Elevating the Post-Acute and
Long Term Care Profession

April 13, 2021

House Substitute Budget Emerges. Today, the House Finance Committee adopted a substitute version of House Bill 110, the state budget bill. The committee also released a brief overview of the changes made in the substitute, along with other detailed documents that are available on the committee's website. The substitute bill cuts taxes by $380 million (2% personal income tax reduction) and increases state spending by more than $700 million ($294 million state General Revenue Funds). For long-term services and supports, the House budget so far proved disappointing. Key aspects of the substitute bill for long-term services and supports:

  • Restores rebasing of SNF rates, but not until June 30, 2022, and only to the tune of $50 million per fiscal year. The substitute also retains the SNF quality incentive program for two years and adds $58.5 million per year to the quality incentive program, but it includes several provisions that severely limit the number of providers who would qualify for the incentive.
  • Retains the DeWine Administration's proposed cap and rollback of ICF/IID rates and does not provide any increase to ID/DD waiver rates except for $5 million per year for adult day services.
  • Retains the Administration's proposed 4% increase to nursing and personal care rates in the Assisted Living, PASSPORT, Ohio Home Care, and MyCare Waivers and Medicaid home health, but does not provide any further increase except, again, for $5 million per year for adult day services.
  • Retains, with some minor changes, the Administration's proposal to give the Director of Health extremely broad authority to issue orders against SNFs and assisted living communities without pre-imposition due process.
We anticipate the House will complete its version of the budget next week and will send it on to the Senate, which begins informal hearings tomorrow. OHCA will continue to advocate forcefully for funding for our hard-pressed members across the continuum of services.

Johnson & Johnson Vaccine Pause. Today, the Centers for Disease Control and Prevention (CDC) and Food and Drug Administration issued a joint statement recommending a pause in use of the Johnson & Johnson (Janssen) vaccine because of 6 cases (out of 6.8 million doses administered) of a rare and severe blood clot called cerebral venous sinus thrombosis. The people affected were women between the ages of 18 and 48. Symptoms occurred 6 to 13 days after vaccination. The federal agencies convened an emergency meeting of the Advisory Committee on Immunization Practices (ACIP) tomorrow to determine next steps. In Ohio, Governor Mike DeWine followed suit by pausing use of the vaccine in all settings, including long-term care. In some cases, vaccine providers were able to fill in with other vaccines. Further action will await ACIP's recommendations.

CDC Offers Webinar on Surface Cleaning and Disinfecting. CDC will present this program, entitled, "When to Clean, When to Disinfect, and What Science Says about SARS-CoV-2 on Surfaces," on Monday, April 19, from 3:00-4:00 p.m. You may register for the webinar at this link and may submit advance questions by tomorrow to eocevent337@cdc.gov with "Partner Call 4/19" in the subject line.

COVID-19 Questions and Answers. We were not able to address the following questions posted to chat during today's SNF member call because of time constraints.

Can you explain KN95 from surgical masks and if we are okay with wearing either one? I notice some people are wearing two at a time and I explain they are similar in protection. We have no cases in the facility, so this is of course, while there are no cases.

The relative value of a KN95 and a surgical mask depends on the quality of the KN95. Different types of masks are discussed generally in this CDC guideline. In the guidance, CDC explains that two surgical (procedure) masks should not be layered over each other and that no other mask should be worn with a KN95.

During weekly testing of employees does it matter if we use rapid tests or PCR?

No, you can use either.

You mentioned earlier that during an outbreak, all visitation (indoor and outdoor) would be cancelled because the QSO says "all." However, while the QSO does say to suspend "all" visits, this language is under the title of "Indoor Visitations During an Outbreak."

That is correct, indoor visitation is used in the title, but in the text of the provision, there is nothing that limits "all" to "all indoor." The only stated exceptions to suspending all visitation are compassionate care and disability rights law.

Has anyone had a positive resident or staff who has been fully vaccinated?

Yes, OHCA has heard examples of positive test results after a person has been fully vaccinated (one person affirmed this in the chat). Very few of these cases have been symptomatic.