August 10, 2020
HHS Releases July - December COVID-19 State Testing Plans
Today, the U.S. Department of Health and Human Services (HHS) publicly posted the July through December COVID-19 Testing Plans from all states, territories, and localities on HHS.gov. The State Testing Plans serve as a roadmap developed in partnership with the Federal government for each jurisdiction's monthly 2020 testing strategy for SARS-CoV-2, the virus that causes COVID-19. The plans include details on responding to surges in cases and reaching vulnerable populations including minorities, immunocompromised individuals and older adults.
"Testing is not just about overall numbers – it is about making sure we're testing the right people at the right time, and incorporating testing into a comprehensive plan for addressing COVID-19," said Assistant Secretary for Health ADM Brett P. Giroir, M.D. "These state plans, along with ongoing and intensive technical assistance, provided by HHS inform what level of federal support each state requires to successfully execute SARS-CoV-2 testing priorities."
Each state plan is required to include details of critical parameters for state testing strategies, including target numbers of tests per month, as outlined in the Centers for Disease Control and Prevention's (CDC's) Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC) guidance document.
Since early March, the Trump Administration approached COVID-19 response as locally executed, state-managed, and federally supported. Teams designated by state governors have worked with subject matter experts from HHS and the Federal Emergency Management Agency (FEMA) to develop plans that set state-specific targets for SARS-CoV-2 testing. The plans build on the extensive technical assistance that has been provided, including additional detail and specificity.
To help meet the numeric testing targets for each state, the Federal government has been procuring and distributing certain testing supplies that are in short supply—namely, swabs and transport media—to each state and territory since May. This Administration will continue to work to meet all needs outlined in the state testing plans. The Federal government will also assist in matching laboratory reagents with the specific needs of each state and is advising commercial suppliers on their allocation—organizing and galvanizing the industry on an unprecedented scale. Finally, CDC staff in each state will provide technical assistance on all aspects of plan implementation, including flexible testing strategies and contact tracing.
In addition, the Federal government has taken numerous actions to expand state's testing ecosystem including: numerous one-on-one state-specific technical assistance briefings and webinars, direct support of testing specimen collection supplies and providing direct resources, providing a detailed list of testing platforms within a state, detailed testing guides and technical information, highlighting leading practices from states, and much more.
Additionally, in May, the CDC awarded a total of $10.25 billion to states, territories, and localities to help implement the goals of each jurisdiction's testing plan. States, territories, and localities are expected to continue using these funds to purchase tests and related supplies, as necessary.
Supportive Statements from States
Emily Travanty, PhD, Colorado Public Health Laboratory Director:
"We have been working in close collaboration with HHS to develop our monthly state plans and have drawn on guidance from the federal multidisciplinary subject matter experts on testing and containment. In addition, this federal state collaboration has helped the Colorado Public Health Laboratory to expand testing capacity and validate additional methods of sample collection and extraction."
Dr. Scott A. Rivkees, Florida Surgeon General:
"Since the beginning of the COVID-19 pandemic, Florida has prioritized testing and we have strived to ensure that those who need a test are able to get a test. We thank our federal partners for these critical resources, and we will continue to do all we can to battle and ultimately beat this invisible enemy."
Dr. John Hellerstedt, Texas Department of State Health Services Commissioner:
"Testing provides vitally important data needed to guide the response to COVID-19. I appreciate the Federal government's partnership in supporting testing. The partnership has provided the state with funding and supplies that have helped facilitate over 4 million tests in Texas. These testing results enable us to understand how and where the disease is affecting Texas communities and inform the steps needed to stop it."
Dr. John Wiesman, Washington State Secretary of Health:
"Testing plans and their implementation are a critical component of our efforts to contain COVID-19. Our state testing strategy sets measurable goals that allow us to work across sectors to understand the prevalence of disease, protect vulnerable communities and adjust our efforts to respond to this unprecedented pandemic."
Each state plan is required to include a robust testing program that ensures adequate SARS-CoV-2 testing, including tests for contact tracing and surveillance of asymptomatic persons to determine community spread. In generancluded representatives from the Office of the Governor and the state public health laboratory, as well as state health officials and epidemiologists.
Each jurisdiction must also ensure testing plan provisions are in place to meet current and future surge capacity testing needs, federal support for point-of-care testing in nursing homes and any other tactics in place designed to maximize the entire testing ecosystem. State testing capacity often includes state health lab through pooled testing, academic institutions including using non-CLIA certified labs for surveillance testing, utilizing 700+ retail pharmacy sites and 1,400+ community-based testing sites, and utilizing 13,000+ FQHCs. The Plans should also address any essential partnerships with academic, commercial, and hospital laboratories needed to meet testing demand successfully.
States were requested to detail how a minimum of 2% of the state's population will be tested each month as well as plans to increase that number by fall 2020. States must list laboratories that will perform tests, along with each laboratory's available platforms and capacity by month. The overall goals for each state were determined in a federal-state collaboration considering multiple factors, including the rate of new cases, plans for mitigation, percent positivity, and other factors.
A multidisciplinary team of experts from HHS has completed a technical review for each jurisdictions' plan to ensure that it is sufficient to mitigate the spread of the virus, protect vulnerable groups, and account for adequate testing supplies and reagents to reach jurisdiction testing goals.
The review panel, chaired by the HHS Assistant Secretary for Health, includes subject matter experts from the Laboratory and Diagnostics Task Force within the Office of Assistant Secretary for Health, the National Institutes of Health (NIH), CDC, and other agencies. The panel also reviews state testing progress, needs assessment, and plans on a monthly basis to determine if modifications are required or additional assistance is needed. Modifications may be necessary if patterns of virus transmission change or are projected to change, case rates increase or additional types of testing and inventory of tests and reagents become available through the Rapid Acceleration of Diagnostics (RADx) program at NIH or other sources.