COVID-19: Information and Resources for Community Health Centers

NACHC’s novel coronavirus (COVID-19) resource page is a hub for information Community Health Centers can use to strengthen readiness efforts and educate their communities. Visit NACHC’s Vaccine Communications Toolkit and our related page: Building the Capacity of Health Centers to Respond to COVID-19.

COVID-19 Vaccine

COVID Data: Infographics and Reports

Personal Protective Equipment (PPE) and COVID Testing

COVID’s Impact on Health Center Finances

Social Determinants of Health and COVID

Telehealth

Health Center Operations

Community Forum

Health Center Boards

Other Resources Related to COVID-19

Latest Updates:

FAQs on Employee Vaccine Mandate (NACHC)
This document is intended to assist health centers with legal considerations regarding imposing employee vaccine mandates from an operational and policy perspective. This FAQ will be a living document that will be updated as the COVID vaccination landscape evolves. Additional resources (e.g., sample policies) will be available to supplement this document. Note that this is a final draft. Click to View FAQ
Advancing Health Center and School Partnerships to Improve COVID-19 Vaccination Administration for Adolescents
This short guide provides practical strategies and sample resources for advancing health center and school system partnerships, including tips on maximizing “summer break” and preparing for “back to school” opportunities. Click here to view
NACHC Fact Sheet for ARP-Capital Funding Opportunity
NACHC has created a Summary Fact Sheet for Health Center reference regarding the FY2021 ARP-Capital (C8E) Funding Opportunity. The ARP-Capital Funding Opportunity presents a unique opportunity to enhance the capabilities of health centers by utilizing HRSA grant funding to complete priority projects, as detailed in the summary sheet. As a reminder, health centers need to submit an application via their electronic handbook (EHB) no later than 11:59pm on June 24, 2021.” Click her for fact sheet
CMS Bulletin on American Rescue Plan Provisions
On June 6, 2021, CMS released a Center Informational Bulletin providing information on the Medicaid, CHIP, and the Basic Health Program related provisions in the American Rescue Plan. The Bulletin includes information on mandatory coverage for COVID-19 testing and vaccine administration for limited beneficiaries, modifications to postpartum coverage, and temporary increase in FMAP for Medical Assistance. CMS intends to issue additional guidance in the coming months on certain provisions, and will continue to offer technical assistance as states begin to implement these changes. This bulletin fails to address how states should define vaccine administration for the 100% FMAP, reimburse FQHCs at their encounter rates, or establish APMs for additional resources required for vaccine administration.
VIDEO: Three Ways Health Center Board Members Can Serve as Ambassadors for the COVID-19 Vaccine
This short video focuses on the role of board members in promoting COVID-19 vaccine confidence and awareness. In addition to handouts on talking points and questions for board discussions, links to important resources are provided. Watch video HERE
Interactive 50-State Map: Weekly COVID-19 Numbers by State
NACHC’s interactive map presents health centers’ state-level COVID-19 numbers for testing, positivity, and vaccine initiation each week, as well as the challenges they are experiencing with deploying the vaccine. Click here to view.

Frequently Asked Questions

NACHC has curated FAQs relevant to operational and technical concerns of health centers. Responses may include links to additional resources or the best-gathered information from subject matter experts. Read them here.

COVID-19 Health Center Advocacy Toolkit

COVID-19 Vaccine

Frequently Asked Questions and Answers on Employee Vaccine Mandate (NACHC)
This document is intended to assist health centers with legal considerations regarding imposing employee vaccine mandates from an operational and policy perspective. This FAQ will be a living document that will be updated as the COVID vaccination landscape evolves. Additional resources (e.g., sample policies) will be available to supplement this document. Note that this is a final draft. Click to view FAQ
Advancing Health Center and School Partnerships to Improve COVID-19 Vaccination Administration for Adolescents
This short guide provides practical strategies and sample resources for advancing health center and school system partnerships, including tips on maximizing “summer break” and preparing for “back to school” opportunities. Click here to view
We Can Do This: HHS COVID-19 Public Education Campaign (Multiple Languages)
  This HHS COVID-19 public education campaign is a national initiative to increase public confidence in and uptake of COVID-19 vaccines while reinforcing basic prevention measures such as mask wearing and social distancing. There are videos, graphics, fact sheets, and podcasts about the vaccines in multiple languages. View resources.
Vaccine Education Resources – Curated by NACHC
On this page, you’ll find resources we selected from the Black Coalition Against COVID-19, Farmworker Justice, the National Rural Health Association and others to help you educate your patients and your communities about the COVID-19 vaccines.  Access here
NACHC COVID-19 Vaccine Communications Toolkit
NACHC is creating materials for health centers to use with their vaccination campaigns. Visit our COVID-19 Communications Toolkit page to find:

