June 12 Employee Huddle

June 12, 2020

Please Note: Time did not allow us to answer every submitted question, so we will get to unanswered questions at next week's KD Huddle. Submit a question now for next week by e-mailing dvolosin@kaweahhealth.org.

Questions and Answers from Kaweah Health Employee Huddle on June 12, 2020

The statement from the World Health Organization regarding asymptomatic spread directly contradicts what we have been saying and is all over social media. What are your thoughts?

The World Health Organization (WHO) has since clarified this statement and backtracked saying it is now unclear about asymptomatic spread. Either way, it is important to know that Kaweah Health closely follows the recommendations from the Centers for Disease Control and Prevention (CDC), rather than the recommendations of the WHO. The reason for this being that the CDC is more conservative and traditionally takes the highest level of precaution, only decreasing safety precautions when evidence has been validated and shows it is safe to do so. At Kaweah Health, the health and safety of our patients and team are our top priorities. We will continue to follow the CDC’s recommendations to ensure we maintain best practices and the highest level of protection for everyone.

Why do staff members think it is okay to wear a facemask but only cover their mouths? The reason I am asking this question is because a few days back I had an appointment and the secretary was wearing a facemask but she was only covering her mouth.

The mask is only effective when it completely covers the mouth and nose. Please hold each other accountable to this with kind reminders when you see masks being worn incorrectly. Also remember, handling the mask includes washing your hands before and after touching it. The less you touch or remove the mask the better protected you are. Please maintain the dress code policy when choosing the mask you wear.

I have been to a couple of Dr.’s offices and PT offices (not affiliated with KD) and was surprised the staff were not wearing masks. If the CDC is recommending masks, why are Dr.’s offices not following that protocol. Is KD working with local offices and sharing those recommendations?

We have created a Physician Office Toolkit and shared that with providers outside of our KD team as well as with anyone else interested. We continue to try and educate others in the community. We are requiring masks and social distancing as well as limited visitors in all our KD clinics and buildings.

Now that the Lifestyle Center has re-opened, are ZUMBA classes or other group classes available?

Zumba (group exercise) classes will not be offered initially when we re-open. They will be offered in the Phase II portion of our reopening plan (hopefully in July).

The information was sent out with the New You Can Use, but, can we go over what is re-opening at the Lifestyle Center?

Cardio equipment is open but spread out for social distancing. Track is open with social distancing. The gym is housing cardio equipment for now so there is no basketball or volleyball. The lap pool is open, one person per lane with a 30-minute limit. The warm water pool is open for independent exercise. The water fountains, locker rooms, showers, and child care are closed.

Can we opt out of our membership without a penalty? During Phase one, there will be no use of showers, and if we can’t shower, that really limits some members on when we can use the facility.

We are currently allowing members to cancel without a 30-day notice or place their membership on a 2-month personal freeze (July and August) at no charge.

How long will the extension of the PTO cap be in effect?

In early April, we announced that we had temporarily increased the cap on PTO accrual from 400 to 500 hours. This was done so that those who could not take their vacation nor had a cash out of PTO pending, would be able to accrue above 400 hours without losing time. The cap will revert back from the temporary limit of 500 hours to 400 hours on June 28, 2020.
- Employees with PTO accrual over 400 will retain their balance until they cash it out or take the time, but will not accrue additional time. We currently have 54 employees who have accrued beyond the 400-hour cap. The accrual amount is noted on paystubs.
- There is a PTO cash-out option for the July 3rd pay check. For those who elected in December of 2019 for a PTO cash-out in 2020, the window to request a cash out for the July 3rd paycheck will open on June 19th. Carmen Rodriguez in HR will send out individual communication to those employees that are over 400 hours and elected a cash out option for 2020. Many of the 54 employees will be able to reduce their accrual with the PTO cash out on July 3rd.
- For employees who cannot cash out PTO and are over or approaching 400 hours, please work with your leaders to request time off.

