Gov. Doug Ducey is offering up to $60 million in federal cash to hospitals to help with staffing — but only if they start promoting and treating some patients with early indications of Covid with monoclonal antibodies.
Christina Corieri, senior adviser to the governor, said the money will buy the services of 750 nurses for eight weeks at hospitals. She said the nurses will be hired by the Department of Health Services and distributed to facilities based on need.
The move comes as several hospitals have said they are stretched to close to capacity, at least in part because of Covid patients who are occupying 30% of their intensive-care beds. And when patients with other conditions are added in, that leaves just 148 vacant ICU beds statewide, or 8%, similar to what was the situation when the virus peaked in January before vaccines were available.
But the significant string attached is that any hospital chain that wants the help will need to have a system-wide practice of promoting and administering monoclonal antibodies, a type of therapy available to those with mild to moderate Covid symptoms that can decrease the level of virus in the blood and, potentially, keep someone out of a hospital.
And the hospitals will be required to offer Covid vaccines to everyone being discharged from the hospital for any reason.
This isn’t the first time Ducey has linked conditions to getting state funds.
He already has told public schools the only way they will get a share of $160 million of other federal dollars is if they do not have policies requiring students and staff to wear masks and if they remain open for the entire year for in-person instruction.
“There’s always been conditions on the staffing support,” said Corieri, noting the state has ponied up cash twice before to help hospitals with staffing.
In prior cases, she said, it was a requirement to participate in the “surge line,” a program to ensure that no one hospital was overwhelmed with patients.
“It is regular practice when funds are being given out that there’s conditions to that funding,” Corieri said.
The strings apparently do not bother the hospitals.
“We applaud the governor for recognizing the tremendous strain on hospital staff during this latest hospital patient surge,” said Ann-Marie Alameddin, president and CEO of the Arizona Hospital and Healthcare Association. As to the conditions, she said Arizona hospitals “are committed to using all of the tools in their toolbox to prevent and treat Covid.
Monoclonal antibodies were given emergency use authorization by the Food and Drug Administration. Results show that it can reduce hospitalization or emergency room visits in patients in the early stages of infection who are at high risk for disease progression — things like diabetes, obesity and hypertension — or those who are 65 and older. It is not recommended for patients already hospitalized for Covid.
Corieri said that clinical tests show positive results.
That is backed up by a study by the Mayo Clinic of nearly 1,400 patients, half of who received the treatment between December 2020 and early April and half who did not.
They were evaluated at 14, 21 and 28 days after treatment. And in each case, the numbers for hospitalization were significantly lower than the untreated group.
Corieri said that while some hospitals in Arizona are making the treatment available, many have not deployed it system wide. But she said that recent development remove some of the reasons that hospitals may have been reticent to participate.
She noted that, at one time, the therapy had to be administered through infusion, a process that could take hours. Now, she said, a simple injection may be all that’s required.
And that, she said, goes to the issue of why the governor wants a system-wide plan for hospitals to administer the therapy — and how it can help deal with the current hospital crowding situation.
“A hospital may decide that their system-wide plan is to send out home-health care to deliver it,” Corieri said.
“They may decide to deliver it at their urgent care” centers, she continued. “They will have flexibility in deciding their deployment plan.”
And if it works as promoted, it can keep a Covid patient out of the hospital.
Corieri said she does not know which hospitals are now providing the therapy. But the governor’s office noted that Tucson Medical Center set up a special clinic within the hospital in January solely focused on this treatment, becoming only the second one in the nation to do so.
The treatment is not for everyone.
Aside from it being available only for those with mild or moderate symptoms, individuals also must be at least 12 years old. That makes it useless to deal with the increasing number school children of that age who cannot be vaccinated and are contracting Covid.
And the therapy is not available to everyone else. The treatment is supposed to be reserved to those at high risk for progressing to severe Covid infection or hospitalization.
That list includes those who are 65 or older, have diabetes, are obese, have chronic kidney disease or are receiving immunosuppressive medications.
Those 55 and older are eligible if they have cardiovascular disease, hypertension or chronic respiratory disease.
And for those in the 12 to 17-year-old age group, the therapy is available to those who are obese, have sickle cell disease, heart disease, neurodevelopmental disorders like cerebral palsy, or asthma or other chronic respiratory disease that requires daily medication for control.
Corieri stressed that the nurses that will be hired are not for the monoclonal antibody therapy programs but instead to help hospitals with their general staffing issues.