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Authors Posts by Carol Ferenz

Carol Ferenz

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0 1166

In an effort to provide feedback to CMS, ANCOR sent this letter to CMS Administrator Verma and Director Lynch regarding the COVID-19 crisis and assistance for I/DD service providers.

The letter identifies additional FAQs needed around state flexibility, funding, technology, and more. ANCOR has been closely following what you and your states are doing. The intention of the letter to CMS is to fortify the statewide asks and to expedite the emergency response waivers that are starting to be submitted.

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ODP Announcement 20-024 provides information regarding the implementation of an online resource for providers (including SCOs) providing ODP services within the ID/A waivers and the Adult Autism Waiver (AAW), to capture important information related to COVID-19 planning.

This online COVID-19 Provider Information Tool is designed to gather service specific information related to the impact of this emergency on providers. Specifically, the purpose of the tool is to:

  • Collect information about potential risk to service(s) and service closures that will help guide future decision making.
  • Create a supplemental record for the purposes of retroactive approvals, documentation, and payments.

The tool was designed to take approximately 7–10 minutes to complete. Once complete, an email will also be sent to the provider for your record. Providers can make multiple submissions to the tool as emergency plans change and new situations arise.

ODP will be reviewing information collected in real-time and reporting daily to regional offices, while working with Administrative Entities to mitigate risks and support providers.

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From our national partner, ANCOR:

As we work to speak up on behalf of people with I/DD and the providers who support them – especially in times of unprecedented crisis – I am writing to seek your help. Can you please take two minutes today to respond to the action alert below. Doing so will send a message to your members of Congress urging them to prioritize resources for people with I/DD when considering how to distribute federal aid in response to the COVID-19 pandemic.

The Ask: Use our email tool to remind your members of Congress that I/DD supports and services are essential lifelines to people with I/DD and their families. They must be funded so that their delivery is not compromised during this public health crisis.

The Details: Congress is working at breakneck speed to address the unique needs of various populations in our country through three different funding packages, one of which is expected to be focused on health care. We need your voice right now to ask Congress to include I/DD supports, including Home and Community Based Services, in that package.

It is crucial for Congress to understand that disability supports are a key component of health services for people with I/DD, and to understand the implications for people’s lives in the community after the crisis if community supports cannot remain financially viable during this crisis.

The COVID-19 crisis is exposing key vulnerabilities in I/DD supports. As people are asked to stay home as community centers and day programs close to try to limit the spread of COVID-19. In turn, providers of those programs face uncertain futures. When the dust settles and we return to life after the pandemic, will there be any place for people with I/DD to go? We need Congress to ensure the answer is yes.

The I/DD workforce is already in crisis. These staffing shortages will be significantly exacerbated as DSPs fall sick or have to tend to loved ones. This is the time for Congress to work on strengthening disability supports through funding for key provisions such as overtime and hazard pay to incentivize DSPs to stay and other workers to join the field; priority access to protective gear and training; financial relief for supports such as day services so they remain viable after the outbreak; and more.

Most importantly, we need Congress to include I/DD services in any stimulus package to ensure there are supports to return to once the current pandemic subsides. With 700,000 people on states’ waiting lists for services, now is not the time to lose critical capacity.

Please speak up TODAY for the inclusion of disability supports in any package Congress prepares to address COVID-19 today, to help ensure people with disabilities have the support they need, when they need it the most.

Shannon McCracken
ANCOR Vice President of Government Relations

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The situation across the Commonwealth is evolving day to day, and no one is sure how long or how severe the impact will be. As you are primarily focused on the care of the people you serve and doing everything to meet their individual needs, AZTAC staff wanted to remind you that it is also important to monitor the associated costs that might increase during a pandemic. Fortunately, the ICF/ID program has a longstanding regulatory process by which you can request additional funding for such increased costs.

Now is the time to be sure you are tracking these costs. Following are some suggestions to think about in case you need to submit a request for a waiver (of the standard interim rate) for additional funding. Documentation is very important toward receiving approval of your request. Having all of your information well documented and compiled in one place will 1) enable you to determine if you need to submit a request; and 2) the information will enable you to clearly describe the issues, your efforts, and the costs in your narrative justification. If you submit a waiver request for additional funding, you will need to document your costs both before and after the impact of the Coronavirus. You will only be able to ask for the increase in costs, not necessarily the full costs, above and beyond what you are already funded for.

(reprinted with permission from AZTAC. The full article from AZTAC is available here.)

