Latest CMS County Positivity Ratings. This week, because of the Presidents' Day holiday, the Centers for Medicare and Medicaid Services (CMS) county-level positivity numbers came out a day late. The Ohio ratings continue to show amazing improvement, both in the CMS colors and the positivity percentages themselves. Only 21 red counties remain in the state. Auglaize, Brown, Guernsey, Hamilton, Lorain, Lucas, Mercer, Montgomery, Richland, Ross, Union, Washington, and Wood Counties went from red to yellow. Marion, Seneca, and Wyandot Counties moved from yellow to green, while Meigs County flipped back to yellow from green. As a reminder, the CMS Quality, Safety, and Oversight letter (QSO) 20-39 mandates that SNFs allow routine, indoor visitation as soon as a county becomes green or yellow, unless the specific center has a COVID-19 case with onset in the past 14 days. In the QSO, CMS directs surveyors to consider citations if a SNF fails to permit visitation under these circumstances.

Vaccination Maintenance Program Webinar Wednesday Thursday. In a change from what we heard previously, the state is holding a webinar Thursday at 10:00 a.m. for SNF and assisted living providers on the planned vaccination maintenance program for residents and staff not vaccinated through the Pharmacy Partnership for Long-Term Care. You should have received a Enhanced Information Dissemination and Collection system (EIDC) notice about the webinar this afternoon. Please use this link to register for the session.

DODD Issues Guidance for Rule Waivers: The Department of Developmental Disabilities (DODD) issued the following notice related to rule waivers for people without a high school diploma or equivalent:

Effective March 1, 2021, OSSAS will make the following changes to the process for granting High School Diploma (HSD)/GED rule waivers to agency providers:

• Initial HSD/GED waivers will be issued for a two-year period. The employee must meet the educational requirement by the end of the two-year period.
• A one-year renewal may be available if extenuating circumstances prevented the DSP from obtaining their HSD or GED during the two-year period.
• There will be a new option to receive a non-expiring HSD/GED waiver if the DSP meets one of the following criteria:
• The DSP is over 50 years old;
• The DSP will only provide services to family members; or
• The DSP will only provide transportation services
• HSD/GED waivers issued prior to March 1, 2021 to individuals who do not meet the requirements for a non-expiring waiver will be renewed for a two-year period to allow the DSP to obtain their HSD or GED.

To request a HSD/GED waiver, fill out the HIGH SCHOOL DIPLOMA/GED WAIVER REQUEST form completely and return to DODD via email at this address: Diploma-GEDWaiver@dodd.ohio.gov.

ODM CMP Grant Updates. Amy Hogan of the Department of Medicaid (ODM) shared a letter for SNFs setting deadlines for the electronic communication device civil money penalty (CMP) grant program. The deadline for applying for a grant is April 1, 2021, and the deadline for acquiring the equipment and submitting receipts is May 31, 2021.

In addition, ODM's Cheryl Guyman sent the following message about the parallel CMP grant program for visitation-related tents and dividers for SNFs. Please note the italicized portion if you are applying for this grant.

Data for visitation project:

• 167 requests received ($424,663)
• 76 approved ($202,165)
• 2 denied (1 - items not reimbursable, 1-assisted living)

The IT department has made changes to our CMP Visitation Project to simplify the process for paying nursing facilities. These changes will be made to our system tonight. The remaining applications will be reviewed and approved or denied by the end of this week. The review of receipts and creation of invoices to be paid will start by the end of this week. IT has automated this process so the time for processing receipts will be greatly reduced.

Can you please notify your members that when entering their online applications to use their full facility business name they have on file with CMS? We have to send copies of the approval letters to CMS and they use names for tracking.

Medicare Accelerated and Advance Payment (AAP) Repayment – Two Months and Counting (from AHCA/NCAL, slightly edited). AAP repayments will begin for all Medicare providers who received AAP payments one year from date of the AAP receipt. Repayment start dates are specific to each provider, associated with their date of AAP receipt. For many providers, repayment dates begin in April 2021.

Providers do not need to take any action to repay. Rather, Medicare Administrative Contractors (MACs) automatically will begin to recover payment amounts by reducing paid claims until the AAP is repaid. AHCA was successful with ensuring members were included in the Continuing Appropriations Act, 2021 and Other Extensions Act. This law extended and modified the repayment schedule. Additionally, the law fixed the interest rate at 4%. Normally, AAP payment extensions are subject to the Treasury Department’s given interest rate. Access to these provisions offers more time to repay and more predictability through a fixed interest rate.  

Based on the statutorily defined schedule, providers should assess their cash flow for quarter two of 2021. For an AHCA overview of the repayment schedule, additional AAP information (including options to request payment extensions), and MAC webpages, click here, and to review the CMS frequently-asked questions, click here. 

Community Vaccination Information from Governor's Office. The following paragraphs are from today's Governor's Office release. This material pertains primarily to the Phase 1B populations.

CENTRAL SCHEDULING SYSTEM UPDATE

Governor DeWine announced today that Ohio's centralized scheduling website has been created, and the Ohio Department of Health (ODH) is now working with vaccine providers to enroll them in the system. The website will serve as a singular location for Ohioans to confirm that they are eligible to be vaccinated, identify nearby providers, and schedule their vaccine appointment.

Ohio and approximately 40 other states chose not to use the centralized system that the federal government intended to develop. Instead, Ohio chose to build its own centralized scheduling system. Despite the significant build time and configuration, the system was built within Ohio's intended timeframe. 

ODH will work directly with vaccine providers to integrate their current systems into the statewide system and assist them in working through current waitlists to potentially integrate these commitments into the centralized system. Providers will be expected to use this system as Ohio looks to the future, and guidance will be provided in the near future regarding deadlines. 

"Once most participating providers have signed up, the next phase will be to make the site live to those seeking to be vaccinated," said Governor DeWine. "Our goal is for Ohioans to have a positive customer experience when we launch the site to make appointments."  

Outside partners, including the Area Agencies on Aging, will be available to help Ohioans who do not have access to the internet with appointment scheduling. 

VIRTUAL TOWNHALLS

As part of Ohio's continuing efforts to ensure equity in Ohio's vaccination program, ODH is holding virtual town hall meetings focused on specific minority communities. These virtual meetings will involve local medical professionals and community leaders who will guide these conversations to discuss the safety and efficacy of the COVID-19 vaccine.

The meetings are intended to jumpstart conversations and give local leaders and attendees the tools they need to better inform members of their communities about vaccine facts, enhance access to trusted resources, and drive conversations in their own communities about why vaccinations are important.  

The town halls will be streamed on Facebook and YouTube. More details are available at coronavirus.ohio.gov/townhall. 

The Town Hall schedule for at-risk populations is as follows:

• Monday, February 22, 6:30 p.m. – African American Ohioans
• Tuesday, Feb. 23, 6:30 p.m. – Hispanic/Latino Ohioans
• Monday, March 1, 6:30 p.m. – Asian American and Pacific Islander Ohioans
• Tuesday, March 2, 6:30 p.m. – Rural Ohioans