June 11, 2020

Senate Finance and House Appropriations Committees Briefing on PPE Availability: June 9, 2020

On June 9, 2020, the Senate Finance and House Appropriations Committees gave a special briefing on the availability and suitability of PPE for frontline state employees. Find updates from Maryland’s Department of Health, Department of Juvenile Services, Department of Public Safety and Correctional Services  and Department of Human Services below.

Gregg Todd
Deputy Secretary, Operations, Maryland Department of Health

Ramping Up PPE Supply

  • Multi-agency task force has been working around the clock to ramp PPE and other necessary items –large deliveries coming on a daily and weekly basis; including
    • Over 6.4 million N-95 respirators and 8.7 million KN-95s
    • 23 million surgical masks
    • 17 million gloves
    • 1.2 million face shields
    • 2.1 million gowns
  • PPE requests are coordinated with local health departments and deliveries go out weekly 

PPE Allocation Principles

  • Focus is to distribute PPE to frontline healthcare workers.
  • PPE is distributed to state facilities and staff based on the activities performed and based on CDC and healthcare guidance.
  • N95 respirators are not recommended for every state employee.
  • CDC:
  •  A surgical N95 (also referred as a medical respirator) is recommended only for use by healthcare personnel (HCP) who need protection from both airborne and fluid hazards (e.g., splashes, sprays).
  • These respirators are not used or needed outside of healthcare settings. In times of shortage, only HCP who are working in a sterile field or who may be exposed to high velocity splashes, sprays, or splatters of blood or body fluids should wear these respirators, such as in operative or procedural settings.
  • Most HCP caring for confirmed or suspected COVID-19 patients should not need to use surgical N95 respirators and can use standard N95 respirators.

PPE Priorities

Highest need:

  • Long-term care facilities/nursing homes
  • Emergency Medical Services
  • Dialysis centers
  • Hospitals/freestanding emergency departments (direct care/contact only)

Second highest need:

  • Urgent care facilities
  • Federally Qualified Healthcare Centers
  • Primary care providers
  • Local Health Department (direct care/contact only)

Third highest need:

  • Congregate homes
  • Schools/Childcare
  • Jails/Prisons
  • Developmental Disabilities Administration facilities and community service providers
  • Home Health Agencies

Additional Priority groups will include other first responders, such as police, fire departments, and public safety. Other essential activities may be considered on a case-by-case basis.

  • 60% – to local health departments based on local partner requests based on approved prioritization
  • 10% to MIEMSS for EMS
  • 10% to state facilities based on need (DPSCS, DJS, etc)
  • 20% for state agencies and as the reserve

Entity

PPE – General              n95          

PPE – Clinical

Hospitals & Healthcare 40% 80% 85%
Long Term care 5% 10%
EMS 10%
Law Enforcement 15%
State LE 5%
Local LE 5%
Corrections 5%
School/Childcare 5%
State Agencies 5%
Surge reserve 5% 5%
Strategic reserve 15% 5% 15%

PPE Distribution by Local Jurisdiction (From 3/20/2020 – 5/26/2020)

PPE Distribution by State Agency (From 3/20/2020 – 6/3/2020)

PPE at MDH Healthcare Facilities

  • MDH Hospitals have N-95 respirators in stock– they are not distributed unless clinically indicated. We routinely offer surgical masks to hospital staff. We will ensure they have the PPE they need to do their jobs.
  • While N-95 respirators are not indicated for all employees, particularly in period of shortage, we are working to make face masks, such as KN-95 masks available for frontline employees.
  • Each brand of N-95 must be fit-tested to each employee.
  • No level of PPE is a substitute to physical distancing and good hand and cough hygiene.
  • We are also implementing administrative and environmental approaches for social distancing in addition to PPE.
  • We continuously reassess and make recommendations regarding PPE based on science and current best practices.
Q&A

Delegate Keith Haynes: Are we in a better position now with the reserves, that all of our state workers would have sufficient PPE?

Gregg Todd: Our goal is to maintain a 60 day supply in our warehouse. The pipelines have opened up. DGS is trying to get contracts in place. We will put targets in place when we start to dip into our stockpile. We are in a much better position now then we were in March.

 Delegate Geraldine Valentino-Smith: Do the numbers for each county meet the need? Or are those just what you have to give out?

Gregg Todd: At this point we are meeting the need, 30 days ago we were not.

Delegate Geraldine Valentino-Smith: Why are home health care providers on the Third Highest Need when they are the providers that travel around?

Gregg Todd: We provided them with as much as we could 30 days ago but not at the level we are able to provide now. We were trying to focus on where we knew the Covid patients were.

Betsy Fox Tolentino
Assistant Secretary of Strategic Initiatives, Department of Juvenile Services
  • The Department of Juvenile Services operates 7 juvenile detention facilities and 6 committed facilities.
  • We have had 7 youths test positive for Covid-19 in DJS facilities, all have recovered.
  • We have had 19 staff members test positive for Covid-19, 15 are currently considered recovered.
  • At the beginning we were fortunate to have an adequate supply of PPE. We had learned much from the H1N1 crisis a few years ago.
  • We have provided masks to our young people, we have done a lot of training on best practices and incentivizing the use of masks for our young people.
  • We also provide PPE packages to those that have been released back into the community.
  • We are inventorying PPE for a potential spike in the Fall. 
Q&A

Delegate Keith Haynes: Have you gotten to the point where you can do contact tracing? 

Betsy Fox Tolentino: Yes, we are doing contact tracing and have been from the very beginning. The virus can enter the facility in a variety of ways. A youth could come in with the virus or a staff member. When we know someone has been exposed we are able to track their movement with our video cameras.

