The Lead November 16, 2023
From the Desk of Angela Schnepf, President and CEO
On November 14, the U.S. House passed a two-step continuing resolution (CR) to keep some federal programs funded until January 19 and others, including the U.S. Department of Health and Human Services until February 2. Absent enacted fiscal year 2024 (FY24) appropriations bills, the federal government is facing a shutdown unless FY24’s second continuing resolution is enacted by midnight on November 17, when the current CR expires. The U.S. Senate is also expected to pass the measure, which President Biden is not expected to veto. CMS has continued a partial hiring freeze they enacted in July. Administrator Chiquita Brooks-LaSure cautioned that the agency’s operations will be in peril if the fiscal standoff in Congress continues.
Kindest regards,
Angela
Top Stories:
Amendment to Prevent Federal Staffing Mandate Adopted in Appropriations Bill
On November 14, LeadingAge issued a vote recommendation to all members of the House of Representatives in support of an amendment to the Fiscal Year 2024 Labor, Health and Human Services, and Education appropriations bill that would prevent the nursing home staffing mandate from going into effect. The amendment was adopted by voice vote and added language to the underlying bill that would prohibit any funds from being used to “finalize, implement, or enforce” the proposed federal minimum staffing rule. A vote on final passage of the FY24 Labor, Health and Human Services, and Education bill has been postponed until the House returns from Thanksgiving. Although it is unlikely that the bill language to halt the proposed staffing rule would survive negotiations between the House and Senate, it sends an important message to the Administration that a majority of House members oppose the federal staffing mandate.
LeadingAge, Coalition Continue Work on Telehealth Permanency
LeadingAge Illinois has been a part of the Telehealth Coalition established in 2021 on telehealth.
In 2021, the Illinois Department of Healthcare and Family Services (HFS) objected to include Medicaid coverage in statute by pointing instead to Medicaid rules that in part relied on federal and state PHEs and feedback from stakeholders. With the expiration of both federal and state PHE rules and a recent MAC meeting on the future of telehealth COVID rules, the Coalition is renewing work on this issue. When the new director takes office at HFS in January, we will join a letter to the director on permanent telehealth Medicaid coverage and payment.
Department of Labor Proposes Paid Leave Rules
The Illinois Department of Labor proposed a new rules titled Paid Leave for All Workers Act implementing Public Act 102-1143, which established the Paid Leave for All Workers Act.
- The Act requires all public and private employers in Illinois (except school districts and park districts), effective January 1, 2024 to grant their employees a minimum of 1 hour of paid leave at their regular rate of pay for every 40 hours worked, up to a minimum of 40 hours paid leave per 12-month period.
- The employer may grant leave time as it is earned, or allow employees to use any or all of their leave time from the beginning of the 12-month period (frontloading). Employers with existing paid leave policies in place prior to January 1, 2024 do not have to change them if they meet or exceed the minimum requirements of the Act.
- Employees who did not previously earn paid leave shall begin to earn paid leave under the Act on January 1, 2024 or the date they begin employment, whichever is later. If leave time is not frontloaded, employees must be allowed to start using their accrued leave time after having worked 90 days past the later of these dates.
- Work time, including overtime, must be counted toward accrual of paid leave and an employee may use their paid leave time for any reason.
- Unused accrued paid leave time from one 12-month period must be carried over to the following 12-month period.
- Complaints may be filed against employers who violate the Act and each violation is subject to a $2,500 fine.
Senate President Pro Tempore Hosted for Meeting at Smith Village
Bill Cunningham (D-Chicago), senate president pro tempore, met with Kevin McGee, CEO of Smith Village and Jason Speaks, Director of Government Relations at LeadingAge Illinois on Wednesday. The hour long meeting included several topics, such as:
- Workforce challenges and needs
- More resources needed for staff
- New funding ideas
- Staffing agency issues
- CMS proposed staffing mandate impact
- Nurse Licensure Compact
- Medication Aides
- Assisted Living surveys
Sen. Cunningham is the co-chair of the Joint Committee on Administrative Rules (JCAR), an important committee that approves or denies state agency rulemaking. In August, the Committee instructed the Illinois Department of Public Health (IDPH) to meet with LeadingAge Illinois and other associations to discuss our concerns on their proposed changes to the Assisted Living regulations. We were successful in blocking their attempts to triple the licensure fees and take out the provider’s opportunity to complete a statement of dispute, which IDPH wanted to delete from the code.
Nursing and Rehabilitation
Nursing Facility Estimated Quality Incentive Payment Listing for January 1, 2024
Click here for more information.
CNA Data Collection History Chart-July Quarter- 2023
Click here for more information.
Home and Community Based Services (HCBS)
Home Health Fee Schedule
Click here for the schedule effective January 1, 2024.
