KANSAS CITY, Mo. — You can hear the concern, and at times, frustration, in David Wiley’s voice as he discusses his struggles to find personal protective equipment for his hospice nurses amid the coronavirus pandemic.
The CEO of Kansas City Hospice and Palliative Care said his staff has enough PPE – for now.
But as the outbreak spreads nationwide, during a week the U.S. Surgeon General Jerome Adams warns will be the country’s “Pearl Harbor moment” — Wiley is worried that he won’t be able to get the supplies needed to protect his nurses.
“As of today, we have enough PPE for our staff,” he told FOX4. “But as the surge comes here, we’re continuing to order supplies every single day, from whatever source possible, in order to be ready.
“I’m out there trying (everyday) to get enough supplies,” added Wiley, whose nurses care for nearly 500 terminally ill patients throughout the metro. “I have to worry about that today, and the next week, and the following six weeks to ensure we’re ready. It is a concern.”
Wiley said vendors have limited the amount of masks and other supplies he can order – even during this crisis when his nurses must wear additional PPE to comply the Centers for Disease Control and Prevention (CDC) rules.
“The allocation from my supply chain is dependent on what we normally order,” he said. “And because we’re in a time of higher demand, we’re restricted from ordering what we (now) need.”
Finding new vendors for PPE is also a challenge, Wiley said. He’s checked Amazon and overseas markets, but discovered those suppliers are expensive.
“We’ve seen a dramatic increase in prices,” Wiley said. “We’re now competing with the public and other care providers who are also ordering from the same sources.”
Low Priority Given To Hospices
Compounding these supply issues, Wiley said, is the low priority given to hospices when emergency PPE are distributed by the state and the Strategic National Stockpile.
“We are certainly concerned that hospices are not prioritized higher for PPE from the Strategic National Stockpile,” he said of the federal stash of masks, gloves, medicines, and other life-saving devices designed to supplement state and local supplies.
Wiley recently asked the state for an emergency supply of protective masks for his nurses.
“We requested 720 N95 masks,” he said. “We followed the appropriate channels to submit our request. But it was denied.”
Why?
“What was explained to me about the prioritization,” he said, “is that the highest priority is given to hospitals, EMS, and other essential health care providers.”
Wiley, however, argues hospice nurses are essential health care workers.
“Our nurses are on the front lines,” he said. “They’re still going in and out of homes to care for their patients. It’s essential that our team is prepared to (safely) go in to multiple patients’ homes.”
Hospices Across the State and Nationwide Echo Similar Concerns
Hospice officials throughout the state and across the country echo Wiley’s concerns.
“PPE are in extremely short supply,” Jane Moore, CEO of the Missouri hospice and Palliative Care Association, told FOX4. “Many are close to running out altogether.
“This comes at a time when hospitals will need to find a way to discharge patients to nursing homes and homes,” she added. “We must be able to protect our staff, the patients, and their families.”
Asked if the shortage of PPE among hospice nurses has reached crisis level, Moore said: The lack of PPE is going to be a crisis if we don’t get them. If PPE can’t be found, hospices may not be able to take on new patients and could have to discharge current patients.”
But finding new suppliers for PPE is a daunting challenge, Moore said.
“Our providers are not able to get PPE through their normal channels. There are none to get. Some are ordering with weeks out to have them come in and don’t know even after ordering may not get them as promised. (And) payments are due upfront.”
Moore is leery to order PPE from China.
“There are no guarantees with payments upfront that the China connections are able to get PPE to providers,” she said. “Again we need help here making sure these companies are going to do what they say.”
She and other hospice officials have also seen an uptick in COVID-19 con artists, who take money for supplies and then disappear.
“We have been trying to find solid providers that are legitimate,” Moore said. “I don’t currently have a company that I know for sure I can provide to my hospices that is going to get the PPE.”
“Only Allowed to Purchase 24 Bottles of Hand Sanitizer Per Month”
Hospice nurses and providers in Kansas have seen some shortages of gloves, masks, and other PPE, but remain “cautiously optimistic” for now.
