Gov. Beshear: Phase 1 Health Care Services Will Begin Reopening Monday

FRANKFORT, Ky. (April 23, 2020) – On Thursday, Gov. Andy Beshear announced that Monday, April 27, the state will begin the gradual restart and reopening of our Phase 1 health care services and facilities, although they will operate vastly different than they did before the outbreak of the novel coronavirus 2019 (COVID-19).

“To do this safely, make sure you are going above and beyond. This is our proof of concept in the medical community. We have to prove that we can do this the right way,” Gov. Beshear said.

On March 23, Gov. Beshear signed an executive order ceasing all elective procedures to limit the spread of COVID-19 and increase hospital capacity to treat patients.

Thanks to Team Kentucky’s extraordinary efforts to flatten the curve up to this point, Gov. Beshear and the Department for Public Health feel safe easing some restrictions on health care procedures and facilities.

The Governor said the phased health care services reopening is the first step under the Healthy at Work initiative he introduced Tuesday to help businesses reopen safely when the time is right.

“Doing this right is about saving lives, making employees safe and making sure the people they serve are safe when we reopen,” Gov. Beshear said.

The initiative set out public health benchmarks for reopening Kentucky’s economy. These benchmarks closely follow the White House’s Guidelines for Reopening America.

Gov. Beshear said a foundational basis for safely reopening the economy requires a massive scaling up of testing capacity in the commonwealth.

Guidance for Health Care Practitioners and Facilities

On April 27, health care practitioners can resume non-urgent/emergent health care services, diagnostic radiology, and lab services in:

• Hospital outpatient setting
• health care clinics and medical offices
• physical therapy settings, chiropractic offices, and optometrists
• dental offices (but with enhanced aerosol protections)

This guidance does not apply to long-term care settings, prisons, other industries, or other settings for which separate guidance has already or will be provided in the future. This guidance does not apply to elective surgeries or procedures which will be addressed in a subsequent phase.

“This is intended to be a phased, gradual reopening so that we can do this thoughtfully, safely, and see the consequences of our actions to make the necessary adjustments,” said Dr. Steven Stack, commissioner for the Department for Public Health.

Dr. Stack emphasized that this is a phased, gradual reopening of services and that a COVID-19 surge may require adjustment.

Telehealth

In all phases, health care practitioners should still maximize telehealth rather than in-person services.

Visitation

Health care facilities should still not allow visitors except when necessary in end-of-life situations, or for vulnerable populations or minors, and even then, visitations should be kept to a minimum.

Waiting Rooms

Health care facilities should also eliminate traditional waiting room or common seating areas and use non-traditional alternatives, for example, a parking lot “lobby.”

Social Distancing

Health care facilities should maintain social distancing, keeping people at least six feet apart in all possible settings, and employ other steps to minimize direct contact between individuals within the health care setting.

Screening and Sanitization

Health care facilities should screen all health care workers, patients and others for temperature and COVID-19 symptoms upon arrival for shift or visit. Staff should be required to stay home if sick. Staff should plan for and ensure enhanced workplace sanitizing enhanced hand hygiene compliance, and easily accessible hand sanitizer throughout the facility.

Personal Protective Equipment (PPE)

Each health care setting must be able to procure necessary PPE via normal supply chains.

All health care providers and staff must wear surgical/procedural masks and gloves while in the health care office/facility.

All patients and other persons in the health care office/facility must:

• Wear a surgical/procedural mask while in a health care facility
• Wear either a surgical/procedural mask or cloth mask/face-covering in all other health care settings

Special Considerations

In high-touch clinical settings (e.g., physical therapy, chiropractic, etc.), health care workers should wear non-latex gloves in addition to enhanced hand hygiene practices described above. Any objects and contact surfaces used for clinical services should be sanitized between patients.

In high-aerosol risk outpatient settings (e.g., dentistry, oral surgery, pulmonary services, etc.), we seek additional input from these professionals regarding steps to assure the safety of both their patients and clinical staff.

