New Way for Medicare Beneficiaries to Get Free Over-the-Counter COVID-19 Tests

The Biden administration is announcing today that more than 59 million Americans with Medicare Part B, including those enrolled in a Medicare Advantage plan, now have access to Food and Drug Administration (FDA) approved, authorized, or cleared over-the-counter COVID-19 tests at no cost. People with Medicare can get up to eight tests per calendar month…

UPDATE! Current Status of the Federal Vaccine Mandates

The status of the COVID-19 vaccine mandates from the Centers for Medicare & Medicaid Services (CMS) and the Occupational Safety and Health Administration (OSHA) vaccine mandates continue to evolve with extensive ongoing litigation and policy adjustments by the respective federal agencies. NAHC’s outside employment law counsel, Polsinelli, has prepared a detailed memorandum setting forth the status of the mandate rules and policy.

It looks like that the ultimate outcome will lie in the hands of the U.S. Supreme Court in the near term. The Court has ordered expedited briefing on the emergency petitions pending before the Court following several Court of Appeals rulings.  That generally means we may see some preliminary decisions from the Court early in 2022.

Meanwhile, NAHC continues to advise members to be prepared for implementation and enforcement of the CMS and OSHA requirements, although holding off on termination or suspension of staff that are not compliant. Also, it is essential that you keep in mind state and local requirements relative to a vaccine mandate or other infection control measures.

We urge you to read the entire memo.

From Polsinelli

Authors: Angelo Spinola & Will Vail

On November 4, 2021, the Biden Administration made three vaccine mandate announcements. Since then, there has been robust litigation bringing these mandates into question. This updated memo will detail these announcements, offer ideas on how to determine their impact (if any) on your business and tell you about some solutions we have created.

One of the announcements came from the Occupational Safety and Health Administration (OSHA). It announced a new Emergency Temporary Standard (ETS) that gives “large” employers the option of requiring vaccinations or allowing employees to test weekly for COVID-19. The Centers for Medicare & Medicaid Services (CMS) also simultaneously issued an Interim Final Rule that requires covered providers to implement a mandatory vaccination policy for “staff” to keep safe those who are receiving care. And finally, the Biden Administration pushed back the compliance date for federal contractors to January 18, 2022 (meaning the second of two shots would need to be administered by January 4, 2022).

Read the entire memo.

UPDATE! Current Status of the Federal Vaccine Mandates

The status of the COVID-19 vaccine mandates from the Centers for Medicare & Medicaid Services (CMS) and the Occupational Safety and Health Administration (OSHA) vaccine mandates continue to evolve with extensive ongoing litigation and policy adjustments by the respective federal agencies. NAHC’s outside employment law counsel, Polsinelli, has prepared a detailed memorandum setting forth the…

Build Back Better Passes the House of Representatives

  • Here is what it means for NAHC members and their patients

The Build Back Better Act, a signature legislative priority for the Biden administration and its allies in Congress, passed the House of Representatives this morning on a party line vote of 220-213. The legislation now heads to the Senate for consideration.

The Build Back Better Act (BBB) is a roughly $1.7 trillion social spending package that, among other things, creates new Medicare benefits for hearing services and enables the government to negotiate some prescription drug prices to lower the costs that seniors pay for lifesaving medicines such as insulin.

The legislation also contains substantial implications for the future of home and community-based services in the United States, as well as training and development of the direct care workforce.

“Today’s historic vote of support for home care comes at a time when the country needs it more than ever,” said NAHC President William A. Dombi, moments after the vote in the House. “Health care at home is widely recognized as high value, high quality, and highly preferred. From pediatric nursing care to home care aide services for those with multiple chronic illnesses as they age, this legislation will provide improved access to home care. We now look to the Senate to complete the work to protect our families and friends who need this essential care. “

NAHC has analyzed the legislation to see how it will impact our members and the wider home care and hospice community.

  • Bill text can be found HERE
  • A section-by-section overview of the bill’s provisions can be found HERE

The BBB bill is the cornerstone of President Biden’s and congressional Democrats’ domestic agenda. Initially proposed spending targets for the package were around $3.5 trillion, but lack of Democratic consensus on the topline figure and scope, as well as narrow margins for Democrats in both the House and Senate forced lawmakers to shrink the overall size and ambition of the bill. This legislation will impact nearly every sector of American society, and there are a number of policies with direct relevance for home health, home care, and hospice providers, some of which are NAHC advocacy priorities.

