COVD-19 national emergency declaration provides flexibility rural health system needs as patient care demands increase

This post contains important information from our partners at the Washington State Hospital Association. For more information, please contact Beth Zborowski at bethz@wsha.org.

President Trump’s declaration of a national emergency on Friday March 13th related to the COVID-19 outbreak is welcome news to Washington’s hospitals.

The health care delivery system in Washington state has been strained by the response to the COVID-19 outbreak. Hospitals have activated their emergency response plans and are evaluating their situation every day, including available space, staff and supplies. The state has authorized flexibility to allow health care workers licensed in other states to provide care to patients in Washington. This week has brought the first positive cases of COVID-19 to some rural communities, widening the range of the impacts and the response zone.

The emergency declaration will allow the State of Washington to seek waivers from certain federal laws governing health care delivery. The Washington State Hospital Association is working with hospitals and the Department of Health to seek waiver of federal laws that most limit hospitals’ ability to respond. Some areas under consideration include:

  • Waiving limits on rural Critical Access Hospitals. Under federal law, critical access hospitals can only have 25 beds and can only keep patients for an average of 96 hours. Waiving this law will allow COVID-19 patients to be cared for in their communities and provide flexibility in movement of patients across the state if one area becomes particularly hard-hit.
  • Emergency Medical Treatment and Labor Act Waiver. Under current law, patients who arrive at the ER must be treated at the ER. This waiver would allow hospitals to screen or triage patients at a location offsite from the hospital’s campus and transfer patients according to their needs.
  • Flexibility in the use of space. This would allow hospital care to be provided in a non-hospital building, freeing hospital beds for the most acute patients while providing beds for those still in need of care.
  • Expedited discharge of patients no longer in need of acute care. Getting patients into appropriate community care settings — like long-term care centers, adult family homes, or with home health — would create significant additional capacity to care for very ill patients. 

The federal emergency declaration will provide much-needed relief to the health care system, however concerns over supplies and staff remain. As the ability to process tests for COVID-19 have increased, the supplies needed to collect specimen for these tests has dwindled.

If you are concerned about your symptoms, contact your primary care provider or call your insurer or local hospital’s nurse triage line to evaluate your symptoms. It is critically important that people use the health care system appropriately. The emergency room should only be used when you are having a life-threatening emergency. Continue to see your health care team for care for chronic conditions to ensure you do not become an emergency.