Petition to State and Federal Governments
Respiratory Therapists To Be Categorized As First Responders
The purpose of this action is to see that respiratory therapists working in hospitals be recognized as first responders. Due to the coronavirus situation, our profession has been dealing first-hand with patients who have, and are suspected of possibly having Covid19. Respiratory therapists are among the first responders within the hospital setting of any patient having significant distress and are frequently putting their own health at risk in order to serve and heal others. These licensed professionals are currently undervalued, underappreciated, and there is a general lack of understanding regarding the importance of their career field. Respiratory therapists deserve to be recognized as first responders not only during this health pandemic, but also during times of economic normalcy for all of their life saving skills in critical settings. #respiratorystrong Mark J. Gilbert, RRT-ACCS, EMT-P
Petition to NYS Department of Health: Bureau of Early Intervention
Approve COTAs to provide Teleheath services to NYS Early Intervention Families
To: The NYS Department of Health, Bureau of Early Intervention, It is with great appreciation that the NYS Bureau of Early Intervention has indeed allowed the provision of services to our most vulnerable population via Telehealth during the COVID-19 outbreak. This however does NOT apply or give authorization to Certified Occupational Therapy Assistants (COTAs) to currently provide this service to the Early Intervention families they are serving. These families are currently not receiving necessary and crucial Occupational Therapy services for their child causing a concern for significant regression and lack of necessary contact/training for the family itself. In addition, these COTAs are currently unemployed and unable to work due to the restrictions implemented by NYS regarding “social distancing” ie: school closures, and the recent order from Governor Cuomo to keep all non essential workers to complete their work at home. COTAs work under the Supervision of the Occupational Therapist but are not required to be under direct line of sight supervision. According to The NYS Office of the Professions, “The amount and type of supervision provided should be based on the ability, level, and clinical experience of the occupational therapy assistant and the setting in which the occupational therapy assistant is providing the services. Good practice suggests that the occupational therapist supervisor participate in the services delivered by the OTA including: -Initial Evaluation -Intervention Planning and Goal Setting -Final Evaluation/Discharge Additionally, the supervisor should periodically assess each patient's progress, and review and sign treatment notes and reports prepared by the occupational therapy assistant.” Therefore we are asking that the Telehealth act be amended to allow COTAs to provide Telehealth sessions to Early Intervention families, under the continued supervision of a Registered Occupational Therapist. We care deeply for the wellbeing of the children receiving Early Intervention services and wish to continue working with these families despite the hardship the COVID-19 virus has inflicted upon us all. We thank-you for your time and swift attention to this matter. Sincerely and respectfully, New York State Early Intervention Providers and Families, specifically Occupational Therapists and Occupational Therapy Assistants
Petition to U.S. House of Representatives, U.S. Senate
Forgive Student Loan Debt for Healthcare Providers Responding to COVID-19
We implore the United States Congress to pass legislation forgiving all remaining student debt for the heroes fighting to keep our country alive. Student debt is only one of the many burdens faced by those combating COVID-19 to save as many patients as possible, but it is one Congress has the power to ease. Healthcare workers are putting their lives and those of their families at risk on the front lines of the international COVID-19 crisis. As a group, nurses, attending physicians, nurse practitioners, physicians assistants, and resident physicians are working in uncertain, understaffed, dangerous conditions. Some have been redeployed from their usual clinical duties, many without appropriate personal protective equipment and other supplies. We have been seeing stories of healthcare workers separated from family, depressed, anxious, working extended hours, sick, and dying. On 3/24/2020 a nurse from New York passed away from complications of COVID-19, likely contracted while working with patients, and there are more to come. The mounting pile of student debt is an enormous weight carried by these workers, especially those who attended college and graduate school for 8+ years. For instance the average medical school graduate’s debt load now exceeds $200,000 (Source: National Center for Education Statistics). The recently enacted CARES Act mandating a six-month freeze on interest and the option to take a break from payments on federal student loans is helpful, but does not go far enough to give assistance to those providing direct care during this pandemic. Let’s show our support as a nation by easing the financial burden - allowing them to afford housing away from family, care for their children while they are working, medical care including mental health services, and relief from the many other extraordinary, intangible costs of providing on the front lines during this time. Thank you for considering supporting this bill. Your constituents, those benefiting from the thankless work done by these healthcare workers every day, want to see this debt forgiven.