Can you please speak to the push from Tulare County Health & Human Services for everybody to get tested for COVID-19 whether they have symptoms or not? Two days ago they stated this testing is important to help us meet our State metrics. If we get tested today and it’s negative that doesn’t mean we can’t get exposed and test positive in a few days, correct? What is Kaweah’s recommendation on asymptomatic testing?

The County has a goal to test as many as people as possible. This is to identify positive cases so they can be isolated. The more you isolate the positive that were unaware they are positive, it can slow chance of them spreading the virus to others. This is another step in impacting the spread of the virus. If you have a negative test today, that does not mean you couldn’t be positive tomorrow. The county has set up collection areas in Dinuba and Porterville to aid in asymptomatic specimen collection for testing.

All along, you have had to get physician order for testing at the Floral site. Has that changed?

This has not changed; we still require a physician order for testing. We are not one of the County’s asymptomatic testing stations. Our testing supplies are still limited so we test symptomatic patients as well as surgical patients.

Are a lot of employees receiving help from the employee relief fund?

To be eligible, a full-time employee had to be docked 36 hours in a pay period and a part-time employee 24 hours. They also had to have less than eight hours of PTO accrued. Not as many employees met this criteria as we had thought, (only about 8 a pay period), so we have development a one-time “give back of PTO accrual” for employees who were docked more than 40 hours in the last five pay periods. This will apply to approximately 250 employees and provide over $100,000 of relief from the fund.

Will the employee antibody testing results (positive/negative) be shared with staff? Will it be as informational not personal identifiable information?

Yes, Dr. Haley has been doing some correlation and summarizing of the results. We will share these as a summary to ensure people are not identifiable.

I had the COVID antibody test, which came back as negative. How accurate is that? Example… if I had the COVID virus in January would it still be positive now, five months later, or are they able to know that information with this being all new.

Antibody testing, in any situation, is very dependent on people’s immune systems and ability to support the antibodies long term. It is possible that the antibodies would still be present.

Are the COVID-19 tests that Kaweah performs and those results reflected in the numbers the Tulare County Health & Human Services Agency reports each weekday?

No, the County does not use our negative test results in their total number. They do include any positive tests results we have.

Why are we only reporting positive employees weekly now and not updating them on the dashboard each time it is released?

The intent was to create a weekly summary in the dashboard of the number of employees positive and recovered to give context to the data.

On 5/27 the clinical snapshot showed 71 positive employees, then on 5/29 it dropped to 43 per the snapshot. Was this an error?

In the reporting we moved from putting the cumulative positive employees on there to showing the current positive employees. An important number to pay attention to going forward is also the number of recovered people. The total cumulative does not represent who is positive right now. We are over three months into our response so we will are making changes in how we share data to ensure a complete picture. If any of it is confusing, let us know so we can adjust.

On 06/02 the categories changed from “positive employees” to “pending recovery”. Does “pending recovery” mean employees who are COVID positive?

Yes, pending recovery means those employees that are COVID positive.

With the number of positive cases rising, do you think Tulare County is experiencing a surge? Are we equipped to handle an increase in positive cases as well as normal flu season if COVID-19 cases continue to rise?

We are very alert to the impending flu season coupled with COVID.We are working to increase our PPE supply to prepare for more cases.We have additional surge areas identified if we need to prepare for more cases at any point in time over the next year.

Recently we were not able to discharge COVID negative patients back to the Skilled Nursing Facilities they came from or needed to be discharged to due to the COVID outbreak. This caused a backup in our acute patient beds. Has anything changed?

Yes, last week we had 30 patients we could not discharge because of this issue. This week things have changed and three of the five local skilled nursing facilities are now accepting their patients back as well as accepting new patients. We are now down to 10 patients awaiting transfer.

Can the facility at the Porterville Developmental Center take some of these patients?

That could be a possibility. They are not ready yet to accept patients at this time. They still need equipment, supplies and staffing. We will continue to communicate with them.