Below is background information on some of those most consequential policies included in the House BBB legislation:

Medicaid Home and Community-Based Services (HCBS) Investment (“Better Care Better Jobs Act”)

  • $150 billion investment to bolster Medicaid HCBS, with the goal of increasing access to services, reducing waitlists, and better supporting the direct care workers that provide the bulk of HCBS. Specifically, the approved language would:
    • Provide a 6% FMAP increase for HCBS;
    • Require coverage of personal care services;
    • Require caregiver supports such as respite care;
    • Require updated of payment rates that “support the recruitment and retention of the direct care workforce”;
    • Require an update of HCBS payment rates at least every three years;
    • Make permanent the protections against spousal impoverishment for recipients of Medicaid HCBS;
    • Make permanent the Medicaid Money Follows the Person (MFP) demonstration that helps those in institutional facilities transition back to the community.
      • See the legislative language for this provision HERE
      • See an overview of the provision HERE

Direct Care Worker Training and Support Investments

  • $400 million/yr for FY2023-2026 for a grant-based program that would bolster frontline caregivers’ access to economic and educational supports. These grants would go to states and territories, to be spent on things like worker wage subsidies, student loan repayment or tuition assistance for a degree or certification in a relevant field, childcare for eligible workers, and transportation assistance, amongst other approved activities that benefit direct care workers. The bill makes clear that aides working in home health, personal care, and hospice, as well as LPNs and LCSWs, are eligible to receive support under these grants.
    • See the legislative language for this provision HERE
    • See an overview of the provision HERE
  • $1 billion over 10 years for a separate program to support the direct care workforce through renewable three-year grants administered by the Dept of Labor. Grants can be used to invest in strategies to recruit, retain, and advance the direct care workforce; implement models and strategies to make the field of direct care more attractive; and improve wages, including through training and registered apprenticeships, career pathways, or mentoring.
    • See the legislative language for this provision HERE
    • See an overview of the provision HERE
  • $20,000,000 to fund a national technical assistance center through HHS’ Administration for Community Living which will develop and disseminate evidence-based strategies for recruitment, education and training, retention, and career advancement of direct care workers and provide recommendations for activities to further support paid and unpaid family caregivers.
    • See the legislative language for this provision HERE
    • See an overview of the provision HERE

Additional Health Workforce Investments

  • $400 million for the Health Profession Opportunity Grant (HPOG) program, which awards grants to organizations to provide education and training to low-income individuals for occupations in the health care field that are expected to either experience labor shortages or be in high demand. Home care and home health aides are identified as being HPOG-eligible professions.
    • See the legislative language for this provision HERE
    • See an overview of the provision HERE

Paid Family and Medical Leave

  • Starting in January 2024, all workers would be eligible for up to four weeks of paid leave for new parents, workers dealing with their own serious medical conditions, and workers who need leave to care for a loved one with a serious medical issue. Benefits would be progressive, with lower-income workers receiving higher levels of wage replacement. Wage replacement would be about two-thirds for the average worker.
    • See the legislative language for this provision HERE

Increases in OSHA Fine Amounts

  • Amends the Occupational Safety and Health Act of 1970 to:
    • Increase the maximum penalty to $700,000 for willful and repeat violations (current penalty is $136,532);
    • Increase the minimum penalty to $50,000 for willful violations (current penalty if $9,753);
    • increase the maximum penalty for both serious and failure-to-abate violations to $70,000. (current penalties are $13,653);
  • See the legislative language for these provisions HERE

The bill also includes a number of provisions that would:

  • Expand Medicaid coverage;
  • Lower prescription drug costs;
  • Extend ACA marketplace health plan subsidies;
  • Add hearing coverage to the Medicare program;
  • Invest tens of billions of dollars in bolstering public health infrastructure and training;
  • Boost funding by over $1 billion for Older Americans Act (OAA) programs that support older adults and family caregivers;
  • Provide $40 million in funding for programs to support family caregivers’ mental health and well-being;
  • Provide $500 million in new grant funding to support medical-legal partnerships (programs that integrate patient-centered legal services into health care settings to address their patient and families’ health-related social needs).

Major health and care-related provisions that were not incorporated into the House bill include:

  • A separate tax credit for family caregivers (A NAHC policy priority issue);
  • New Medicare dental and vision benefits.

