The Lead August 26 2021 - LeadingAge Illinois

From the Desk of Angela Schnepf, President and CEO

Home and Community Based Services (HCBS):
More Details: Additional Payments for Vaccinations in a Home Setting
CMS Webinar on FY 2022 Hospice Final Rule: What Hospices Need to Know
Comments Submitted on Home Health Rule

Independent Affordable/Subsidized Housing:
House-Passed Budget Resolution Paves Way for Affordable Housing, Services Investments

Supportive Living:
2020 Supportive Living Cost Report Files

Assisted Living:
Call to Action: Week 3 of Campaign to “Release the PRF”

Life Plan Communities/CCRC:
Life Plan Community Advisory Group Meeting on Market Opportunities and Growth – Only One Week Away!

Nursing and Rehabilitation:
National Nursing Homes Stakeholder Call with CMS and CDC
Updates to COVID 19 Vaccination Modules

Other:
COVID Update Calls – How to Handle Breakthrough COVID Cases. And do any of us Really Need Boosters?
McKnight’s Honors LeadingAge Illinois Member
50 Senior Living and Care Companies Honored on ‘Best Workplaces’ Lists for 2021

From the Desk of Angela Schnepf, President and CEO
As we enter the last month of summer, we are gearing up and preparing for the 2022 legislative session through holding member public policy priorities forums to set our policy agenda for the session that begins in January. We are holding a member forum for each member segment and our final forum is August 31 where we will hear from our Home and Community-Based Services (HCBS) members.

If you were unable to attend one of the forums, but would like to share you input and recommendations for our 2022 Public Policy Priorities, please e-mail our public policy team.

Kindest regards,

Angela

Top Stories:

IDPH Meetings Recap
LeadingAge Illinois and the other associations had a couple of meetings with the Illinois Department of Public Health (LeadingAge Illinois and the other associations had a number of meetings with the Illinois Department of Public Health (IDPH) this past week, with another meeting scheduled for today. Here is a recap out what was discussed.

Staffing/Workforce:
We again indicated that we are seeing a significant staffing crisis across long term care facilities and urge the Department and the administration to consider re-implementing the Temporary Nursing Assistant (TNA) program until the end of the public health emergency. We will continue to push for this. We have also been speaking with legislators on this important issue.

Staffing Reports:
The Department’s plan for facilities to report staffing data is on hold with an update to come soon, according to the Department. They met recently with CMS on getting access to the PBJ data that is reported to the federal government from facilities.

Implementation of New Policy for Systematic Processing of Long Term Care Admissions and Additional MEDI Edits
The Illinois Department of Healthcare and Family Services (HFS) posted a new Provider Notice regarding Implementation of New Policy for Systematic Processing of Long Term Care Admissions and Additional MEDI Edits. Click here for the notice.

Help Set the LeadingAge Illinois 2022 Public Policy Priorities
The LeadingAge Illinois 2022 Public Policy Priorities Member Forums are your opportunity to provide input and help us set our 2022 Public Policy Priorities. In these free, one-hour virtual forums LeadingAge Illinois staff will provide a recap of the spring legislative session, a landscape for the 2022 session, and provide other information and updates to give you the background needed to help us identify the top legislative priorities for the next year. Please come prepared to discuss your challenges and suggestions on how we can have a stronger impact in your day-to-day operations, and more.

Member Forums (all virtual):
HCBS Forum
Tuesday, August 31
10:00 – 11:00 a.m.
Register Here

Nursing Facilities Forum (COMPLETED)
Life Plan Communities/CCRC Forum ( COMPLETED)
Assisted Living (COMPLETED)
Housing Forum (COMPLETED)
Supportive Living Forum (COMPLETED)

You can also submit your feedback and recommended priorities via e-mail. Let us know the burdens and challenges that are impacting your community as well as potential legislative/regulatory remedies that can remove them.

Impending Deadlines
We want to keep you up to date on upcoming deadlines. Check here each newsletter for updates. Check here each newsletter for updates.

August 30: Funding of $103 Million from American Rescue Plan Dedicated to Reducing Burnout and Promote Mental Health in the Health Care Workforce. Applications for each of the funding opportunities are due August 30.

LeadingAge Comments to DOL on OSHA ETS for Healthcare Employers
LeadingAge submitted comments today on the OSHA Emergency Temporary Standard (ETS) for healthcare providers. Some of LeadingAge National’s asks included a request to delay enforcement or rescind the ETS because existing guidance and requirements are sufficient to protect workers, provide additional guidance and education, have OSHA inspectors use discretion in enforcement, use CDC recommendations as the sole standard for providers, and to not extend or make the ETS permanent. Earlier this week LeadingAge, along with AHCA/NCAL, Argentum, ASHA, and the Pediatric Complex Care Association sent a letter to the Department of Labor requesting that the OSHA Emergency Temporary Standard (ETS) not be converted to a permanent standard.

