June 19 Employee Huddle

June 19, 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 & ANSWERS FOR 06/19/20 EMPLOYEE HUDDLE

1. I have seen in his press conferences where the Governor has announced they have distributed millions of masks and gowns to hospitals. Out of all the PPE we have procured, masks and gowns especially, what percentage, or how many of those were provided by the state government?

• We request supplies from the county routinely. The county then escalates the request to the state. At this point, we have received about 60,000 N95 masks from that supply and 5,000 isolation gowns. This is about 60% of our current volume for masks and 10% of the gowns.

2. How is our PPE supply?

• We have a steady supply of surgical masks for our daily source control use. Our N95 volume is over 100,000 and our isolation gown numbers are over 30,000. We do not have a steady supply of either of these items at this time. Our current goal is to stock up enough supply for 3 months of use without need for incoming supply as well as have a steady flow of stock coming in as we anticipate use to increase as we move forward the next year.

3. It seems that China and Japan are experiencing a resurge of COVID or maybe shutting down to prevent a reoccurrence or spread. What are your thoughts about the rising number here in Tulare County?

• I have no doubt we will continue to see positive cases in our county. With the county opening and people returning to activities, if they are not following safety measures to prevent or slow the spread, we will experience that surge we have been trying to prevent. I believe awareness has improved, a lot of people are cautious and those at risk are taking precautions to keep themselves healthy but many people are not being careful so I do think our numbers will go up. We need to continue to share the message of being safe and lead by example.

4. What is the situation with COVID at the Rehab hospital on Akers?

• We have five positive COVID patients at the Short Stay Rehab part of the Rehab Hospital. These patients have been moved into an isolated area, which was set up previously for this purpose. We are working on adjusting the airflow in the rooms, but for now, they have HEPA filters. We are making sure all of our employees are wearing the correct PPE when caring for all patients.

5. How long will the CC stay open?

• Incident Command will stay in place until the disaster has ended. Our disaster has not ended. The incident command system is one that is used in responses to disasters like a fire. It stay there until the fire is out and then it is still open while recovery and clean up occurs. The resources may change as the needs change but the incident command team continues to take those changes into account and will adjust accordingly.

6. How many employees have been tested? How many have tested positive for the antibodies?

• As of yesterday, 2,105 have been tested; 69 have tested positive, which gives us a 3.3% positivity rate.

7. Are the same 58 people that tested positive for the antibody some of the same 67 employees that have recovered from COVID? I was wondering if there is a direct link between the two.

• It is helpful when discussing Infectious Diseases, to know the two testing categories. There is the antigen testing which tests for the virus itself, and the antibody testing after the virus is gone. I ran a report and looked at the positive listing for the ones we have run the antigen test on, which was 2100. Some of those being multiple tests on the same person. Then I looked at a number of the positive antibody tests, but those had not had the antigen testing for comparison. The antibody test is not required of those that have tested positive for the virus. The correlation is a great question, but we don’t have enough data to answer that yet.

8. What happens if you test positive for the COVID antibodies? What measures are you supposed to take?

• Not enough is known at this point. It is too early on a new disease to make any generalizations or absolutes. The antibody test we do gives us an index reading. This is the ratio of the readout of your sample compared to a known positive calibrate. If your reading is 1.4 or greater, it is a positive reading. Regardless of the reading, I would recommend you still follow all recommended precautions. However, if you have a high antibody titer, I would encourage you to go to the Central California Blood Center and donating plasma, because you might save someone’s life. The plasma treatment is experimental, but early indications were very positive. Like every new disease, the more data we get, the more certain we will become, but there have been some encouraging signs.

9. Why are people still having to wait 7-10 days for results?

• Due to the increased volumes of testing, some tests have to be sent out to commercial labs to keep up with the demand. These labs take about 7 days to result back.

10. Which patients are being tested?

• KD tests symptomatic patients. All patients are screened or asked the symptoms questions on admit. Symptomatic patients are tested. Patients brought in for elective procedures that involve aerosolization of respiratory particles are tested – this includes surgery, endoscopy, sleep lab. We are also testing people before admission to Skilled Nursing Facilities and Mental Health due to the difficulty with separation people in these settings. To take it a step further we are trying to keep them isolated for a 14 day period as much as possible to prevent outbreaks. This is difficult in both these settings since it is a living situation.