What are the hospitals views as far as bringing more workers back from working remotely and how this effects direct patient care.

I’m not sure of this question? We are concerned about employee safety and certainly if they were to be hospitalized. At this time, we have only one employee hospitalized. All others that were have discharged and many have fully recovered.

Is the hospital wanting more of us to work directly with patients despite the number of employees who have tested positive?

We want to ensure that our employees are safe and utilizing appropriate precautions at all times, and especially while providing patient care. This includes the correct masks and handwashing. We also request that our employees comply with precautions when not at work as exposures are happening in the community as well. So add social distancing to the others as an important precaution and please limit the size of gatherings.

Some of my coworker are concerned because we can fulfill our job duties just as effectively by working remotely and we would rather not put patients at risk by having more contact with more people.

Each Director is evaluating their area to determine employees that will return on-site. For those returning, we want to be sure we have safe social distancing with regards to offices and seating arrangements. The Executive Team will be meeting on this again before July 6th.

If the number of cases continues to rise, will the remote employees continue to work from home past the week of July 6^th?

To be determined.

Do we need to quarantine if we travel out of the area?

No, we are not requiring employees to quarantine after travel. We ask that you self-monitor for COVID symptoms and contact Employee Health if needed.

Due to the financial state of the hospital, can we expect layoffs to happen?

Unfortunately, the answer is yes. We have been meeting with all of the Vice President’s and evaluating what measures need to be taken. This is not something that is easy for us to decide, but necessary due to the financial losses we have taken since the beginning of the pandemic.

Our EVS staff is amazing and I know they work their little buns off. However, have we now implemented having them clean/sanitize door handles, elevator buttons, high touch surfaces, etc., in the main hospital as well as our off campus offices/locations or should we take that upon ourselves to do?

EVS has increased their cleaning in all high touch and high traffic areas but if you are in one of those areas, it would also be a good idea to routinely wipe surfaces down.

Can the antibody testing show if you currently have COVID?

No, the antibody test can only show if you have the antibodies in your system. It cannot tell you if you have it at the time of the testing.

Can employees refuse the antibody testing?

Yes, the antibody testing is 100% volunteer.

What happens if an employee refuses the COVID testing?

There are some groups that have to be tested for the COVID virus on an ongoing basis. Our skilled nursing facility workers are mandated by CDPH to be tested routinely. If an employee refused to be tested, we would first see if there was an alternate job they could be transferred to. If not, the leaders within those areas would have to have a process in place to deal with these types of issues. An employee can also be transferred to another area.

Does the antibody test only for COVID-19 or does it test for the other COVID strains as well?

Our antibody test is specifically for the COVID-19 virus. There are other tests available for the other strains of COVID, but those are not include in our antibody test.

Would Kaweah Health still be implementing the safety practices we currently have now even if we were to have treatment for COVID 19?

Yes, we would still be creating an environment with infection control measures to reduce spread and prevent more people from becoming ill even if there was a treatment. What we would hopefully see with treatment is shorter time with illness for those who are sick. A vaccine would also slow the spread and may create an environment where we do not have to have source control in the form of masks.

When will volunteers be allowed back in our facilities?

We value our Guild members and volunteers very much, but also do not want to put this group of people at unnecessary risk. Many fall into the high-risk categories. This is being evaluated often, but it could be some time before we allow this group to return on-site.

Do you know what departments will be affected in the layoffs?

Yes, we do. We have been working with our leaders to determine the best course of action. There will be between 40 to 50 layoffs and the notices will be going out in the next couple of weeks.

Are we tracking employees that have second jobs in case there is an outbreak at their other work site?

We issued a letter at the beginning of the pandemic asking those that had a second job to pick one location to work at. However, we have not been tracking this.

Is there any update on whether being positive for the antibody testing equals immunity to the virus?

No, there haven’t been any updates on immunity to the virus if positive for the antibodies.