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Authors Posts by Carol Ferenz

Carol Ferenz

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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.

ANCOR has been actively engaged in collecting and disseminating COVID-19 updates, news, resources, and best practices. Tools included range from our State Tracker, CDC updates, FAQs, and the recording from our first National COVID-19 Briefing.

Monday, March 16, at 3:00 pm EDT, ANCOR is hosting a National COVID-19 Preparedness & Response Briefing for Community Providers, with the latest news and guidance for I/DD providers, as well as ideas from providers and state association leaders about steps they’re taking to maximize their response efforts in their states.

Speakers during the second National COVID-19 Preparedness & Response Briefing will include:

  • Clint Chapman, Professional Medical Fulfillment
  • Lois Gibson, Oregon Resource Association
  • Loralei LaVoie, OMRS & Community Provider Association of Oregon
  • Scott Livengood, Alpha Supported Living Services & Community Residential Services Association (Washington)
  • Donna Martin, ANCOR
  • Shannon McCracken, ANCOR
  • Brian Riddle, Professional Medical Fulfillment
  • Amy Staed, KAPP (Kentucky)

This briefing is free and open to all ANCOR members, and advanced registration is required. Register today.

The Wage and Hour Division (WHD) provides information on common issues employers and employees face when responding to influenza, pandemics, or other public health emergencies, and their effects on wages and hours worked under the Fair Labor Standards Act, and job-protected leave under the Family and Medical Leave Act.

Use this link to view the recently posted guidance on WHD’s website.

Also, the Department issued a press release with links to this guidance, as well as guidance from OSHA and OWCP.

The Department of Human Services (DHS) has developed an EVV Compliance Audit Survey in order to enable provider agencies to confirm which Electronic Visit Verification (EVV) system(s) they will be using to capture and submit EVV data for Personal Care Services (PCS) to the DHS EVV Aggregator*. This information will help DHS to ensure each provider agency’s business operations are properly supported.

To supply this information, the provider agency’s EVV point of contact must complete the brief compliance audit survey for each 9-digit Master Provider Index (MPI) number used by your organization for PCS by March 20, 2020, to identify how your organization will submit EVV data to the DHS EVV Aggregator. Failure to complete the survey for each of your organization’s PCS MPI(s) may result in your provider agency not being sufficiently supported to submit EVV data to the DHS EVV Aggregator for all EVV system(s) your organization intends to use. The link to the survey is found here.

All provider agencies subject to the EVV requirements for PCS must complete this compliance audit survey.

Submission of EVV data continues to be required to comply with the 21st Century Cures Act as mandated by the Centers for Medicare and Medicaid Services (CMS).

  • Providers are expected to already be capturing and verifying EVV visit data.
  • Providers opting to use an Alternate EVV system must complete any integration and certification activities by March 31, 2020 unless an Extension Request has been submitted and confirmed as received by the EVV resource account.
  • Claims submitted after July 1, 2020 for Personal Care Services without a matching EVV visit will be denied.

*The DHS EVV Aggregator stores all EVV visit data, regardless of the EVV source (including those using the DHS Sandata EVV system).

In response to growing concerns about the spread of COVID-19 and its potential impact on the delivery of services to individuals with an intellectual disability or autism, the Department of Human Services (DHS), Office of Developmental Programs (ODP) has developed the following operational guidance and recommendations for providers of intellectual disability and autism services.

Information will continue to be shared and disseminated going forward to address questions and concerns that have been brought to our attention. We continue to monitor information from the Pennsylvania Department of Health and the U.S. Centers for Disease Control and Prevention. Guidance developed by DHS will be centrally located on this page, which will be updated as additional guidance becomes available. We encourage you to continue to consult these resources for updates on COVID-19, information on staying healthy, and updates on the situation in Pennsylvania.