11. When will the antibody testing be available to the public?

• It is available now through your physician’s office. We sent out the information to our medical staff. Our physician liaison team will be disbursing the flyer with all of the necessary information to the local medical offices.

12. Are we seeing more employee positives due to work related exposure or community exposure?

• As of yesterday, we have had 115 employees and 2 travelers with COVID-19. 66 of these employees have recovered and 45 are currently quarantined. We believe about ½ to be community exposure and ½ to be work related. Several newly positive employees appear to be work related from patient exposure on the West Campus.

13. Do we only have one positive employee in the hospital? Can you give us an update on the employee?

• Yes, one employee remains in the hospital. At this time, the employee is doing better, speaking and participating in care.

14. You said last week that the layoffs have already began. Is it limited to the 40-50 employees you mentioned last week or will there be another wave of layoffs?

• The Executive Team and Board are still working through the budget process for Fiscal Year 2021, which begins on July 1, 2020. I don’t know if there will be additional layoffs; we hope to avoid doing more. So much depends on the balance of revenue and corresponding controls of expense. It is critical that everyone focus on reducing expenses, such as supplies and overtime as much as possible. The Executive Team will meet again on Monday to make our final decisions on the budget, and will present it to the District Board on June 29^th for approval.

15. How much money has been raised for the Employee Relief Fund?

• Over $100,000 has been raised from our employees and community members.

16. How many employees have received assistance through that fund?

• We will be providing PTO accrual back to employees who docked more than 40 hours in the last five pay periods, equal to 15% of their docked hours. This will affect about 275 benefit-eligible employees and utilize all of the funds.

17. Will there be annual raises this next fiscal year?

• We do our best to keep our pay competitive so we can retain our staff members as well as recruit new ones. The decision regarding raises for next year is not final yet, but we should know by the end of June. We will let the employees know when that decision has been made.

18. What is the new Foundation Employee Giving Campaign?

• First, I wanted to thank all of those that donated to our Employee Relief Fund. Currently, we have almost 55% of our employees donating to the Foundation, which is exceptional.
• Our new Foundation campaign is the “Hope in Motion Giving Campaign”. This five-month campaign features advanced technology to help our patients, suffering from strokes or traumatic injuries, learn to walk again. This new piece of equipment is the Safegait 360 Balance and Mobility Trainer. It is a track and harness system with built in fall assistance. Our goal is to raise $300,000 from employee and community donations.
• We sent out a letter to our current employee donors, stating the Employee Relief Fund campaign was ending and unless we heard from them, we would roll over their donations to this new campaign. If there are any questions, you can reach the Foundation office at 624-2359.

19. Has Kaweah Health received any additional financial assistance for COVID related costs?

• We received $13.2 million a couple of months ago as part of the CARES Act 3.0. We have also received $25,000 from the State of California through the California Hospital Association, as well as $1,000,000 for our skilled nursing facilities and rural health clinics to help with the cost of testing supplies and PPE.
• When we were asked to surge to 150% capacity, we had to shut down our elective surgeries to make room in the hospital for COVID patients. This resulted in a 40% loss of revenue, which had a profound and immediate impact on our financial performance. The months of March, April and May were very devastating; we found ourselves operating $40 million under budget, which has us operating deeply in the red. We fully expect this to carry into next year, which is why we are making some difficult decisions for next year’s budget. We will do everything we can to protect jobs because are single most important asset is our people. We are people taking care of people.
• Last week we met is a special session with the Board , focusing specifically on the budget and we will meet again with them on Wednesday. Under normal circumstances, we would be working on a budget that would produce a positive margin. This year, however, we will be aiming towards a budget that will break even, or have a small 1% margin, which would cover our debt index and a smaller capital budget. We have never done that before, but these are unique times. We still will have difficult decisions to make; it is very unlikely we will be able to provide raises this year. But other things we have looked at are staff reductions, we may have to move forward with some of those actions, but less dramatically. Eventually we will have to get back up to that 2% margin, but it will take time.