Community Care Program Rules Adopted on EHR
The Illinois Department on Aging (DoA) adopted emergency rules for the Community Care Program, that went into effect October 18 for 150 days. The rules implement enhanced options for Emergency Home Response Services (EHRS) that include fall detection and global positioning systems monitoring, and also implement extension of a federal waiver allowing a legally responsible individual (LRI), such as a spouse, representative payee, or power of attorney, to serve as a home care aide when a qualified CCP aide is not available or unable to provide services in the customer’s plan of care.
Housing
HUD Announces New Streamlined Enrollment Process for Affordable Connectivity Program
HUD announced a new data-sharing agreement with the Federal Communications Commission (FCC) to enable streamlined eligibility verification for residents of HUD’s Multifamily Housing programs to enroll in the Affordable Connectivity Program (ACP). The ACP provides a discount on monthly internet service for qualifying households, and households can establish eligibility based on the fact that they receive federal housing assistance. Previously, residents of HUD’s Public Housing programs had access to streamlined verification for the program, but residents of HUD’s Multifamily Housing programs, including Section 202 Supportive Housing for the Elderly, did not. After advocacy by LeadingAge and others, the FCC and HUD committed to expanding their data sharing agreement to reduce the burden on ACP applicants to demonstrate eligibility. LeadingAge strongly supports expanded internet access in affordable senior housing and will continue to work with HUD, FCC, and Congress to ensure access.
LeadingAge HOTMA Implementation Resources and Call Recording Available
The 2016 Housing Opportunity Through Modernization Act (HOTMA) imposes new asset limits for some residents of certain HUD housing programs. HOTMA brings significant changes, and LeadingAge is here to help: On November 13, LeadingAge and six national housing partners hosted a call with HUD Multifamily Housing leadership to clarify the current approach to the new asset limits. During the call, HUD staff clarified how housing providers should approach the asset limit currently and how residents could be impacted. LeadingAge’s call recording is available here, and more HOTMA updates for LeadingAge members is available here. LeadingAge also hosts a members-only monthly workgroup on HUD Compliance and Oversight, where housing providers can hear updates from LeadingAge and guest speakers, as well as discuss valuable tips with their peers. Visit our LeadingAge HOTMA webpage and HUD’s HOTMA for Multifamily Housing webpage for more information.
HUD Officially Extends Standards for Success Reporting to December 31
In response to advocacy by LeadingAge and others, HUD has extended the 2023 Standards for Success report submission due date to December 31. The Standards for Success reporting period began October 1, 2022 and ended September 30, 2023. The report submission due date was originally October 30. However, this year the Standards for Success data elements are being updated to improve data validity and quality of reporting, and there are glitches in the reporting form. HUD reported that the work has an anticipated completion date of November 2, which is after the usual report submission due date of October 30. LeadingAge has worked with Grant Solutions to identify and solve glitches reported by housing provider members. Previously, Grant Solutions was allowing extensions by request, but LeadingAge urged HUD to broadly extend the reporting timeframe to help preserve the integrity of the data submitted by Service Coordinators across the country. HUD has officially extended the deadline to December 31, 2023, for all Multifamily Service Coordinator grantees. Reporting entities can submit their reports to HUD through the Standards for Success reporting tool and data repository, GrantSolutions OLDC, by direct data input (OLDC Form) or data file upload (Data File). If a provider was able to submit their reports at an earlier time using a third-party service, they may not need to take additional action at this time.
Other
Ombudsman Person-Directed Living Change Collaborative
Every year the Long-Term Care Ombudsman Program in Illinois engages in a State Initiative and for 2024 the initiative is to encourage long-term care communities to embrace person-directed living to promote systemic changes in long-term care culture.
The Long-Term Care Ombudsman program is supporting person-directed living for residents who live in long-term care through leading a Change Collaborative for nursing homes and assisted livings in Illinois. The focus of this Change Collaborative is to support the communities involved to engage in a change initiative that supports listening to what their residents need, want, and deserve.
Collaborative Details:
- The Change Collaborative will occur from November 2023 to September 2024.
- There must be a commitment from the home’s ownership and leadership.
- Each home must complete the Artifacts of Culture Change 2.0 tool at the beginning and end of the collaborative.
- Each home will engage in at least one initiative to implement change through the course of the year (i.e., changing their dining experience, person directed engagement, etc.)
- The group will meet monthly via Webex to track changes/share/brainstorm
- In between meetings, an email group will be established where the participants can post questions and share information, resources, etc.
- An advisory group will be established of industry leaders to assist in leading the way.
If you are interested in more information on this Collaborative, join the informational meeting early December 2023. Please email your intent to join the meeting to Aging.SLTCOProgram@Illinois.gov. Type “collaborative” in the subject line to expedite the return email with the meeting line.