Senior Housing Providers, Other Aging Services to Plan Booster Shot Clinics
With the Delta variant surging in many parts of the country, booster doses of a COVID-19 vaccine may be needed to maintain strong viral protections. Subject to approval by the FDA and recommendation by CDC’s Advisory Committee on Immunization Practices (ACIP), COVID-19 boosters will potentially be available for eligible vaccinated individuals, including health care providers, residents of long-term care communities, and other older adults. Unlike with the initial rollout of the COVID-19 vaccine, CDC will NOT be coordinating clinics for booster shots; affordable senior housing providers, home and community based services providers, and other aging services providers should work with pharmacies directly to start planning shot clinics or booster shot access in the broader community for residents and staff. More info here.

From CDC: Frequently Asked Questions: COVID-19 Vaccine Boosters
HHS announced a plan to begin offering COVID-19 vaccine booster shots this fall. CDC’s independent advisory committee, the Advisory Committee on Immunization Practices (ACIP), will continue to meet and discuss data on the evolution of the pandemic and the use of COVID-19 vaccines. ACIP will make further recommendations on the use of boosters for the public after a thorough review of the evidence. Below are answers to commonly asked questions about COVID-19 vaccine boosters.

Q: When can I get a COVID-19 vaccine booster?
A: Not immediately. The goal is for people to start receiving a COVID-19 booster shot beginning in the fall, with individuals being eligible starting 8 months after they have received their second dose of mRNA vaccine (either Pfizer-BioNTech or Moderna). This is subject to FDA approval and CDC’s Advisory Committee on Immunization Practices (ACIP) authorization and recommendation.

Q: Who will be the first people to get a booster dose?
A: Once FDA approves and ACIP recommends a booster dose, the goal is for the first people eligible to be those who were the first to receive their shots in the earlier phases of the vaccine rollout and those who are most at risk. This includes healthcare providers, nursing home residents, and other seniors.

Q: Why are we waiting to start offering COVID-19 vaccine boosters?
A: The COVID-19 vaccines authorized in the United States continue to be remarkably effective in reducing risk of severe disease, hospitalization, and death, even against the widely circulating Delta variant. However, COVID-19 constantly evolves. We’re looking at all available data to understand as much as we can about how well the vaccines are working, including how new variants, like Delta, affect vaccine effectiveness. Once FDA approves and ACIP recommends, the goal is for people to start receiving a COVID-19 booster shot this fall.

Q: Will people who received Johnson & Johnson’s (J&J/Janssen) COVID-19 vaccine need a booster shot?
A: It is likely that people who received a J&J COVID-19 vaccine will need a booster dose. Because the J&J vaccine wasn’t given in the United States until 70 days after the first mRNA vaccine doses (Pfizer-BioNTech and Moderna), the data needed to make this decision isn’t available yet. We expect more data to come in the next few weeks. With those data in hand, we will keep the public informed with a timely plan for J&J booster shots as well.

Q: Can people who received Johnson & Johnson’s (J&J) COVID-19 vaccine get a booster dose of an mRNA vaccine?
A: There’s not enough data currently to support getting an mRNA vaccine booster dose (either Pfizer-BioNTech or Moderna) if someone has gotten a J&J vaccine. People who took the J&J vaccine will likely need a booster dose, and more data is expected in the next few weeks. With those data in hand, we will keep the public informed with a timely plan for J&J booster shots as well.

Q: If we need a booster, does that mean that the vaccine is not working?
A: No. The COVID-19 vaccines are working very well to prevent severe illness, hospitalization, and death, even against the widely circulating Delta variant. However, with the Delta variant, we are starting to see reduced protection against mild and moderate disease. For that reason, we are planning for a booster shot to maximize vaccine-induced protection and prolong its durability.

Q: What’s the difference between a booster shot and an additional dose?
A: An “additional dose” refers to people who are moderately to severely immunocompromised receiving an additional dose of an mRNA COVID-19 Vaccine (Pfizer-BioNTech or Moderna). This is because they may not have received adequate protection from their initial 2-dose vaccine series.

A “booster dose” is a supplemental vaccine dose given to people when the immune response to a primary vaccine series was adequate but is likely to have decreased over time.

ABE Portal and Manage My Case (MMC) Downtime
This notification informs Long Term Care (LTC) providers that the Application for Benefits Eligibility (ABE), the ABE Partner Portal, and Manage My Case (MMC) will not be available beginning at 4:00 PM CST on Thursday, September 2, 2021 through Tuesday, September 7, 2021 for planned upgrades.

