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Authors Posts by Jim Sharp

Jim Sharp

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Hole torn in a dollar bill with medicaid text

Excerpt from: Pennsylvania Capital-Star, Nov. 23, 2021

The Democratic Wolf administration says it wants to spend $1.2 billion in American Rescue Act funds to shore up home and community-based services offered through the state’s Medicaid program, all with an eye toward allowing more of the commonwealth’s residents to access services closer to home. On Monday, the administration dropped the formal details of a plan to direct the federal relief money toward seniors and adults with intellectual and physical disabilities; adults dealing with such behavioral health needs as substance abuse disorder or mental illness; and children with chronic and complex medical needs, the administration said in a statement.

In its statement, the administration said the money also would be used to pay for:

  • Increasing access to home and community-based services;
  • Providing necessary supplies to safely facilitate services;
  • Additional trainings and learning opportunities through workforce support;
  • Supporting families caring for their loved one;
  • Improving functional capabilities of people with disabilities;
  • Enhancing transitional supports; and
  • Home and community-based services capacity building.

RCPA continues its discussions and advocacy with the Department of Human Services on spending priorities for human services, especially initiatives targeting rate structures and the workforce crisis.

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Businesses Left in Limbo on COVID-19 Mandate
Excerpts from: The Hill, November 10, 2021

Businesses are in limbo after a federal court halted the Biden administration’s vaccine-or-test mandate for private employers.  

Employers are preparing to enforce the Occupational Safety and Health Administration’s (OSHA) rule, which would require businesses with 100 or more employees to mandate COVID-19 vaccinations or weekly testing by Jan. 4.

But it’s now unclear whether the requirement will survive legal challenges after the 5th U.S. Circuit Court of Appeals temporarily blocked the rule over the weekend, creating confusion among companies on how to move forward. Labor lawyers are urging businesses to continue preparing for key OSHA deadlines, given that the court’s stay, for now, is only temporary.

“I think it’s prudent for employers to proceed with planning assuming that the OSHA rule, at least in some form or fashion, will be implemented pending final resolution of the various court cases,” said Michelle Strowhiro, a lawyer at McDermott Will & Emery who advises businesses on COVID-19 employment issues.

While the OSHA rule requires businesses to mandate weekly testing for unvaccinated employees by January, the most important deadline is coming up soon. By Dec. 5, employers must collect employees’ proof of vaccination and provide paid leave for those getting the shot, while unvaccinated employees must begin wearing a mask. 

The risks are high for businesses banking on the rule being overturned. Employers that don’t comply face fines of up to $136,532 for willful violations. 

“Employers should be keeping one eye on the courts and one eye on taking the steps necessary to comply with the regulation by the time it comes into effect in early December so that they’re not caught flat-footed,” said Evandro Gigante, an employment attorney at Proskauer Rose LLP. 

Large companies that don’t already track their employees’ vaccination status are scrambling to adopt systems to verify that information ahead of the December deadline. They’re also crafting rules that lay out religious and disability accommodations and the penalties for employees who don’t comply with the OSHA requirement. 

The OSHA rule has already drawn a flurry of lawsuits from GOP-led states and conservative interest groups. Following a challenge from Texas, Louisiana, Mississippi, Utah and South Carolina, the 5th Circuit temporarily halted the rule Saturday, citing “grave statutory and constitutional issues.”

The OSHA rule has been challenged in several different circuit courts, and the cases will likely be combined into one and sent to a federal appeals court as soon as next week. Experts say the lottery will probably send the case to a less conservative court than the 5th Circuit, which previously allowed Texas’s controversial six-week abortion ban to remain in effect.

Whichever side loses the case is expected to appeal to the Supreme Court, which has a 6-3 conservative majority. Labor lawyers largely believe that the OSHA standard is constitutional, and they note that it is less strict than other federal vaccine mandates for health care workers and federal contractors. However, it’s still unclear whether the rule would survive the high court. 

In the meantime, the Biden administration is urging large employers to move forward with workplace vaccine requirements as it fights to protect its rule in court.

Private vaccine mandates have steadily grown more popular throughout the pandemic. Several companies, including United Airlines and Tyson Foods, have already enacted their own vaccine requirements that are far stricter than the minimum OSHA standard.

An October survey from consulting firm Mercer found that 34 percent of employers — made up mostly by businesses with 100 or more employees — currently have some form of vaccine mandate in place.

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The Center for Medicare & Medicaid Services (CMS) has released a one-page overview titled “COVID-19 Vaccination Requirement for Health Care Providers and Suppliers.” The one-pager gives an overview of the facilities and organizations that are required to participate in the vaccine mandate as well as guidance for meeting the standards and the enforcement process.

