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Authors Posts by Melissa Dehoff

Melissa Dehoff

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Melissa Dehoff is responsible for all medical rehabilitation and brain injury service issues. Ms. Dehoff attends multiple state-level meetings to advocate on behalf of members on brain injury and rehabilitation issues and is a member of the Department of Health Traumatic Brain Injury Advisory Board.

As required by the Biden-Harris Administration, the Centers for Medicare and Medicaid Services (CMS) issued an emergency regulation that requires the COVID-19 vaccination of eligible staff at heath care facilities that participate in Medicare and Medicaid programs.

The regulation will create a consistent standard within Medicare and Medicaid while giving patients assurance of the vaccination status of those delivering care. These requirements will apply to approximately 76,000 providers and cover over 17 million health care workers across the country.

Facilities covered by this regulation must establish a policy ensuring all eligible staff have received the first dose of a two-dose COVID-19 vaccine or a one-dose COVID-19 vaccine prior to providing any care, treatment, or other services by December 5, 2021. All eligible staff must have received the necessary shots to be fully vaccinated (either two doses of Pfizer or Moderna or one dose of Johnson & Johnson) by January 4, 2022.

The regulation also provides for exemptions based on recognized medical conditions or religious beliefs, observances, or practices. Facilities must develop a similar process or plan for permitting exemptions in alignment with federal law.

CMS will ensure compliance with these requirements through established survey and enforcement processes. If a provider or supplier does not meet the requirements, it will be cited by a surveyor as being non-compliant and have an opportunity to return to compliance before additional actions occur. CMS’s goal is to bring health care providers into compliance. However, the Agency will not hesitate to use its full enforcement authority to protect the health and safety of patients.

The requirements apply to: Ambulatory Surgical Centers, Hospices, Programs of All-Inclusive Care for the Elderly, Hospitals, Long Term Care facilities, Psychiatric Residential Treatment Facilities, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Home Health Agencies, Comprehensive Outpatient Rehabilitation Facilities, Critical Access Hospitals, Clinics (rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services), Community Mental Health Centers, Home Infusion Therapy suppliers, Rural Health Clinics/Federally Qualified Health Centers, and End-Stage Renal Disease Facilities.

The Centers for Disease Control and Prevention (CDC) issued a new report, “Differences in State Traumatic Brain Injury-Related Deaths, by Principal Mechanism of Injury, Intent, and Percentage of Population Living in Rural Areas-United States, 2016–2018,” that shows Traumatic Brain Injury (TBI)-related death rates are higher in the South and Midwest regions of the United States (U.S.). States with a higher percentage of people living in rural areas also had higher rates of TBI-related deaths during 2016–2018. Suicide and unintentional falls contributed the highest number of TBI-related deaths in most states. Some additional key findings from this report include:

  • The South and Midwest regions had the highest rates of TBI-related deaths (19.2 per 100,000 and 18.1 per 100,000, respectively). The overall U.S. TBI-related death rate was 17.3 per 100,000.
  • The Northeast and West regions had the lowest rates of TBI-related deaths (12.8 per 100,000 and 16.8 per 100,000, respectively).
  • The lowest rate was in New Jersey (9.3 per 100,000), while the three highest state rates were in Alaska (34.8), Wyoming (32.6), and Montana (29.5).
  • Suicide was responsible for the highest number and the highest rate of TBI-related deaths for most states.
  • More than 40 percent of TBI-related deaths were due to homicides or suicides.

The Traumatic Brain Injury (TBI) Advisory Board, established under section 1252 of the Federal Traumatic Brain Injury Act of 1996 (42 U.S.C.A. § 300d-52), will hold a virtual public meeting on Friday, November 5, 2021. Due to health concerns related to the novel coronavirus (COVID-19), the virtual public meeting will be conducted by means of Microsoft Teams from 10:00 am–3:00 pm.

Meeting materials will be sent out before the virtual public meeting and will also be available on the TBI Advisory’s website.

To join the Microsoft Teams meeting, dial: (267) 332-8737. The conference ID is 594 546 760#.

The Department of Health’s (DOH) Head Injury Program (HIP) strives to ensure that eligible individuals who have a traumatic brain injury receive high quality rehabilitative services aimed at reducing functional limitations and improving quality of life. The TBI Advisory Board assists the Department in understanding and meeting the needs of persons living with traumatic brain injury and their families. This quarterly virtual public meeting will provide updates on a variety of topics, including the number of people served by HIP. In addition, meeting participants will discuss budgetary and programmatic issues, community programs relating to traumatic brain injury, and available advocacy opportunities.

For additional information, or for persons with a disability who wish to attend the virtual public meeting and require an auxiliary aid, service, or other accommodation to do so, contact Nicole Johnson, Division of Community Systems Development and Outreach at (717) 772-2763, or for speech and/or hearing-impaired persons, contact V/TT (717) 783-6514 or the Pennsylvania Hamilton Relay Services at (800) 654-5984.