As negotiations over the legislation move to the Senate, NAHC will continue to advocate for polices that will benefit patients, families and the home-based providers that care for them. We are closely tracking the movement on this massive bill, and will be updating members on relevant developments as they arise. Stay tuned to NAHC Report for updates.

Build Back Better Passes the House of Representatives

  • Here is what it means for NAHC members and their patients

The Build Back Better Act, a signature legislative priority for the Biden administration and its allies in Congress, passed the House of Representatives this morning on a party line vote of 220-213. The legislation now heads to the Senate for consideration.

The Build Back Better Act (BBB) is a roughly $1.7 trillion social spending package that, among other things, creates new Medicare benefits for hearing services and enables the government to negotiate some prescription drug prices to lower the costs that seniors pay for lifesaving medicines such as insulin.

The legislation also contains substantial implications for the future of home and community-based services in the United States, as well as training and development of the direct care workforce.

“Today’s historic vote of support for home care comes at a time when the country needs it more than ever,” said NAHC President William A. Dombi, moments after the vote in the House. “Health care at home is widely recognized as high value, high quality, and highly preferred. From pediatric nursing care to home care aide services for those with multiple chronic illnesses as they age, this legislation will provide improved access to home care. We now look to the Senate to complete the work to protect our families and friends who need this essential care. “

NAHC has analyzed the legislation to see how it will impact our members and the wider home care and hospice community.

  • Bill text can be found HERE
  • A section-by-section overview of the bill’s provisions can be found HERE

The BBB bill is the cornerstone of President Biden’s and congressional Democrats’ domestic agenda. Initially proposed spending targets for the package were around $3.5 trillion, but lack of Democratic consensus on the topline figure and scope, as well as narrow margins for Democrats in both the House and Senate forced lawmakers to shrink the overall size and ambition of the bill. This legislation will impact nearly every sector of American society, and there are a number of policies with direct relevance for home health, home care, and hospice providers, some of which are NAHC advocacy priorities.

Below is background information on some of those most consequential policies included in the House BBB legislation:

Hospice and Palliative Care Training Support

  • $90 million for various investments to train, educate, and bolster the specialty hospice and palliative care provider workforce, including $25 million in funding for broad-based palliative care and hospice education and training, $20 million for palliative medicine physician training, $20 million for palliative care and hospice academic career awards, $20 million for hospice palliative care nursing, and $5 million for dissemination of palliative care information.
    • See the legislative language for this provision HERE

Medicaid Home and Community-Based Services (HCBS) Investment (“Better Care Better Jobs Act”)

  • $150 billion investment to bolster Medicaid HCBS, with the goal of increasing access to services, reducing waitlists, and better supporting the direct care workers that provide the bulk of HCBS. Specifically, the approved language would:
    • Provide a 6% FMAP increase for HCBS;
    • Require coverage of personal care services;
    • Require caregiver supports such as respite care;
    • Require updated of payment rates that “support the recruitment and retention of the direct care workforce”;
    • Require an update of HCBS payment rates at least every three years;
    • Make permanent the protections against spousal impoverishment for recipients of Medicaid HCBS;
    • Make permanent the Medicaid Money Follows the Person (MFP) demonstration that helps those in institutional facilities transition back to the community.
      • See the legislative language for this provision HERE
      • See an overview of the provision HERE

Direct Care Worker Training and Support Investments

  • $400 million/yr for FY2023-2026 for a grant-based program that would bolster frontline caregivers’ access to economic and educational supports. These grants would go to states and territories, to be spent on things like worker wage subsidies, student loan repayment or tuition assistance for a degree or certification in a relevant field, childcare for eligible workers, and transportation assistance, amongst other approved activities that benefit direct care workers. The bill makes clear that aides working in home health, personal care, and hospice, as well as LPNs and LCSWs, are eligible to receive support under these grants.
    • See the legislative language for this provision HERE
    • See an overview of the provision HERE
  • $1 billion over 10 years for a separate program to support the direct care workforce through renewable three-year grants administered by the Dept of Labor. Grants can be used to invest in strategies to recruit, retain, and advance the direct care workforce; implement models and strategies to make the field of direct care more attractive; and improve wages, including through training and registered apprenticeships, career pathways, or mentoring.
    • See the legislative language for this provision HERE
    • See an overview of the provision HERE
  • $20,000,000 to fund a national technical assistance center through HHS’ Administration for Community Living which will develop and disseminate evidence-based strategies for recruitment, education and training, retention, and career advancement of direct care workers and provide recommendations for activities to further support paid and unpaid family caregivers.
    • See the legislative language for this provision HERE
    • See an overview of the provision HERE

