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03/16/2021

Today's COVID-19 Report: Tuesday, March 16

Tuesday, March 16, 2021

Here are the latest need-to-know updates for Tuesday, March 16 regarding the COVID-19 pandemic and other topics of importance.


A REMINDER TO ALL MEMBERS

Check LeadingAge's FAQs and Resources on COVID-19 Vaccines and Issues Surrounding Vaccinations frequently. 
The Ohio Department of Health (ODH) released a toolkit with talking points, language tips, social media language, and trusted resources to help providers better communicate information regarding the COVID-19 vaccines. 

In Today's Report

  • Expanded Visitation: Webinars introduce changes
  • Ohio releases Strategic Action Plan on Aging
  • Biden Administration increases reimbursement rate for administering COVID-19 vaccines
  • LeadingAge Ohio members give voice to budget issues
  • Next round of MDS Exception Reviews beginning
  • CMP Electronic Device Payments: May 31 deadline announced
  • Complexities of unwinding Medicaid enrollment: tied to end of PHE
  • LeadingAge and AHCA release joint nursing home policy recommendations
  • Quality Metrics tool down for maintenance
  • LeadingAge Need to Know

Expanded Visitation: Webinars introduce changes

Today’s Nursing Home and Assisted Living webinars presented by Ohio Department of Aging (ODA) were plagued by technical difficulties, but the slides and the content successfully shared Ohio’s intent to incorporate last week’s Centers for Medicare and Medicaid Services (CMS) guidance to safely expand visitation. Each webinar’s slides indicated that a new order would be dated April 2021; LeadingAge Ohio is working to obtain a more specific date. 

Today CMS released a graphic to further explain the expanded visitation options. Read the full press release and review the graphic in English and Spanish. Per CMS, facilities should allow responsible indoor visitation at all times and for all residents, regardless of vaccination status of the resident, or visitor, unless certain scenarios arise that would limit visitation for:

  • Unvaccinated residents, if the COVID-19 county positivity rate is greater than 10 percent and less than 70 percent of residents in the facility are fully vaccinated;
  • Residents with confirmed COVID-19 infection, whether vaccinated or unvaccinated, until they have met the criteria to discontinue transmission-based precautions; or
  • Residents in quarantine, whether vaccinated or unvaccinated, until they have met criteria for release from quarantine.

The updated guidance also emphasizes that “compassionate care” visits should be allowed at all times, regardless of a resident’s vaccination status, the county’s COVID-19 positivity rate, or an outbreak. Compassionate care visits include visits for a resident whose health has sharply declined or is experiencing a significant change in circumstances.

Finally, today's webinars indicated that for both nursing homes and assisted living the testing cadence for vaccinated staff will be weekly and for unvaccinated staff, twice weekly. The state-supported testing will provide three different options (PCR & Antigen; Antigen only; PCR only) in each setting (NH and AL), with the next opt-in dates of March 22 through March 26. As before, providers can opt-out but must follow the required testing cadence. Based on the presentation, we believe the implementation date for this new testing cadence will be April 2021, but we are awaiting clarity on a number of questions that were raised by the presentations and anticipate addressing as many as possible at next week’s all-member LeadingAge Ohio call on Tuesday, March 23 at 11:30AM.

Ohio releases Strategic Action Plan on Aging

Last week Ursel J. McElroy, Director of the Ohio Department of Aging (ODA), released Ohio’s Strategic Action Plan on Aging (SAPA), a project on which LeadingAge Ohio participated as an Advisory Committee member. While COVID disrupted the timeline of its development,  the goals of the SAPA are that all Ohioans live longer, healthier lives with dignity and autonomy and that disparities and inequities among older Ohioans are eliminated. The SAPA prioritizes 15 issues to improve the lives of all older Ohioans. It then provides a menu of evidence-informed strategies to be implemented at the state and local levels to improve outcomes.

Facilitated by the Health Policy Institute of Ohio under a contract with the Ohio Department of Aging – a project for which LeadingAge Ohio had advocated through its Pathways conversations -- the SAPA builds on and aligns with the 2020 Summary Assessment of Older Ohioans, the 2019-2022 State Plan on Aging, and the 2020-2022 State Health Improvement Plan. It also builds upon the work of the COVID-19 Ohio Minority Health Strike Force.

To achieve the goals of the SAPA, Director McElroy is calling on state and local partners in the public and private sectors, including LeadingAge Ohio members, to act on the SAPA by aligning with its issues, advocating for policy change and funding, implementing one or more of the evidence-informed strategies, partnering and collaborating, and evaluating the state’s progress. The 2020-2022 Strategic Action Plan on Aging and supporting documents are available here.  LeadingAge Ohio will provide additional insights into the plan in the near future.

Biden Administration increases reimbursement rate for administering COVID-19 vaccines

Effective for COVID-19 vaccines administered on or after March 15, 2021, the national average payment rate for physicians, hospitals, pharmacies, and many other immunizers will be $40 to administer each dose of a COVID-19 vaccine. This represents an increase from approximately $28 to $40 for the administration of single-dose vaccines and an increase from approximately $45 to $80 for the administration of COVID-19 vaccines requiring two doses. The exact payment rate for administration of each dose of a COVID-19 vaccine will depend on the type of entity that furnishes the service and will be geographically adjusted based on where the service is furnished.

