The Lead September 2 2021 - LeadingAge Illinois

From the Desk of Angela Schnepf, President and CEO:

Home and Community Based Services (HCBS):
Hospice Public Reporting of HIS Data to Resume February 2022 based upon July 1 – September 30, 2021 HIS Records
How do State Vaccine Mandates Apply to Home Care?

Independent Affordable/Subsidized Housing:
Supreme Court Ends Eviction Moratorium; LeadingAge One-Pager on Eviction Prevention

Nursing and Rehabilitation:
FAQs on the Pending Nursing Home Vaccine Mandate
Nursing Home Workforce Support and Expansion Act
Nursing Home Advisory Group Call Summary
The Staffing Crisis in Long-Term Care

Other:
Vaccination Update
LeadingAge Co-Signs Letter to the State Department Requesting Employment-Based Immigrant Visas Be Prioritized

From the Desk of Angela Schnepf, President and CEO:
The Illinois Department of Healthcare and Family Services (HFS) has issued a revised provider notice on the $75 million in America Rescue Plan Act (ARPA) funding approved by the Illinois General Assembly for skilled nursing facilities. The funds will be distributed to facilities actively serving the Medicaid program.

HFS will be sending out specific instructions for accessing the sub-award agreements and budget templates to individual providers soon. The emails will be sent to provider contacts from the CARES Act funding.

Providers who did not establish CARES Act funding accounts should contact the HFS Program Support Line at 866.385.0600 (toll free) between 7 a.m. – 5 p.m. CST, Monday through Friday to receive assistance in establishing an account for ARPA funding.

Kindest Regards,

Angela

Top Stories:

U.S. Senators Implore HHS to Release the Remaining Provider Relief Funds
A total of 43 U.S. Senators, including the chair of Senate Finance Committee and chair of SFC Health Subcommittee, sent a bipartisan letter to HHS Secretary Becerra on August 26 saying, “As the health care provider community continues to respond to the challenges posed by the pandemic, this funding should be released without any further delay.” They said they wanted an immediate update on how the remaining funds would be distributed. LeadingAge helped encourage U.S. Senators to sign on to this letter led by U.S. Senators Susan Collins and Jeanne Shaheen. Regrettably, this is at least the 3^rd or 4^th letter from members of Congress directed at HHS regarding the need for the remaining PRF to get into the hands of providers who are still battling the COVID-19 virus and suffering financial losses and additional expenses because of those efforts. Let’s hope this finally gets them to act.

On a related note, it has been reported that HHS has hired outside firms to audit the PRF reports that will be coming in (first PRF report is due September 30) explaining how providers used the PRF funds. This process appears similar to how HHS approached the Phase 3 applications where some of them went through a more detailed financial review. This action was likely also taken to respond to pressure from Congress and other governmental oversight agencies for HHS to account for how these dollars were used following much criticism about how the first few rounds of funds were distributed early in the pandemic.

DHS Downstate Medical Field Operations Assignments
HFS released a provider notice regarding a change impacting some downstate Medicaid providers. DHS caseworkers in the counties identified in the notice will be switching to facility-based assignments as opposed to task-based.

IDPH Clarification on Staff Vaccine Requirement
Illinois Department of Public Health (IDPH) clarified statements made during Friday’s IDPH webinar on the Governor’s Executive Order mandating staff vaccinations.

In their clarification, IDPH stated that with the Delta variant causing a rapid increase in infection rates across the state and nation and downstate hospitals in Illinois approaching capacity for hospital and ICU beds, staff in high risk settings will now be required to receive the vaccine or be subject to routine testing.

The Executive Order requires healthcare workers to be fully vaccinated by September 5. Those who are unable or unwilling to be vaccinated will be required to get tested for COVID-19 at least once per week until they can prove that they are fully vaccinated. IDPH may require increased testing in certain situations. Additional guidance from IDPH is forthcoming.

Per Section 2A of the Executive Order, the mandate applies to all healthcare settings and includes, but is not limited to:

Adult Day
Assisted Living
Hospices
Rehabilitation Facilities
Skilled Nursing Facilities
Supportive Living

Ask Your Congressional Office to Level the Playing Field and Mandate Vaccines for all Health Care Providers
LeadingAge has posted their action alert for members to send to Congress asking for support for LeadingAge’s position that all health care providers should be included in the Administration’s expected vaccine mandate for nursing home staff. Please circulate this alert to your members as well. LeadingAge has a letter drafted for members to give out if they get a response and talking points for meetings that LeadingAge will share as needed. This is obviously a long-shot, but it is important to raise with Congress as the crisis continues. Marsha is covering this issue and will be happy to work with you to get (virtual) meetings, respond to office questions, etc.

