Supplemental Mayor's Local Disaster for Public Health Emergency Order No. 3 - 04/09SUPPLEMENTAL MAYOR'S LOCAL DISASTER FOR PUBLIC HEALTH
EMERGENCY ORDER NO.3
SUPPLEMENTAL ORDER OF THE MAYOR OF THE CITY OF PARIS,
TEXAS REGARDING THE COVID-19 PUBLIC HEALTH EMERGENCY
TO WIT: USE OF FACE MASKS FOR HEALTH CARE PERSONNEL IN
NURSING HOMES.
WHEREAS, beginning in December, 2019, a novel coronavirus, now
designated SARS-CoV2 which causes the disease COVID-19, has spread
through the world and has now been declared a global pandemic by the World
Health Organization; and
WHEREAS, on March 5, 2020, the World Health Organization Director
General urged aggressive preparedness and activation of emergency plans to
aggressively change the trajectory of this epidemic; and
WHEREAS, the Center for Disease Control and Prevention is closely
monitoring the growing number of COVID-19 cases that have spread into the
United States; and
WHEREAS, 7,038 cases of COVID-19 and 97 deaths from COVID-19 have
been reported in the United States according to the CDC as of 4:00 P.M. on
March 18,2020; and
WHEREAS, on March 13, 2020, Texas Governor Greg Abbott reported a
total of 39 confirmed cases of COVID-19 in the State of Texas and as of March
18, 2020 the total confirmed cases in the State of Texas is 83; and
WHEREAS, by Thursday, April 2, 2020, the number of reported cases in
the State of Texas had risen to 4,669; and
WHEREAS, the first confirmed case in Lamar County, Texas was
announced on March 19, 2020, and WHEREAS, there have since been four
additional confirmed cases in the county; and
WHEREAS, the COVID-19 virus spreads between people who are in
close contact with one another through respiratory droplets produced when an
infected person coughs or sneezes, and droplets can also be generated by
talking, laughing, or exhaling; and
WHEREAS, the CDC has stated that people are the most contagious
before they start showing symptoms of COVID-19, and individuals can be
infected with the virus and be contagious even when they have no symptoms;
and
WHEREAS, Dr. Tom Ingelsby, Director of Johns Hopkins Center for
Health Security, has determined that face coverings should be required because
COVID-19 can spread when asymptomatic people go out in public and that
requiring individuals to wear face masks or coverings will reduce transmission
of the virus; and
WHEREAS, the United States Surgeon General, Dr. Jerome Adams,
acknowledges that there is a significant amount of asymptomatic spread and
recommends that individuals use face coverings and attempt not to touch their
faces to reduce the spread of COVID-19; and
WHEREAS, Dr. Anthony Fauci, Director of the National Institute of
Allergy and Infectious Diseases, has further recommended that individuals
wear facial coverings to prevent individuals from infecting others; and
WHEREAS, the residents of nursing homes facilities constitute a
particularly vulnerable population; and
WHEREAS, on March 31, 2020, Gov. Greg Abbott issued Executive Order
GA -14, in which he stated that every person in the State of Texas shall, except
where necessary to provide or obtain or provide essential services, minimize
social gatherings and minimize in-person contact with people who are not in
the same household as recommended by the President and the CDC;
NOW, THEREFORE, I, MAYOR OF THE CITY OF PARIS, TEXAS,
PURSUANT TO THE AUTHORITY VESTED IN ME BY TEXAS GOVERNMENT
CODE CHAPTER 418, THE CITY'S EMERGENCY MANAGEMENT PLAN, AND
THE CITY COUNCIL OF THE CITY OF PARIS, HEREBY FIND AND ISSUE THE
FOLLOWING RECOMMENDATIONS IN THE FURTHERANCE OF PUBLIC
HEALTH AND TO STEM THE TIDE OF THE COVID-19 PANDEMIC:
Section 1. That the findings and recitations set out in the preamble to
this Order are found to be true and are hereby adopted by the Mayor and made
a part hereof for all purposes.
Section 2. This Order applies to all nursing homes within the corporate
limits of the City of Paris, Texas.
Section 3. Order Rg ardin y Face Masks for Health GargjEyrsonntl
in Lona -Term Care Facilities. All nursing home health care personnel shall
wear facemasks at all times while in the nursing home, regardless of whether
or not an employee or resident has received a diagnosis of COVID-19. If N95
respirators or medical procedure masks are unavailable, personnel may wear
cloth masks.
Section 4. Recommendations Re arding AdditioRgl__rrgtggtjyLe
Measures in Ngrsing Homes. The City further strongly recommends that all
nursing homes strictly follow the "COVID-19 Long -Term Care Facility
Guidance" issued by the Centers for Medicare and Medicaid Services on April 2,
2020, a copy of which is attached hereto as Exhibit A and is incorporated by
reference as if fully set forth herein.
