Happy Fall to everyone – CALTCM is moving strongly forward in amazing ways. It has been a very busy, exciting year. The grant team we formed managed to obtain a CDPH grant to educate one- and two-star nursing facilities on leadership from an infection prevention perspective. I’m very proud and want to express my sincere gratitude to all the faculty and administration for stepping up and creating a fabulous experience for these 3 cohorts, totaling 30+ facilities in need of guidance. Mike Wasserman and Barbara Hulz have gone above and beyond in preparing for these trainings. Thank you to all involved. 

The Medication Access and Training Expansion (MATE) Act went live June 27 and requires all DEA-registered providers to complete eight hours of training on opioid or other substance use disorders prior to renewal of their DEA License.  The exclusions include all practitioners graduating in good standing within the last 5 years, board-certified addiction specialists, and those with prior X-waivers.  

In 2018, AB 2789, the mandatory provider e-prescribing law for California, was designed to coincide with the new Medicare EPCS (Electronic Prescribing of Controlled Substances) requirement that was to go live nationally at the start of 2022.  AB 2789 goes live January 1, 2022 and extends the EPCS expectations from controlled substance to all prescriber and dispenser prescriptions with very few exemptions possible.  The CMA posted a helpful article on this subject on October 5 (link provided below).

ALERT: Requirement for Patient Representative is delayed 12 more months for 1418.8 (Epple) decision-making.

I wanted to start this year with a grateful word of thanks to all of our CALTCM members. Our CALTCM friends and family are leaders in medicine, nursing, administration, pharmacy, social services, ombudsman, and more who believe in quality and safety in post-acute and long-term care.  Your efforts help CALTCM serve as the medical voice of long-term care in California.  Your work through the pandemic has been heroic and the sacrifices have been many.  

The 9 page (AFL-20-53 ) update should be studied by management in the SNF and hospital setting since it sets expectations for testing during care transitions, dialysis care, and outbreaks.  In addition, it creates a new expectation that all HCP will be tested weekly, even when in surveillance mode.  The guidance allows for routine use of Antigen testing rather than exclusive use of RT-PCR testing.  This should allow facilities to have immediate test results.  The tracking and reporting requirements for testing results in symptomatic and asymptomatic persons are also addressed.  

On March 9, CALTCM produced our first webinar on COVID-19.  On August 31st we produced our 21stwebinar.  It truly has taken a village of volunteers.  Some of the webinars attracted a thousand-plus attendees.  Over 200 people participated in our most recent webinar, which is a remarkable achievement in view of the abundance of information that is available online.

Our country now has the distinction of having the most COVID cases in the world.  Our response as a nation is a stress test that has exposed our lack of a coordinated system of health care in this country.  In my community, there remains a shortage of naso-pharyngeal swabs, a public expectation of easy access to testing (County Public Health Department can do 100-120 tests per day), and many facilities still don’t have real-time access to adequate PPE.  Because of the lack of PPE and nasopharyngeal swabs, testing in some facilities for influenza/RSV/Other viruses is not being done. There appears to be an over-reliance on quarantine of residents with respiratory illness as well as shelter-in-place strategy to keep their facilities COVID-naïve.

In the second issue of the WAVE for June this year, I wrote about how to access “AMDA on the Go” podcasts, which are offered free to post-acute and long-term care professionals.  Over the summer, AMDA has added a number of new features including expert discussion from the Colorado Geriatric Journal Club, and now, practical clinical applications from the August issue of JAMDA.  In this podcast, Dr. Philip Sloane, the new co-Editor-in-Chief, summarized take-home lessons from: Increasing the Value of ER visits, Reducing Avoidable Transfers, Quantifying the Impact of Incomplete nursing home transfer documentation, and Measuring the Value of High-Intensity Telemedicine in Senior Living communities.  I found this podcast to whet my appetite for the details of these articles, which I can now more effectively share with my facilities and home health agency.

CALTCM has had a busy 2019, Summer is near and the Leadership and Management in Geriatrics (LMG) course and the Fall Conference will be upon us in no time at all.  We would like to give you a quick update on our current programs and an update on two membership benefits you will not want to overlook – if you are not a member yet, take a few moments and join CALTCM today to be eligible for these opportunities.