Additional Health Workforce Investments

  • $400 million for the Health Profession Opportunity Grant (HPOG) program, which awards grants to organizations to provide education and training to low-income individuals for occupations in the health care field that are expected to either experience labor shortages or be in high demand. Home care and home health aides are identified as being HPOG-eligible professions.
    • See the legislative language for this provision HERE
    • See an overview of the provision HERE

Paid Family and Medical Leave

  • Starting in January 2024, all workers would be eligible for up to four weeks of paid leave for new parents, workers dealing with their own serious medical conditions, and workers who need leave to care for a loved one with a serious medical issue. Benefits would be progressive, with lower-income workers receiving higher levels of wage replacement. Wage replacement would be about two-thirds for the average worker.
    • See the legislative language for this provision HERE

Increases in OSHA Fine Amounts

  • Amends the Occupational Safety and Health Act of 1970 to:
    • Increase the maximum penalty to $700,000 for willful and repeat violations (current penalty is $136,532);
    • Increase the minimum penalty to $50,000 for willful violations (current penalty if $9,753);
    • increase the maximum penalty for both serious and failure-to-abate violations to $70,000. (current penalties are $13,653);
  • See the legislative language for these provisions HERE

The bill also includes a number of provisions that would:

  • Expand Medicaid coverage;
  • Lower prescription drug costs;
  • Extend ACA marketplace health plan subsidies;
  • Add hearing coverage to the Medicare program;
  • Invest tens of billions of dollars in bolstering public health infrastructure and training;
  • Boost funding by over $1 billion for Older Americans Act (OAA) programs that support older adults and family caregivers;
  • Provide $40 million in funding for programs to support family caregivers’ mental health and well-being;
  • Provide $500 million in new grant funding to support medical-legal partnerships (programs that integrate patient-centered legal services into health care settings to address their patient and families’ health-related social needs).

Major health and care-related provisions that were not incorporated into the House bill include:

  • A separate tax credit for family caregivers (A NAHC policy priority issue);
  • New Medicare dental and vision benefits.

As negotiations over the legislation move to the Senate, NAHC will continue to advocate for polices that will benefit patients, families and the home-based providers that care for them. We are closely tracking the movement on this massive bill, and will be updating members on relevant developments as they arise. Stay tuned to NAHC Report for updates.

 

Build Back Better Passes the House of Representatives

Here is what it means for NAHC members and their patients The Build Back Better Act, a signature legislative priority for the Biden administration and its allies in Congress, passed the House of Representatives this morning on a party line vote of 220-213. The legislation now heads to the Senate for consideration. The Build Back…

What the Build Back Better Legislation Means for Home Care

The Build Back Better (BBB) plan is a $1.85 trillion social spending package released last week by the House of Representatives and NAHC has analyzed the legislation to see how it will impact our members and the wider home care and hospice community.

  • Bill text can be found HERE
  • A section-by-section overview of the bill’s provisions can be found HERE
  • A summary post on the bill’s framework developed by the White House can be found HERE

The BBB bill is the cornerstone of President Biden’s and congressional Democrats’ domestic agenda. Initially proposed spending targets for the package were around $3.5 trillion, but lack of Democratic consensus on the topline figure and scope, as well as narrow margins for Democrats in both the House and Senate forced lawmakers to shrink the overall size and ambition of the bill. This legislation will impact nearly every sector of American society, and there are a number of policies with direct relevance for home health, home care, and hospice providers, some of which are NAHC advocacy priorities.

Agreement on the BBB framework was supposed to result in a House vote this week on the “hard infrastructure” package that passed the Senate months ago. However, that vote was delayed once more, as House progressives indicated they would withhold support for the infrastructure deal until it becomes clearer that the Senate is on-board with the BBB legislative details. More negotiations are expected in the coming days, but the release of the House bill this week provides the clearest signal yet of what will ultimately be in a final package.