LTC providers should wait until ABE is back online to submit applications and upload documents. Any documents with a due date to return to the state during this time should be uploaded once the system is available or LTC providers may continue to utilize the Central Scanning Unit to fax documents to 217.557.4965.

If you have questions, contact the Bureau of Long Term Care toll free at 844.528.8444.

FDA Notice Regarding Discontinuation of Certain N95 Respirators
The FDA issued a notice instructing health care personnel to discontinue using certain N95 respirators manufactured by Shanghai Dasheng Health Products Manufacturing Co., Ltd. You can read the full letter here.

TANs and Pendings Update
Matt Werner, LeadingAge Illinois Medicaid consultant, has provided his weekly update on Transaction Audit Numbers (TANs) and Medicaid Pendings.

Home and Community Based Services (HCBS):

More Details: Additional Payments for Vaccinations in a Home Setting
Yesterday, LeadingAge reported that the Centers for Medicare & Medicaid Services (CMS) said it is providing additional payments to healthcare providers who administer doses to multiple residents at home, a move that is intended to incentive equitable vaccine access for older adults in smaller and rural group home settings. LeadingAge now has an article which summaries the details here.

CMS Webinar on FY 2022 Hospice Final Rule: What Hospices Need to Know
CMS will host a webinar on Tuesday, August 31 from 1:00 – 2:00 PM CST to educate providers about the changes in the Hospice Quality Reporting Program resulting from the Hospice Final Rule. The webinar will offer an overview of the rule, detail changes, and describe the public reporting of quality measures (QMs). Here is the link to register and to receive an email notification when the recorded version of the webinar is available, sign up here.

Comments Submitted on Home Health Rule
Comments were submitted to the federal register today on the Home Health Prospective Payment System proposed rule. Access the rule here. Submit comments here referencing CMS-1747-P. Read the LeadingAge comments here. Comments are due by 4pm CST this Friday, August 27.

Independent Affordable/Subsidized Housing:

House-Passed Budget Resolution Paves Way for Affordable Housing, Services Investments
The House of Representatives passed the Fiscal Year 2022 Budget Resolution, which sets the stage for Congress to consider $3.5 trillion in “care economy” infrastructure investments. Included for consideration are billions for affordable housing and home and community based services (HCBS) investments benefitting older adults. The effort could also advance key policy changes for the Low-Income Housing Tax Credit (LIHTC) program, which funds the majority of new affordable housing development across the country. The House committees plan to complete their work after Labor Day, which leaves only a small window for advocacy on behalf of older adults. LeadingAge is advocating for bold investments in housing, services, and other priorities, and LeadingAge members can easily add their voice during this critical time. More info here.

Supportive Living:

2020 Supportive Living Cost Report Files
The Illinois Department of Healthcare and Family Services (HFS) has posted the 2020 Supportive Living Cost Report Files here.

Assisted Living:

Call to Action: Week 3 of Campaign to “Release the PRF”
Argentum officially relaunched the Standing with Seniors website (see press release) as part of their five-week campaign encouraging the administration to “Release the PRF.” The website provides a central place for information on the impact of COVID-19 on senior living communities, residents, and caregivers, including infographics for each state, a clock showing the elapsed time since the CARES Act relief funding was signed into law, information for policymakers and staff, and a link for advocates to take action and send a message to the administration and Congress on the urgent need to release the relief funds.

Along with the revamped website, Senators Susan Collins (R-ME) and Jeanne Shaheen (D-NH) were joined by more than 30 of their Senate colleagues in sending a letter to HHS on the need to release funds. These recent efforts follow the joint letter to the administration that kicked off the campaign two weeks ago.

CALL TO ACTION: This week, your help is needed to help to amplify the message through three actions: emailing the administration, using social media, and through our grassroots platform:

Send an email directly to administration officials, sharing the urgent need for relief to your communities. Emails should be sent to: Danita Hunter, deputy administrator at HRSA and Jordan Grossman, chief of staff to HRSA acting administrator Diana Espinosa. Please keep your emails brief and succinct on the need for the administration to release funds; you should not discuss specific funding issues from earlier phases. Here is a sample email with guidelines:

Guidelines:

Please understand that HRSA staff are only responsible for administering the fund, they are not responsible for authorizing the release of funds. These emails are to bring awareness on the need for additional funds and to ask for their help in encouraging HHS to release funds.
Please be brief in your message, and do not go into specific details on your financial situation and need for relief. Specific information will be considered during an eventual application process.
Please do not dispute or otherwise raise issues relating to a previous award determination; HHS is in the process of evaluating an appeals process for previous award determinations to provide an appropriate forum to resolve disputes.
Please only send one email from your organization. We want HRSA staff to hear from a range of operators on the need to release funds so they can relay these requests to HHS, not to inundate them.