  • COVID-19 vaccine key messages and FAQs
  • Sample social media posts and graphics
  • Posters in Spanish and English to hang in your health center to encourage staff to get vaccinated. View materials.
  • Selfie signs: “I Got Vaccinated Because…” signs in English and Spanish to print and distribute to people getting the COVID vaccine to post on social media. View and download selfie signs. (February 2020)
CDC: Talking to Patients about Different Vaccines and Side Effects
The following CDC resources contain basic and up-to-date information about the COVID-19 vaccines, including possible side effects:
Vaccine Storage Expectations
View information about storage and handling requirements for the current COVID-19 vaccines.
From the Field: Sample Health Center Vaccine Resources
The Health Center Clearinghouse has recently launched a COVID-19 vaccine resources page to provide greater access to vaccine-related resources in the collection. COVID-19 vaccine resources are now categorized into topic areas including Vaccine Confidence Communications and Local, Regional, and State Collaborations. We’re actively looking for field-generated COVID-19 vaccine templates and samples to add to the collection. Please submit yours here!
 
Guide: Microplanning for COVID-19 Vaccine Delivery in Health Centers
This two-page guide shares “microplanning” steps for health centers to use for COVID-19 vaccination. View guide.

Also watch the videos of the December and January webinars where Claire Hannan of the Association of Immunization Managers and staff from several health centers answer questions and provide guidance on microplanning for both Flu and COVID-19 vaccinations in 2020/2021.

Talking Points: CDC and FDA Recommendation to Pause Use of Johnson & Johnson COVID-19 Vaccine
These talking points concern the CDC and FDA’s April 13 recommendation to pause the use of the Johnson & Johnson/Janssen COVID-19 vaccine after six reported U.S. cases of a rare and severe type of blood clot. The recommendation was made in order to prepare the health care system to recognize and treat patients appropriately. View talking points. (April 13, 2021)
Health Center Clearinghouse Vaccine Distribution Resources
Find resources from HRSA’s National Resource Center (NRC) for Training and Technical Assistance. Go to Clearinghouse. (December 2020)

COVID Data: Infographics and Reports

Dashboard: Weekly COVID-19 Numbers by State
NACHC’s dashboard presents health centers’ state-level COVID-19 numbers for testing, positivity, and vaccine initiation each week, as well as the challenges they are experiencing with deploying the vaccine. Click here to view.
Updated Weekly: Infographic of National Findings on Health Centers' Response to COVID-19
This infographic presents findings from the Bureau of Primary Health Care, Health Resources and Services Administration, and  Health Center COVID-19 Survey. The information includes the percentage of health centers meeting the testing needs of their communities, the number of overall patients tested for COVID-19, and how many of those patients tested positive for the virus. In addition, the information includes the turnaround time for COVID-19 test results and the percentage of health centers that may run out of personal protective equipment (PPE). The infographic also provides data on COVID-19 challenges to health center budgets and operations. Please contact Sarah Baizer at sbaizer@nachc.org with any questions.
Infographic: Health Centers’ Challenges with COVID-19 Testing
NACHC’s new infographic provides high level findings from the aforementioned report on this topic, and includes some additional testimonials from health center staff on their experiences with COVID-19 testing. (October 2020).
Infographic: Health Centers on the Frontlines of COVID-19: The First 6 Months
NACHC’s infographic looks at health centers’ response to COVID-19 from the beginning of the pandemic in early April to early October. The infographic presents important COVID-19 data including the number of health center patients tested, health centers’ testing capabilities, health centers’ telehealth and visit rates, how many sites have temporarily closed, and how many staff have tested positive over time. (October 2020).
Infographic: Health Centers’ Experiences with Paycheck Protection Program (PPP) Loans During COVID-19
This infographic presents findings from Capital Link and NACHC’s assessment of health centers’ PPP loan application process. The information includes how many health centers applied, the average amount they each received and the total estimated amount received by all health centers as well as restrictions that could possibly be lifted to provide health centers with more funding opportunities. Please contact Sarah Baizer at sbaizer@nachc.org with any questions.