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White House Updates COVID-19 Data
LeadingAge participated in a call with the White House Office of Public Engagement, led by the director, former Representative Cedric Richmond and Dr. Cyrus Shahpar, Data Director, providing an update on COVID-19 and vaccines, and discussing sources of data available on the CDC COVID-19 Data Tracker. Representative Cedric Richmond said, “COVID is within our control”, focusing his presentation on vaccination rates, the importance of education, and his experience talking to vaccine-hesitant people in his home state, Louisiana. He emphasized the following – the difference in hospitalization and death between vaccinated and unvaccinated; that the research behind the vaccines is actually a decade long, not something new; and that the final FDA approval should alleviate doubts about safety. And, of course, that everyone should be responsible. He noted that they expect the regulation on boosters to drop on September 20, approving the booster 8 months after the second shot (except for immunocompromised persons). Dr. Shahpar focused on the valuable state, county and local data available on the CDC COVID data tracker website, although with the caveat that some states don’t report county-level data. Other datasets highlighted included a site on health equity (using the Social Vulnerability Index); vaccine confidence; a weekly state profile report site.

Town Hall Summary: Member Concerns About Vaccine Mandates
On Thursday, August 26, 2021, LeadingAge hosted an all-member Town Hall to discuss the recent CMS vaccine mandate announcement, as well as LeadingAge’s policy position and advocacy on the issue. A summary article of the event is available here.

Home and Community Based Services (HCBS):

Hospice Public Reporting of HIS Data to Resume February 2022 based upon July 1 – September 30, 2021 HIS Records
CMS has shared information on key reporting deadlines and dates when Care Compare will be refreshed including helpful charts. Hospice providers will want to review these dates so they don’t miss the opportunity to correct data before it is reported.

How do State Vaccine Mandates Apply to Home Care?
LeadingAge briefly reviewed the states that do and do not explicitly – or even implicitly – require Home Care organizations to mandate the vaccine for employees. This article is part of LeadingAge’e ongoing tracking project of all states that are mandating or banning vaccine mandates for healthcare workers.

Independent Affordable/Subsidized Housing:

Supreme Court Ends Eviction Moratorium; LeadingAge One-Pager on Eviction Prevention
The Supreme Court ended the CDC’s current eviction moratorium more than 5 weeks ahead of it expiration date on October 3, calling it an “unlawful” act by the agency. The ruling puts hundreds of thousands of renters at risk for eviction; LeadingAge members can take action now to prevent evictions among older adults. More information about the Supreme Court ruling and the impacts on older adults is available here; LeadingAge has also published a new one-pager on eviction prevention for older adults.

Nursing and Rehabilitation:

FAQs on the Pending Nursing Home Vaccine Mandate
LeadingAge has released an FAQs article related to the pending federal nursing home COVID-19 vaccine mandate. LeadingAge cautions that the main theme of the FAQs is that we don’t know, and won’t know until the rule comes out, but LeadingAge share what they’re thinking about in pondering these questions. LeadingAge will continue to update these FAQs as more information becomes available, so check them out here and check back regularly.

Nursing Home Workforce Support and Expansion Act
On August 27, Representatives Steven Horsford (D-NV), Barbara Lee (D-CA) and Jamaal Bowman (D-NY), introduced the Nursing Home Workforce Support and Expansion Act of 2021. The bill, supported by LeadingAge, will help provide funding to help long-term care providers recruit and retain health care professionals. This legislation is also included in the Elder Justice Reauthorization and Modernization Act of 2021, introduced earlier this month. The bill provides $400 million for each fiscal year 2022 – 2025, to states and territories to support grant programs for workers providing care in post-acute and long-term care settings. Grant funds would be provided based on their population of adults over 65 years of age and people with disabilities.

The funds MUST be used to:

provide wage subsidies to employees in post-acute and LTC position
provide student loan repayment or tuition assistance to eligible individuals
guarantee affordable and accessible childcare for eligible individuals
provide transportation assistance to eligible individuals.