Below is background information on some of those most consequential policies included in the House BBB legislation:

Medicaid Home and Community-Based Services (HCBS) Investment (“Better Care Better Jobs Act”)

  • $150 billion investment to bolster Medicaid HCBS, with the goal of increasing access to services, reducing waitlists, and better supporting the direct care workers that provide the bulk of HCBS. Specifically, the approved language would:
    • Provide a 6% FMAP increase for HCBS
    • Require coverage of personal care services
    • Require caregiver supports such as respite care
    • Require updated of payment rates that “support the recruitment and retention of the direct care workforce.
    • Require an update of HCBS payment rates at least every three years.
    • Make permanent the protections against spousal impoverishment for recipients of Medicaid HCBS.
    • Make permanent the Medicaid Money Follows the Person (MFP) demonstration that helps those in institutional facilities transition back to the community.
      • See the legislative language for this provision HERE
      • See an overview of the provision HERE

Direct Care Worker Training and Support Investments

  • $400 million/yr for FY2023-2026 for a grant-based program that would bolster frontline caregivers’ access to economic and educational supports. These grants would go to states and territories, to be spent on things like worker wage subsidies, student loan repayment or tuition assistance for a degree or certification in a relevant field, childcare for eligible workers, and transportation assistance, amongst other approved activities that benefit direct care workers. The bill makes clear that aides working in home health, personal care, and hospice, as well as LPNs and LCSWs, are eligible to receive support under these grants.
    • See the legislative language for this provision HERE
    • See an overview of the provision HERE
  • $1 billion over 10 years for a separate program to support the direct care workforce through renewable three-year grants administered by the Dept of Labor. Grants can be used to invest in strategies to recruit, retain, and advance the direct care workforce; implement models and strategies to make the field of direct care more attractive; and improve wages, including through training and registered apprenticeships, career pathways, or mentoring.
    • See the legislative language for this provision HERE
    • See an overview of the provision HERE
  • $20,000,000 to fund a national technical assistance center through HHS’ Administration for Community Living which will develop and disseminate evidence-based strategies for recruitment, education and training, retention, and career advancement of direct care workers and provide recommendations for activities to further support paid and unpaid family caregivers.
    • See the legislative language for this provision HERE
    • See an overview of the provision HERE

Additional Health Workforce Investments

  • $400 million for the Health Profession Opportunity Grant (HPOG) program, which awards grants to organizations to provide education and training to low-income individuals for occupations in the health care field that are expected to either experience labor shortages or be in high demand. Home care and home health aides are identified as being HPOG-eligible professions.
    • See the legislative language for this provision HERE
    • See an overview of the provision HERE

Major provisions that were not incorporated into the House bill include paid family and medical leave, a tax credit for family caregivers, Medicare drug price negotiation, and new Medicare dental and vision benefits.

As Congressional negotiations progress, NAHC will continue to advocate for the inclusion in the reconciliation package of additional polices that will benefit patients, families and the home-based providers that care for them. We are closely tracking the movement on this massive bill, and will be updating members on relevant developments as they arise.

What Build Back Better & Infrastructure Legislation Mean for Home Care & Hospice

The US House of Representatives is trying to pass its massive “Build Back Better” (BBB) social spending legislative package, as well as the “hard” infrastructure legislation that was approved by the Senate months ago (the Infrastructure Investment and Jobs Act) today, November 5th, 2021. Bill text of the latest version of the BBB can be…

Biden Administration Issues Sweeping Vaccine Rules for Health Care, Businesses

The Biden administration announced yesterday that his administration will require COVID-19 vaccinations for workers in most health care settings that receive Medicare or Medicaid reimbursement. NAHC is currently studying the administration’s announcement and we look forward to receiving more details in the very near future.

“NAHC has encouraged vaccinations throughout the pandemic. We look forward to seeing the details of the President’s Executive Order,” said NAHC President Bill Dombi in response to the news.

That said, we believe the policy will include, but is not limited to:

  • home health agencies
  • hospices
  • hospitals
  • dialysis facilities
  • ambulatory surgical settings.

According to the White House, these requirements will apply to approximately 50,000 providers and cover over 17 million health care workers, a majority of health care workers across the country. “This action will create a consistent standard across the country, while giving patients assurance of the vaccination status of those delivering care,” said the White House in a statement released Thursday.

The Administration’s plan is to include the mandate as part of the federal Medicare Conditions of Participation (CoPs). The CoPs also affect state Medicaid programs as federal requirements incorporate those standards into the conditions under which states are entitled to receive federal matching supports for a state’s Medicaid spending.