Personal Protective Equipment (PPE) and COVID Testing

Inform Policymakers of COVID-19 Testing Challenges: Call for Information
NACHC is seeking input from health centers on COVID-19 testing challenges (SARS-CoV-2 virus detection only) they have experienced over the past few months and/or they anticipate experiencing as communities reopen. Please fill out this quick 5-10 minute assessment. We seek to elevate health centers’ experiences and better advocate on behalf of health centers for COVID-19 responses efforts as well as for long-term health center funding. Please contact Sarah Baizer at sbaizer@nachc.org with any questions. We greatly appreciate your insights with this project.
Understanding the Supply Chain and Strategic National Stockpile
NACHC has brought together resources for health centers to better understand how the Strategic National Stockpile works and how understanding the supply chain to request resources from the federal government is essential. Additionally, NACHC sent a letter to the FEMA Administrator informing him of the role health centers are playing in their local responses and developed a template for PCAs to share with their own state emergency managers and governor emphasizing these points.

CDC Personal Protective Equipment (PPE) Burn Rate Calculator
The CDC has launched a new tool to help health care facilities plan and optimize the use of PPE for response to COVID-19. The PPE burn rate calculator is available online here.

COVID’s Impact on Health Center Finances

NACHC Fact Sheet for ARP-Capital Funding Opportunity
NACHC has created a Summary Fact Sheet for Health Center reference regarding the FY2021 ARP-Capital (C8E) Funding Opportunity. The ARP-Capital Funding Opportunity presents a unique opportunity to enhance the capabilities of health centers by utilizing HRSA grant funding to complete priority projects, as detailed in the summary sheet. As a reminder, health centers need to submit an application via their electronic handbook (EHB) no later than 11:59pm on June 24, 2021.” Click her for fact sheet
CMS Bulletin on American Rescue Plan Provisions
On June 6, 2021, CMS released a Center Informational Bulletin providing information on the Medicaid, CHIP, and the Basic Health Program related provisions in the American Rescue Plan. The Bulletin includes information on mandatory coverage for COVID-19 testing and vaccine administration for limited beneficiaries, modifications to postpartum coverage, and temporary increase in FMAP for Medical Assistance. CMS intends to issue additional guidance in the coming months on certain provisions, and will continue to offer technical assistance as states begin to implement these changes. This bulletin fails to address how states should define vaccine administration for the 100% FMAP, reimburse FQHCs at their encounter rates, or establish APMs for additional resources required for vaccine administration.
An update to the CPT code set that includes new vaccine-specific codes to report immunizations for the novel coronavirus (SARS-CoV-2)
The American Medical Association (AMA) published an update to the Current Procedural Terminology (CPT®) code set that includes new vaccine-specific codes to report immunizations for the novel coronavirus (SARS-CoV-2). Health centers must update their EMRs and educate staff on the latest codes added for  severe acute respiratory syndrome COVID-19  and vaccine administration. Please see the attached AMA press release for more details. https://www.ama-assn.org/press-center/press-releases/ama-announces-vaccine-specific-cpt-codes-coronavirus-immunizations
Payment for COVID-19 Vaccines
Payment for COVID-19 vaccines and their administration in Rural Health Clinics (RHCs) and FQHCs will be implemented in the same way flu/pneumococcal vaccines are handled in RHCs and FQHCs.  Influenza and pneumococcal vaccines and their administration are paid at 100 percent of reasonable cost through the cost report. No visit is billed, and these costs should not be included on the claim. The beneficiary coinsurance and deductible are waived. There is a CMS webpage that addresses COVID-19 vaccine polices and guidance.  Please see https://www.cms.gov/covidvax.