Petition to U.S. House of Representatives, U.S. Senate, Donald J. Trump, Vice President Mike Pence
US Physicians/Healthcare Workers For Personal Protective Equipment in COVID-19 Pandemic
www.frontlineppenow.org As cases of COVID-19 escalate around the country, physicians and other healthcare workers (HCWs) are facing severe shortages of personal protective equipment (PPE). This shortage is already a major crisis and will place an insurmountable strain on the health system of this country as cases continue to rise and more people require hospitalization for complications of COVID-19. As a result of this shortage, recommendations from the Centers for Disease Control (CDC) for appropriate PPE for HCWs on the frontlines have shifted. This shift does not come in response to overwhelming evidence, rather to a supply chain issue. As quoted directly from the CDC website: “PPE recommendations for the care of patients with known or suspected COVID-19: Based on local and regional situational analysis of PPE supplies, facemasks are an acceptable alternative when the supply chain of respirators cannot meet the demand."..."When the supply chain is restored, facilities with a respiratory protection program should return to use of respirators for patients with known or suspected COVID-19."(1) These statements in no way suggest that droplet precautions are adequate, supported by the statement that as soon as the supply chain has been restored, we should go back to using N95 respirators. As a result of these recommendations, many hospitals have taken the CDC recommendations to mean that facemasks are the preferred PPE, rather than a less desired (and potentially less safe) alternative. They have thus rationed respirators to be made available only for procedures, such as intubation and bronchoscopy, during which the virus is more likely to become aerosolized. This is putting our HCWs in tremendous danger of contracting and spreading COVID-19, which is unacceptable in the country with the most expensive health care system in the world. The evidence that droplet precautions are acceptable is lacking. CNN recently published an article titled “Health care workers getting sicker from Coronavirus than other patients”.(2) This statement is corroborated by data from a Harvard Study in China that suggested HCWs were at a 20% increased risk of severe infection compared to the general public. This risk decreased once the Chinese implemented full gear: protective suit, medical goggle, face shield, N95 mask and gloves – following this change there were no further reports of infected HCWs.(3) The debate is still ongoing as to whether or not COVID-19 can be transmitted via droplets vs. aerosols, yet as we speak, HCWs around the world continue to get infected, end up in critical condition, and die while using “appropriate PPE”. According to an ahead of print New England Journal Article on aerosol and surface stability of COVID-19, the virus can be detected up to 3 hours after aerosolization.(4) According to Dr. Milton, professor of environmental health at University of Maryland, “you cannot tell epidemiologically between something aerosol transmitted by weak sources and large droplet spray”, and he suspects the capability of long distance transmission will be dependent on the degree of symptoms.(5) Considering the mortality risk and lack of data to support a step-down to surgical masks, N-95 masks should continue to be the standard PPE for care of COVID-19 patients. As a physician, I do not know how long it takes to make an N95 mask, but I do know how long it takes to train a physician, a nurse practitioner, a physician’s assistant, a respiratory therapist or nurse. We are the supply chain that needs to be protected. Our friends from Italy have described the loss of infected HCWs as a critical hit to an already strained system. Infected HCWs are of no benefit to patients – in fact, they pose a serious risk.(6) They not only endanger the health of their colleagues, families, and communities, they also serve as a vector to infect the most vulnerable among us – the patients they care for. China, Italy, and S. Korea have more experience with this virus than we do and are taking the protection of their HCWs seriously. In France, Dr. Benjamin Davido, Infectious Diseases and Clinical lead for COVID-19, explains the importance of protecting HCWs against the severity of the illness, by using FFP2, the European equivalent of N95 masks.(7) “If we don’t do all we can to protect them (HCWs), they will quickly transition from providers to patients… Governments must support private-sector manufacturers in providing N95s and other equipment to HCWs.”