“They’re holding their own,” said Jane Kelly, executive director of the Kansas Home Care and Hospice Association. “But if this virus gets much worse and spreads, they’re going to be in trouble.”
To illustrate her members’ concerns, Kelly shared emails she’s received about PPE shortages amid this pandemic.
“We are getting patients from larger facilities like most of us and are now burning through our PPE sooner than we anticipated,” a hospice member in North Eastern Kansas wrote. “(But) we are hospital-based so we are probably in a better position than stand-alone facilities. Our hospital has received a shipment of much needed PPE from the state allocation through our local emergency management request.”
The hospice member, however, had trouble securing enough hand sanitizer for her staff.
“Our hospital is only allowed to purchase 24 bottles of hand sanitizer per month now,” she said. “We found a distillery that has switched over to making hand sanitizer and are purchasing a 55-gallon drum. We now have a community partner who is going to Texas to pick it up for us.”
A Topeka-based hospice and palliative care provider told Kelly: “We currently have enough supplies. We were able to locate a vendor, but had to order large quantities (5,000 N95 MASKS) that we were able to share with other organizations.
“We have implemented the CDC recommendations for PPE use,” the provider added. “ (But) we’re not sure that we have enough to last through this pandemic.”
Zero N95 Masks And Less Than 200 Surgical Masks
The National Hospice and Palliative Care Organization (NHPCO) said some of its members, especially those in COVID-19 hot spots, are completely out of supplies.
“Providers have shared the grim realities of the nationwide PPE shortage, with one noting they have zero N95 masks and less than 200 surgical masks, another sharing that they have no shields and only a week’s worth of gowns, and a third noting they had resorted to ordering industrial style paint masks from Amazon but those are no longer available for purchase,” the association said in a news release.
To address those shortages, the association has pushed for federal changes to give hospice nurses “priority status” for PPEs during the COVID-19 outbreak.
“There’s a FEMA (Federal Emergency Management Agency) distribution supply chain, but hospices are not included on that FEMA distribution,” NHPCO spokesman Jon Radulovic told FOX4. “There’s never been a situation like this and it’s understandable that the focus is on what’s happening in hospitals now.
“But hospitals are not the only ones who need PPE,” he added. “As the wave of COVID-19 touches more communities, hospices need to make sure their staff are protected.”
NHPCO is working with Congressional leaders to ensure future coronavirus legislation clarifies that hospice nurses have priority access to PPEs when emergency supplies are distributed, Radulovic said.
“People go under hospice care every day. And with COVID-19, we need to make sure our nurses have the proper protective equipment.
“They’re still going in and out of patients’ homes (and some nursing homes),” he added. “They need to be safe and protected.”
In Spite of Shortages, Hospices Will Rise To The Challenge
Despite these shortages, hospice officials say their nurses will continue to provide compassionate care for patients during their final days and hours.
“There was a period in the 1980s when the AIDS epidemic started and became a national crisis,” Radulovic said. “Hospices rose to the challenge during that crisis. We believe hospices will do that again.”
The CEO of Kansas City Hospice and Palliative Care agrees.
“We’re in extraordinary times right now and we want to be able to provide the expert compassionate care to our families and patients every single day,” David Wiley said. “And we’re working very hard to make that happen.”
How To Help Hospices During This Shortage
What can the public do to help hospices as they struggle to find PPE and other supplies?
“Stay home,” said Jane Moore with the Missouri Hospice and Palliative Care Association. “No parks, golf course, basketball games, or house gatherings. Only go to the store when necessary.”
“The public needs to get serious about this virus. This is going to take participation from everyone.”
Financial donations can also help hospices as they scramble to shore up supplies.
“Those will help offset the increased prices we’re paying to buy necessary PPE to protect our staff,” Wiley said. “Some people have had donated masks, which has been helpful. We have a significant need for N95 masks.”
“I don’t want to send the message that our people are not protected,” he added. “Because they are. As of today, we have enough PPE to care for all our staff. But I am concerned.”
Donations to the Kansas City Hospice and Palliative Care Association can be made at this link.
The National Hospice and Palliative Care Organization has an emergency fund to helps hospices during times of crisis. Donations can be through the National Hospice Foundation at this link.