Health enters play an important role in the distributions of the COVID -19 vaccine.  Since the vaccine’s doses are provided for free by the federal government, FQHCs can only bill for the administration.   Reimbursement varies depending on the payer.  For Medicare FQHCs will be reimburse via the cost report (noted on page 129 of the COVID-19 CMS FAQs).  For Medicaid health centers should reach out to their State Medicaid Agency.  Reimbursement for commercial insurances will vary based on the negotiated contract.

COVID -19 CMS FAQs

https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf

To contact your State’s Medicaid Agency

https://www.medicaid.gov/about-us/contact-us/contact-your-state-questions/index.html

Oct. 5 Memo: COVID-19 Provider Relief Fund -- New Opportunities and Risks
This October 5 memo from NACHC explains two important announcements from HHS regarding the Provider Relief Fund. These announcements may have significant – and differing – impacts on health centers, depending on the degree to which they are currently facing operating losses directly related to COVID-19. The memo outlines these new policies, as well as which health centers they impact and how they should respond. Read the memo.
NACHC Formally Comments on Paycheck Protection Program (PPP) SBA Form 3510
On 11/25/20, NACHC formally responded to the Small Business Administration with comments on the negative implications of Form 3510 “Loan Necessity Questionnaires” for health center borrowers with $2M or more in PPP funds. NACHC, with significant input from Capital Link, pointed out that the Form requires information and data that borrowers could not have known at the time of application, resulting in concerns that loan forgiveness decisions will be based on information the health center cannot fully provide. In addition, NACHC endorsed comments submitted by the American Institute of Certified Public Accountants (AICPA). See full letter attached.
NACHC Letter to HRSA on the Provider Relief Fund
On 11/24/20, NACHC sent a letter to HRSA about the Provider Relief Fund (PRF). The letter outlines nine requests and recommendations regarding the appropriate use of PRF funds.
CODING ALERT - New CPT Codes for tests detecting COVID-19 and the Flu -Announced October 2020
The American Medical Association (AMA) recognized that with the flu season upon us, providers need unique Current Procedural Terminology (CPT) codes to distinguish tests for Influenza A, Influenza B, and RSV, which includes SARS-CoV-2.  Before the 10/07/2020 announcement, the same code 87631 would be used for all testing.  However, to address this urgent need, AMA published the newly approved CPT codes to improve the reporting of the laboratory tests.  Find more detailed information here.
Deadlines Related to Federal Funding Sources for COVID-19 Relief
This chart summarizes upcoming deadlines related to BPHC grant funds, Paycheck Protection Loans, Provider Relief Fund allotments, and other Federal funding sources related to COVID-19. It is excerpted from Tab 2 of the NACHC spreadsheet on these funding sources.
Podcast Series: Strategies to Manage Financial Operations During COVID-19.
NACHC and partners at BKD, LLP collaborated to produce a five-part podcast series to help health centers manage their fiscal solvency during COVID-19 response and recovery. Based on the NACHC-BKD video series, Financial Office Hours: Strategies to Manage Financial Operations During COVID-19, podcast topics include managing your health center’s cash flow, paycheck protection, provider relief funding, grants management, and staffing.

All 5 podcasts of the series are available here.

Claims Reimbursement for Testing and Treatment of Uninsured
NACHC worked with FTLF to produce a short background and analysis document for the field on the HHS Claims Reimbursement for Testing and Treatment to Health Care Providers and Facilities Serving the Uninsured Program. The analysis summarizes key terms and conditions of the Program as applicable for Health Centers. You can access it via the Health Center Resource Clearinghouse here.
State Medicaid COVID-19 Resource Guide
NACHC developed a resource guide to assist FQHCs and primary care associations (PCAs) in planning for Medicaid sustainability this year and into 2021. Access it here.
Expanded Document on Financial Resources – Now Includes Summary of HHS Grant Funding
NACHC has updated and expanded its document outlining financial resources for health centers, PCAs, and HCCNs during the COVID-19 pandemic. This expanded document now has a section on HHS grant funds, including 330 funds and the $100 billion fund. Other sections address the Paycheck Protection Program, Emergency Paid Leave, Main Street Loans, Economic Injury Disaster Loans, FEMA assistance, unemployment, Federal tax credits and deferrals, and advanced Medicare payments.

