Archive December 2021

All of the articles archived for the month that you have specified are displayed below.

State Workforce Survey & Marketing Campaign

The Maine Department of Labor (MDOL), Economic and Community Development (DECD) and Health and Human Services (DHHS) are working together on a marketing campaign aimed at recruiting more individuals into direct care and behavioral health jobs. MHCA is part of an advisory group helping to provide guidance on the development of this important campaign.

To inform this campaign, the State of Maine's marketing agency partner (Pulse Marketing) has put together a brief survey to learn more about the motivations, challenges and aspirations of current direct care workers as well as those who may be interested but not yet connected to the field.

The survey takes about 10 minutes to complete and all results are anonymous. Thank you. Please feel free to share the excerpt below with colleagues and friends.

Interested in direct care or behavioral health work or entering the healthcare field? Looking for a career change and considering a shift to more meaningful work? Currently working in the direct care or behavioral health field?
Take this 10 minute survey to share more about what you’re looking for in your job, your career challenges and motivations, and your career aspirations. Your feedback will be completely anonymous and help strengthen Maine’s direct care & behavioral health workforce.
Survey translations available in: Français (French)Español (Spanish)Português (Portuguese); Soomaali (Somali) ???? (Arabic)

Staff contact:

Increased Payment Rates for Long Term Care Facilities & Restoration of the SWA

On Wednesday, December 29th, Governor Mills announced an increase in payment rates for long term care facilities to support 125% of Minimum Wage for Direct Care Workers. The Mills Administration also announced a proposed $7.6 Million for the restoration of the Supplemental Wage Allowance (SWA).
As part of the biennial budget to increase pay for direct care worker to at least 125% of the state’s minimum wage, the legislature passed the minimum wage increase in a bipartisan effort to address the work force shortage. The implementation date of the increased minimum wage was slated to begin on January 1, 2022. DHHS had planned to delay implementation of the rate increase to nursing homes and residential care facilities until July. MHCA continued to advocate and seek clarity on implementation of the legislation. The Governor has now directed the Department to utilize $4.5 million of already appropriated funding to begin the increased payments on January 1, 2022 in line with the legislative intent.
Further, the Governor announced she is proposing in her forthcoming supplemental budget an additional $7.6 million to restore the supplemental wage allowance to assist nursing homes and residential care facilities with increased labor costs through the remainder of Fiscal Year 2022 (January 1- June 30, 2022).
“Today's announcement is welcome news as Maine's long-term care facilities continue the fight against COVID-19,” said Angela Westhoff, President and CEO of the Maine Health Care Association. “MHCA appreciates the Mills Administration's plan to expedite financial support to providers and their staff. Not only does it align with legislative intent, but it also reaffirms our collective commitment to supporting our dedicated staff who have logged many long hours during this pandemic caring for Maine’s most vulnerable citizens.”
Finally, the Mills Administration also announced that the Department will waive the minimum occupancy penalty on nursing homes that are experiencing low occupancy rates.
To read the full announcement click here.
Staff contact:

Update on Phase 4 Provider Relief Fund and ARP Rural Payments

Last week, HRSA provided updated information on the status of PRF Phase 4 and ARP Rural Payments. Topics include size of Phase 4 awards, additional detail on Phase 4 methodology, update on hospital funds transfer to SNFs, and updated timelines regarding receipt of funds and provider requests for individualized support. To view total provider state by state data awards for Phase 4 to-date, click here and for ARP Rural, click here.
A total of 315 Maine providers (across multiple health care sectors) received Phase 4 funding totaling $60,691,173. For rural funding, there were 314 providers who received a total of $129,052,464.
Reporting Period 2 begins on January 1, 2022 and the extended Reporting Period 1 ended on December 20, 2021. No additional Reporting Period 1 extensions will be offered. Due to technical difficulties during the Reporting Period 1 dates, HRSA urges providers to submit as soon as possible.
Phase 3 reconsiderations are taking longer than expected- over 4,500 were submitted. HRSA expects to complete the review of reconsiderations between January and March 2022. Rural and Phase IV Reconsideration is expected to launch in February.
At HRSA’s request all questions should be directed to their Support Line at 1-866-569-3522.
For more information on HRSA PRF funding updates, please review AHCA/ NCAL summary document here.
Staff contact:

CMS Releases Surveyor Guidance on LTC Vaccine Mandate

On Tuesday December 28, 2021, the Centers for Medicare & Medicaid Services issued surveyor guidance on assessing long-term care facilities’ compliance with a federal mandate for healthcare worker COVID-19 vaccinations.