Questions about the meeting should be directed to Nicole Johnson.

The Office of Long-Term Living (OLTL) has announced that a Financial Management Services (FMS) Stakeholder meeting has been scheduled for November 5, 2021 from 1:00 pm–2:30 pm. The purpose of this public meeting is to discuss upcoming changes for the administration of FMS under Community HealthChoices (CHC), the OBRA waiver, and Act 150 programs. Both representatives from OLTL and the CHC Managed Care Organizations (MCOs) will be in attendance. The meeting details are provided below:

Join from the meeting link.

Join by meeting number
Meeting number (access code): 2633 774 7977
Meeting password: Stakeholder

 

Tap to join from a mobile device (attendees only)
+1-408-418-9388,,26337747977## United States Toll
+1-202-860-2110,,26337747977## United States Toll (Washington D.C.)

 

Join by phone
+1-408-418-9388 United States Toll
+1-202-860-2110 United States Toll (Washington D.C.)
Global call-in numbers

 

Join from a video system or application
Dial 26337747977@pa-hhs.webex.com
You can also dial 173.243.2.68 and enter your meeting number.

The Department of Health and Human Services (HHS) Secretary Xavier Becerra has again issued the renewal of the COVID-19 public health emergency (PHE) due to the continued consequences of the COVID-19 pandemic. The renewal became effective on October 18, 2021 and will extend the PHE into early 2022. This PHE status enables the Centers for Medicare and Medicaid Services (CMS) to keep all applicable waivers in place.

The Pennsylvania Department of Aging recently announced a “Save the Date” for an upcoming virtual forum with the Alzheimer’s and Dementia Related Disorders Task Force on November 4, 2021 from 9:00 am–12:30 pm. The primary topic of the virtual forum is Physician and Consumer Education in Early Detection, Diagnosis, and Treatment.

Registration will open on October 13, 2021. Questions should be directed to Heidi Champa, Aging Services Specialist.

The Council on Brain Injury (CoBI) has announced an upcoming webinar/clinical forum, “Caregiver Needs: Insights for Professionals,” on October 13, 2021 from 3:30 pm–5:00 pm. This lecture will address an often-overlooked group — the caregivers of those living with acquired brain injuries (ABI). Caregivers often step into their roles out of love, a sense of duty, or a lack of other options. They often don’t recognize themselves as “caregivers” and can end up neglecting their own needs, feeling exhausted and isolated, and at risk for health complications themselves. Elissa Lewin (of Nancy’s House) will discuss the importance of helping caregivers to recognize their own physical and emotional needs and how professionals can help. A live question and answer session will follow the presentation. Please register here.

This session is intended for a professional audience. There is no cost to attend. 

The following announcement/reminder was issued and directed to Personal Care Homes (PCH), Assisted Living Residences (ALRs), and nursing facilities (NFs) by the Department of Human Services (DHS)/Office of Long-Term Living (OLTL):

This message is to serve as a reminder that the deadline to apply for American Rescue Plan Act (ARPA) payments is Friday, October 15, 2021. If you have not yet submitted your Facility Acceptance Form, please do so on or before October 15 using the highlighted directions below. The facility acceptance form may be found on the DHS Long-Term Care Providers page. PCH and ALR providers that already submitted a Facility Acceptance Form do not need to resend a form.


This message is to update and replace the Listserv email sent on August 31, 2021 with the subject “American Rescue Plan Act (ARPA) One-Time Payments – Notification, Instructions, and Timelines.”

The Office of Long-Term Living has published revised lists of qualifying entities and payment amounts for personal care home (PCH) and assisted living residence (ALR) ARPA payments. The revised lists are available as of September 9, 2021, on the DHS Long-Term Care Providers page under the heading ‘American Rescue Plan Act (ARPA) Funding.’ Revisions include the addition of providers omitted from the original published list and corrected payment amounts for providers that experienced a change of ownership or a name change between April 1, 2020 and June 1, 2021. These revisions resulted in adjustments to payment amounts for all qualifying PCH and ALR providers.

PCH and ALR providers that already submitted a Facility Acceptance Form do not need to resend a form. 


American Rescue Plan Act (ARPA) One-Time Payments – Notification, Instructions, and Timelines

Governor Wolf signed Act 24 of 2021, which allocates $282 million of federal funding from the American Rescue Plan Act (ARPA) for payments to nursing facilities (NF), personal care homes (PCH), and assisted living residences (ALR). To qualify for the one-time payment, a facility must be in operation as of June 1, 2021.

