2
1 Brief summary of why the waiver is needed:
1.1 Background. On January 31. 2020, as a result of confirmed cases of 2019 Novel
Coronavirus, Secretary of Health and Human Services, Alex M. Azar II determined a
nationwide public health emergency exists.
1
1.2 On February 29, 2020, Washington State Governor Jay Inslee declared a state-wide State
of Emergency due to the outbreak in Washington State of COVID-19, the illness caused by
the SARS-CoV2 virus. Governor Inslee directed state agencies and departments to do
everything reasonably possible to assist affected political subdivisions in an effort to
respond to and recover from the outbreak. On March 13, 2020, the President declared a
national emergency under the Stafford Act, which allows, among other things the
opportunity for CMS to waive requirements under Medicare, Medicaid, and CHIP, and
CMS announced the availability of multiple blanket waivers, as well as the process for
requesting additional flexibilities.
1.3 Washington State is at the epicenter of COVID-19 outbreak in the U.S., and in conjunction
with New York now has the highest number of confirmed cases. As of March 14, 2020,
the Department of Health reports that there have been 642 confirmed cases of COVID-19
in Washington State and 40 deaths from the disease. Community transmission of COVID-
19 is occurring. Surveillance data suggest that the number of COVID-19 cases in
Washington State will continue to significantly increase for an undetermined period of
time.
1.4 At this time many providers in the state have opened or are working to open alternative
care sites, and the Department of Health is urging hospitals to increase beds beyond their
licensed bed capacity or to house patients in units that do not meet licensing standards.
1.5 A number of other providers are in voluntarily and mandatory quarantine. Long term care
providers have been most hard hit, with the vast majority of the deaths in the U.S.
occurring from residents in Washington nursing homes.
1.6 Subsequent to my initial declaration of a State of Emergency on February 29, 2020, I have
issued seven (7) additional emergency orders mandating, among things: the closure of all
K-12 public and private schools statewide; the prohibition of in-person classroom
instruction at all public and private universities, colleges, technical schools, and
apprenticeship programs; the prohibition of certain activities at nursing homes and
assisted living facilities, as well as additional precautions that must be taken to protect
these vulnerable populations; and the gathering of certain large groups of persons
statewide. The state anticipates the need to take additional emergency action on a broad
range of issues within 24 to 48 hours. This request is supported by Governor Inslee, the
Washington State Health Care Authority, Department of Social and Health Services,
Department of Health and providers throughout the states.
1
Secretary Azar subsequently issued a declaration under the Public Readiness and Emergency Preparedness Act
for medical countermeasures against COVID-19, effective February 4, 2020.