The guidance only applies in 25 states where a federal judge earlier this month lifted a temporary injunction that had blocked the Nov. 5 vaccination rule from taking effect. The following jurisdictions are not covered by any court-ordered injunctions: California, Colorado, Connecticut, Delaware, Florida, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Tennessee, Vermont, Virginia, Washington, Wisconsin, and the District of Columbia. Meaning this memo is relevant to Maine providers.

In this
Dec. 28 memo, CMS said surveyors would begin enforcement within 30 days. Among key details: Any facility with a staff vaccination rate at that time above 80% with a specific plan to achieve a 100% rate within 60 days would not be subject to additional enforcement action. At the 60-day mark, a facility above 90% with a plan to achieve a 100% staff vaccination rate within an additional 30 days would not be subject to additional enforcement action.

CMS said facilities would be considered compliant if policies and procedures are developed and implemented for ensuring all staff are vaccinated for COVID-19; and 100% of staff have received at least one dose of COVID-19 vaccine, or have a pending request for, or have been granted qualifying exemption, or identified as having a temporary delay as recommended by the CDC.

The agency said anything less than at least one shot for 100% of staff (not counting a pending or granted exemption or CDC-recommended temporary delay) would count as non-compliant. Those facilities will receive notice of their non-compliance with the 100% standard, but CMS said those in the 80% to 99% range would receive some relief if they continued to pursue vaccination plans.

Staff Contact:

AHCA releases updated information on Boosters and recorded townhall with U.S. DHHS

Earlier this week, AHCA/NCAL, LeadingAge, and the AARP co-hosted a town hall featuring Admiral Rachel L. Levine, Assistant Secretary for Health for the U.S. Department of Health and Human Services and the head of the U.S. Public Health Service Commissioned Corps to answer questions about the Omicron variant, boosters, and why we need to step up the timeline to get the booster. Walter Ramos, President and CEO of Rogerson Communities, also spoke about his experience encouraging booster uptake, as well as a family member of a current nursing home resident. Each speaker also provided information on why a booster is so critical given the spread of Omicron.
AHCA/NCAL has also updated its
handout on the importance of boosters based on the latest data considering the rapid spread of the Omicron variant. This handout, as well as other resources, is available on the #GetVaccinated website.

Staff Contact:

LTC Townhall with HHS Sec. Xavier Becerra on Omicron/Boosters: Co-sponsored by AHCA/NCAL

Long Term Care Stakeholder Town Hall with HHS Secretary Xavier Becerra on Boosters and Omicron
Co-sponsored by AHCA/NCAL, LeadingAge, & Service Employees International Union
Thursday, December 30, 2021
11:00 am Eastern
The Omicron variant of COVID-19 is spreading quickly. Thankfully, we know vaccinations and especially boosters can increase the level of protection significantly. Increasing protection in our most vulnerable citizens with vaccinations and boosters is a top priority for the Department of Health and Human Services (HHS). 
To learn more about what you can do to protect yourselves and your residents, we invite you to join HHS Secretary Xavier Becerra and other Senior COVID-19 Response Leaders for a Virtual Town Hall – co-sponsored by AHCA/NCAL, LeadingAge, and SEIU – to discuss the latest news on the Omicron variant of COVID-19 and the impact of boosters for residents and staff.
The Virtual Town Hall will be held on Thursday, December 30th at 11:00 AM ET. When it’s time, please join the Virtual Town Hall at:  

Staff Contact:

OSHA Withdraws Healthcare ETS

Last week The Occupational Safety and Health Administration (OSHA) updated its website to withdraw the non-record keeping portions of the healthcare emergency temporary standards (ETS) issued in June. The ETS is no longer in effect, however, the record keeping requirements in the ETS will continue as they were adopted under another section of the OSHA Act. 