Section 5. Pen"all"'Ityf r Failure to -Wear Fac ks. A violation of
Section 3 of this Order is punishable as a Class C Misdemeanor by a fine not to
exceed $500.00.
Section 6. Posting, The City of Paris shall post this Supplemental Order
No. 3 on its website. In addition, the owner, manager, or operator of any facility
that is likely to be impacted by this Order is strongly encouraged to post a copy
of this order onsite.
Section 7. This Supplemental Order shall remain in full force and effect
until 11:59 p.m. on May 26, 2020 unless otherwise rescinded, amended,
extended, or superseded.
ORDERED this 9th day of April, 2020.
ww
Steve: Clifford, M—D., Mayor
Ellis, City Clerk
APPROVED AS TO FORM
Step anie H. Harris, City Attorney
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COVID 19 ��inmit°n C�°m "'��;April 2, 20201
The Centers for ]ivdedicaare, & Medicaid Services (CIMS) and the Centers p"cnn°I[.Xse se Ccanntncwp and
Prevention (CDC) are issuing new recommendations to State and local governments and long-term car
faacilities (also knomin as nursing pacaummes) to help midgate the spread of the 2019 , Novel Coronavirus
(C,OVID-d )a L,ong ter na care fficiiities are a cmnticaap component onuenmt of Arnnenic's healthcare system. They
are Unique, as tdaey serve as dmuwtllu pmeaudtdmcaame providers and as Full time homes f6r some of the most
vulnerable Americans.
In recent weeks, GMS and CDC, at IPresidennt. "]["muump's direction, have ww ork.ed together to swiftly issue
unprecedented targeted direction to the long ..:term care facility industry, incIluding an general prohibition
of visitors inmpmdenm"nented on March 13, 2020, as wwredp as strict infection control and other sc reenmirig
uuptptn,u ut p,ti:.nrtu w p..: o wever, recent a� bservaations made
dry CDC" an C`M experts onsite in :faacipities
have emphasized that even more must be donne to universally pmpfernent tdnis key guidance.
To provide critical, needed leadership for the Nation's long-term care faac,idnties to prevent further spread
ofCOVID..p9,, CMS and CDC are now recommending the following immediate actions to keep patients
and residents safea
Y. Nursing Homes should immediately ensure that they are complying lyinm =ith all CMS and CDC
guidance related to infection control.
In particular, facilities should focus on adherence to appropriate hand hygiene as set fbrth by
t;;CC
CAMS has also rcce ntly issued extertsive,in axon _c onu r u� ruu:un a nce, including =a self
assessment ent c hec kl ist that long....term care d' cudpfp s can uas tui determine their corn Alia ncatt with
these crucial infiectionn control actions,
e ' g j i! 'to long terms came facilities on C;OVID,p ,,, pp and�cn ntn�,,�u ..n °nc:waadc:d. also uAc,�en° to t�d�C, s s ,.
also use i.pi.(Ja on conservation. a:nl"paerso aa:d protective eq,uipwnnnenat: (PPE) when unable to
Cc.:wllcavw the long t:ernmm care facility guidance.
. As long-term care faa.cilities are an critical part of the heaaptheaare system, and because of the ease
of spread d inm. long term care facilities and the, severity of illness that occurs in residents with
COVID,.. , CMS urges State and local leaders to consider the needs of long-term mm ca re facilities
with respect to supplies of PPE and C:OVID,,,.19 tests.
State and local health departments slma.aa:uld work together with long term care p'auciIitie,s in their
communities to determine and help address long tcnnnn care faacipit:y needs for PPE and/or
COVID- 19 tests.
Medicare is nous, ccoverpmau „ COYID„,,p testing when furnished to eligible Ibenncopmcpumries by
c.hoom ie to enter fiac.ppptp s to conduct
certified laboratories. "�"sp�.11lmmom�t:mom•pcs may�wts,�io �.
o'liFt:ll -1. testing.
3. Long .,,.t:ermnn care facilities should immnmmnediantely mmmn.palmmmrie:unt; symptom screening for all.
* In accordance with p,p°tpjjwou^M.? prnt;pMduuanp regardless cop'reans orn entering as
long ..:termn"n care p"aau:,pppt:y (including residents, staff'. visitors, outside beaa tpncaare workers,
vendors, etc;.), should be asked about Ctvt, pD.-1 9 sayrrnptcomes and they must also have their
temperature (.,,heckecp, An exception to this is Emergency l edicaaal Service (EMS) workers
responding tc) an urgent medical need, " ftey do not have to be screened, as they are typically
screened separately,
tely,
* Facilities ilities shou.uld limit access points and ensure that all amcc,es spble entrances have an screening
station.