Additionally, ODP is collaborating with the Centers for Medicare and Medicaid Services (CMS) to make emergency amendments to its Home and Community-Based Waivers in response to a COVID-19 outbreak. The amendments under consideration provide for flexibility that may be necessary to continue ensuring the health and safety of ODP waiver participants. The types of modifications and flexibility ODP is seeking include but are not limited to the following areas: suspension of the Community Participation Supports requirements for time in community settings; staffing requirements; service location size limitations; remote/telephone for supports coordination; and where certain services can be provided. Additional information about the amendments will be provided in subsequent releases of this document.

Supports Coordination Organizations (SCOs)
ODP is providing the following guidance to SCOs regarding Supports Coordination Monitoring and Individual Support Plan (ISP) Team Meetings (i.e. annual reviews, critical revisions, six-month reviews, and ad hoc planning meetings).

Effective immediately and until further notice, ODP is permitting SCOs to choose to conduct Supports Coordination Monitoring and ISP Meetings remotely; using phone or video conferencing solutions. When either of these responsibilities are completed in place of a required face to face meeting, the Supports Coordinator should document the occurrence in a corresponding service note.

Community Participation Support/Day Habilitation Providers – Time in Community
ODP is providing the following guidance for all Community Participation Supports providers regarding requirements for time in the community during the Coronavirus (COVID-19) outbreak.

Until further notice, the requirement that providers support each individual at least 25% of time in community settings is suspended. Providers do not need to meet the twenty-five percent (25%) of time in the community requirement during the emergency and should evaluate potential risk and exposure by individual and community activity (i.e. walks in the park or neighborhood likely to be low risk for exposure). For ID/A waivers, ISP Teams do not need to complete variances when individuals will not spend 25% of their time in the community on average per month during this time.

Providers should ensure staff adherence to already implemented industrial hygiene procedures and implement additional infection control measures as recommended by PA Department of Health and the Centers for Disease Control for all workstations, sensory areas (including materials and devices), durable medical equipment, etc.

Where this change will require revisions to service authorizations for individuals to account for additional time in facility settings, providers should contact the applicable SCOs.

Residential and Community Participation Support Providers – Limiting Visitors
ODP is providing the following guidance for residential providers (i.e. Residential Habilitation and Life Sharing) regarding actions that can be taken to limit visitors during the COVID-19 outbreak. Until further notice, residential providers should refer to the Long Term Care Facility (LTCF) Visitation Guidance found at this MyODP location.

How should Community Participation Support/Day Habilitation facilities monitor or limit visitors?
Facilities should screen visitors for the following:

  1. International travel within the last 14 days to restricted countries. For updated information on restricted countries, visit this web page.
  2. Signs or symptoms of a respiratory infection, such as a fever, cough, and sore throat.
  3. Has had contact with someone with or under investigation for COVID-19.

If visitors meet any of the above criteria, facilities may restrict their entry to the facility.

How should Community Participation Support/Day Habilitation facilities monitor or restrict facility staff?
The same screening performed for visitors should be performed for facility staff (numbers 1, 2, and 3 above).

  • Staff who have signs and symptoms of a respiratory infection should not report to work.
  • Any staff that develop signs and symptoms of a respiratory infection while on the job should:
  1. Immediately stop work, put on a facemask and self-isolate at home;
  2. Inform the appropriate supervisor, and include information on individuals, equipment, and locations the person came in contact with; and
  3. Contact and follow the local health department recommendations for next steps (e.g., testing, locations for treatment).

Recommendations for Providers:

  • Recommendation #1: Exercise and promote hygienic practices.
  • Recommendation #2: Review your agency back-up plan and infection control procedures.
  • Recommendation #3: Report all suspected or confirmed cases of COVID-19 to ODP
  • Recommendation #4: Contact ODP before making any changes to your business practice whenever possible.
  • Recommendation #5: Document what actions were taken and maintain evidence for why actions were taken.
  • Recommendation #6: Stay Informed

Please read ODP’s announcement for further information; this Alert provides the highlights.


