Elevating the Post-Acute and
Long Term Care Profession

May 13, 2021

Ohio to Pull out of Federal Unemployment Compensation Program. Governor Mike DeWine today announced that he will end Ohio's participation in the Federal Pandemic Unemployment Compensation (FPUC) program on June 26, 2021. FPUC provides federal funding to pay people on unemployment compensation an additional $300 per week, in addition to the regular amount. Many OHCA members and other businesses have pointed to these supplemental unemployment payments as a disincentive to returning to work, noting that low-wage workers such as nursing assistants and direct support professionals say they can make more money by not working. Several other states with Republican leaders already decided to turn down the federal assistance. Governor DeWine was quoted as saying, in support of his decision, "[w]hen the program was put in place, it was a lifeline for many Americans at a time when the only weapon we had in fighting the virus was through social distancing, masking, and sanitization .... This is no longer the case as we now have an abundant supply of vaccines." 

CMS Issues Guidance on ARPA FMAP Increase. The Centers for Medicare and Medicaid Services (CMS), by way of a State Medicaid Directors Letter (SMD), provided guidance to states about all aspects of the 10% Federal Medical Assistance Percentage (FMAP) increase for home and community-based services (HCBS) enacted by the American Rescue Plan Act (ARPA). The increased FMAP runs from April 1, 2021, through March 31, 2022. The SMD lists HCBS to which the enhanced FMAP applies, clarifies how states can comply with ARPA's requirement that the funding supplement and not supplant existing state HCBS spending, and gives guidelines for and numerous examples of permissible ways states can spend the state dollars they save through the enhanced FMAP. CMS confirmed in the letter that the savings can be used as state match for additional Medicaid expenditures, but the money can be recycled only once. States will have three years, until March 31, 2024, to spend the money. A couple of the many examples of how states can use the savings from the enhanced FMAP, quoted verbatim from the letter, are:

  • Increase rates for home health agencies, PACE organizations, and agencies or beneficiaries that employ direct support professionals (including independent providers in a self-directed or consumer-directed model) to provide HCBS under the state Medicaid program. CMS expects that the agency, organization, beneficiary, or other individuals that receive payment under such an increased rate will increase the compensation it pays its home health workers or direct support professionals.

  • Providing nursing facilities or other institutional settings with funding to convert to assisted living facilities or to provide adult day services, respite care, or other HCBS.
OHCA, working with partner organizations, has developed a comprehensive proposal for using part of Ohio's allocation of funding from the enhanced FMAP, along with money from ARPA's State and Local Fiscal Recovery Program, to assist members. Now that federal guidance is out for both of these funding sources, we will move forward with advocacy on our plan.

CDC Drops Mask Recommendation for Fully Vaccinated People. The Centers for Disease Control and Prevention (CDC) today revised its guidance on what being fully vaccinated means for the general public. CDC removed its masking and distancing recommendations for vaccinated people, summarizing the changes as follows:

Fully vaccinated people can resume activities without wearing a mask or physically distancing, except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance.

Another exception is that masking is still required on planes, buses, and other forms of group transportation. CDC explained its rationale for relaxing the recommendations as, "[r]isk of SARS-CoV-2 infection is minimal for fully vaccinated people. The risk of SARS-CoV-2 transmission from fully vaccinated people to unvaccinated people is also reduced."

The guidance also lists all of the circumstances in which fully vaccinated people can refrain from quarantining, per previously-issued guideline changes.

CDC makes it clear in the new guidance that it does not apply to health care settings. The April 27, 2021, guidance for health care, which relaxed the masking recommendations in some instance, stil requires fully vaccinated workers to wear masks when providing services and unvaccinated workers to wear masks in additional circumstances. This guidance remains applicable. 

Long-Term Care COVID-19 Case Numbers Plummet. The Health Department's (ODH's) latest COVID-19 dashboard for long-term care brought more good news. Last week's slight rise in total current cases, to 409 resident and staff cases combined, proved a momentary blip in the downward trend. This week, ODH reported 311 cases, only 103 of which are residents. These numbers are from all of the state's more than 2,000 SNFs, assisted living communities, and ICFs/IID.