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Physical Disabilities & Aging

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Accommodating Employees with COVID-19-Related Symptoms
The Job Accommodation Network posted a blog on “Accommodating Employees with COVID-19-Related Symptoms.” The blog discusses accommodating employees who have COVID-19 or who have recovered from COVID-19 but have long-term effects. Accommodation suggestions for limitations such as shortness of breath, fatigue, joint pain, and more are included.

State Strategies for Keeping Workers Safe During COVID-19
The National Conference of State Legislatures (NCSL) published a report, “Making Work Safe and Accessible During a Pandemic,” which examines the rules and guidance issued by federal, state, and local agencies to help keep workers, including those with disabilities, safe on the job. The report provides state examples and best practices on paid sick leave, personal protective equipment, and other workplace safety measures that accommodate all workers’ needs and mitigate the spread of COVID-19. The report is the third in a series developed in collaboration with the State Exchange on Employment & Disability on the opportunities and challenges stemming from the pandemic and its impact on the employment of people with disabilities.

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What’s in the American Rescue Plan? 

Executive Summary

On March 10, 2021, the U.S. House of Representatives passed the American Rescue Plan of 2021 (ARP) on a 220-211 vote. President Biden signed the bill into law the following day, March 11. Originally compiled in nine House Committees over the past month, the Senate amended and passed the ARP the week before on a 50-49 vote before the bill was sent to the House for the final vote. The ARP is a $1.9 trillion economic stimulus package that was passed through the budget reconciliation process as a response to the economic and health effects of the COVID-19 pandemic.

The ARP contains strong provisions intended to assist working individuals and families, COVID-19 pandemic support and vaccination response funding. Additionally, the bill contains measures directed to supporting working families in the US, including $1,400 direct stimulus payments to qualifying individuals, continued unemployment insurance benefits and an overhaul to the Affordable Care Act.

The House-proposed minimum wage increase to $15 per hour was ultimately excluded from the Senate version of the bill due to Byrd Rule limitations on the budgetary reconciliation process. This allowed Senators to object to the specific provision of the reconciliation bill that would have increased the minimum wage, while the Senate Parliamentarian ruled the provision did not meet the change in spending requirement necessary to be contained in a reconciliation bill. Below are highlights of the bill that may impact ANCOR members.

ANCOR Priorities & Public Health Provisions

Home and Community Based Services

HCBS is currently funded as a set of optional services offered through HCBS waivers or state Medicaid plans. The original ARP language increased the HCBS Federal Medical Assistance Percentage (FMAP) by 7.35% for one year beginning on April 1, 2021. The final ARP HCBS provision increased the FMAP bump from 7.35% to 10%. The ARP also includes funding for the establishment of nursing home strike teams to manage COVID-19 outbreaks.

Paycheck Protection Program (PPP)

The ARP has increased business and organization eligibility for the program, notably now including most 501(c)(3) nonprofits that employ fewer less than 500 employees per physical location, rather than overall. An additional $7.25 billion has been authorized for the PPP.

Provider Relief Fund

An additional $8.5 billion is allocated for rural providers that serve Medicaid and Medicare beneficiaries. The funding must be used by providers for COVID-19-related expenses, such as increased workforce training, medical supply purchasing or lost revenue due to the public health crisis.

Public Health Funding

The ARP designates $7.5 billion to the CDC for the planning, distribution and tracking of COVID-19 vaccines. A further $7.6 billion is directed to provide state, local and territorial public health departments with funding for staff, equipment and other supplies to combat the public health crisis.

Medicaid/CHIP Vaccine

State Medicaid programs and the Children’s Health Insurance Program are required to provide COVID-19 testing, vaccines and treatment without cost sharing for one year after the end of the public health emergency.

Funding for State, Local & Tribal Governments

The ARP provides $350 billion in funding relief to states, localities and tribes. States, including the District of Columbia, will receive $195.3 billion; local governments will receive $130.2 billion; and tribal governments will receive $20 billion. The funding is available until December 31, 2024.

Public Health Workforce

The ARP robustly provides $9.1 billion to support the public health workforce. Of this, $7.7 billion is established for expanding and continuing the recruitment, hiring and training of public health workers to sustain state and local public health departments.

FMAP Increase for ACA Expansion

For states that have not expanded Medicaid eligibility and coverage to meet current Affordable Care Act (ACA) criteria, the ARP incentivizes the adoption of ACA standards by offering such states an additional five percentage-point increase in the state’s FMAP for two years.

