COVID-19 Top Five Things to Know for March 31, 2020

1. Governor Announces CA Health Corps and Waived Licensing/Amended Scopes of Practice
   Governor Newsom announced today that he signed an Executive Order to waive professional licensing  and certification requirements and amend scopes of practice for certified nursing assistants, home health aides, and nursing home administrators, among others to respond to the pandemic. He announced the creation of the California Health Corps and related website healthcorps.ca.gov to immediately recruit 37,000 retired and inactive, as well as students, workers into the field.  
2. FMLA Includes New Exemptions
   The Department of Labor provided clarification on employers / employees who are exempted from the FMLA Expansion, including amongst others health care providers, nursing facility, retirement facility, nursing home, home health care providers, any facility that performs laboratory or medical testing, pharmacy, or any similar institution, employer, or entity. This includes any permanent or temporary institution, facility, location, or site where medical services are provided that are similar to such institutions. We are seeking clarification on housing providers. Consult with an attorney as these exemptions have nuances that you must be aware of.
3. More information at https://www.dol.gov/newsroom/releases/whd/whd20200328 and https://www.dol.gov/agencies/whd/pandemic/ffcra-questions#58
4. CDPH Announces Temporary Waiver of Specified Regulatory Requirements
   CDPH has issued AFL 20-32 announcing a temporary waiver of specified regulatory requirements due to the state of emergency related to the COVID-19 outbreak. No need to submit individual program flexibility requests. Valid until June 30, 2020 and may be extended. Waivers include the following categories: Licensure - allows for the immediate care of any SNF waiting for approval of initial licensure, change of service or increase in bed capacity.
5. • a. Staffing - staffing ratios of 3.5 ppd and 2.4 CNA ppd (statute)
   • b. Staffing - staffing ratios of 3.5 ppd and 2.4 CNA ppd (regulation
   • c. Services - flexibility in providing or suspending activity programs
   • d. Space Conversion - capacity, use, etc.
   • e. Space Conversion - temporary use and conditions of statewide waiver
   Read the full AFL: https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/AFL-20-32.aspx
6. CMS Emergency Declaration Waivers
   Highlights include:
• a. SNF waivers: waiver of 3 day hospital stay for coverage of a SNF stay, including dislocations; waiver of PASARR; waiver for use of non-patient rooms to accommodate more beds in SNFs;  waiver of Nurse Aides training and certification requirements for 4 months;
• b. Home Health waivers: waiver for Home Health RAPs extension of auto-cancellation dates; extending 5-day completion for comprehensive assessment; waiver of 30-day OASIS submission; waiver of initial assessment via remote monitoring or record review; waiver of onsite visits for HHA Aide supervision
• c. Hospice: waiver of requirement to use hospice volunteers; waiver of timeline for comprehensive hospice assessment from 15 to 21 days; waiver of requirement to provide certain non-core services, including PT, OT & ST; waiver of onsite visits for hospice aide supervision
  
  https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf
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7. PACE Routine Audits Suspended
   The PACE memo says that CMS is suspending routine audit activity for PACE organizations. Audits related to instances of “noncompliance where the health and/or safety of beneficiaries are at serious risk (for example, lack of access to critically needed health services or prescription drugs)” and those related to infection control related complaints. For those interested, this suspension also extends to Medicare Advantage plans. On a related note, Brendan at LeadingAge national had an email exchange with CMS and they said PACE organizations may use telephone only for “face to face” visits for the time being; we’ll press to get this more officially.
8. resources
   We have up to the minute and regular updates that consolidate state and national information on our COVID-19 Resources page and LeadingAge California Connect.