Social Determinants of Health and COVID

The Impact of COVID-19 on PRAPARE Social Determinants of Health Domains.
This fact sheet outlines how PRAPARE SDOH domains impact individuals’ risk of morbidity and mortality from COVID-19. Care team members and aligned social service partners can use this information to identify those who may be most vulnerable during the pandemic, prioritize patients in need of outreach and additional services, and develop plans for addressing social risks in the community. For more information, email prapare@nachc.org.

Telehealth

Resource Guide on State Telehealth Coverage in Medicaid

Updated October 2020

As of August 2020, 96% of health centers were conducting visits virtually. Looking ahead, it is critical that state and federal policy protect the ability of health centers to provide and be reimbursed for telehealth services. This Resource Guide on State Telehealth Coverage in Medicaid provides important understanding of how states may improve Medicaid coverage of telehealth, sample state plan language and model state legislation.

Click here for more information

Telehealth Peer Learning Community
CSI Solutions and partners have launched a free telehealth peer learning community to enable rapid access to telehealth information and resources. It is intended to provide a forum for exchange of questions, resources and best practices. It is dominated by health centers, high-performing organizations and subject matter experts. Join here.
Re-Opening Dental Practices during COVID-19: Legal Analysis
This memo, authored by FTLF in partnership with NACHC, provides considerations for health centers in determining the re-opening of dental services during the COVID-19 pandemic. Brief analysis of FTCA coverage, malpractice liability, CDC guidance and applicable OSHA rules are provided. It is available on the Health Center Resource Clearinghouse.
Telehealth Implementation Quick Guide
The Telehealth Implementation Quick Guide provides a short overview of reimbursement and legal considerations for telehealth during the pandemic, operational guides compiled from health centers for implementing telemedicine and telephonic visits, and sample workflows. It was produced by a cross-NACHC working group, national subject matter experts and field practitioners. It is available on the Health Center Resource Clearinghouse.

Health Center Operations

COVID-19 Workforce Virtual Toolkit: Resources for Healthcare Decision-Makers Responding to COVID-19 Workforce Concerns
A new toolkit from ASPR TRACIE provides a curated set of resources and tools for decision-makers managing healthcare workforce challenges in response to the COVID-19 emergency. Access the toolkit here.
Rural Health Care Surge Readiness
COVID-19 Scams
Health centers should be aware of several scams circulating related to COVID-19. Learn more.
Section 1135 Waivers: Elements Necessary for FQHCs in Response to COVID-19
A host of states are currently pursuing Section 1135 waivers to respond to the COVID-19 public health emergency. Potential actions included in these waivers seek to address workforce, facilities/alternative site locations, telehealth and Medicaid/CHIP flexibility. NACHC has prepared the following document to provide more information on these efforts. Read it here.

Health Center Boards

Health Center Boards: COVID-19 Response and Emergence Resources
A series of over 20 short articles (many also available in Spanish) and videos are available to help health center boards understand the impact of the pandemic, consider future strategy post-pandemic, and strengthen governance processes. Tailored resources address the impact of COVID-19 on health center strategy, budgeting, telehealth, virtual board member orientation, promoting vaccine confidence, board recruitment and retention, and more. These resources include discussion questions that can be used at board meetings. All resources are on the COVID-19 Governance Spotlight section on the Health Center Resource Clearinghouse.

Community Forum

Community Health Center Networking Group: NACHC Noddlepod Introductory Video
NACHC has launched a Community Health Center Networking Group via the online platform Noddlepod which:

  • consolidates the broad range of information on COVID-19 from many different sources (e.g., BPHC, CMS, NACHC, ECRI) in a single location where you can quickly find information on a specific topic
  • enables members to share information and questions quickly

To access this Noddlepod site, email shansen@nachc.org. Need help navigating the platform? Check out the introductory video.



Other Resources Related to COVID-19
Rural Health Care Surge Readiness
Centers for Disease Control and Prevention
Bureau of Primary Health Care — BPHC has developed a Coronavirus FAQ that includes a new section on vaccines.
Health Center Resource Clearinghouse

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