Testing Sites and Eligibility

Gov. Beshear announced that just today, the state ran 6,769 tests. In addition to health care facilities, Kentuckians can be tested free of charge for COVID-19 at:

Kroger sites

• Throughput of 300-330 tests per site per day
• All Kentuckians are eligible to be tested at Kroger sites

Louisville (Jefferson County)

Shawnee Park, 4501 W Broadway, Louisville, KY 40211

• Testing conducted Monday, April 27- Friday, May 1 from 8:30 a.m. – 5:30 p.m.
• Hand sanitizer and face mask to be distributed at the site

Lexington (Fayette County)

Bluegrass Community & Technical College, 500 Newtown Pike, Lexington, KY 40508

• Testing conducted Monday, April 27- Friday, May 1 from 8:30 a.m. – 5:30 p.m.
• Hand sanitizer and face mask to be distributed at this site

Owensboro (Daviess County)

Owensboro Community College at 4800 New Hartford Road, Owensboro, KY 42303

• Testing conducted Tuesday, April 28- Thursday, April 30 from 8:30 a.m. – 5:30 p.m.

Bowling Green (Warren County)

South Warren High School, 8140 Nashville Road, Bowling Green, KY 42101

• Testing conducted Tuesday, April 28 – Thursday, April 30 from 8:30 a.m.-5:30 p.m.

Walgreens site

Through a separate partnership with Walgreens, Gov. Beshear said the company would offer a drive-through testing option in Lexington, starting Friday.

• The location is 2296 Executive Drive, Lexington, KY 40505
• The site is open seven days a week, from 9 a.m. to 5 p.m. ET.
• Visit walgreens.com/coronavirus for additional information on registering and eligibility

Update on long-term care facilities

Gov. Beshear announced that as of Thursday, 530 residents and 251 staff had been diagnosed with COVID-19. Of those, 85 residents and one staff member have died of COVID-19 or complications from COVID-19.

Gov. Beshear reminded Kentuckians of the precautions the state is taking in long-term care facilities, including encouraging all residents to wear masks, canceling communal dining and social activities, minimizing entry into resident rooms, restricting non-essential personnel from entering the building, daily temperature checks and adopting a low threshold to transfer ill residents to a higher level of care.

Acting Secretary Eric Friedlander for the Cabinet for Health and Family Services provided other updates on how the cabinet is working with so many organizations and local officials to respond to the needs of long-term care facilities.

Medical Laboratory Professionals Week

Today, Gov. Beshear recognized Medical Laboratory Professionals Week, April 19-25, an annual celebration of medical laboratory professionals and pathologists who play a critical role in health care and patient advocacy.

“We are thankful for the laboratory medicine profession,” Gov. Beshear said. “To every lab professional out there working during this very trying time, we appreciate you.”

Condolences

The Governor sent condolences to the family of Patsy Carol Stith passed away on Monday at St. Elizabeth in Fort Thomas related to COVID-19. Stith was 76 years old. Patsy was an active senior who enjoyed yard work, gardening, and making crafts.

Patsy was a mother to three sons. She was “mamaw” to her grandchildren and great-grandchildren. She has a sister and brothers, along with many friends, who will miss her. We mourn her loss the Governor said.

Gov. Beshear also sent his condolences to family, friends, and colleagues of the Hopkins County Sheriff’s Deputy Terry Vick. Vick, 43, passed away April 22 after a traffic accident on Western Kentucky Parkway. He was a husband, father, and U.S. Marine Corps veteran who had been in law enforcement for 17 years.

Deputy Vick was the school resource officer at Hanson Elementary but had just completed an overnight security detail at Madisonville North Hopkins High School’s COVID-19 testing site, according to Hopkins County Sheriff Charles Young.

“He was helping people get testing during this crisis. Tonight, we remember him and all he contributed,” Gov. Beshear said.

The Governor said thank you to the Kentucky Organ Donor Affiliates and Kentucky’s Circuit Court Clerks for donating 1,500 COVID-19 swab tests, which were delivered to the DPH warehouse in Frankfort today.

Every year, April is National Donate Life Month. Although different this year, we are still honoring those donors who gave the gift of life, the recipients who are alive today because of them, and those 1,000 Kentuckians today on the waiting list. Everyone can do his or her part to be kind and register as an organ donor to give the gift of life.  www.donatelifeky.org.

