Veteran litigator Angelo Spinola answers questions about how agencies are rising to meet the biggest employment law challenges they face, including those posed by the COVID-19 Pandemic.
Even in the best of times, human resource issues pose an enormous challenge to home care agencies. But when responding to a global pandemic, many agencies found themselves scrambling to address new questions. How do you help employees with childcare challenges? How do you handle on-boarding (and firing) when everyone is working off-site? Who pays for COVID tests, and how should time spent getting the test be compensated? Can employers require vaccinations?
For the 15th episode of Talking Home Care, Pat speaks with Angelo Spinola of Littler Mendelson, a leading employment law litigator about these and other issues. They also discuss the subscription-based, on-line Home Care Toolkit Littler developed and constantly updates. The Toolkit gives agencies access to a world-class HR resource, policy manual, and document library that’s like adding an expert to your staff.
The Home Care Alliance of Massachusetts has negotiated a special agreement with Littler to give our members access to the Toolkit at a great price, with a portion of all sales supporting the Alliance! To learn more or to order your subscription, contact Melissa Mann at MMann@littler.com or (404)760-3928.
You may listen to the podcast by clicking any of the platform images above, clicking “play,” or downloading it directly (Length: 40 minutes; Size: 29 MB).
Front-line heroes share their stories about overcoming the challenges posed by the COVID-19 Pandemic.
The COVID-19 Pandemic has created huge challenges to healthcare systems across the globe, including here in Massachusetts. As part of National Home Care and Hospice Month, we collected first-hand stories from our members about the front-line challenges they faced, and how they overcame them.
For the 14th episode of Talking Home Care, we’ve collected these stories into a single podcast. They are introduced by Alliance Executive Director Pat Kelleher and are read by drama students at Winthrop Middle School.
You may listen to the podcast by clicking any of the platform images above, clicking “play,” or downloading it directly (Length: 41 minutes; Size: 29 MB).
Dr. Ashish Jha of Brown University sees a difficult winter ahead in terms of battling COVID-19, but reasons to hope in the spring.
In mid-November, I had the pleasure of listening to a virtual presentation from Dr. Ashish Jha, Dean of the Brown University School of Public Health, as part of the Massachusetts Association of Health Plans Health Policy Speaker Series. At the time, people were finalizing their Thanksgiving plans while the Coronavirus Pandemic began its fall resurgence.
Dr. Jha expressed deep concern about our present situation. “The virus is in a very bad place,” he said at the beginning of his remarks. In his assessment, there is no doubt that there is more virus in the community today than during the springtime peak, and the current count of 200,000 new cases each day is unacceptable. However, he believes there is a path forward that will bring us to something like pre-pandemic normalcy in the near future, especially with the promise of effective vaccines. As such, he said, our priority must be to save lives during the winter months.
Jha put a great deal of focus on what he called “priorities,” noting that COVID-19 does not care about our priorities are. In other words, he said, that while he was personally emphatic to our individual needs, the virus does not care that I prioritize seeing some family, but not others. The virus will spread wherever and whenever it sees fit.
Jha also discussed priorities in the context of the public policy response to the pandemic. He believes maintaining fully operating schools and hospitals should be our sole societal priorities. Yet, he said, just days before his talk, New York City shut down in-person learning, while continuing to allow people still to dine together indoors. This is, he called “upside-down.“
Jha was, however, not naïve to the fact that shifting our priorities to focus on schools and hospitals is expensive. It means large-scale federal support for restaurants and their workers to survive the winter months. He recognized this decision is “politically challenging,” as broad economic shutdowns have been unpopular and politicized. But, in his opinion, it is the best way for us to save lives as we await distribution of vaccines.
The more hopeful part of Jha’s presentation centered around the rapid development of vaccines. At the beginning of the pandemic, he admits he hoped for a 50-60% effective vaccine. Now that early data shows two vaccine candidates with 90%+ efficacy, he is extremely hopeful. He also noted that scientific integrity was not compromised through this process, it was just expedited by conducting the typical steps all at once (e.g., simultaneous human and animal studies).
While he said that we must not lose sight of the short-term task at hand (containing the virus during the winter), Jha is hopeful that we could achieve 30% immunity by the end of January, at which point virus-spread tends to naturally slow. By April or May, he hopes anybody who wants to be vaccinated will be. This may sound ambitious, he noted, and distribution nuances as well as vaccine education, will surely slow any rollout; but he saw it as feasible.
In the meantime, he said we must continue to wear masks, get tested, and only see people from our own household.
Since the onset of the pandemic and the declarations of federal and state emergencies, the Home Care Alliance of Massachusetts shifted much of its attention and resources to COVID-19-related membership support. To that end, the Alliance:
Was the first state to create guidelines for members—both medical and non-medical—admitting COVID-positive patients. This guidance was adopted by many other states and shared by the National Association for Home Care & Hospice (NAHC)
Offered regular calls for CEOs of certified and private care agencies to share and learn from each other, as well as calls for clinical directors, HR mangers, and hospice directors
Published more than 50 COVID Updates, a new publication exclusively for our members
Advocated for, and secured, multiple Medicaid waivers, including full payment for remote visits, waiver of certain in-home assessment requirements, and allowance of a remote audio-visual face-to-face (F2F)
Worked with MassHealth on guidance to keep telehealth waivers permanent
Hosted more than a dozen webinars on topics such as: accessing the PPP program, documenting telehealth visits for payment, unemployment and COVID, the CARES ACT, and Medicare stimulus funding
Advocated with the state for COVID support funding, resulting in Massachusetts being among the most generous states in passing federal Medicaid money to agencies in the form of 10% rate increases for home health, 20% rate increases for continuous skilled nursing, and 10% provider payment relief for providers in the State Home Care Program
Answered hundreds of member regulatory questions related to the pandemic
Developed and hosted a COVID-19 Resource page that includes Allied member COVID resource services, generating more than 1,500 page views between March and August
Secured Board of Registration in Nursing clarification, assuring that the federal change related to NPs and home health services will remain operative in Massachusetts after the State of Emergency
Worked with MassHealth on the new agency-directed PCA model program
Coordinated strategy with the Home Care Aide Council on expanded services and increased funding in the EOEA home care program
Worked with the Massachusetts Medical Society to educate physicians about audio-visual F2F assessment requirements
Worked with assisted living facilities and other acute and post-acute providers to educate them on the federal temporary changes to the Medicare homebound requirement
Worked with the Betsy Lehman Center on an infection control training and toolbox for use in homemaker and aide training
Other 2019-2020 Work
Among the member supportive services over the past twelve months, the Alliance and Foundation have:
Moved the entire Spring Conference and Trade Show to a virtual platform available to members on demand
Offered members a one-time 15% dues discount
Worked with state legislators and other stakeholders to advance an effective non-medical home care licensure bill; Legislation is unlikely to be signed into
law prior to the end of the 2020 Legislative Session
Produced a series of videos for our website and for members’ use on working with Private Care home care agencies
The Alliance has unveiled detailed guidance for agencies regarding admissions from, and discharges to, hospitals related to COVID-19.
Today, the Home Care Alliance of Massachusetts unveiled detailed guidance for home health agencies regarding admissions from hospitals related to COVID-19. The guide is available as a Word document and providers are encouraged to create policies and procedures that reflect their own agencies’ operations, capabilities, and community/patient needs.
The guide was co-authored with Kimberly Skehan of Simione Healthcare Consultants. Because of the nature of the crisis, we are making this available to all agencies, regardless of current membership status.