COVID-19 Vaccine News. Today, Dr. Ruth Link-Gelles of the Centers for Disease Control and Prevention (CDC), one of the key players in the federal COVID-19 vaccine distribution effort, met with AHCA/NCAL state affiliate representatives, including OHCA, to share the latest information from CDC's perspective. Dr. Link-Gelles explained that the Pharmacy Partnership for Long-Term Care will be limited to Walgreens, CVS, and "a couple" smaller pharmacies that she did not name. Providers who originally chose other pharmacies will be defaulted to one of the large chains. Dr. Link-Gelles said only SNFs will be included in the first wave of vaccinations via the Partnership. The second wave, after both doses are administered in SNFs, will cover other congregate settings such as assisted living (other than assisted living in the same building as a SNF) and ICFs/IID, but not inpatient hospices.
As for timing, Dr. Link-Gelles pointed to CDC's Advisory Committee on Immunization Practices (ACIP), which is expected to recommend an Emergency Use Authorization for the BioNTech/Pfizer vaccine on December 10. After that, there will a 2-3 week period during which the Pharmacy Partnership members will communicate with facilities and schedule clinics. She characterized the Walgreens letter to facilities last week as premature and inaccurate, although she did not specify how.
During the ramp-up period, pre-determined numbers of doses will be distributed to jurisdictions, which are mostly states. The jurisdictions then will pass the vaccine on to others to administer, in accordance with the federally-defined phases, but constrained by an initially short supply of vaccine and the cold-chain management requirements. While the current Phase 1a is limited to health care workers, ACIP is scheduled to meet tomorrow to consider whether to elevate long-term care residents to the first phase. Unlike the Pharmacy Partnership's on-site clinic model, Dr. Link-Gelles suggested these early vaccinations are likely to be delivered in "mass-vax" settings. CDC is planning for the Partnership to vaccinate most if not all staff along with residents by allocating, in the case of SNFs, twice as many doses as each center has beds.
After Dr. Link-Gelles left the meeting, AHCA/NCAL's Mark Parkinson said the arrangements she described were a change from previous statements that long-term care staff and residents would be first in line. He indicated it would be up to states whether their initial vaccine allocations go to long-term care or just to hospitals and first responders. We will attempt to get clarity from state officials tomorrow about how much vaccine the state will receive and how it will be disseminated.
SNF Nurse Featured on Governor's Press Conference. During his press conference today, Governor Mike DeWine, as he has done previously, included statements by health care workers about the real-life stresses that COVID-19 puts on them and on the health care system. This time, one of the featured speakers was a nurse from a skilled nursing center who expressed the pain and sadness staff members experience when people for whom they provide care pass away from the disease and urged the public to consider the potential consequences of their actions for vulnerable residents. You may view the brief clip at this link.
SNFs Receive Mortality-Based QIP Payments. This morning, members began to report that they received Quality Incentive Program (QIP) payments from United Healthcare on behalf of the Department of Health and Human Services (HHS). These payments are based on September mortality data as reported in the National Healthcare Safety Network (NHSN). The notice accompanying the payments is very generic and appears to be the same as the notice for the case-based payments in early November. The extremely complex formula for calculating the mortality-based payments is included in the same HHS document as the case-based payments. AHCA/NCAL now predicts the October QIP payment to come by Friday. As for Phase 3 of the Provider Relief Fund General Distribution, AHCA/NCAL expects the payment formula by the end of next week. Providers who applied and qualify for Phase 3 should get most of the amount for which they applied.
BWC Providing Up to $15,000 in Assistance for Indoor Air Quality Improvement; Must Complete Work by December 30. As announced last week, the Bureau of Workers Compensation (BWC) is offering $28 million in federal Coronavirus Aid, Relief, and Economic Security (CARES) Act funding to reimburse SNFs, assisted living communities, and adult day centers for inspections, assessments, maintenance, and improvements to indoor heating, ventilation, and air conditioning (HVAC) systems to control the spread of the COVID-19. This program, which provides up to $15,000 of financial assistance for each independently licensed facility, is open to both state fund and self-insured employers. Per OHCA's request, BWC is considering adding other facilities such as ICFs/IID and inpatient hospices. They will let us know shortly if these providers are permitted to apply.
While this funding assistance is helpful, the downside is that because these are CARES Act dollars, expenses must be incurred before December 30, 2020. According to BWC, that means the improvement must be bought, paid for, and installed to qualify. Obviously, you need to move quickly if you wish to obtain this funding, but BWC will consider retrospective funding requests if the qualifying expenses were incurred between March 1 and December 30, 2020. Page 6 of the BWC Indoor Air Quality Assistance Application provides a list of qualifying expenses, and their frequently-asked questions outlines other helpful information. Providers are encouraged to visit the BWC COVID-19 Indoor Air Quality Assistance Program website for more information. Questions can be directed to grants@bwc.state.oh.us.
Revised ODM Medicaid Eligibility Guidance. The Department of Medicaid issued a second revised version of Medicaid Eligibility Procedure Letter (MEPL) 150, now dubbed 150B. This MEPL originally came out in May and implements the requirement of the Families First Coronavirus Response Act that states not remove anyone from the Medicaid rolls if they wish to qualify for the 6.2% Federal Medical Assistance Percentage (FMAP) increase provided by the act. The latest revision, effective tomorrow, accounts for a recent federal rule change that allows a state to move a Medicaid beneficiary from a category for which they are no longer eligible to another category for which they are now eligible, so long as there is one. An example of this would be a person who formerly was in the expansion group but ages into Aged, Blind, and Disabled coverage on or after December 1.