The funds MAY be used to:

establish a reserve fund for emergency financial assistance
provide in-kind resource donations, such as interview clothing and conference attendance fees
provide assistance with activities designed to lower barriers to employment, including legal assistance
support eligible employers in offering not less than two weeks of paid leave per year.

Representative Steven Horsford’s press release can be found here.

The full text of the bill can be found here.

A summary of the bill can be found here.

Nursing Home Advisory Group Call Summary
Thanks again to all who participated in the monthly Nursing Home Advisory Group call this past Tuesday. It was another great call with close to 150 participants. Read a summary of the call here. Next month’s Nursing Home Advisory Group call will take place on Tuesday, September 28 and will be a special edition Town Hall Conversation. If you would like to be added to the email list for the monthly call, please email Jodi.

The Staffing Crisis in Long-Term Care
On September 17, 2021 at 1:00 p.m. CST, Executive Director of the Hartford Institute for Geriatric Nursing, Dr. Tara Cortes, will host a panel of experts to discuss the crisis in recruitment, retention, and adequate staffing in long-term care. Speakers and the focus of their presentations include: Robyn I. Stone, Dr. PH: Beyond Minimum Staffing in Long-Term Care: Understanding Staff Competencies and the Workplace Culture that Supports Good Practice; Ann Kolanowski, PhD, RN, FAAN: RN Staffing in US Nursing Homes: The Elephant In The Room; and Representative Jan Schakowsky: SOS: Save Our Staff: Improving Staffing Standards for Better Care. The webinar registration is available here.

Other:

Vaccination Update
A few vaccination updates to provide:

Who is moderately to severely immunocompromised?
Following CDC’s recommendation on August 13, that individuals who are moderately to severely immunocompromised receive an additional dose of COVID-19 vaccine, we have received questions about who falls into this category. In making this determination, healthcare and vaccine providers may find it useful to refer to this guidance from CDC. In addition to detailing exactly who CDC considers moderately to severely immunocompromised, the resource also provides tips on discussing additional doses with eligible patients.

Co-administration of vaccines:
We’ve received a number of questions recently about co-administration of the COVID-19 vaccine with other vaccines as providers prepare for COVID-19 boosters, flu shots, and other injection scenarios. The CDC recently updated guidance on co-administration of the COVID-19 vaccine with other vaccines. This information is available here and states that the COVID-19 vaccine can now be administered at the same time as other vaccines, including flu vaccines. There is no need to delay the previously-recommended 14 days before and after administration of the COVID-19 vaccine. CDC notes, however, that when simultaneously administering vaccines on the same day, vaccine injection sites should be at least one inch apart and providers may wish to consider administering vaccines in different limbs.

We note that the guidance on co-administration of the COVID-19 vaccine with TB tests (tuberculin skin test or an interferon release assay) has not changed. TB tests may be administered prior to or at the same time as COVID-19 vaccination; however, if COVID-19 vaccination has already taken place, TB testing should be delayed until 4 or more weeks after completion of COVID-19 vaccination. This information is available here.

This Week’s Drive for 75
For our sixtieth segment (can you believe it’s been that many?), we featured a mash-up of articles on individual experiences with vaccine hesitancy, and pondered how convincing a vaccine hesitant person to get the vaccine can be like getting a cat out of a ceiling. Our sixty-first segment reviewed an article that called delta variant the “Goldilocks Virus” and explained how we ended up where we are with delta. You can read the full transcripts here.

LeadingAge Co-Signs Letter to the State Department Requesting Employment-Based Immigrant Visas Be Prioritized
On August 30, LeadingAge joined 10 long-term care and post-acute provider organizations in sending a letter to the Department of State, requesting foreign-trained nurses and health care workers immigrant visas be prioritized. Currently, the family-based immigrant visas are prioritized. If the State Department were to amend the immigrant visa prioritization, the entry of foreign-trained nurses and health care workers would be accelerated, and these health care professionals could be available to help with the LTC staffing crisis. We also offered to meet with the State Department to discuss the current workforce crisis we are facing.

The letter was co-signed by: AHCA/NCAL, Argentum, The Society for Post-Acute and Long Term Care, Association of Jewish Aging Services, Lutheran Services in America, American Seniors Housing Association, National Association of State Veterans Homes, Pediatric Complex Care Association, National Association of State Veterans Homes, and American Network of Community Options and Resources (ANCOR).