FEDERAL NEWS

CMS Releases Guidance on Therapeutics
CMS released a memo today highlighting the importance of timely use of therapeutics among individuals who test positive for COVID-19. The memo, which addresses all CMS-certified settings, states that all patients testing positive for COVID should be evaluated to determine the appropriateness of monoclonal antibodies or oral antivirals to prevent serious illness and death. CMS further states that infection control should be reinforced and nursing homes should continue to comply with requirements to educate residents and staff on the importance of COVID-19 vaccination and offer or assist with accessing vaccination. We note that the guidance does not include any new policy or enforcement. Read more about this communication here.

Coalition of States Petitions CMS to Rescind Vaccination Mandate Rule and Guidance
A coalition of 22 States on November 17 filed a Petition for Rulemaking asking CMS to rescind the omnibus COVID-19 staff vaccination mandate rule issued in November 2021.  This is an administrative proceeding, not a lawsuit, initiated under a section of the federal Administrative Procedure Act (APA) which requires agencies to give interested parties an opportunity to request the issuance, amendment, or – as in this case – repeal of a rule.  Among other issues, the States assert that CMS did not have the authority to issue the vaccination mandate, and that the agency must take changing circumstances (such as information concerning the effectiveness of vaccines to prevent disease transmission by those vaccinated) into account.  The APA requires agencies to consider petitions they receive and to respond within a reasonable time.  If the response is to deny a petition, agencies generally must provide a statement of the grounds for the denial.  If CMS denied the petition, the States potentially could seek judicial review of that decision. If CMS elected to grant the petition, it presumably would then publish a notice of a proposal to repeal the rule and inviting public comment, following the normal rulemaking process.  LeadingAge will follow this story as it develops.  The participating states are Alabama, Arizona, Alaska, Arkansas, Florida, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, Ohio, Oklahoma, South Carolina, Texas, Tennessee, Utah, Virginia and Wyoming.

White House Campaign to Increase Rates of Updated COVID-19 Vaccinations
On November 22nd, the White House released a fact sheet outlining its “Six Week Campaign to Get More Americans their Updated COVID-19 Vaccine Before End of the Year.” The Plan focuses on making it even easier to get vaccinated, particularly for older people and the communities most impacted.  The announcement talks about additional funding – $350 million through the HHS Health Resources and Services Administration (HRSA) and $125 million through the HHS Administration on Community Living (ACL).

Today’s White House fact sheet specifically mentions “new enforcement guidance to ensure nursing homes are offering updated COVID-19 vaccines and timely treatment to their residents and staff.”  It reiterates existing requirements that residents be educated on the benefits of COVID vaccines and offered the opportunity to receive them. The fact sheet says that in its guidance, CMS will make clear that nursing homes with low vaccination rates will “be referred to state survey agencies for close scrutiny, and that those who do not comply with the requirement…will face enforcement actions, including the need to submit corrective action plans…”.  The language in fact repeats current requirements. Further the fact sheet indicates that the White House will work with governors to enable them to see how their state is performing compared to other states and to help them encourage action and increased vaccination uptake in the poorest performing nursing homes. A new QSO memo came out today, but it is focused on therapeutics.  See item #4 below. LeadingAge and AHCA put out a joint response to the White House Fact Sheet.

LEADINGAGE KANSAS NEWS

Friday Webinar
Join us each Friday for an update on what is going on pertaining to COVID, updates on the association front, and much more.

If you haven’t registered already, you can do so here. You can also see archived webinars and get handouts here.

LEADINGAGE NATIONAL NEWS

LeadingAge Coronavirus Call Today: Dr. Ali H. Mokdad 
Professor of Health Metrics Sciences at the Institute for Health Metrics and Evaluation (IHME) and Chief Strategy Officer for Population Health at the University of Washington will join us to share new projections for COVID cases going into the fall and winter.  If you haven’t registered for LeadingAge Update Calls, you can do so here. You can also find previous call recordings here. Note that to access recordings of the calls you need a LeadingAge password. Any staff member of any LeadingAge member organization can set up a password to access previous calls and other “members only” content.

LeadingAge Hosts Office Hours on HUD’s COVID-19 Supplemental Payments (CSPs)
HUD’s fifth round of COVID-19 Supplemental Payments (CSPs) are currently open for request. The CSPs are available to HUD-assisted Multifamily Housing providers to cover unbudgeted COVID-19 costs at properties, including staffing, security, and cleaning costs, as well as internet installation and back-up generator installation costs. CSP-eligible costs must be completed by January 31st and requested for reimbursement from HUD by February 21, 2023. During the current and likely last round of CSPs, HUD has allowed two extra reimbursement categories: costs related to training residents on the use of technology, and costs related to creating outdoor gathering spaces for residents to socially distance. To answer additional questions, LeadingAge is hosting “CSP Office Hours” on Wednesday, November 30th, from 12:00 – 1:30 PM ET. Register here in advance:  https://us02web.zoom.us/meeting/register/tZUsdOmsqz0rHNJjlsq-TuyanHG4d_SzFPXu and reach out to Juliana (Jbilowich@leadingage.org) with questions. To join LeadingAge’s weekly Housing Network calls, reach out to Linda (lcouch@leadingage.org) or Juliana (jbilowich@leadingage.org).

LeadingAge Plan to Increase Uptake of Vaccines/Boosters and Katie Sloan Meeting with HHS Secretary Becerra.
LeadingAge and AHCA were contacted by HHS Secretary Xavier Becerra on November 18th. He asked the two associations to collaborate with HHS to increase the uptake of bivalent boosters by residents of nursing homes.  LeadingAge and AHCA jointly developed and submitted this plan. The plan focuses on three sets of activities: supporting nursing homes with the lowest rates of resident vaccinations/boosters to help them improve their rates; making the offering of vaccines/boosters part of the hospital discharge process; and improving the ability of all nursing homes to offer vaccines/boosters quickly when a resident agrees to be vaccinated.  In the meeting, the group agreed on the following:

• Help the lowest performing nursing homes to increase their vaccination/booster rates – LeadingAge and AHCA agreed to educate association members on this and requested that HHS mobilize the QIO program to help us do so. 
• Ask hospitals to make vaccines/boosters available as part of the discharge process, recognizing that 90% of nursing home admissions are people coming from hospitals.  Administrator Brooks-LaSure said they would do that “very quickly.”
• Find a solution that enables nursing home residents to receive vaccines/boosters quickly once they agree to be vaccinated. HHS officials said this would take some refinement and changes in current requirements related to registered vaccine administrators and state and federal reporting requirements. But they said they would look into it.

One key difference in the White House fact sheet and the LeadingAge/AHCA/HHS plan is that the White House document’s discussion includes residents and staff.  The plan the associations are collaborating with HHS on focuses exclusively on residents.

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