RCPA continues to engage with the Department of Human Services (DHS) and the Governor’s office on Pennsylvania specific recommendations and guidance as it relates to this mandate. We will continue to apprise members of any changes or state specific implications.

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Photo by Markus Winkler on Unsplash

Mandatory Vaccination Update
Medicare and Medicaid Programs: Omnibus COVID-19 Health Care Staff Vaccination
OSHA Emergency Temporary Standard (ETS)  

RCPA continues to work for clarification with our State stakeholders from the Department of Human Services (DHS) and the Governor’s office as well as for guidance at the federal end through our National Councils.

The National Council on Mental Wellbeing has received several questions around the recent vaccine mandates released by the Biden Administration. The following links and summaries from the Council’s federal consultant group may answer some of your questions.

On November 4, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule with comment (IFC), entitled “Medicare and Medicaid Programs: Omnibus COVID-19 Health Care Staff Vaccination” (Rule and Press Release).The FAQ provides excellent scenario-based guidance that may be applicable to your agency.

The IFC stipulates that all staff members of certain providers and suppliers participating in the Medicare and Medicaid programs, including those who perform their duties outside of a formal clinical setting, must be fully vaccinated against COVID-19 unless exempt. The definition of applicable facilities under the Medicare-certified providers and suppliers is listed under federal statute (for example, the current Medicare definition of CMHCs (there are 129 Medicare-certified CMHCs throughout the country), which is Section 4162 of the Omnibus Budget Reconciliation Act of 1990 (Pub. L. 101–508, enacted November 5, 1990) (OBRA 1990), which added sections 1861(ff) and 1832(a)(2)(J) to the Act, includes CMHCs as entities that are authorized to provide partial hospitalization services under Part B of the Medicare program).

However, the definition of Medicaid-certified providers and suppliers will vary by state. To that end RCPA, as part of its efforts, is seeking this clarification and to confirm determinations on which providers and suppliers are subject to the IFC. 

As noted in the summary below, the IFC does not allow for weekly testing in lieu of vaccination and maintains the employer’s right to require full vaccination of employees regardless of exemptions listed in the IFC. The final rule is expected to be published in The Federal Register on November 5, 2021, with an expected effective date of January 4, 2022. There will be the opportunity to comment on the IFC. Comments must be received no later than 60 days after the publication of the IFC in The Federal Register.

Also released was the Occupational Safety and Health Administration (OSHA) Emergency Temporary Standard (ETS) for COVID-19 Vaccination and Testing in the Workplace (Rule; Fact Sheet; Press Release). The ETS requires employees who are employed by private-sector employers with 100 or more employees to get vaccinated or test negative for the virus once per week and wear a mask indoors. It also requires employers to provide paid time off for employees to get vaccinated and recovery time from vaccination. The 28 states with OHSA-approved state plans must also adhere to the ETS.

The ETS mandates that employers determine the vaccination status of each employee, obtain acceptable proof of vaccination status from vaccinated employees, and maintain records and a roster of each employee’s vaccination status.

The testing requirement for unvaccinated workers is slated to begin on January 4, 2022, and employers must comply with all other requirements (i.e. providing paid time off for employees to get vaccinated and masking for unvaccinated workers) by December 5, 2021. Employees falling under the ETS rules will need to have their final vaccination dose by January 4, 2022.

OSHA has published a series of resources with respect to this ETS, including frequently asked questions, guidance materials, and reporting requirements.

RCPA will continue to update members on the status and any changes to the current information that has been published.

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Dual Diagnosis Professional Conference Series:
Trauma Informed Care — Overview and Practical Applications

The Department of Human Services’ Office of Developmental Programs (ODP) and the Office of Mental Health and Substance Abuse Services (OMHSAS) are pleased to announce the Dual Diagnosis Professional Conference Series, which offers presentations focused on supporting individuals with intellectual disabilities and autism (IDA) and mental health needs. The selected presenters share their expertise on best and promising practices as well as provide general knowledge. Session topics, which focus on increasing capacity to serve individuals with dual diagnosis in the community, are chosen based on identified needs and with input from the field of professional stakeholders.

  • Invited audience of all professional stakeholders, including direct and clinical supporters for individuals with IDA are encouraged to attend.
  • Registration is required and is without charge to attendees.
  • Three (3) hours of training credit and a certificate of achievement is provided.

Please see the flyer for additional information, including registration information.

If you have questions or concerns regarding registration for this event, please email PA Training.

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