Case information

As of 5 p.m. April 23, Gov. Beshear said there were at least 3,481 coronavirus cases in Kentucky, 161 of which were newly confirmed.

Unfortunately, Gov. Beshear also reported six new deaths Thursday, raising the state’s toll to 191 deaths related to the virus.

The newly reported deaths include a 68-year-old male from Muhlenberg, a 62-year-old female from Jefferson, an 87-year-old female from Adair, a 73-year-old male from Henderson, a 77-year-old male from Jefferson and a 93-year-old female from Kenton.

At least 1,335 people have recovered from COVID-19 in Kentucky.

To date, at least 42,844 people have been tested. At least 1,115 people have ever been hospitalized with 302 currently hospitalized.

At least 570 have ever been in the ICU with at least 163 people currently in the ICU.

Gov. Beshear also offered an update on the racial breakdown of COVID-19 patients and victims, which unfortunately highlights existing disparities in health and health care access.

The Governor said with about 78.36% of the known cases accounted for, 76.36% of Kentuckians who tested positive were white, 13.48% were black or African-American, 5.13% were Asian, 4.96% were multiracial and 0.08% were Native American or Alaskan Native.

The Governor also said with about 73.36% of the known cases accounted for, 92.11% of people who tested positive were non-Hispanic and 7.89% were Hispanic.

On fatalities attributed to the coronavirus, with about 85.86% of the known cases accounted for, Kentucky deaths are about 79.27% white, 17.68% black or African-American, 1.83% Asian and 1.22% were multiracial.

On fatalities attributed to the coronavirus, with about 82.72% of the known cases accounted for, Kentucky deaths are about 98.73% non-Hispanic and 1.27% Hispanic.

More information

The Governor is asking all Kentuckians to continue to fight the spread of the virus by following his 10-step guidance, which includes practicing social distancing and staying healthy at home. Gov. Beshear says these efforts have the potential to save the lives of as many as 11,000 Kentuckians.

Read about other key updates, actions, and information from Gov. Beshear and his administration at governor.ky.gov, kycovid19.ky.gov and the Governor’s official social media accounts Facebook, Twitter and YouTube.

Watch the Governor’s social media accounts at 5 p.m. ET each day for his regular briefing. Kentuckians can also access translated COVID-19 information and daily summaries of the Governor’s press conference at tinyurl.com/kygovespanol (Spanish) and tinyurl.com/kygovtranslations (more than 20 additional languages).

The U.S. Centers for Disease Control and Prevention (CDC) encourages people to follow these steps to prevent illness. Kentuckians who want advice can call the state hotline at 800-722-5725 or call their local health care provider.

State Looks To Expand COVID-19 Testing

By Victoria Ratliff
TheStatehouseFile.com

INDIANAPOLIS—With labs lined up and ready to process more COVID-19 tests, the lack of basic supplies is keeping the state from expanding testing further.

“We have the ability to run the tests, we need to now be sure we’ve got the ability to take the test,” Dr. Kristina Box, the state health commissioner, said at Gov. Eric Holcomb’s virtual press briefing Wednesday.

Box said getting the swabs used to get a sample from a person as well as the solution known as “viral transport medium” needed for the tests is difficult.

“We have tried to buy swabs,” Box said. “…The federal government has taken over the supply of a lot of this. It’s not a question of money. I have plenty of money. If I can find them, I’d buy them and will buy them.”

Previously, Indiana was restricting coronavirus tests to individuals who had symptoms and were either in high-risk categories such as elderly or with underlying health problems or were essential workers including those in health care and first responders.

Box said that the state now wants physicians to test anyone whom they believe may have contracted COVID-19.

She said she has heard stories from Hoosiers who had symptoms, such as a sore throat and fever, but were unable to get tested. With the appropriate amount of supplies, she said increasing testing will be critical to identifying those who came in contact with the sick individual and to track the spread of the virus.

