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Govt. Affairs

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ANCOR is issuing a third call to action this week because we just updated our message to Congress about funding supports for people with intellectual / developmental disabilities (I/DD) during the COVID-19 outbreak. The new message reflects greater urgency, given Congressional negotiations that are occurring right now.

The Ask: Please use this updated email action tool to ask Congress to fund disability supports as it negotiates a third COVID-19 package.

The Details: Senate Republican and Democrats are working on competing packages for a third round of COVID-19 funding legislation. Because the negotiations surrounding combining these packages are creating new openings for the needs of people with I/DD to be heard, we are sending Congressional offices a revised message from the one we sent yesterday. This new message further emphasizes how urgently disability supports need funding to ensure the well-being of the people they support during the outbreak. It also expresses disappointment that these supports have not been included in funding packages to date. It is very important that you speak up during this critical time when legislation is being drafted!

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The following information was provided to RCPA by Jeffrey J. Worley, Esq. | Gibbel Kraybill & Hess LLP.  We appreciate his sharing of this important information.

FMLA and Paid Leave
Congress passed the Families First Coronavirus Response Act on March 18, 2020, and the President signed the legislation shortly thereafter. The provisions below become effective within 15 days. We will provide further guidance on the details of below as they are released in the coming days. The Act contains the following provisions that will affect a business’s employees directly:

The Family Medical Leave Act Expansion.
The following modifies the rules under the expansion of FMLA due to the COVID-19 emergency and does not change the other sections of the Act :

  • Employers* with “fewer than 500 employees” in 20 or more calendar weeks in 2020 or 2019 are now subject to the FMLA extension.
  • Eligible employees** are now those that were employed for 30 calendar days or more.
  • Qualifying need for leave now means an employee who is unable to work or telework due to the need to care for a child under the age of 18 years old if such child’s elementary or secondary school, or place of care is closed or a childcare provider is unavailable due to a COVID-19 emergency declared by a Federal, State, or local authority.
  • Leave: 1. The first 10 days of leave under the expansion may be unpaid leave; 2. If an employee has accrued vacation, personal, medical, or sick leave he or she may substitute it for unpaid leave; 3. After an employee has exhausted the first 10 days of leave, an employer must provide paid leave each additional day of leave taken; 4. These payments are set at two-thirds of the employee’s normal pay at the normal scheduling period, but cannot exceed $200/day or $10,000 aggregate.
  • Return: employers with fewer than 25 employees may not be required to put an employee on leave back in his or her position that no longer exists due to the health emergency. Several requirements apply.
  • Tax relief may be available for payment made pursuant to the expansion.

*Regulations may be passed to exempt small businesses with fewer than 50 employees if compliance would jeopardize the business as a going concern

**Regulations may be passed that exclude health care providers and emergency responders and those employers may elect to exclude employees from the definition without further regulations

Emergency Paid Sick Leave.
The following modifies establishes rules for paid sick leave due to the COVID-19 emergency:

  • Employers* who employ “fewer than 500 employees” are subject to the requirements.
  • Eligible employees** are all employees of an employer, regardless of the amount of time employed.
  • Qualifying need for leave means an employee that is unable to work or telework due to the following: 1. The employee is subject to a Federal, State, or local quarantine or isolation order related to COVID–19; 2. The employee has been advised by a health care provider to self-quarantine due to concerns related to COVID–19; 3. The employee is experiencing symptoms of COVID–19 and seeking a medical diagnosis; 4. The employee is caring for an individual who is subject to an order as described in (1) or has been advised as described in (2); 5. The employee is caring for a son or daughter of such employee if the school or place of care of the son or daughter has been closed, or the child care provider of such son or daughter is unavailable, due to COVID–19 precautions; 6. The employee is experiencing any other substantially similar condition specified by the Secretary of Health and Human Services in consultation with the Secretary of the Treasury and the Secretary of Labor.
  • Leave: 1. Full-Time employees shall receive 80 hours of paid leave; 2. Part-Time employees shall receive leave equal to the number of hours usually worked in a two-week period; 3. Compensation for (1)-(3) above shall be at the regular rate of pay, but not exceed $511 per day and $5,110 in the aggregate, and compensation for (4)-(6) above shall be at the rate of two-thirds of normal pay, but not exceed $200 per day and $2,000 in the aggregate.
  • Employers may not: 1. Require an employee to find a person to cover their hours; 2. Require an employee to use other paid leave; 3. Retaliate against an employee for seeking paid sick leave; 4. To the extent their current policies provide more benefits or leave, substitute their policies with this Act.
  • A posted notice is required under the Act, but the Secretary of Labor will release examples before compliance is required.

* Regulations may be passed to exempt small businesses with fewer than 50 employees if compliance would jeopardize the business as a going concern

** Except that an employer of an employee who is a health care provider or an emergency responder may elect to exclude such employee from the application of this subsection.

Each situation is different and you should contact our offices or your legal counsel for specific guidance.  Should you have any questions concerning the above, particularly when leave starts and stops, and calculating the amount of leave and pay required by the act, please do not hesitate to contact Jeff at [email protected] or 717.291.1700. More laws, regulations, and guidance will be issued to provide greater detail to employers in how they are to enact the requirements of the new Act.