In a acccorc:.panrnc°e with pHm.t ii�ll:p.:p..� yt ,a;uuualpmnw , oyer resident should be assessed For symnruptm:omnn,s
and have their temperature checked every play.
Patients and residents who enter pdclpltues should be screened for COVID-.y 9 tprnm°couu b testing,
H'ava'ppabpew
4. Long term care facilities should ld e nsmure all staff are using appropriate PPE when they are
interacting,with patients ammnup residents, to the extent PIl:E is available and per ,,D-C—'
l iooiiiidaiiiigiltwe on conservation cop"P,PE,
faor the duration of the state o f ernergemncy in their State,, all long term care p"acippt puierscomnrnel.
should wear a p"acennnaa.sk while they are in the ppncpppty
* Full P1111f3' should be worn per CDC guidelines fcor the care mop"any resident with known or
suspected CO V pp t... 19 per CDC guidance on c,comn,ser va io n cop"I['11133.
If COVID-19 traamnsmpssucorn, occurs in the pacdllpty, healthcare personnel should. wear fumlI l'FIE
for the care of all residents irrespective a:op"t.;'OVIR..p diagnosis or symptoms.
Patients and resident's who must regularly leave the fficpppt:y for care (e.g., her nodiaalysis
patients) sh ou k.] wear p"anca;;aunnaspc.s whenn outside of their rooms,
10 Whemnpossible, all long-term care facpppty residents, whether they have t.'Opp.::)...p. 9 syrn ytorns
or not, shouu d cover their noses and mnrncou.uths when staff are in their mems. Residents can use
tissues for this, They could also use cloth, non medical rmnasks when those are available.
]UR_esmu a,mts should not use medical nas� .s uumnpess they are p: OV11[1pp19 po siitive or assumed
to be COVID-.19 .positive.
5. 1➢p'co amwaropmp ft'a nsmnnpsspcomn within long ,,,.term care facilities, facilities should use separate staffing
teams ffirOVID..p9-pncosptive m° resiii.tlemnt;s to the best: of their ability, and work with State and
local leaders to designate separate facilities or units within a facility to separate t".” " 1pp,,.1
negative residents frm:omrm OV"ID.1.9 positive residents and pmndlpviclummuls with unknown
:°O'VII[D,,,,19 status.
➢:...cornp;..:term care facilities should exercise as best as possible ssible ccornsist:emnt assignment (rtlleaanll n.
the assignment of staff to certain patients and residents) fi-, ur app patients and residents
regardless of symn°upotcorns or COVID..p 9 staatuusW his practice can enhance e staff's iarmnpplaraty
with their assigned pnatl.emnts and residents, helping t.pvermn detect emnnergirng condition changes
that uumnfammrunlplaarstaff may not notice, The (,:nal is to dec n.,,,aase the number of diff6rennt staff
interacting with each 1pnaaa:lc°nt: and resident as well as the rno.urnnben u.)f times those staff interact
with the patient and resident, Also, staff as much as possible should not work acro� ,.,,s units or
floors.
i.. Long term care fiacilities should redeploy existing training related to consistent
assignment, and ensure, staff are &rn iliar with the signs and symptorns of COV ID M.
Long term care facilities should separate patients and residents who have COVID 19 Fro nn
patients and residents who do not, or have an unknown status.
i. To this end, long-term care facilities should -work,with State andjocap community
leaders to identify and designate facilities dedicated to patients and residents with
known C'OV111.1-19 .positive and those with suspected C'OVIDE 19, ensuring they are
separate from patients and residents who are COVID... 19 negative;
iE CMI19 .positive units, and facilities must be capable ani maintaining strict infection
controlP ractices and testing protocols, as required by regulat ion;
1. When possible, fiazilides shmAld exercise consistent assignment, or have
separate staffing tearns for 0.)VIIII.) 19 .positive and COVID 19 ,negative
11patients,
iii. Tliere rnay be a need for some of these COVID 11positive long-term care facilities
to have the capacity, staffing, and infi-astrucAure to rilanage Ihigher intensity patients,
inchJing ventihator rrianagern ent;
hi. State agencies includirig health departments, hospitals, and nursing horne associations
will have to ensure coordination anionfacilities to deterrnine which facilities will
have a designation and to provide adequate staff supplies and PPE; and, if possible,
isolate all admitted residents (nncpuding readmissions) in their room in the COVID
19 --positive facility for 14 days iftheir COVID ,19 status is unl<.nown; and
v, 1,ong-term care facilities shotild, to the fulh:;st extent possible, inform residents and
their families of firnitations of their access to and ability to leave and re enter the
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facility, as well as any requirements and procedures for placement in alternative
facilities lFor COVID-19-posifive or unknown status.
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