“Now the questions are, are all the places open and available to do tests for individuals? Are they accessible? Do we have them all over the state, and do they have the swabs and viral transport media that they need to do that testing,” she said.

The state reported 394 additional positive COVID-19 cases Wednesday, bringing the state’s total to 12,438. There were also an additional 31 deaths, making the toll now 661 fatalities. Box said those numbers may grow, both because there had been problems with the state’s online system for reporting positive cases and deaths that have now been resolved and because some earlier cases may only belatedly be found to have been from coronavirus.

At the press briefing, Lt. Gov. Suzanne Crouch announced that 13 rural Hoosier communities will receive nearly $2 million in grants from the state’s Office of Community and Rural Affairs to aid them during the pandemic. These funds may be used to expand medical facilities to help with the patient load, provide fixed or mobile testing, and provide grants or loans to small businesses.

As the state begins the process of reopening the economy, Holcomb said he will work closely with neighboring states in the Midwest. Governors of seven Midwest states announced recently they are coordinating their efforts to phase-in the reopening of businesses due to their shared borders and the numbers of people who live in one state but work in another.

Holcomb said he has called with the other governors nearly daily and keeps a real-time conversation about how to reopen the economy in the region.

“It’s very important that we know what each other is doing,” he said, not just in terms of the numbers of infections but also “what are we thinking in terms of long-term, short-term, opening up, and how we’re considering doing that.”

FOOTNOTE: Victoria Ratliff is a reporter for TheStatehouseFile.com, a news website powered by Franklin College journalism students.

12 Ways The Last Recession Changed America’s Schools — And What That Means For The Years Ahead

by MATT BARNUM

Schools are bracing for a recession. State budgets are cratering, leading education advocates to seek federal help. And though most teachers’ jobs have been safe so far, schools may soon face painful cuts.

For many education leaders, this sounds all too familiar.

American schools had to make substantial cuts a decade ago, following the Great Recession, and many states have only recently seen their education budgets recover.

No one knows how similar this economic downturn will be to the last one. But research on how the Great Recession affected schools offers hints about what policymakers can expect and how they might limit the harm done to students — though the difficult reality is that an economic decline is likely to hurt schools and students.

“You’re trying to mitigate the harm — you’re not able to eliminate it,” said Dan Goldhaber, a University of Washington professor who has studied teacher layoffs.

Here are some notable takeaways from that research.

1. The Great Recession did lasting, not just short-term, damage to school budgets.

Schools in most states were spending less money per student in 2015 than in 2008, according to this paper from the Center on Budget and Policy Priorities, a progressive think tank. Even years after the initial downturn, Florida, Arizona, and North Carolina — the three states with the biggest cuts — were spending 20% less than they had been before. It wasn’t until 2016 that education funding in most states had recovered.

2. Hundreds of thousands of public school staffers lost jobs.

This study provides an overview of what the Great Recession meant for public schools, including:

• Ultimately, about 300,000 school employees lost their jobs. That’s nearly 4% of the education workforce.
• States were hit harder if they relied more on state taxes, as opposed to local tax revenue, to fund schools. That’s because sales and income taxes fluctuate more than property taxes.
• The federal stimulus helped fill funding gaps, though other research has suggested it ran out too soon and wasn’t targeted to the districts where it was needed most.

3. High-poverty schools’ budgets were hit hardest.

That’s the conclusion of a paper that looked at national data and also zoomed in on Texas. Across the country, high-poverty districts rely more on state funding — and while affluent school districts saw those dollars drop by about $500 per student, high-poverty districts in the same state lost over $1,500 per student.

4. Teachers unions may have blocked even deeper funding cuts.

States with laws barring collective bargaining saw deeper funding cuts to schools, even controlling for other factors that could explain why. This study suggests, though can’t prove, that strong unions may play a protective role.

This aligns with prior research showing that stronger teachers unions help ensure money earmarked for education actually reaches school districts, which helps students academically.

5. Seniority-based layoffs may have come with harmful consequences.

The last recession prompted a major debate about how to determine which teachers get laid off. Seniority was often a key factor. This study, though, suggests that this approach can have negative consequences.