Sample E-Mail:

Ms. Hunter and Mr. Grossman,

I am writing on behalf of [company name], which serves [more than ##] seniors across ## states. As you know, the COVID-19 pandemic has placed enormous burden in caring for highly vulnerable seniors, with acquiring PPE, routine testing, infection prevention and control resources, labor expenses, and compounded by the unprecedented drop in occupancy rates.

We appreciate HRSA’s attention to disbursing provider relief funds to help offset these expenses and losses. These funds are very helpful, but more relief is critically needed. Anything you can do to help expedite the release of additional funds would be extremely appreciated.

Please don’t hesitate to reach out if you have any questions.

Use the Argentum grassroots platform to send messages to the administration and Congress. Pre-written messages are available and it takes less than a minute to contact policymakers (only need to input your name and address).

Life Plan Communities/CCRC:

Life Plan Community Advisory Group Meeting on Market Opportunities and Growth – Only One Week Away!
The next LPC Advisory Group meeting, focused on market opportunities and growth, is on Monday, August 30, 2021, 1:00 PM CST. To discuss this evolving and ever-relevant topic, we have a dynamic panel of experts: Nicole Fallon, LeadingAge; Dan Hermann and Lisa McCracken, Ziegler; Rich Navarro and Brad Paulis, Continuing Care Actuaries; and Joann Handy, strategic consultant. To register for the calls and receive the Zoom link, email Dee Pekruhn.

Nursing and Rehabilitation:

National Nursing Homes Stakeholder Call with CMS and CDC
A national nursing homes stakeholder call with CMS and CDC was held this afternoon. CMS reiterated that while much of the upcoming vaccine mandate cannot be discussed because of the rulemaking process, they were able to clarify some questions that have been circulating, including those included in the LeadingAge FAQs, including timing of the rule’s release and enforcement. CMS noted that while NHSN data indicates that vaccination is serving to protect residents during the delta surge and revision of visitation and other guidance is not indicated at this time, survey reports are showing concerning increases in other resident issues such as weight loss, loss of mobility, and increased need for assistance with ADLs.

CDC shared considerations for securing ongoing vaccination for residents and staff, including additional doses and boosters for those who are eligible. CDC encouraged nursing homes to work with long-term care pharmacy partners, pointing out that we are in a much different circumstance that when vaccines initially rolled out in December. We now enjoy ample supply and broader community eligibility and access. Providers can consider pairing booster clinics with flu vaccine clinics, as CDC no longer discourages co-administration of the COVID-19 vaccine with other vaccinations (read all about that here). NHSN is being updated to include questions about additional COVID-19 doses.

Updates to COVID 19 Vaccination Modules
Two new questions have been added to the data collection form to allow facilities to report additional vaccine doses.

New Question 4- Cumulative number of residents or healthcare personnel eligible to receive an additional dose or booster of COVID-19 vaccine
New Question 5- Cumulative number of residents or healthcare personnel received an additional dose or booster of COVID-19 vaccine (by vaccine manufacturer)

Facilities should refer to the following guidance to determine individual who are eligible to receive additional doses or boosters after receiving a complete vaccination series: Interim Clinical Considerations for Use of COVID-19 Vaccines-CDC

You can access training materials at Weekly Healthcare Personnel (HCP) & Resident COVID-19 Vaccination webpage which includes data collection forms, tables of instructions, tracking worksheets ( coming soon), training slides, analysis with reporting guides, CSV file resources.

Other:

COVID Update Calls – How to Handle Breakthrough COVID Cases. And do any of us Really Need Boosters?
All update calls are at 2:30 PM, CST. Next week LeadingAge Coronavirus call will focus on breakthrough COVID-19 cases and expert analysis of what is next with the Delta Variant and other hot topics like booster shots and return to schools for children means for families. On Monday, August 30, LeadingAge will welcome fellow LeadingAge member Barbara Thomas, CEO of Kendal at Oberlin who will talk about her recent experience with breakthrough COVID-19 cases and the lessons learned from the experience. On Wednesday, September 1, a perennial favorite speaker the LeadingAge update calls, Dr. Monica Gandhi will outline her thinking and rationale about whether boosters are needed and provide candid advice on what is happening with COVID-19. If you haven’t registered for the calls on Mondays and Wednesdays at 2:30 PM CST, you can do so here.

McKnight’s Honors LeadingAge Illinois Member
McKnight’s honors LeadingAge Illinois member Terri Cunliffe as one of their Women of Distinction 2021. Congratulations Terri, on your well-deserved success!

50 Senior Living and Care Companies Honored on ‘Best Workplaces’ Lists for 2021
Fifty companies providing residential senior living and care are in the spotlight this morning after Fortune announced its Best Workplaces for Aging Services lists for 2021, the fourth round of such lists Fortune has published in partnership with people analytics firm Great Place to Work.