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Today Governor Wolf announced mitigation strategies to stop the spread of the Coronavirus (COVID-19), which include the statewide closures of day program facilities including Older Adult Day facilities licensed under 6 Pa. Code Chapter 11, Adult Training Facilities licensed under 55 Pa. Code Chapter 2380, and Prevocational Facilities licensed under 55 Pa. Code Chapter 2390. Closures are effective Tuesday, March 17, 2020 and are in effect until further notice. ODP Announcement 20-022 provides further guidance regarding these closures and policy adaptations effective March 17, 2020.

Webinar – COVID-19: Update for CPS Providers, a webinar outlining the impact of COVID-19 on CPS Providers – will be presented by Deputy Secretary Ahrens tomorrow (March 17, 2020) at 1:30 pm and will be posted on the ODP Coronavirus (COVID-19) website within 3 hours. Use this registration link.

Facility-based Community Participation Support (CPS) providers are being asked to communicate with individuals, families, Supports Coordinators, and other providers to help ensure coordination of care.

ODP advises CPS providers of the following:

  • During the response to COVID-19, CPS may be provided in private homes.
  • ODP requests that providers arrange for in-home or alternate provision of the day service by facility staff when a service recipient’s family or caregiver is employed in essential roles like health care, first responders, or human services, and are reliant on the Community Participation Support day program for coverage during work.

For CPS providers who have residential, companion, or in-home support service offerings, prepare to redeploy staff from facilities to fill other essential staffing needs. Direct Support Professionals qualified under CPS may provide services in any other ODP service offering during the response to COVID-19. All staff must receive training on any participants’ ISPs for whom they are providing support. Training on the ISP must consist of basic health and safety support needs for that individual, including but not limited to the “Fatal Four.”

  • ODP encourages providers that only offer CPS to contact other provider agencies in your local area and develop cooperative arrangements to supply staff to support participants in other service areas like residential, companion, or in-home support.
  • For non-facility based CPS providers, please prepare to redeploy CPS staff to support essential supports for health and safety within your own agency or through cooperative agreements with other provider agencies.
  • ODP is working with the Centers for Medicare and Medicaid Services (CMS) to allow “retainer payments” to be made to CPS providers. Additional guidance will be provided.
  • On-call and Remote Support services can be used to promote health and safety of CPS service recipients, when at home and not receiving another service. CPS providers should work with ISP Teams to coordinate details. Additional guidance will be provided.
  • Closures of facilities covered under this guidance do not need to be reported through the Enterprise Incident Management (EIM) system.

See the list of Chapter 2380 and 2390 providers affected by county.

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ODP has announced that all Older Adult, Adult Training, and Prevocational Facilities are included in Governor Wolf’s statewide closure announcement, effective immediately. This action is taken as a precaution to assist with slowing the spread of the virus. It is recommended that providers consider redeployment of the staff who work in these facilities to needed areas like residential, in-home support, companion services.

Additional guidance will be coming from ODP shortly, and Deputy Secretary Ahrens will be offering a webinar tomorrow (March 17, 2020) at 1:00 pm. Further information will be shared as soon as it is available.

Also today, Governor Wolf announced mitigation strategies to stop the spread of the Coronavirus (COVID-19) in the following counties:

Beginning Friday, March 13, in Montgomery County; Saturday, March 14, in Delaware County; and beginning on Sunday, March 15 in Bucks and Chester counties. The mitigation strategies will be effective for 14 days. The Governor’s mitigation plan for all counties includes: (1) a no visitor policy will be implemented for correctional facilities, nursing homes, and others to be evaluated, (2) schools and child care centers licensed by the Commonwealth will be closed, (3) adult day care centers will be closed, and (4) while travel is allowed, it is requested that people refrain from non-essential travel.

The purpose of this communication is to outline functions managed by the Office of Developmental Programs (ODP) that will be suspended, and the essential functions that will continue, during the implementation of the above listed counties’ mitigation plan. If this mitigation strategy is applied in other counties/regions in the state, ODP will take a similar approach.

ODP has determined that the following functions and activities are being suspended in the above listed counties:

  • Annual licensing site visits
  • Facility-based Community Participation Support (CPS) services
  • Independent Monitoring for Quality (IM4Q) interviews (suspended statewide as of 3/12/2020)
  • Supports Intensity Scale meetings
  • Quality Assurance and Improvement (QA&I)– remaining site visits

The following have been identified as essential functions by ODP. Additional operational guidance will be provided to staff involved in these operational areas.

  • Licensing – Complaints will be followed-up on and investigated as appropriate
  • Abuse and Neglect Investigations – critical investigations will continue using remote methods/telephone whenever possible
  • Supports Coordination Organizations – will continue all individual monitoring and individual planning using remote methods/telephone
  • Administrative Entity – AEs are assigning staff that will be working remotely to complete essential functions including: review and approval of ISPs, incident review, certified investigations related to abuse and neglect, and waiting list management functions

ODP continues to evaluate information on a daily basis along with the Governor’s office. Please continue to be on Alert for updated information.