Using data from Charlotte, North Carolina, the paper shows that students entering grades where an effective teacher was laid off did worse on state tests in the future. (A teacher’s effectiveness here was measured by both principal evaluations and their impact on student test scores.) Losing an experienced teacher, rather than a novice teacher, didn’t make a clear difference.

Prioritizing experience also requires laying off more teachers, since novice teachers are paid less.

“Layoff policies that do not incorporate increasingly available measures of teacher effectiveness fail to consider all the best available information when making high-stakes decisions,” concluded researcher Matt Kraft.

This is consistent with research comparing different layoff policies and another recent study showing that states that banned seniority-based layoffs saw greater increases in high school graduation rates.

Keep in mind, though, that measuring teacher performance is fraught, and will be particularly difficult right now because of the closure of school buildings. In fact, a number of states have already waived teacher evaluation requirements this year.

6. In some districts, low-income, black, and Hispanic students were more likely to see their teachers laid off.

In Los Angeles, public schools, just 2% of white middle and high school students had their teachers laid off in 2008 and 2009, while over 4% of black and Latino students in the district did, according to this study.

That kind of inequity can happen if districts, particularly large ones, make layoff decisions using district-wide criteria where high-poverty schools often come out on the bottom.

Other research showed that the layoff process can lead to unnecessary churn, as teachers shuffled between schools with more or fewer layoffs. That can also hurtstudents.

There are ways to avoid this: make layoffs on a school-by-school basis, or choose to protect the most disadvantaged schools from layoffs. Los Angeles did the latter in response to a court case, and the study found that this made layoffs more equitable. The approach also has the benefit of making those schools more appealing because they offer greater job security.

7. Job uncertainty likely hurt teachers’ performance.

During economic downturns, teachers, like many people, are forced to worry about their job security. This study finds that these concerns have tangible consequences.

8. Teachers were less satisfied with their jobs.

In 2012, just 39% of teachers reported being very satisfied with their jobs, the lowest figure in decades — down from 62% in 2008. The survey can’t prove what explained this steep decline, but the Great Recession is a likely culprit. Teachers reported greater stress, and most said their schools’ budgets had been cut.

Paradoxically, other research has shown that teacher turnover actually decreased during the recession, probably because when there aren’t many good job prospects, few people voluntarily leave their current jobs.

9. Private schools lost students.

During an economic downturn, private school tuition can become a luxury some families can’t afford. Indeed, this draft study found that private school enrollment declined steeply in areas harder hit by the Great Recession. This was particularly the case among white, affluent families from the suburbs. In the most affected areas, private school enrollment dipped from 9% of students to about 5%.

This has implications for the bottom lines of both private and public schools: private schools lose tuition dollars, while public schools bear the cost of educating additional students while budgets are strained.

Federal data shows that private school enrollment bounced back by 2015.

10. States made dramatic education policy changes in pursuit of a relatively small pot of federal money.

When states are desperate for money, they’ll make big changes to get it. That was the key takeaway from the Race to the Top competition, which incentivized states to make policy changes in exchange for additional federal stimulus dollars. Even states that didn’t win extra money still enacted reforms favored by the Obama administration, like tougher teacher evaluations and the expansion of charter schools.

Those changes would quickly prove controversial, and a number of states have rolled back the practice of tying teacher evaluations to student test scores.

Right now, there doesn’t seem to be much appetite from either the current administration or big philanthropies for a similar program.

11. Many students were displaced from their homes — and that likely hurt student academically.

An increase in home foreclosures was a defining feature of the last recession, which meant many students were displaced from their homes. Using data from before and during the Great Recession in Boston, this paper documents how those moves hurt the academic performance of both the displaced children and their future classmates.

Educators have long worried about the toll that frequent school moves take on students and school systems.

12. Ultimately, the Great Recession appears to have hurt students’ performance in school.

Two separate studies have documented that students did worse on state or federal tests when their schools cut spending.

One paper found that test score declines were largest in school districts serving more low-income students and students of color. In other words, there are evidence students did worse overall and existing disparities widened.

In the last decade, federal test scores have flat-lined or even dipped, which some attribute to the Great Recession.