These one-time ARPA funds must be used for COVID-19 related costs not otherwise reimbursed by federal, state, or other sources of funding. The Office of Long-Term Living (OLTL) sent a letter dated August 30, 2021, with details about the payments, including information about the approved use of and reporting on these funds. For reference, a sample of the letter, a list of qualifying entities and payment amounts, and a copy of the Facility Acceptance Form are available on the DHS Long-Term Care Providers page under the heading ‘American Rescue Plan Act (ARPA) Funding.’

Nursing Facility Payments

  • ARPA NF Payment #1 – Medical Assistance (MA) Days
    • The total funds available for a one-time payment to Non-Public and County NFs pursuant to Act 24 (ARPA NF Payment #1) is $198,000,000. Each facility’s ARPA NF Payment #1 is calculated by dividing the facility’s MA days, as reported for the NF Assessment for the third quarter of calendar year 2019, by 4,976,570, the revised total 2019 MA days for all facilities, as reported for the NF Assessment for the third quarter of calendar year 2019, to obtain an NF specific quotient. Each NF’s quotient is multiplied by $198,000,000 to determine its payment amount.
  • ARPA NF Payment #2 – Licensed NF Beds
    • The total funds available for a one-time payment to Non-Public and County NFs pursuant to Act 24 (ARPA NF Payment #2) is $49,000,000. Each facility’s ARPA NF Payment #2 is calculated by dividing the facility’s licensed NF beds as of March 31, 2020 by all licensed Non-Public and County NF beds as of March 31, 2020 to obtain an NF specific quotient. Each NF’s quotient is multiplied by $49,000,000 to determine its payment amount.

NFs enrolled in MA do not need to submit requests for funding. All NFs enrolled in MA will receive the funding, provided they meet the criteria described above. OLTL will distribute the funding as a one-time gross adjustment. NFs enrolled in MA can expect to see the payment appear as a gross adjustment transaction/lump sum payment on the PROMISe remittance advice dated September 6, 2021, with payment occurring September 15, 2021.

NFs not enrolled in MA must complete the Facility Acceptance Form and return it by October 15, 2021, to DHS. Providers may also fax the completed form to the OLTL Bureau of Finance at 717-787-2145. Checks will be issued and mailed in the order in which DHS receives Facility Acceptance Forms.

PCH/ALR Payments

  • ARPA PCH/ALR Payment #1 – Licensed Occupancy
    • The total funds available for a one-time ARPA payment to PCHs and ALRs pursuant to Act 24 (ARPA PCH/ALR Payment #1) is $27,000,000. Each PCH/ALR Payment #1 is calculated by dividing the licensed occupancy of the PCH or ALR, as determined by the most recent DHS inspection on or before April 1, 2020, by the total licensed occupancy of all PCHs and ALRs, including those with a special care designation, as determined by the most recent DHS inspection on or before April 1, 2020, to obtain a facility-specific quotient for each PCH and ALR. Each facility’s quotient is multiplied by $27,000,000 to determine its payment amount.
  • ARPA PCH/ALR Payment #2 – Supplemental Security Income (SSI) Residents Served
    • The total funds available for a one-time ARPA payment to PCHs and ALRs pursuant to Act 24 (ARPA PCH/ALR Payment #2) is $3,000,000. Each ARPA PCH/ALR Payment #2 is calculated by dividing the number of individuals for whom the PCH/ALR received a state SSI payment from DHS in March 2020 by the total of all PCH’s/ALR’s individuals for whom a state SSI payment was made in March 2020 to obtain a facility-specific quotient. Each PCH’s/ALR’s quotient is multiplied by $3,000,000 to determine its payment amount.

PCHs and ALRs must complete the Facility Acceptance Form and return it by October 15, 2021, to DHS. Providers may also fax the completed form to the OLTL Bureau of Finance at 717-787-2145. Checks will be issued and mailed in the order in which DHS receives the Facility Acceptance Forms. 

Act 24 of 2021 requires the ARPA funding to be obligated by December 31, 2024, and spent by December 31, 2026, or returned to the commonwealth. Additionally, these funds must be used for COVID-19 related expenses. Providers must keep documentation to prove that these funds were used for their response to the COVID-19 pandemic in case of an audit. Any person or entity accepting an ARPA payment agrees to provide documentation to DHS, upon request, for purposes of determining compliance with Act 24 requirements. Instructions on expenditure reporting will be provided at a later date.

DHS recommends that providers consult their accountants or attorneys for further clarification on acceptable uses of ARPA funding. DHS encourages providers to review guidance for eligible expenditures on the U.S. Department of the Treasury website in their Compliance and Reporting Guidance.

NFs that have questions about the information in this Listserv should contact the OLTL Provider Helpline at 800-932-0939.

PCHs and ALRs that have questions about the information in this Listserv should contact the Operator Support Hotline at 866-503-3926 or via email.