LeadingAge is continuing to dig into the pricing changes but is hopeful that the combination of increased reimbursement, more supply coming online, and easier to store vaccine product will allow members who have appropriate staff – such as nursing homes, assisted living, home health, hospice, and PACE – to more easily set up ongoing processes to continue vaccinating their own staff, residents, and patients, including those who are homebound. We also hope these types of changes allow for more easy access to ongoing vaccination, via mobile clinics or other community-based partners, for our affordable housing members. This a reminder, once again, for Ohio providers to register through the Ohio Department of Aging survey process.

LeadingAge Ohio members give voice to budget issues

As the biennium budget process continues, LeadingAge Ohio was asked to present testimony at the March 4 Ohio House Families, Aging, and Human Services Committee on challenges faced by aging services providers both before and during the COVID-19 pandemic. Last week’s Virtual Lobby Week closed with 20 different legislative visits. LeadingAge Ohio extends its thanks to those of you who participated in the meetings. Virtual visits allowed LeadingAge Ohio members to ‘pack in’ far more than during a traditional lobby day (and, of course, required zero travel). Policy briefs created for communicating association priorities include: Nursing facility budget issue brief; Adult day budget issue brief; HCBS budget issue brief; PACE advocacy issue brief.

Next round of MDS Exception Reviews beginning

Last Monday, Ohio Department of Medicaid's (ODM) contractor Myers & Stauffer started its next round of MDS exception reviews in Ohio nursing homes. Consistent with the pace of the previous round, ODM anticipates completing 73 reviews by the end of June. LeadingAge Ohio is notified when a member facility is scheduled and will follow-up to ensure communication regarding the review has been received by the member. LeadingAge Ohio’s Stephanie DeWees (sdewees@leadingageohio.org) is available to assist member organizations prepare for the reviews. At the associations’ request, ODM is planning education to assist facilities target the areas of concern raised through the exception review process. 

CMP Electronic Device Payments: May 31 deadline announced

Per the Ohio Department of Medicaid (ODM), 766 Ohio nursing facilities have had applications for CMP funding of electronic devices approved, an amount totaling $1.95 million; however, just $1.1 million has been paid out. The difference between the two amounts reflects the significant number of facilities that haven’t yet submitted receipts. The deadline to make purchases and/or submit for reimbursement is May 31, so LeadingAge Ohio encourages members who have yet to submit receipts to do so soon.

Complexities of unwinding Medicaid enrollment: tied to end of PHE

The Ohio Department of Medicaid (ODM) reported in its meeting with the associations last week that staff have been discussing HHS’ 56-page unwinding guidance for a number of months for there are 20+ populations that require specific protocols.

The public health emergency (PHE) has created challenges for the Administration, since they are prohibited from discontinuing Medicaid coverage, except in narrow exceptions, during the PHE. Following the end of the PHE, states will have four months to catch up on the Medicaid application backlog and six months to process renewals. While the HHS secretary can only renew the PHE for 90 days at a time, HHS has indicated that it expects PHE to last through CY2021; HHS has promised to notify states 60 days prior to the end of the PHE. ODM is looking at changes to notices and processes to make the complicated “unwinding” easier.

Renewals pose particular challenges. Counties have been “leaving the case open” / not sending a notice, not running the case, etc.; ODM noted that it is now important that the state/county send renewal notices to those individuals who would have been due for a renewal during the PHE, notifying them that their coverage will continue but that, if documentation is not received by the end of the PHE, coverage will be discontinued at that point.

Finally, ODM reported that it is working on a state plan amendment to disregard accumulated assets for 12 months, a particularly important modification given stimulus check distributions. MEPL 151 does indicate that stimulus checks aren’t counted for income for MAGI and for non-MAGI it’s not counted as resource for 12 months after receipt.

LeadingAge and AHCA release joint nursing home policy recommendations

Yesterday LeadingAge and the American Healthcare Association (AHCA) announced a set of policy recommendations aimed at ensuring quality in nursing homes. Released under the name “Care For Our Seniors,” the recommendations are intended to help resolve systemic challenges in long-term care. LeadingAge intends to follow up throughout the year with additional recommendations that extend the concepts to support more improvements in nursing homes and other parts of the continuum. The proposals reflect the importance of understanding how policy solutions must reflect sensitivity to a facility’s size and location (rural vs. urban). The recording of yesterday’s morning’s press conference is available and materials are posted on the LeadingAge Care for our Seniors Act page.

Quality Metrics tool down for maintenance

LeadingAge New York announced the Quality Metrics tools will be moving to the cloud. This tool includes the 5-Star Analysis Report and the SNF Trend Report. The move will necessitate taking the site down for at least a week beginning Monday, March 22. LeadingAge New York is working with an outside vendor to move the platform, and  the tool will be back online as soon as possible.

LeadingAge Need to Know: COVID-19 – March 16, 2021

LeadingAge shares the latest coronavirus news and resources with members twice each weekday. This morning's update featured an Action Alert: Urge Congress to Pass H.R. 1868 Before April 1 Action Alert.

Check out the full report here.


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Questions

Please send all questions to COVID19@leadingageohio.org. Additionally, members are encouraged to visit the LeadingAge Ohio COVID-19 Working Group facebook gro up to pose questions to peers and share best practices. LeadingAge is continuing its daily calls for all members.  To participate in these daily online updates, members should register here.  

LeadingAge Ohio is working to ensure that the information in our daily alerts, on our website, and all coronavirus-related communications is as accurate as possible. However, LeadingAge Ohio makes no guarantees about the accuracy of the information. 

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Our national partner, LeadingAge, is an association of 6,000 not-for-profit organizations dedicated to expanding the world of possibilities for aging. Together, we advance policies, promote practices and conduct research that support, enable and empower people to live fully as they age.