In response to a question from NAHC President Bill Dombi, the CMS told NAHC that the “staff vaccination requirement would only apply to Medicare and Medicaid-certified provider and supplier types that are regulated under the Conditions of Participation. If an entity is not regulated under the CoPs, then this requirement would not apply.”

Noncompliance with the Conditions of Participation can trigger a range of penalties including termination from Medicare and/or Medicaid, Civil Monetary Penalties as high as $20,000 per  day, suspension of Medicare and/or Medicaid payments, and the insertion of temporary management.

Notably for Medicaid home care, not all providers are subject to CoPs. Federal Medicaid standards specify CoP application only for “home health services” and “hospice” care. While states can require other home care services to be provided through entities that meet Medicare CoPs, most do not.  This means that the vaccination mandate is not likely to apply to a host of Medicaid home services such as private duty nursing, personal care services, home and community-based services (HCBS) optional services for the elderly, and section 1915 waiver programs for HCBS.

 

 

CMS is developing an Interim Final Rule with Comment Period that will be issued in October to lay out the vaccination requirements for health care providers. Nevertheless, CMS expects Medicare and Medicaid facilities to comply with the new vaccination requirements now and health care workers in covered facilities are being urged to begin vaccination without further delay. Facilities are urged to use all available resources to support employee vaccinations, including employee education and clinics, as they work to meet new federal requirements.

“There is no question that staff, across any health care setting, who remain unvaccinated pose both direct and indirect threats to patient safety and population health,” said Xavier Becerra, Secretary for Health & Human Services. “Ensuring safety and access to all patients, regardless of their entry point into the health care system, is essential.”

Additionally, the Department of Labor, through the Occupational Safety and Health Administration (OSHA), will issue an Emergency Temporary Standard requiring all businesses with more than 100 employees to either mandate vaccinations for all workers or require them to take weekly COVID-19 tests.  Each violation of the OSHA standard could trigger a $14,000 penalty. The White House believes the OSHA standard will cover 80 million workers, or two-thirds of the nation’s workforce.

The announcement leaves some important questions unanswered. Such as:

  • When will Interim Final Rule and the OSHA Emergency Temporary Standard be published?
  • What will be the vaccination deadline for employees in the Interim Final Rule?
  • What vaccination exemptions will exist in the Interim Final Rule?
  • How will the vaccination exemptions be managed and monitored?
  • How will employees be counted? Full-time, FTE, all individuals regarding duration of a workday?
  • How will the mandate apply to franchise operations that individually do not have 100 employees, but exceed that number in combination?
  • Are there other ways beside the federal CoPs that the Administration can use to expand the reach of the mandate?
  • How does the mandate apply to self-directed care programs where the state or locality may be considered a joint employer?
  • What are the penalties for non-compliance outside of the $14,000 penalty referenced for an OSHA requirement?

You can expect NAHC to be in frequent contact with the administration and health care officials to obtain answers to these questions. When we receive answers, we will pass them on to NAHC members as quickly as possible. Please stay tuned to NAHC Report and other NAHC communications for updates.

The home care, home health, and hospice sectors of our health care system already suffer from severe staffing shortages and here is the very real possibility of even more significant staffing shortages should workers walk off the job rather than submit to vaccination. Shortages in staff will inevitably impact patients and patient care. This is a delicate balancing act in trying to keep patients and the workforce safe. NAHC hopes the Biden administration couples this action with efforts to help providers attract and retain more employees.

This action by the Biden administration builds on the vaccination requirement for nursing facilities recently announced by the Centers for Medicare & Medicaid Services (CMS), and will apply to:

  • nursing home staff
  • hospital staff
  • staff in other CMS-regulated settings
  • clinical staff
  • persons providing services under arrangements
  • volunteers
  • staff not involved in direct patient, resident, or client care.

Requiring Employers to Provide Paid Time Off to Get Vaccinated

OSHA is developing a rule torequire employers with more than 100 employees to provide paid time off for the time it takes for workers to get vaccinated or to recover if they suffer post-vaccination illness. This requirement will be implemented through the ETS.

New Support for Small Businesses Impacted by COVID-⁠19

Small Business Administration (SBA) will increase the maximum amount of funding a small business can borrow through the COVID Economic Injury Disaster Loan (EIDL) program, which provides long-term, low-cost loans, from $500,000 to $2 million. (An SBA analysis of current COVID EIDL borrowers who qualify for the increase shows that more than 80 percent have 25 employees or less.)