(6) This letter serves to urge our government, industry, media and general population, to assist HCWs in obtaining immediate access to critical PPE, including N-95 masks. Our HCWs are already on the front lines, taking care of patients without appropriate protection, and our COVID cases and we are nowhere near the peak. Many hospitals are already running out of protective supplies. (NY Times, 3/9/2020) Recommendations to protect HCWs should not be based on what’s available; availability should be based on what is necessary. We urge the government to access the Strategic National Stockpile, and to utilize both the public and private sector to immediately increase production of PPE supplies. In addition, we urge our hospital systems to maintain the highest level of PPE standard for our HCWs, and demand the supply of N-95 masks. Sincerely, Dr. Milla J. Kviatkovsky Dr. Constance Chace Dr. Supraja Thota https://www.frontlineppenow.org/ #frontlineppenow #getmeppe References: 1) https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html 2) Howard and McLaughlin, ‘Health care workers getting sicker from coronavirus than other patients,’ expert says, CNN Health, March 12,2020 3) Xihong Lin, ‘Analysis of 25,000 Lab-Confirmed Cases in Wuhan: Epidemiological Characteristics and Non-Pharmeceutical Intervention Effects, Department of Biostatistics and Department of Statistics, Harvard University and Broad Institute 4) N Doremalen et Al, 2014, Aerosol and Surface Stability of HCoV-19 (SARSC-CoV-2) compared to SARS-CoV-1, New England Journal of Medicine 5) Souchery, ‘Unmasked: Experts Explain Necessary Respiratory Protectin for COVID-19’, Center for Infectious Disease and Research Policy, Feb 13, 2020 6) Osterholm and Olshaker, ‘Health-Care workers are the front-line warriors against coronavirus. We must protect them’, The Washington Post, Feb 14, 2020 7) Duqueroy, COVID-19: Advice From a French Doctor on the Frontline, Medscape, 3/16/2020
Petition to Nye county commissioners, Pahrump valley fire & Rescue service
Remove Scott Lewis from fire chief
The local fire chief Scott Lewis is also the Nye county emergency manager he does not care about public safety nor does he care about the safety of other personnel from other agencies nor his own in an incident that occurred in 2019 he attacked a then 16 year old Good Samaritan with a CPR certification for helping out several of his neighbors community he would then attack the same now 17 year old again in 2019 again where the boy worked as a grocery store assistant after a medical emergency occurred in the parking lot and he responded again as a good samaritan also having ties to a volunteer fire department as a cadet Mister Lewis attacked the boy verbally as well as went to the other department to complain about the boy assisting at the call and just to be clear the boy possessed all the proper equipment and minimum certifications to be on scene Scott's Behavior both times was unbecoming of the uniform and highly inappropriate he even went as far as to stalk the young boy prior to intimidating him by using multiple law enforcement agenciesas well as attacking the boy over his fallen firefighter mother this petition is to remove him from office as either both emergency manager and fire chief or he can vacate one of the positions
Petition to Florida Governor, Donald J. Trump, Marco Rubio, Rick Scott, Donna E. Shalala, Carlos A. Gimenez, Debbie Mucarsel-Powell
MASS TESTING for Covid before any orders for social distancing are relaxed!
Experts are unanimously and universally recommending MASS TESTING of the population for the COVID 19 virus as a prerequisite to "restarting" the economy or relaxing social distancing orders. The US is testing at a rate of less than 3.2 per thousand, in eleventh place among industrial nations. This is unacceptable, as mass testing is the only way to isolate the COVID 19 virus in our communities and slow its spread considerably. Social distancing alone, without testing, is just a momentary pause (at considerable expense both socially and economically); but premature loosening measures will be counterproductive, and will only result in further harm to the population and economy. The people demand that our local, state and federal leaders commence a massive project (with the help of private industry and capital) for universal testing across the country before any relaxation of standards are considered. Time is of the essence. The people are living in a state of permanent anxiety and it doesn't help when we see the lack of coordination across the spectrum to tackle this severe health crisis. People are dying and suffering unnecessarily while we spend valuable time bickering about the details. There will be time for that AFTER we defeat this pandemic. The urgent and most consequential action to be taken right now is MASS TESTING - let's get it done!
Petition to Riverside county sheriff department, DA Mike Hestrin, Sheriff Chad Bianco, Riverside County Board of Supervisors, Chuck Washington, Kevin Jeffries, Karen Spiegel, V. Manuel Perez, Jeff Hewitt, Peter Aldana, Paul Angulo, Jon Christensen, Phil Williams, Kathleen Kelly, Tami Scott, Niamh Ortega, Tina Daigneult, Aaron Brown, Countywide Oversight Board for the County of Riverside
Implement PERT in Riverside County to decrease police presence on mental health calls!
