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March 19, 2020

Dear Speaker Pelosi, Leader McConnell, Leader McCarthy and Leader Schumer:

The past few days have made a dramatic difference in the reality facing our nation due to the novel coronavirus (COVID-­‐19) pandemic outbreak. There are dwindling supplies of N95 respirators, isolation gowns, isolation masks, surgical masks, eye protection equipment, intensive care unit (ICU) equipment and diagnostic testing supplies in areas that had the first community outbreaks. Schools have closed in numerous states, leaving many front line health care personnel with an impossible choice - caring for their children or caring for their patients - a choice that can be alleviated if Congress takes swift and comprehensive action to assist with providing childcare during this unprecedented time.

The ability for front line health care personnel to go to work and provide care to patients will make the difference in whether those who contract COVID-­‐19 and have life threatening or serious complications from the disease recover or not. America's hospitals and health systems, physicians and nurses, are fully engaged in the work to bend the trajectory of this pandemic, and we also must be there to care for those who contract it. America is counting on Congress to provide direct funding to frontline health care personnel and providers, including nurses, physicians, hospitals and health systems, to respond to this pandemic.

It is clear that COVID-­‐19 will test the capacity of America's health care system. The choices that Congress makes about funding will make the difference between the ability of America's health care system to overcome supply shortages, staffing shortages, and financial challenges so that they can continue to serve their communities.

Since our last funding request, there have been critical developments in several states that have revealed the seriousness of the funding need. Due to expenses to treat COVID-­‐19 patients, hospitals are currently losing up to $1 million per day. This loss may increase as the outbreak spreads. There are extraordinary efforts to supply needed equipment. Front line health care personnel are not able to go to work due to lack of childcare and closing of schools, resulting in personnel shortages and significant expenses to backfill staff - when that is even possible. Hospitals need help providing childcare for their staff members so they can come to work.

In order to make sure supplies and inpatient beds are available, surgeries that are not absolutely critical are being postponed in many areas; however, this results in serious financial hardship for many hospitals and physician practices. Some facilities and practices are able to absorb significant losses for a period of time but others, such as rural facilities, are not. Clearly, we need all possible inpatient capacity to respond to the COVID-­‐19 pandemic. Congress needs to assist hospitals, physician practices and other providers on the brink of financial collapse so they are able to make payroll to front line health care personnel and all employees in order to ensure that as many inpatient beds as possible are available during this pandemic.


  1. Creating a Stabilization Fund for Emergency Expenses Related to COVID-­‐19
    Critical funding includes covering loss of revenues due to suspension of elective services not related to COVID-­‐19, testing costs, additional training for front line health care providers on pandemic preparedness plans, training on telemedicine and telehealth capacities, and increased costs associated with higher staffing levels and backfilling when necessary; sourcing and purchasing additional and potentially more expensive supplies and equipment, when available; standing up emergency operations centers; providing housing and care for patients who do not require hospitalization but do not have housing in order to prevent spread of COVID-­‐19; construction or retrofitting facilities to provide separate areas to screen for COVID-­‐ 19; and additional security.
  1. Providing Critical Childcare Needs For Frontline Health Care Personnel
    Ensuring there is quality childcare for front line health care personnel in need through direct funding to front line health care personnel and facilities, or, like some states have done, partnering with schools and daycare centers to provide funding to ensure there is quality childcare. This will make a critical difference in having more front line health care personnel.
  2. Surge Capacity
    Providing the funding for the capacity to care for mildly or moderately sick COVID-­‐ 19 patients in an alternative care site when they cannot appropriately care for themselves at home, such as outpatient facilities or large structures in the community that are in close proximity to a hospital will provide additional capacity for sicker COVID-­‐19 patients that need more intensive care. This is a crucial step in ensuring we have as much inpatient capacity as possible to respond to the sickest COVID-­‐19 patients. Funding also may involve creating temporary structures.

It is clear that the expenses associated with responding to COVID-­‐19 will be extraordinary. It also is clear that in those communities that are experiencing community spread, these expenses are already being incurred, creating a significant cash flow problem. Based on the initial costs in the states with growing COVID-­‐19 community spread, Congress should allocate $100 billion to front line health care personnel and providers, including physicians, nurses, hospitals and health systems, and direct the federal agencies to begin to infuse funds immediately so that they can afford to take the necessary steps to fight the battle against this unseen enemy. It is our mission to care for our communities and without a significant financial commitment from Congress, our front line health care personnel and providers will struggle to respond. We ask that Congress provide resources to ensure America's health care system can respond with the best possible outcome.

Thank you for your ongoing leadership during this difficult time. Sincerely,

Richard J. Pollack James L. Madara Loressa Cole

President and CEO CEO and Executive Vice President Enterprise CEO



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