Governor outlines budget cuts. In his press conference today, Governor Mike DeWine said that he identified $775 million in state budget cuts to be applied between now and June 30. He does not intend to use any of the Budget Stabilization (rainy day) Fund this fiscal year and did not discuss any of the multiple federal fiscal sources coming to Ohio, except for education funding under the Coronavirus Aid, Relief, and Economic Security Act. Of the $775 million, Governor DeWine said $210 million will come from Medicaid, $355 million from education, $110 million from higher education, and $100 million from all other government programs. He deferred questions asking for specifics on the Medicaid reductions to a news conference tomorrow by Budget and Management Director Kim Murnieks. No provider rate cuts were mentioned. Legislative action would be necessary to cut SNF or ICF/IID rates.

Liability protection legislation introduced. Senator Matt Huffman (R-Lima) introduced Senate Bill (SB) 308, which would protect businesses from liability for COVID-19-related claims. In addition to a general business provision establishing a wanton and willful misconduct standard for liability during a declared disaster, SB 308 contains language developed by OHCA, the Ohio Hospital Association, and the Ohio State Medical Association for health care providers. This language would expand an existing statute on disasters to include emergencies, to cover long-term services and supports providers, to adopt a wanton and willful standard, and to include wrongful death lawsuits.

Bureau of Infectious Diseases provides webinar. The Department of Health's (ODH's) Bureau of Infectious Diseases is offering a webinar on infection control Friday, May 8, at 2:00 p.m. According to ODH, "[i]n this webinar, you will hear from fellow nursing facilities, representatives of ODH and Centers for Disease Control and Prevention on strategies to prevent and limit the spread of COVID-19." Topics include communication, early and aggressive intervention when identifying suspected cases, cohorting residents and staff, appropriate use and re-use of personal protective equipment (PPE), and hand and environmental hygiene. To participate in the webinar, please use this link (not available until Friday).

Clarification on discontinuing isolation. In yesterday's COVID-19 Update, we discussed new guidance from ODH on when to discontinue isolation for health care workers and for patients. We noted that the guidance was updated to take into account recent changes by the Centers for Disease Control and Prevention, but we neglected to point out that for patients (not staff), ODH retained its more stringent 14-day isolation guideline.

ODH, CMS begin Infection Control Focus Surveys. Please be aware that ODH is moving forward with Infection Control Focus Surveys under the direction of the Centers for Medicare and Medicaid Services (CMS). Federal surveyors are in Ohio, teaming with ODH to perform these surveys this week based on specific infection control complaints or immediate jeopardy complaints. ODH reports that about a dozen focus surveys will be conducted this week. ODH will request a number of items before the survey:

• Access to your electronic medical records, census numbers by unit, a list of residents alphabetically with room numbers, and an updated floor plan.
  
• The name of the person responsible for infection control and prevention, a list of employees/contract staff with phone numbers and titles, work schedules for specified dates for nursing and nurse aides, and the direct number for a contact person.
  
• A list of family members who frequently visit residents, any new admissions over the last month, the process for notifying families/sponsors, and anyone who has PPE precautions in place, including the type of precautions.
  
• Copies of policies and procedures: infection control, including the surveillance plan; emergency preparedness, including emergency staffing strategies; transfer/discharge; and change in condition.

HB 197’s impact on Workers’ Comp claims. Following Governor DeWine’s Executive Order declaring a state of emergency due to COVID-19 and the legislature’s passage of House Bill 197 to respond to the Executive Order, CompManagement shared with OHCA an outline of the two measures' direct impact on the Bureau of Workers’ Compensation. You will note that there are important provisions related to claims and time limits which could affect your injured workers as well as your rights related to claims appeals.

CMS issues more Medicaid administrative FAQs. CMS published a new set of frequently-asked questions about Medicaid and the Children's Health Insurance Progam (CHIP). While most of the questions and answers get deep into the weeds of Medicaid administrative matters, there are some of interest. One points out that a state cannot take any action during the public health emergency to increase a person's patient liability (pages 15-16). Other answers address self-attestation of information such as assets, presumptive eligibility (hospitals can make presumptive eligibility determinations for people who are not hospital patients), and the ability of states to increase provider rates temporarily, including by supplemental payments such as OHCA has requested of Ohio.