Amendment #482 to H4219

COVID Long Haul Rehabilitation Pilot Program

Mr. McMurtry of Dedham moves to amend the bill in Section 2 by inserting after item 1599-2028 the following item:

1599-2028A. For a reserve to fund a pilot program to assist patients who have contracted COVID-19, who have recovered from the effects of the virus sufficiently to be ambulatory but who still suffer from debilitating symptoms and/or side-effects related to COVID such as significant shortness-of-breath, severe muscle pain and/or weakness, chronic pain or fatigue, vertigo or lack of balance, depression and/or anxiety (only COVID-related). This pilot program shall be known as the COVID Long Haul Rehabilitation Pilot Program (LHPP).

Long Haul Pilot Program Patient Protocols

Patients who exhibit long-haul symptoms shall only be eligible for the pilot program if they are referred by a physician. Other conditions of the program include the following:

1) Once patients are accepted into the program, each patient will be given a health risk assessment which will include a full blood panel and A1c test.

2) Each patient will be required to go through a 1 hour in-take evaluation to determine the appropriate level and duration of their exercise regimen.

3) Patients will then be assigned to small groups with lead physiologists who will guide and coach the individuals within these groups.

4) Patients will be required to attend 2 scheduled ½ hour exercise sessions a minimum of 2 times per week.

5) Patients who do not adhere to the attendance requirements will be discharged and removed from the program. Patients with legitimate absentee notification will be exempt from this requirement. The pilot program will not receive financial reimbursement once a patient has been removed.

6) Patients will have full access to the facility and all amenities during the time of the pilot program.

7) Outcomes will be confirmed and evaluated by an independent third party research institute affiliated with a major Boston academic research hospital.

8) This program will be designed and delivered by exercise physiologists.

Long Haul Pilot Program Exercise Physiologist Qualifications

Exercise physiologists are uniquely qualified to prescribe and dispense exercise as a medicine. An exercise physiologist for the purpose of this pilot program will be defined as an individual with 4-8 years of education and training in exercise physiology who has received their academic degree in physiology and who also has experience in treating the following conditions with an individualized physical exercise regimen:

1. Cardiovascular disease

2. Weight management issues

3. Pre-diabetes

4. Diabetes

5. Muscular pain/ joint pain

6. Depression and anxiety

7. Circulation issues

8. Other related conditions

Exercise physiologists involved in this pilot program shall also be trained specialists in dealing with the emotional and psychological barriers associated with long haul COVID lifestyle adjustments. One primary focus will be to ensure that the patient “comes back tomorrow”.

Long Haul Pilot Program Host Facility Requirements

Facilities that wish to host or sponsor a long haul pilot program must adhere to the strictest and most up-to-date safety, sanitary and COVID alleviation and prevention standards. These facilities must have put in place high-level, clinically/medically-recognized health and safety protocols. The following operating procedures, designed to minimize and eradicate the potential spread of COVID-19 and other similar viruses and diseases, are as follows:

1. Host facilities shall establish a committee to ensure that health and safety protocols are put in place and updated periodically to address prevailing health and safety concerns.

2. Committees established at host facilities must exhibit the ability to accommodate the rules and regulations set forth by the Massachusetts Safety and Standards Checklist regarding:

a. Social distancing

b. Separation requirements

c. Directional pathways

d. Adhere to limitations on maximum facility occupancy at any given time

3. Medical Application Standards:

a. Written policies and procedures regarding patient/guest safety

b. Documented emergency action plans and procedures

c. Individualized health assessments

d. Disease management and prevention programs

e. Lifestyle change/health risk reduction programs

f. Physical therapy, post-operative/injury

g. Physical therapy, continuing care programs

h. Implementation and maintenance of a Medical Advisory Board: A Medical Advisory Board (“MAB”) is a group of healthcare professionals headed by a Medical Director that meets on at least a quarterly basis for the purpose of reviewing and providing oversight for all aforementioned medical applications, with particular focus on the medical requirements involved in the long haul pilot program. The members of the MAB should be recognized experts in their fields. Their combined experience and valued insights should direct the facility in all efforts to enhance all existing wellness programs, as well as maintain and improve the safety protocols for pilot program participants. The MAB will also play a large part in determining what new services and/or lifestyle improvement programs may be needed or valuable to the patient. The MAB shall supervise the medical aspects of the long haul pilot program.

i. Each host or sponsoring facility shall have a Medical Director. The Medical Director shall be a licensed medical physician who sits on the Medical Advisory Board and oversees, directs, and reviews all communications with the MAB. The medical director shall be responsible for the safe and appropriate application of all medical programs within the facility.