The implementation of a PERT program in Riverside County would not only decrease police presence during emergency responses to a person experiencing behavioral health issues, but it would also ensure that a licensed mental health clinician is always in attendance with a law enforcement officer to assess the person in distress. All law enforcement officers are trained on behavioral health awareness, response, and de-escalation tactics. Law enforcement officers in Riverside County have a history of being negligent to de-escalate behavioral health-related crises and unnecessarily using excessive force on behavioral health calls which ultimately caused the death of Matthew Tucker in 2016 as well as the unjust mistreatment of Joseph Ramirez in 2020. PERT is a program used in San Diego County and should be a model for all counties to partner their law enforcement agencies with mental health providers and emergency medical services to provide the safest assessment and assistance. ~What is PERT? The Psychiatric Emergency Response Team (PERT) is a program of Community Research Foundation (CRF) in partnership with San Diego County Health and Human Services (HHSA), San Diego County law enforcement, emergency medical services (EMS), and consumer advocacy organizations. PERT contributes to the well-being of persons living with mental illness by actively and compassionately assisting those in crisis who come to the attention of law enforcement and EMS to access appropriate services through on-scene assessments and referrals. PERT pairs a licensed mental health clinician with a law enforcement officer/deputy or EMS community paramedic. The teams ride together in the field for their entire shift and are first responders to assist persons in behavioral health related crises. PERT provides training to all San Diego County law enforcement agencies, as well as fire service personnel and dispatchers on behavioral health awareness and response, including de-escalation. Vision: Persons living with mental illness will have access to and be referred to programs at the appropriate level of service and no person will be hospitalized or incarcerated unnecessarily. Mission: PERT provides effective and compassionate crisis intervention to persons (including their family members and supports) living with mental illness who are contacted by law enforcement officers/deputies and EMS. The goal is to safely and effectively de-escalate crises and provide appropriate referrals that offer the least restrictive level of care, thus avoiding unnecessary hospitalization and incarceration. PERT is recognized as a "best practice" model that epitomizes law enforcement, EMS and clinicians working together to provide the best service options for persons living with mental illness. PERT Cores Values: We believe that persons living with mental illness should be compassionately assessed and be referred to assistance that is appropriate to those needs. We believe that first responders and behavioral health clinicians have a responsibility to collaboratively work together with persons living with mental illness, their family and support persons, and the community as a whole to ensure that people receive the level of care they require. We believe that on-scene partnership of behavioral health and first responders contributes to the well-being of persons living with mental illness and to the community. We believe that outreach efforts to marginalized groups in the community assist persons to meet identified needs and assist communities to recognize and address larger issues related to community health and safety. History: In the early 1990's, there were several officer involved shootings and critical incidents involving persons living with mental illness. At that time, there was a gap in collaboration between law enforcement and mental health providers. The community at large, mental health consumers, family members, San Diego County HHSA, and law enforcement agencies convened to recommend that officers/deputies receive additional training in recognizing and responding to persons experiencing behavioral health issues and acquire clinical support from behavioral health professionals. Hence, PERT is the result of community partners collaborating to provide optimal service for persons (and their family members and supports) living with mental illness, including the provision of training to public safety personnel throughout San Diego County. ~Information provided by Community Research Foundation.
Petition to Bill Dodd, Gavin Newsom, DIane Feinstein, Kamala D. Harris, Mike Thompson
Armer Law; They take care of us. We need to take care of them.
Santa Rosa Police Detective Marylou Armer was denied COVID19 testing twice before she went into the emergency room, was put into a coma and died alone. Armer spent two weeks with a fever, aching body and shortness of breath. Armer asked twice to be tested for COVID-19. Armer was denied by Kaiser Permanente’s Vallejo Medical Center. She was not considered vulnerable because of her age and no underlying medical conditions. Armer was finally cleared to be tested on March 23, when her husband brought her to the emergency room. She was sedated, intubated, and placed in a medically induced coma. She died on March 31. Armer was with the Santa Rosa Police Department for 20 years and her death is devastating to all who worked with her to help victims of crimes that include domestic and dating violence, sexual assault, stalking, child abuse and elder abuse. But this is not an isolated incident. There have been several first responder deaths as a result of COVID-19 in the past few weeks – and there will be more. To date more than 20 law enforcement personnel alone, as well as nurses, doctors and firefighters have died from COVID 19. Athletes and Celebrities, and those with money at their disposal have been getting tested when they have no symptoms. Marylou knew something was wrong and was denied access to healthcare that may have saved her life. "Armer Law" would allow that during any epidemic or pandemic, first responders which include but are not limited to; law enforcement, social workers, healthcare, and EMS workers, can NOT be denied testing, and should automatically be approved at the first sign of symptoms. They are on the front lines, entering people’s homes and having to make physical contact with the public, and they have the highest risk of exposure. Also provided would be regular, continued testing if necessary, and treatment covered by worker’s compensation, not sick leave. This death was preventable. Our first responders take care of us, it is time to take care of them.