SBA will ensure that no small business has to start repaying these loans until two years after they receive the funding, so small businesses can get through the pandemic without having to worry about making payments.

Next, SBA will make it easier for small businesses with multiple locations in hard-hit sectors like restaurants, hotels, and gyms to access these loans.

SBA will offer a 30-day exclusive window of access where only small businesses seeking loans of $500,000 or less will receive awards after the new improved loan product launches.

Paycheck Protection Program (PPP) Loan Forgiveness Process

The administration’s plan is to make it easier for more than 3.5 million PPP borrowers with loans of $150,000 or less to get their loans wiped clean. Under the new streamlined approach, SBA sends a pre-completed application form to the borrower who can review, sign, and send back to SBA, which then works with the lender to complete the forgiveness process.

SBA expects more than 2.5 million additional small businesses to take advantage of this streamlined process in the months ahead, helping them avoid needless bureaucracy and avoid costly principal and interest payments on their loans.

Launching Community Navigator Program to Connect Small Businesses to Assistance

The ARP invested $100 million to establish a new SBA Community Navigator program, which will deploy trusted community partners in underserved communities to better connect business owners to federal, state, and local resources. Community Navigators will work with small business owners every step of the way to ensure that they are able to access the help that they need. Under the President’s plan, the SBA will complete the competitive review process to select Community Navigators and put them to work in underserved communities this Fall.

Access to Booster Shots

The Administration is preparing for COVID-19 vaccine boosters to start as early as the week of September 20th, subject to authorization or approval by the FDA and a recommendation from the CDC’s Advisory Committee on Immunization Practices (ACIP). Booster shots will be free and are to be made available at 80,000 locations around the country.

The National Association for Home Care & Hospice has strongly communicated to HHS how important it is that shipments of booster vaccines be sent directly to home care providers, so that safe and efficient booster vaccinations of the elderly and disabled – the most at-risk population – can take place in the home. NAHC will continue to make this case and we will keep our members up to date on this critically important topic.

Affordable and Available At-Home Tests

Walmart, Amazon, and Kroger will offer to sell rapid at-home tests at-cost for the next three months. In addition, Medicaid must cover at-home tests for free for beneficiaries, and states should ensure that any tools they use to manage at-home testing do not establish arbitrary barriers for people seeking care. The administration also plans to expand the number of retail pharmacy sites around the country where anyone can get tested for free through the HHS free testing program to 10,000 pharmacies.

The administration is also urging:

  • states to require school employees to be vaccinated;
  • schools to set up regular testing in their schools for students, teachers, and staff consistent with CDC guidance.

Getting Monoclonal Antibody Treatment to Those Who Need It

The Administration will increase the average weekly pace of shipments of free monoclonal antibody treatment to states by a further 50 percent in September. Monoclonal antibody treatments have been shown to reduce the risk of hospitalization by up to 70 percent for unvaccinated people at risk of developing severe disease. As hospital systems experience increased COVID-19 cases, many have identified monoclonal antibody treatment as a key tool to improve health outcomes, prevent hospitalizations and reduce the strain on overburdened hospitals.

Expanding the Pool of Health Care Professionals Providing Treatment by Deploying Federal Monoclonal Antibody Strike Teams

The COVID-19 Surge Response Teams have conducted in-person technical assistance and virtual trainings for physicians and health system officials to increase education and interest in administering these treatments. To ensure that more patients can access these lifesaving COVID-19 therapeutics, the Administration’s COVID-19 surge response effort will launch monoclonal antibody strike teams to deploy clinical personnel through HHS, FEMA, and DOD to help hospitals and health systems stand up the delivery of this key treatment option. HHS will also take action to amend the Public Readiness and Emergency Preparedness (PREP) Act declaration to allow more providers, including pharmacists, to administer this treatment.

This is a critical topic for our industry and our country and NAHC is heavily engaged in both studying and communicating concerns on this topic. Please stay tuned for updates.

Biden Administration Issues Sweeping Vaccine Rules for Health Care, Businesses

The Biden administration announced yesterday that his administration will require COVID-19 vaccinations for workers in most health care settings that receive Medicare or Medicaid reimbursement. NAHC is currently studying the administration’s announcement and we look forward to receiving more details in the very near future. “NAHC has encouraged vaccinations throughout the pandemic. We look forward to…