4. Staffing Requirements and Qualifications: All host /sponsoring facilities shall be required to employ personnel in the following full-time positions with the qualifications listed:

a. Fitness Director: must have minimum of an Exercise Physiology degree

b. Operations Manager: must have a BS in Facility and Operations Management with 5+ years’ experience.

c. Medical Director: all facilities must have a licensed medical physician to oversee the MAB. The Medical Director will be responsible for overseeing the medical and behavioral change programs within each facility. The Medical Director will work with the MAB and facility management to coordinate various interdisciplinary teams to execute the facility’s medical and wellness policies, systems, and agenda. The Medical Director and the MAB shall supervise the medical aspects of long haul pilot program.

5. Cleaning and Hygiene Procedures: the host/sponsoring facilities shall maintain and enforce the following cleaning protocols in accordance with the Massachusetts Safety and Standards Checklist:

a. Provide ample and sufficient sanitizing wipes easily accessible for patients and staff to clean equipment before and after each individual use.

b. Provide ample and sufficient hand sanitizing stations easily accessible for patients and staff to consistently sanitize their hands.

c. Staff shall be required to spray down equipment with EPA approved disinfectant at scheduled times throughout the day to maintain optimal safety and cleanliness. Staff must log and track cleaning times.

d. Staff shall be required to disinfect high touch, high use areas consistently throughout the day with EPA approved N list (?) cleaning products and log and track times

e. Host/sponsoring shall increase cleaning staff to maintain and enable consistent, thorough, and continuous facility sanitations

6. Air Quality and Control

a. Host /sponsoring facilities shall be required to purchase, install, and continuously operate non-thermal plasma self-contained electronic air and surface contamination unit(s).

b. Said unit(s) shall have the capacity to eradicate bacteria, viruses, mold and odor at an average reduction rate of 90% in the air and 95% on surfaces in large occupied spaces by creating oxidized molecules from ambient air using no-thermal plasma technology

c. Said unit(s) will not use chemicals in any aspect of operation and will comply with USDA National Organic Standards (7 CFR Part 205)

d. Said unit(s) shall be powered by standard 120-volt outlet

e. Said unit(s) shall have no effect on temperature or humidity of the facility

f. Said unit(s) shall offer continuous 24-hour treatment

g. Said unit(s) can be calibrated for different operations cycles

h. Said unit(s) shall be compliant with OSHA safety and air quality regulations

7. Safety Standards and Required Protocols: Host/sponsoring facilities shall be required to implement and maintain the following protocols:

a. Any person entering the facility shall be checked in for tracing purposes (facility must have a computerized check-in system)

b. Facilities shall maintain and updated member/patient contact process email or cell phone

c. Signs shall be posted conspicuously throughout required spaces communicating safety regulations and requirements for said spaces

d. All new patients shall be required to fill out a detailed health check form

e. Automatic External Defibrillators (AEDs) shall be required; one unit for every 50,000 sq. ft. to ensure prompt and timely application

f. All staff shall be trained in CPR and AED use

g. Facilities shall train all employees in an emergency action plan for the following:

1. Fire

2. Health emergency

3. Active shooter

4. Positive Covid test

h. Facilities shall track and document training times and keep records of trained personnel.

For a reserve to fund a COVID Long Haul Rehabilitation Pilot Program …………………… $4,000,000.

Federal COVID-19 Response Fund ………. 100%

Additional co-sponsor(s) added to Amendment #482 to H4219

COVID Long Haul Rehabilitation Pilot Program