NOTE: ODP is offering a webinar tomorrow – Friday, March 13 – entitled ODP Update: Coronavirus (COVID-19), 2:30 pm and 3:00 pm.
Please join Deputy Secretary Kristin Ahrens and Medical Director Dr. Gregory Cherpes as they present information related to the Coronavirus (COVID-19). The 30-minute webinar will provide all stakeholders with important information on strategies related to prevention and mitigation.

Please be considerate of space and attend either the 2:30 pm or 3:00 pm session.
The webinar will be posted on the Coronavirus (COVID-19) Updates page on MyODP within 3 hours. You may register for the webinar using this link.

GoToMeeting is offering emergency licenses to help people to work from home:

Free Emergency Remote Work Kits for Health Care Providers, Educational Institutions, Municipalities, & Nonprofit Organizations
Starting immediately, we will be offering our critical front-line service providers with free, organization-wide use of many LogMeIn products for 3 months through the availability of  Emergency Remote Work Kits.

These kits will include solutions for meetings and video conferencing, webinars and virtual events, IT support and management of remote employee devices and apps, as well as remote access to devices in multiple locations. For example, the “Meet” Emergency Remote Work Kit will provide eligible organizations with a free site-wide license of GoToMeeting for 3 months. Eligible organizations include health care providers, educational institutions, municipalities, and nonprofit organizations.

Additionally, we have learned that Clocktree.com is a HIPAA compliant telehealth platform that is also offering a free 90-day trial membership.

Many of our members have been in contact with RCPA staff, with questions regarding concerns about COVID-19 and operating programs serving individuals with IDD and autism in the community. The concern for the health and safety of individuals and staff is of utmost importance and may require providers to make adaptations in their program’s normal operating procedures. We have been in touch with leadership at the Office of Developmental Programs (ODP) and have posed these questions to them for consideration.

Deputy Secretary Ahrens has advised us that they have been in communication with CMS this week to discuss PA’s emergency response and are expected to share additional guidance by the end of this week. Until then, providers should follow guidance from the Department of Health (DOH), as they are the lead in communication for PA on this issue.

ODP Medical Director Dr. Greg Cherpes has agreed to spend some time with our members next Wednesday, March 18, during our IDD Committee meeting. If you have any specific questions you would like for him to address, please submit those to Carol Ferenz by close of business on Monday, March 16.

As soon as RCPA receives any additional guidance from ODP, we will send an Alert to ensure that you have the most up-to-date information.

Community HealthChoices (CHC) is Pennsylvania’s new waiver program for people with physical disabilities or a brain injury, and older Pennsylvanians.

Join Pennsylvania Assistive Technology Foundation and Pennsylvania Health Law Project for a webinar on CHC Thursday, March 26, 2020 from 1:00 pm – 3:00 pm.

You will learn:

  • WHAT CHC is and WHO may enroll.
  • HOW individuals with disabilities and seniors can join CHC.
  • WHAT services are available in the CHC Medicaid Waiver.
  • HOW to get the services you need through CHC and HOW to challenge service denials.

This webinar is for anyone who works with people with physical disabilities, brain injuries, and older Pennsylvanians who are dual eligible. Register here to participate.

Hosted by: Pennsylvania Assistive Technology Foundation (PATF) and Pennsylvania Health Law Project (PHLP), and funded by a generous grant from the HealthSpark Foundation.

This live, recorded webinar will include captioning and time for Q&A. If you have any questions, please contact Josephine Tramontano at 888-744-1938 or via email.

The Office of Developmental Programs (ODP) Deputy Secretary Kristin Ahrens’ presentation of the FY 2020–21 ODP Budget Briefing is now available on MyODP. This presentation involves a briefing on the Governor’s Proposed State Fiscal Year 2020–21, as it pertains to the budget for ODP. Presenters were Deputy Secretary Ahrens and Rick Smith, Director of the Bureau of Financial Management and Program Support. You may access this webinar at this link.