requests on behalf of the hospitals within the county.

Ventura County
The Board of Supervisors will be holding a vote on Oct. 6 regarding the allocation of CARES Act funding.

San Bernardino County
HASC has requested COVID-19 related data and expenditures from hospitals to develop a request for funding. HASC is in the process of scheduling meetings with the county CFO, Board of Supervisors and hospital executives.

9/11 Monthly Call with Southern California Edison

HASC remains in close contact with SCE as weather conditions present a risk for Public Safety Power Shutoffs (PSPS). PSPS events occur when power is temporarily shut off to a facility (or facilities) to reduce the risk of potential ignitions sparked by power lines. Most recently, our hospitals answered the call to aid in energy conservation efforts and were among the largest contributors of energy use reduction.

Fight Flu Together Campaign

HASC, CHA and the Regional Associations are collaborating on a statewide public awareness campaign called Fight Flu Together. We’ve developed a dedicated website (FightFluTogether.org) to promote vaccination and educate the public about the benefits and the safety precautions being implemented this flu season. The associations are also providing hospitals with English and Spanish communications toolkits and assets to be shared on their owned platforms. Additionally, we’re partnering with local public health departments, counties, hospitals and associations to help amplify this important messaging. The campaign officially launched on Sept. 24.

With Board Report questions or comments, contact HASC President/CEO George W. Greene.

Contact:
George W. Greene
(213) 538-0706
ggreene@hasc.org