OSHA intends to issue a final standard in the coming months that will incorporate much of the June ETS. Meanwhile OSHA strongly encourages all health care employers to continue to implement the ETS’s requirements and notes they will continue enforcement of COVID safety standards through the general duty clause. For details on the June ETS, see
AHCA/NCAL’s summary.
Due to the withdrawal of the June healthcare ETS, health care employers, including all assisted living, nursing or other long term care providers, are now subject to
OSHA’s vaccine mandate ETS. At this time the vaccine mandate ETS is effective, with a January 7, 2022 hearing before the United States Supreme Court. The OSHA vaccine mandate would apply to those providers also covered by CMS’s vaccine mandate interim final rule, should the government prevail and the IFR be implemented. The CMS IFR is not being enforced pending a hearing before the U.S. Supreme Court, also set for January 7, 2022.

The OSHA vaccine ETS includes an option for testing unvaccinated employees (the CMS IFR does not). OSHA will not issue citations for noncompliance with any requirements of the ETS before January 10 and will not issue citations for noncompliance with the testing requirements before February 9, so long as an employer is exercising reasonable, good faith efforts to come into compliance with the standard. OSHA notes that it plans to work closely with employers to provide compliance assistance. 

MHCA will continue to provide updates on these requirements. Please watch for an announcement of educational information on OSHA’s vaccine and testing requirement from AHCA/NCAL in the coming weeks.

Staff Contact:

CDC Updates Return to Work Guidance

Last week the Centers for Disease Prevention and Control (CDC) announced updates to their guidance on Managing Health Care Personnel with COVID-19 Infection or Exposure. This new guidance provides a shortened return to work criteria for both infections and exposure that incorporates a testing strategy in some circumstances.
The following guidance should continue to be used to determine duration of isolation and quarantine for patients and residents.   
The new criteria are as follows:

Return to Work After COVID-19 Infection
The CDC now indicates that health care workers who have tested positive for COVID-19 can return to work depending on the severity of their COVID-19 infection, but should monitor for symptoms after returning to work and seek testing, should symptoms develop. Also, Antigen testing is preferred for symptomatic health care personnel (HCP) and for asymptomatic HCP who have recovered from COVID-19 infection in the prior 90 days.

For contingency and crises staffing situations shorter time frames can be used (see CDC site for contingency and crisis staffing).

For conventional staffing, HCP who were asymptomatic throughout their infection and are not moderately to severely immunocompromised:
  • Return to work after 7 days with a negative antigen or PCR test within 48 hours prior to returning to work.
  • Or 10 days if testing is not performed or a positive test at day 5-7 since the date of their first positive viral test.
HCP with mild to moderate illness who are not moderately to severely immunocompromised:
  • Return to work after 7 days with a negative antigen or PCR test within 48 hours prior to returning to work
  • Or 10 days if testing is not performed or if a positive test at day 5-7 since symptoms first appeared; and
    • At least 24 hours have passed since last fever without the use of fever-reducing medications; and
    • Symptoms (e.g., cough, shortness of breath) have improved.
HCP with severe to critical illness who are not moderately to severely immunocompromised:
  • In general, when 20 days have passed since symptoms first appeared; and
    • At least 24 hours have passed since last fever without the use of fever-reducing medications; and
    • Symptoms (e.g., cough, shortness of breath) have improved.
HCP who are moderately to severely immunocompromised, may shed beyond 20 days after symptom onset or, for those who were asymptomatic throughout their infection, the date of their first positive viral test.
Use of a test-based strategy (2 negative tests 24 hours apart after symptom resolution) and consultation with an infectious disease specialist or other expert such as occupational health specialist is recommended to determine when these HCP may return to work.

Return to Work After Higher-Risk Exposure
HCP who have received all COVID-19 vaccine doses, including booster dose, as recommended by CDC; do not require work restriction unless they develop symptoms and test positive:
  • They must test as soon as possible after 24 hours from exposure and 5-7 days after exposure.
  • Continue to use source control masks and PPE as recommended by CDC (no change)
HCP who are either fully vaccinated but without a booster or are unvaccinated, should exclude from work for 7 days following the higher-risk exposure:
  • With a negative test 48 hours before returning to work; and
  • HCP did not develop symptoms
Return to Work After a Low-Risk Exposure
No work restrictions regardless of vaccination status but must continue to use source control masks and PPE per CDC recommendations. (no change)

