COVID-19 UPDATE #210
December 10, 2021
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While 96 percent of ARP Rural Funds have been distributed, there are a notable number of providers that have not yet received awards or their awards appear to be inaccurate. HRSA has noted five key reasons for delays:
- Provider did not have Optum ID Accounts for all qualifying subsidiaries by 11/30
- Awards are substantial – over $100K
- Conflicting data comparing the application and HRSA data
- Complex corporate structures
- Denial letter is in process
If a provider did not have Optum ID Accounts set up by November 20, 2021, HRSA has indicated it may be early 2022 before awards are made. Regarding the latter four possibilities, HRSA is conducting manual paper reviews of the applications and, in some instances, will be requesting additional information from providers. A few have already received such requests.
The advocacy goal of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) is to establish a process whereby HRSA provides status updates on applications so providers have predictability about when or if the funds will arrive. Here is a link to a blog post and summary of HRSA’s December 2, 2021, webinar explaining these points. AHCA/NCAL understands the crisis this is creating for some providers and is working hard on a solution.
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EMERGENCY PLANNING GUIDELINES: SEEKING YOUR HELP |
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Last year the Washington Legislature passed SHB 1218, legislation related to emergency preparedness and planning in long term care centers in Washington. The Department of Health and DSHS are required to develop guidelines for emergency preparedness plans. The agencies are required to consult with stakeholders, including providers, the local health jurisdictions, and the LTC Ombuds Program. An initial report has been developed and is due to the Legislature this month.
We need your help! DOH and DSHS are beginning to look at next steps of the SHB 1218 work, including development of infection control/infection prevention/epidemic preparedness guidelines as required by the Legislation. The project team has developed this brief survey to gather information on potential guidance needs and potential barriers to implementation. The survey can be taken anonymously; questions collecting identifying information are optional. The survey will be available until December 31.
We believe it is critical for providers to share the challenges of dealing with multiple jurisdictions having oversight in long term care settings and encourage you to complete and submit this brief survey to help inform this work. If you have questions, email Lauri St. Ours or call her at (800) 562-6170, extension 104. |
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UPCOMING OFFICE HOURS: CMS INTERIM FINAL RULE ON VACCINE MANDATE |
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On Monday, December 13, 2021, at 1 PM PST, the Centers for Medicare and Medicaid Services (CMS) will host office hours to discuss recent updates on the CMS Interim Final Rule (IFR) on Vaccine Mandates provided by Sarah Skubas, Attorney at Law, Jackson Lewis, along with AHCA/NCAL Chief Medical Officer Dr. David Gifford. The update will be followed by a question and answer session where attendee questions on vaccine mandates will be addressed.
Registration is limited, and a recording will be available following the webinar. Please contact educate@ahca.org with any registration issues or questions.
CMS recently released a QSO memo advising state survey agencies they should not enforce the IFR regarding the vaccine mandate or requirements for policies and procedures in certified Medicare/Medicaid providers and suppliers while there are court-ordered injunctions in place pending additional clarity from the courts.
AHCA/NCAL recommends members continue to encourage staff to get COVID-19 vaccines and prepare for a vaccine mandate so that if the government’s arguments prevail, policies and procedures can be quickly implemented. We will provide additional details as soon as anything changes.
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L&I EMERGENCY RULE ADOPTION |
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Chapter 296-62, General Occupational Health Standards
The Department of Labor & Industries (L&I) continues to respond to the 2021 passage of Substitute Senate Bill 5254 (SSB 5254) regarding voluntary use of personal protective equipment (PPE) during a state of emergency, and Engrossed Substitute Senate Bill 5115 (ESSB 5115), also known as the Health Emergency Labor Standards Act (HELSA), This rulemaking maintains new sections of WAC regarding public health emergency related reporting and notification requirements for infectious and contagious disease.
This emergency rule supersedes WSR 21-17-051 filed on August 10, 2021.
The emergency rule includes requirements for when there is a public health emergency for an infectious or contagious disease and as such, the requirements are applicable to COVID-19.
Under the emergency rule:
- Employers with more than 50 covered employees at a workplace or worksite are required to report infectious or contagious disease outbreaks of 10 or more employees to L&I;
- Definitions for Covered Employee, Public Health Emergency, Worksite or Workplace and Test- confirmed are included;
- Employees are not required to disclose any medical condition or diagnosis to their employer;
- Employers, except for certain healthcare employers, are required to notify employees in writing of potential exposures within one business day; and
- Employees and contractors must be permitted to voluntarily use personal protective equipment.
The HELSA was signed by Governor Inslee on May 11, 2021 and is currently enforceable under RCW 49.17. Senate Bill 5254 gives employees the voluntary option to protect themselves from transmission of COVID-19 by use of employer provided PPE in circumstances where the PPE does not pose a safety or security issue for the employer. COVID-19 continues to be recognized as a very serious workplace hazard and until permanent rulemaking for infectious and contagious diseases is adopted, this temporary measure will help to reduce the transmission of this disease in the workplace.
L&I filed a Preproposal Statement of Inquiry (CR-101) on May 13, 2021, WSR 21-11-051, regarding permanent amendments to existing permanent rules to address hazards from COVID-19 or other outbreaks of infectious or contagious diseases. Some parts of the emergency rule will be considered for permanent rulemaking. If you have questions, you can call L&I at (800) 423-7233.
The links below provide additional information about this rulemaking:
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CMS UPDATES BLANKET WAIVERS WITH 1135 WAIVER FOR DIRECTORS OF FOOD AND NUTRITION SERVICES IN SKILLED NURSING |
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CMS has updated the COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers to include the new waiver for directors of food and nutrition services for 42 CFR 483.60(a)(1) and 483.60(a)(2), which is found on page 21. As previously reported, members should continue to pursue training for individuals serving in this role to be in compliance when the waiver ends. Skilled nursing facilities must keep in mind that they still need to comply with the state WAC requirements outlined in WAC 388-97-1160 Dietary Personnel. There is no waiver in place for the state requirements.
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COVID-19 INSPECTIONS IN HIGH-HAZARD INDUSTRIES NATIONAL EMPHASIS PROGRAM | FREE AND CONFIDENTIAL CONSULTATION AVAILABLE |
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L&I's Division of Occupational Safety & Health (DOSH) is offering free and confidential consultation services as part of a new program to reduce or eliminate worker exposure to COVID-19 at worksites where unvaccinated employees may have a high frequency of close-contact exposures. L&I is implementing the National Emphasis Program (NEP) – Coronavirus Disease (COVID-19) adopted by Federal OSHA in DIR 2021–03 (CPL 03) in Washington State as DOSH Directive 2.80.
The goal of this program is to significantly reduce or eliminate worker exposure to COVID-19 by focusing on industries and worksites where unvaccinated employees may have a high frequency of close contact exposures. This goal will be accomplished by a combination of inspection targeting, outreach to employers and compliance assistance.
An on-site consultation involves a review of your written safety program, a work site walk through, followed by a confidential written report. The consultant will schedule this visit with you at your convenience. The consultant will address your concerns about occupational health or safety hazards and answer any related questions during the visit. Citations or penalties will not be assessed as a result of a consultation.
DOSH provides consultations to more than 2,000 businesses a year with the goal of improving safety and eliminating worker compensation claims. We are reaching out to provide education and compliance assistance.
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WHCA continues to post resources and information as it becomes available on our website. If you have questions or need additional information, please call the WHCA office at (800) 562-6170.
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