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Harrisburg, PA – To help make the public aware of COVID-19 preparedness and procedures, the Wolf Administration has created a library of free outreach materials for businesses, organizations, and anyone interested in displaying important messaging on COVID-19.

The materials are available at PAcast.

“The goal is for everyone to have access to and be encouraged to share the information important to stopping the spread of COVID-19,” Gov. Wolf said. “Please help us share awareness while using caution and protecting yourself.”

Posters are available in multiple sizes and every Pennsylvanian is encouraged to make them accessible to their community of friends, community or religious group members, and business associates to print and post. The administration also expects the posters to be available in newspapers across the state for residents to tear out and post throughout their communities.

Properly sized graphics are available at PAcast for social media. Gov. Wolf also encourages everyone to make use of COVID-19 social media content on the Pennsylvania Department of Health’s Facebook and Twitter pages.

The most up-to-date information, including video graphics, footage of all of the governor’s press conferences and b-roll, is also available at 08PAcast. Additional materials will be added to the library as they become available and as the situation evolves.

MEDIA CONTACT: Lyndsay Kensinger, 717-783-1116

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Late last week, the House passed the Families First Coronavirus Response Act (HR 6201). The final bill was extensively negotiated between House Democrats and the White House. The bill is now with the Senate for passage early next week. This is the second funding package in the federal response to COVID-19.

The bill proposes:

Increased Federal Funding

  • Provides states with a 6.2% increase on their traditional FMAP for all medical services, if they agree to certain terms.
  • FMAP increase will last the length of the Public Health Emergency.
  • This will not apply to either an expansion or administrative FMAP.
  • No specific rate increase to ensure that relief for the Medicaid states is shared with disability workforce.
  • Provides the territories with a 6.2% increase on their traditional FMAP and a corresponding increase in their allotments for the next two fiscal years.
  • Provides $1 billion in grant funding to help states manage and expand their unemployment insurance programs.

Sick Leave

  • Employees of employers with fewer than 500 employees and government employers, who have been on the job for at least 30 days, with the right take up to 12 weeks of job-protected leave under FMLA to be used for any of the following reasons:
    • To adhere to a requirement or recommendation to quarantine due to exposure to or symptoms of coronavirus;
    • To care for an at-risk family member who is adhering to a requirement or recommendation to quarantine due to exposure to or symptoms of coronavirus; and
    • To care for a child of an employee if the child’s school or place of care has been closed, or the child-care provider is unavailable, due to a coronavirus.
  • After the two weeks of paid leave, employees will receive a benefit from their employers that will be no less than two-thirds of the employee’s usual pay.
  • Employers with 500 or less employees will get all wages associated with the sick leave and FMLA provisions 100% covered via tax credits.
  • Employers with more than 500 employees are excluded.
  • DOL will have the option of exempting workers at any company with fewer than 50 employees, if it determines that providing paid leave “would jeopardize the viability of the business as a going concern.”
  • The caregiving component of the paid sick leave provisions does not cover a family member or other individual stepping in as a caregiver if COVID-19 results in someone losing their usual source of care and does not apply to caring for adults with disabilities.
  • Unlike earlier drafts, it does not establish a permanent paid sick leave entitlement for all families.
  • $15 million for the Internal Revenue Service to implement tax credits for paid sick and paid family and medical leave.
  • Amendments to FMLA would expire in a year and exemptions are available for small businesses.
  • There is no additional funding for SSA to administer these programs.

Testing, Treatment, and Other Medical Provisions

  • Zero cost-sharing in Medicaid program related to testing and diagnosis of COVID-19, waiving all cost sharing for labs and diagnostics.
  • State option to provide coverage for the uninsured for these services through the Medicaid program. Provides states with 100% FMAP for all the services related to the cost sharing for those states taking up this state option.
  • Leaves Medicaid cost-sharing in place for medical services related to treatment of COVID-19.
  • No provisions ensure people with disabilities have access to a 90-day medication and medical supply fills.

Telehealth

  • Waives current prohibitions surrounding the furnishing of telehealth services in the Medicare program, during the current public health emergency, furnishing a service allowable under the Medicare program, even if the program did not pay for such service, is a qualifying relationship.
  • Silent on Medicaid telehealth.

Nutrition Assistance

  • $250 million for the Senior Nutrition program in ACL.
  • $400 million to assist local food banks to meet increased demand for low-income Americans during the emergency. Of the total, $300 million is for the purchase of nutritious foods and $100 million is to support the storage and distribution of the foods.
  • Suspends the work and work training requirements for SNAP during this crisis.

We will continue to share information with our members as we become aware.

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