Other Important Provisions

Earned Income Tax Credit

For Tax Year 2021, the credit amount and income limit at which the credit is adjusted will both be increased. Additionally, workers over the age of 65 will be eligible to claim the credit.

Child and Dependent Care Tax Credit

The ARP is making significant changes targeted toward reducing child poverty. This reinforcement of the social safety net includes a one-year-though expected to become permanent-initiative of raising the $2,000 Child Tax Credit to $3,000 for children under the age of 18 and to $3,600 for children under the age of 6 (previously, 17-year-old children were ineligible). Periodic payments are also authorized, as opposed to the traditional lump sum measure.

Support for Low Income-Families

The ARP allocates $4.5 billion to LIHEAP, the Low-Income Home Energy Assistance Program, which helps families offset home heating and cooling costs. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) will also provide $35 in additional monthly payments per person to women and children as part of a temporary, four-month increase.

Child Care and Development Block Grant (CCDBG)

The ARP has authorized $15 billion for the CCDBG program, which could specifically be used for health care workers regardless of income. An additional $24 billion is allocated for a childcare stabilization fund intended to be used for childcare personnel expenses, cleaning supplies and personal protective equipment, and mental health supports.

Funding for the Individuals with Disabilities Education Act

Grant funding has been increased for qualifying public education programs, including $2.58 billion for states, $200 million for preschool grants and $250 million for infant and toddler programs.

Medicaid Coverage for Pregnant and Postpartum Women

States are now allowed to offer full coverage and benefits to women during their pregnancy and up to a year after the last day of pregnancy. This would drastically extend coverage past the current cutoff of 60 days postpartum. If a state opts into this provision, it must be run under the CHIP program.

COBRA Premium Assistance

The Consolidated Omnibus Budget Reconciliation Act (COBRA) has traditionally provided health insurance to individuals who lose coverage following employment termination. The ARP has made COBRA coverage more affordable for affected individuals by covering 100% of premiums until September 30, 2021.

Pandemic Unemployment Assistance (PUA)

PUA and other enhanced unemployment benefits have been extended through August 2021 as a COVID-19-related measure. The weekly Federal Pandemic Unemployment Compensation has been extended to September 6, 2021 and will continue to be $300 a week per worker.

Conclusion

The American Rescue Plan contains overwhelming support for communities that have been most affected by the COVID-19 pandemic. Notably, the HCBS FMAP increase in this bill was secured as a result of the ongoing advocacy from ANCOR members to increase quality of services to the I/DD community through this process. Reinforcing essential needs like affordable living, childcare and community health will revitalize the vulnerable populations that have struggled to meet their own needs in the last year and beyond. From low-income laborers to working families to individuals with disabilities, the ARP is establishing a strong foundation for the health recovery and economic rebuilding of Americans impacted by the public health crisis.

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Shannon McCracken
Vice President of Government Relations
ANCOR
606.271.3555
smccraken@ancor.org

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The Centers for Medicare and Medicaid Services has issued a revised nursing home guidance that provides updated guidance for visitation in nursing homes during the COVID-19 public health emergency, including the impact of the COVID-19 vaccination. As a result of this guidance, the Department of Human Service issued a notification to long-term care facilities, personal care homes, and assisted living residences in Pennsylvania to implement this guidance immediately.

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Photo by Markus Winkler on Unsplash

From ANCOR: 

For your awareness, see below for an announcement by the Department of Labor:

“The U.S. Department of Labor today announced plans to rescind two final rules that would significantly weaken protections afforded to American workers under the Fair Labor Standards Act. The first Notice of Proposed Rulemaking proposes the withdrawal of the Independent Contractor Final Rule issued by the department on issued on Jan. 7, 2021, for several reasons. They include the following:

  • The rule adopted a new “economic reality” test to determine whether a worker is an employee or an independent contractor under the FLSA.
  • Courts and the department have not used the new economic reality test, and FLSA text or longstanding case law does not support the test.
  • The rule would narrow or minimize other factors considered by courts traditionally; making the economic test less likely to establish that a worker is an employee under the FLSA.

Among its provisions, the FLSA requires covered employers to pay employees at least the federal minimum wage for every hour worked and overtime premium pay of at least one and one-half times their regular rate of pay for every hour worked over 40 in a workweek. An independent contractor has no FLSA protections.

The second Notice of Proposed Rulemaking seeks to rescind a current regulation on joint employer relationships under the Fair Labor Standards Act, published in the Federal Register and which took effect on March 16, 2020. In February 2020, 17 states and the District of Columbia filed a lawsuit in the U.S. District Court for the Southern District of New York against the department, arguing that the Joint Employer Rule violated the Administrative Procedure Act. The court vacated the majority of the Joint Employer Rule on Sept. 8, 2020, stating that the rule was contrary to the FLSA and was “arbitrary and capricious” due to its failure to explain why the department had deviated from all prior guidance or consider the effect of the rule on workers.