As we go through this, I would encourage all of you to keep open lines of communications with your employees.  This is something that none of us have been through.  Your employees are concerned about their health, their finances, and their jobs.  Keep a listening ear-but also know that you do not have to provide instantaneous responses.  Things are changing hour by hour.  It is ok to not know how to respond.  But is important that you are listening and communicating.

For additional information as to how GKH is responding this situation, please see the link below-
https://gkh.com/news/2020/03/coronavirus-preparations/

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Late this afternoon, the Governor ordered all businesses to close at 8:00 pm tonight (Thursday, March 19), except for those considered life-sustaining. For those businesses that are not considered life-sustaining and do not close, the state will begin to take enforcement actions on Saturday, March 21, at 12:01 am.

RCPA members are considered life-sustaining businesses. For a complete chart of life-sustaining businesses, use this link.

Additional information regarding the Governor’s declaration can be found below:

Questions, please contact Jack Phillips.

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This afternoon (Thursday, March 19), drug and alcohol stakeholders received the below email from the Department of Drug and Alcohol Programs Secretary Jen Smith. If you did not receive her email, please see it below in its entirety. The Secretary also provided helpful resources that can be found below:

Email from Sec. Smith:

Good evening,

First, I want to take an opportunity to thank each of you for the work that you are doing during this unprecedented time. As the front line of defense for our community you are making decisions and implementing procedures based on evolving guidance as we navigate unchartered waters. The department recognizes this is no easy task and fully commit to communicating timely to you as information is available.

As you develop continuity plans to mitigate COVID-19, I thought it would be helpful to share strategies that sister state agencies are adopting, as well as procedures from other states. The policies and procedures below and attached were developed for the safety of patients and staff during this time.

  • The Department of Human Services recently released guidance to restrict visitors to all state centers and state hospitals in line with the Center of Disease Control. The press release can be found here which details visitation policies that you may find useful in adopting.
  • Additionally, numerous attachments to this email are documents developed by Delaware for both patient and staff screenings in the event either party presents with COVID-19 symptoms.

With the spread of COVID-19 changing operations for the foreseeable future, continued flexibility will be key to successfully navigate this situation. One of the things that I have learned during my time in the drug and alcohol field is that this community is resilient. Thank you for your patience and your commitment to the individuals you serve. Together, we will get through this.

Jen Smith
Secretary
Drug and Alcohol Programs

Questions, please contact Jack Phillips.

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From ANCOR:
Two minutes of your day is all we need to ensure the well-being of people with intellectual and developmental disabilities (I/DD) and that the supports they rely on aren’t overlooked during the COVID-19 outbreak.

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.

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Text of March 18 press release.

Harrisburg, PA — Health care professionals licensed under any of the Department of State’s Bureau of Professional and Occupational Affairs (BPOA) licensing boards can provide services to patients via telemedicine during the coronavirus emergency.

“Telemedicine provides health care professionals flexibility to continue treating their patients while following best practices on social distancing as outlined by the Department of Health,” Secretary Boockvar said. “The department requested, and Governor Wolf granted us, the authority to allow health care professionals from out-of-state to treat Pennsylvania residents using telemedicine, when appropriate, due to COVID-19.”

This new guidance applies to the following boards:

o Chiropractic
o Dentistry
o Medicine
o Nursing
o Optometry
o Pharmacy
o Podiatry
o Psychology
o Osteopathic Medicine
o Nursing Home Administrators
o Occupational Therapy Education and Licensure
o Physical Therapy
o Social Workers, Marriage and Family Therapists, and Professional Counselors
o Examiners in Speech-Language Pathology and Audiology
o Veterinary Medicine

Currently, no Pennsylvania law prohibits the practice of telemedicine.

Additionally, the department is working with the Governor’s office, the Department of Health, and Department of Human Services to identify regulations and requirements that can be suspended to give medical providers and facilities the flexibility they need to respond to the crisis. We will publish these notifications on our website as they become available.

Governor Wolf also granted the department’s request for a suspension to allow licensed practitioners in other states to provide services to Pennsylvanians via the use of telemedicine, without obtaining a Pennsylvania license, for the duration of the emergency. Out-of-state practitioners must:

o Be licensed and in good standing in their home state, territory, or country.

o Provide the Pennsylvania board from whom they would normally seek licensure with the following information prior to practicing telemedicine with Pennsylvanians:
• their full name, home or work mailing address, telephone number and email address; and
• their license type, license number or other identifying information that is unique to that practitioner’s license, and the state or other governmental body that issued the license.

Please submit the information requested above to the appropriate board resource account listed on the BPOA website.

All practitioners using telemedicine in Pennsylvania must remain informed on all federal and state laws, regulations and guidance regarding telemedicine, including a practitioner’s obligations under the Health Insurance Portability and Accountability Act (HIPAA) and recent guidance provided by the U.S. Department of Health and Human Services.

Authorization to engage in telemedicine from a professional licensing standpoint is separate and apart from any insurance coverage/payment issues that fall under the Department of Health, the Department of Human Services, the Department of Insurance, or any other state or federal agency.

The Department of Human Services issued guidance for Behavioral Health Services Telemedicine here. The Department of Drug and Alcohol Programs released Telehealth guidance for their programs and providers here.

Questions, please contact Jack Phillips.

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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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