The Low or High-Risk Exposure Definition is defined as:
  1. Being within 6 feet of a person with confirmed COVID-19 infection; OR
  2. Having unprotected direct contact with infectious secretions or excretions of the person with confirmed COVID-19 infection.
High-risk exposure is defined as:
  1. Exposure of HCP's eyes, nose, or mouth to material potentially containing COVID-19, particularly if these HCP were present in the room for an aerosol-generating procedure
  2. Prolonged contact >15 min with a person infected with COVID-19 (resident, visitor, or co-worker), especially if they were not using a source control mask or if the HCP was not using appropriate PPE during the encounter.
Low-risk exposure is defined as:
  1. Having body contact with the patient (e.g., rolling the patient) without gown or gloves, may impart some risk for transmission, particularly if hand hygiene is not performed and HCP then touch their eyes, nose, or mouth.
AHCA/NCAL and MHCA continues to advocate to the federal and state government for increased access to antigen tests and staff to help in long term care facilities, particularly as the Omicron variant spreads, which will increase the need for testing.

We strongly encourage providers to continue to strictly follow all other infection prevention and control practices, such as the use of PPE, source control masks and social distancing. Providers should review the CDC guidance on Interim Infection Prevention and Control Recommendations in Nursing Homes for more information. The new CDC guidance does not necessarily supersede local or state guidance nor OHSA guidance.

Boosters Recommended by January 1, 2022
Finally, residents and staff should aim to receive their boosters by January 1, 2022. The Omicron variant continues to rapidly spread across the U.S., and data continues to show the effective?ness of boosters in fighting this new variant. The urgency to get long term care residents and staff a booster has never been greater.
CDC is working on updating this guidance in the coming days to more closely align with the new return to work guidance for health care personnel.

Staff Contact:

Maine DHHS/CDC releases mAb toolbox

In response to advocacy efforts by MHCA on behalf of member homes Maine DHHS and CDC has released a toolkit to assist in administration of monoclonal antibody (mAb) therapies in congregate care facilities – i.e. LTC, ALFs, grp homes. The following are components of this introductory “Toolbox” for facilities to use when identifying residents eligible for such treatment. Included in the toolkit are:
2. List of relevant mAb providers for facilities
3. Eligibility “checklist” to help identify individuals appropriate for mAb therapies
4. Template info letter that facilities could send residents/families ahead of a COVID outbreak
5. FAQ/talking points on mAb therapies 
As noted in the intro sheet, DHHS and Maine CDC expects that the indications and options for mAb therapies may change significantly in the coming weeks with the emergence of the omicron variant, but DHHS has committed to updating this toolbox as new information becomes available.
As the holidays approach we sincerely thank you for all you do and continue to do as this global pandemic drags on. In the words of the Grateful Dead, what a long strange trip it's been. We are here if you need support. Don't hesitate to reach out with questions, concerns or comments.

Staff Contact:

Maine Health Care Association CEO Message

As the end of 2021 quickly approaches, I wanted to take a few moments to thank the membership for your continued support and your unwavering dedication to caring for your residents. I recognize how much of a continued struggle it has been with severe staffing shortages exacerbated by a pandemic that continues to rage on.

When I started back in June, it seemed like the worst of COVID was behind us. Little did we know that the Delta variant would soon arrive, and COVID-19 positive cases would reach numbers higher than what had ever been previously recorded in Maine.

Public health officials across the country are predicting a very concerning Omicron surge post holidays. Media reports over the past few days, as well as newly released scientific research, has provided evidence that Omicron is more contagious than any previous version of the COVID-19 virus. But the good news is that vaccines appear to provide strong protection against severe illness and mortality. While the new strain has not spread widely yet in the United States, AHCA/NCAL is urging us all to prepare. Omicron is not as deadly as Delta, yet it still will likely create major problems in the long term care sector.

Booster shots will be important in the ongoing efforts to protect staff and residents. If you haven’t held your booster shot clinic yet and need assistance, please reach out to us so that we can assist you.
Finally, I want to express my personal gratitude and deep appreciation to all of you, the MHCA staff, and board members for welcoming me to the association. As we move ahead into 2022 together, there is hope that there are brighter days to come! Best wishes for a happy and healthy holiday season!
Angela Cole Westhoff
President/ CEO

Staff contact:
<< [1] 2 3 4 >>