The department invites comments from the public on both proposed rules at www.regulations.gov. The comment periods end on April 12, 2021.

Anyone who submits a comment (including duplicate comments) should understand and expect that the comment, including any personal information provided, will become a matter of public record. The division will post comments without change at www.regulations.gov and include any personal information provided. The division posts comments gathered and submitted by a third-party organization as a group, using a single document ID number at the site.

More information about the proposed rules is available at www.dol.gov/agencies/whd/flsa/… and at www.dol.gov/agencies/whd/flsa/2020-joint-employment.”

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Doris Parfaite-Claude
Federal Advocacy and Research Manager
American Network of Community Options and Resources
Alexandria, VA
(703) 535-7850, x108
dparfaite-claude@ancor.org

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Background: The Centers for Medicare & Medicaid Services (CMS) approved temporary changes to the OBRA and CHC 1915(c) waivers beginning March 6, 2020 in response to the COVID-19 pandemic.  Approval of these changes is covered under Appendix K, Emergency Preparedness and Response, which states may use during emergency situations to request amendments to their approved waivers.  These changes addressed potential staffing shortages and the need for service provision not included in approved service descriptions to ensure participant health and safety needs could be accommodated for the duration of the COVID-19 statewide emergency. The Office of Long-Term Living (OLTL) extended the same flexibilities to the Act 150 Program. CMS approved an amendment to Appendix K which allowed some flexibilities to continue until March 5, 2021.

In January 2021, OLTL submitted another amendment to request extension of the Appendix K flexibilities until six months after the end of the Public Health Emergency (PHE). CMS has not yet approved the amendment; however, they recently instructed OLTL to assume that any previously approved flexibilities will continue to be approved in the interim.

Until further notice, the Appendix K flexibilities can continue in the CHC waiver, the OBRA waiver, and the Act 150 program.  For additional details on the flexibilities, please go to the OLTL COVID19 Provider Resources web page to view the guidance updated for the CHC waiver on January 4, 2021 and updated for the OBRA waiver and Act 150 Program on January 15, 2021.

Additional questions should be directed to the OLTL Provider Helpline at 1-800-932-0939.

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Dates: April 7, 14, 21, and 28, 2021

Time: 7:00 – 8:00 pm ET

Temple University’s Institute on Disabilities is hosting a four-part virtual webinar/conversation, Healthy Sexuality: Talking to your child, youth or adult about healthy sexuality. All are welcome to attend, but this conversation series is designed for parents, support coordinators, adults with disabilities, educators, and other professionals.

Conversation Leaders

  • Beverly L. Frantz, PhD, and Parris A. Boyd, LSW, Institute on Disabilities at Temple University
  • Loretta A. Sachs, Behavioral Health Specialist, Milestone Centers Inc., Health Care Quality Unit West

Webinar Schedule

  • Session 1, Wednesday, April 7 – How to start a conversation about healthy sexuality, how to answer questions, and what topics to start with.
  • Session 2, Wednesday, April 14 – The Good-Hearted Living model will be explored. How to incorporate positive thinking and joy into our lives.
  • Session 3, Wednesday, April 21 – This session will explore the intersection between the Good-Hearted Living model and healthy sexuality.
  • Session 4, Wednesday, April 28 – How to achieve good boundaries and positive consent, especially virtually?

There are no fees for these events, but registration is required for each session. For more information, email parris.boyd@temple.edu.

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CDC Guidelines were updated March 8, 2021:

How to Protect Yourself and Others

COVID-19 vaccines are effective at protecting you from getting sick. Based on what we know about COVID-19 vaccines, people who have been fully vaccinated can start to do some things that they had stopped doing because of the pandemic.

We’re still learning how vaccines will affect the spread of COVID-19. After you’ve been fully vaccinated against COVID-19, you should keep taking precautions in public places like wearing a mask, staying six feet apart from others, and avoiding crowds and poorly ventilated spaces until we know more.

To read all of the guidance visit the CDC: When You’ve Been Fully Vaccinated web page.

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DHS has released a set of responses to questions presented by stakeholders during DHS Secretary Teresa Miller’s 2021–2022 budget review.

The responses have been formatted by agency and has a link to the DHS Blue Budget book that will provide line item budgetary information. RCPA will be reviewing these responses, and if you have questions, please contact your RCPA Policy Director.

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