Delegate Wendell Beitzel: Could you inform us about what is going on in the western region juvenile facilities?

Betsy Fox Tolentino: There was an announcement of 2 facilities closing. Meadow Mountain Youth Camp which is in western MD and serves boys and also The Carter Center which is on the eastern shore and serves girls. Its an opportunity to consolidate resources.

Delegate Luke Clippinger: Of the 200 people under supervision, how many are in private facilities? Do they have youths from Maryland and other states?

Betsy Fox Tolentino: The 200 is the number of kids in the program that DJS operates. There are about 169 in private programs that we use around the state. Yes, there are youths from other states.

Delegate Luke Clippinger: How are we able to ensure that the private facilities are doing what they need to do to ensure adequate safeguards are in place? Do you feel adequate safeguards are in place?

Betsy Fox Tolentino: Yes, I do. Any private facility we use in the state of Maryland is either licensed by DJS, the Department of Human Services, or the Department of Health. We work together to make sure our private programs have the support they need.

Delegate Carol Krimm: Can you tell us the status of the 4 staff members that have not recovered?

Betsy Fox Tolentino: They are still within the period of time where they are not considered recovered. They are still displaying symptoms and have not returned to work yet.

Delegate Carol Krimm: Are you doing daily temperature checks at the facilities?

Betsy Fox Tolentino: Yes, every person who comes into the facility has to answer a questionnaire and have their temperature checked.

Christopher McCully
Deputy Secretary of Administration, Department of Public Safety and Correctional Services
J. Michael Zeigler
Deputy Secretary of Operations, Department of Public Safety and Correctional Services
  • As of June 8th, the department reported a total of 634 Covid-19 positive individuals.
    • 400 are facility staff
    • 234 are inmates
    • 281 have recovered so far – 230 facility staff, 51 inmates
  • We have approximately 10,000 full time contractual employees.
  • We have approximately 19,000 incarcerated individuals in our custody.
  • When someone tests positive, contact tracing is immediately initiated.
  • We have tested over 9,000 staff and inmates.

 Q&A

Delegate Kirill Reznik: Where is your supply of test kits coming from

Michael Zeigler: Corizon provides our tests for inmates, and our staff tests come from the Maryland Department of Health.

Delegate Kirill Reznik: Is there a reason there are 2 different test kits?

Michael Zeigler: They are 2 separate avenues. We test inmates through one and staff through another avenue.

Delegate Kirill Reznik: Are the tests the same?

Michael Zeigler: I do not know the answer, but I can find out.

Delegate Kirill Reznik: Where are the kits being processed?

Michael Zeigler: I can get that information to you.

Delegate Kirill Reznik: Can you also find out if any of the tests from the Maryland Department of Health are from the 500,000 test kit reserve we purchased from South Korea?

Delegate Keith Haynes: Do we have enough PPE now to serve the staff under the current numbers should we have another surge? What is the process for temperature checks upon entering a facility?

Michael Zeigler: By April 3rd we had mandatory use of PPE by all employees. We have an audit team going around to ensure PPE is being used correctly. We have enough PPE should there be a surge through the fall.

Christopher McCully: The temperature screening process was put out by the Maryland Department of Health, that is the one we use. We also have the no touch thermometers.

Delegate Keith Haynes: Are the temperatures being logged for accountability?

Michael Zeigler: They are logged if they are abnormal.

Delegate Geraldine Valentino-Smith: Do you have enough tests? Once staff or inmate is tested, what is the protocol that would constitute retesting?

Michael Zeigler: We are testing inmates in conjunction with the staff. So far we have been able to obtain enough tests. We are working on protocol for retesting. We are also looking into rapid testing.

Delegate Geraldine Valentino-Smith: Through Covid have you needed more personnel per shift?

Michael Zeigler: We are allowing video visitation which does not take as much staff. We have shut down volunteer programs and any outside vector that could bring the virus into the facility. We have tripled the sanitation in the facilities. 

Delegate Luke Clippinger: How many people are currently being held at the Baltimore City Detention Center?

Michael Zeigler: I would have to look that up.

Delegate Luke Clippinger: How many inmates have been tested and how many have tested positive as of today?

Michael Zeigler: Those number are on our website.

Delegate Luke Clippinger: Do you believe you will be able to test every inmate within the next couple weeks?

Michael Zeigler: Yes, we have a schedule.

Delegate Carol Krimm: Are the inmates complying with wearing a mask, is there a directive?

Michael Zeigler: We do have a directive, and most are happy to wear the mask.

Delegate Shaneka Henson: What is driving your timeline? At what point will you open access for the inmates to those programs, services, and visits?

Michael Zeigler: We are looking at a number of things. Testing is a huge factor. Once we get data from the testing we can put people in groups based on the results. We can then work back towards normalcy.

Delegate Shaneka Henson: How do you maintain quality control and ensure the programs you are putting in place are being implemented?

Michael Zeigler: The audit team is one our big factors. They were sent out to do reviews to ensure everyone is following policy. We have a 24 hour hotline people can call to find out information about their loved ones.

Delegate Keith Haynes: Are you anticipating any fiscal issues as it relates to providing the necessary PPE moving forward?

Christopher McCully: We have procured a lot of supplies on our own. We don’t see at this time any detrimental impact; we will continue to order the supplies we need.

Chief Rainer Harvey
Division of Administrative Operations, Department of Human Services
  • DHS moved aggressively to purchase the PPE for frontline staff.
  • All PPE issued has met the CDC requirements.

For additional information on Maryland’s response to the COVID-19 pandemic and the implications for Maryland businesses please visit our COVID-19 Resources page, or reach out to us directly at (410) 321-8200.

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