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State mulls more COVID-19 testing at homes for disabled


DORAL, FL – JUNE 18: General view during BioReference Laboratories hosts Grand Opening of COVID-19 (Coronavirus) Antibody Testing Collection Event at the Miami International Mall with local Government Officials providing opening remarks on June 18, 2020 in Doral, Florida. (Photo by Jason Koerner/Getty Images for BioReference Laboratories )

Gov. Ron DeSantis’ administration appears poised to address rising criticism over its handling of COVID-19 in group homes that take care of residents with intellectual and developmental disabilities.

The deadly respiratory disease has shown itself to be efficient at moving rapidly through prisons, jails, nursing homes and assisted living facilities. But it also can be a problem for the places where people with disabilities live.

One of the ongoing complaints is a lack of testing in group homes. In response, the DeSantis administration said this week it is “evaluating options” to expand testing for staff members and residents at the facilities.

The administration also announced that the state will start providing the names of group homes where residents and staff members have tested positive for COVID-19 on a weekly basis. The first weekly report will be Friday, the Agency for Persons with Disabilities said.

The agency sent a statement Wednesday night to The News Service of Florida noting the changes. If implemented, the policies — particularly access to free tests for group homes — would be a reversal for the DeSantis administration, which has prided itself on how it has taken steps to curb the spread of COVID-19 in nursing homes and assisted living facilities.

“The Agency for Persons with Disabilities is committed to the highest standards of care for our customers,” agency Director Barbara Palmer said in the statement. Additionally, Palmer said she was working closely with state Surgeon General Scott Rivkees and other officials in the DeSantis administration “to ensure the needs of Floridians with developmental disabilities remain a priority in all aspects of care.”

“I am proud to work to protect individuals with developmental disabilities from COVID-19 in every way possible,” Palmer said.

The agency already tracks COVID-19 cases at more than 2,000 licensed group homes that it licenses. While the DeSantis administration started making available the details of testing information at nursing homes and ALFs, it has not disclosed that data for group homes.

The potential changes highlight how Florida officials have handled the coronavirus outbreak differently between facilities that serve seniors and people with disabilities. Group homes were not included in recently passed emergency rules that require nursing homes and assisted living facilities to test staff members every two weeks. The state is providing free tests to nursing homes and ALFs to carry out the new policy.

Kari Bates, executive director of The Arc of Putnam County, sees first-hand the differences in the state’s testing policies. That’s because Bates offers her clients access to ALFs and group homes.

She recalled first noticing a difference in the testing policies early in the COVID-19 pandemic. She said local emergency operations officials sent face masks for her ALF clients and staff members but that nothing was sent for her group home staff and clients. Additionally, when the Florida National Guard initially contacted her about testing ALF staff members and residents for COVID-19, there was no mention of testing people at the group homes.

“It logically didn’t make sense to me. While I understand how it’s happening when you look at the clientele and the risk factors, the people in the APD (Agency for Persons with Disabilities) homes are in congregate settings. They are typically an older age. They have all sorts of co-existing conditions, and they are just as much at risk as an ALF resident,” Bates said.

Curt Decker, executive director of the National Disability Rights Network, said Florida isn’t the only state with COVID-19 policies that have left behind people with intellectual and developmental disabilities.

“We’ve allowed everybody, including health departments, to pretend this is not a serious problem for this population because we are not identifying it,” he said. “This population just falls off the table and is considered not important enough or a priority enough to deal with, even though they are experiencing this.”

In Florida, group homes are an integral part of the service-delivery system for people with intellectual and developmental disabilities. Organizations like Decker’s network hold out community-based facilities as an alternative to institutional care.

But Decker worries that uneven COVID-19 policies may make the community environments less safe.

“It makes me nervous. Am I putting my clients in a worse situation? We think the community is better for them to have real integrated lives,” Decker said. “We are just putting them in more jeopardy.”

The News Service reported last week that The Arc of Florida wanted the Agency for Persons with Disabilities to advise county health departments on the need to test people at group homes. And in its statement, the agency said county health departments are testing at group homes “whenever there is or was an indication of possible exposure to COVID-19.”

Providers, though, say they don’t want testing after the fact.

Arc Jacksonville Executive Director Jim Whittaker said he tried for months to get the Duval County Health Department to test residents and staff members at his five facilities but that he was repeatedly denied. All that changed last week after one of his residents tested positive for COVID-19. Days later, Whittaker said, a staff member at the home also tested positive.

“For me, it was all preventative,” Whittaker said. “But we were told group homes were not a priority.”

Immediate attempts to contact the Duval County Health Department for comment were unsuccessful.

Arc of Alachua County Executive Director Mark Swain has been able to get preventive testing for his group home clients and staff.

“But it took a lot to get them (health officials) to understand that because they weren’t receiving the correct information from the top down,” he said.

Alachua County Health Department Administrator Paul Myers, though, said he didn’t need to be sold on the idea.

“We embraced the testing of that population and the residents and continue to do so to this day,” Myers said, adding that testing is conducted every two weeks. “Now it’s just on cruise control.”

Myers defended the state’s decision to make testing at nursing homes and assisted living facilities the top priority.

“When everything is a priority, nothing is a priority. And those who are in those ALFs and nursing homes are my top priority in Alachua County,” he said. “My No. 1 priority continues to be the nursing homes and the ALF where we have a lot of danger for that population.”

Decker said Myers’ remark underscored the problem.

“You are a public health person,” Decker said. “Why do we have to explain to you that people with these particular disabilities are very, very vulnerable and need the same kind of care?”

UPDATED: IMPORTANT FUNDING ANNOUNCEMENT FOR ALL MEDICAID PROVIDERS

For all Medicaid and CHIP providers: The U.S. Department of Health and Human Services (HHS) has announced additional distributions from the Provider Relief Fund to eligible providers that participate in the Medicaid and Children’s Health Insurance Programs.

NEW!: HHS Planning Two Webinars Next Week for Providers on Medicaid Provider Relief Portal and Application Process

HHS will be holding two webinars next week titled, Getting started with the Provider Relief Fund
for Medicaid and CHIP Distribution
. These are to assist providers in understanding how to use the Medicaid provider relief portal and submit applications to the portal. These webinars will be held on:

Funding Overview:

On June 10, HHS is launching an enhanced Provider Relief Fund Payment Portal that will allow eligible Medicaid and CHIP providers to report their annual patient revenue, which will be used as a factor in determining their Provider Relief Fund payment. The payment to each provider will be at least 2 percent of reported gross revenue from patient care; the final amount each provider receives will be determined after the data is submitted, including information about the number of Medicaid patients providers serve.

To be eligible for this funding, providers must not have received payments from the $50 billion Provider Relief Fund General Distribution and must have billed their state Medicaid/CHIP programs or managed care plans for healthcare-related services from January 1, 2018 through May 31, 2020.

Other terms and conditions may apply. Please see the HHS announcement at https://www.hhs.gov/about/news/2020/06/09/hhs-announces-enhanced-provider-portal-relief-fund-payments-for-safety-net-hospitals-medicaid-chip-providers.html.

HHS has posted additional information to their website regarding this funding opportunity for Medicaid and CHIP providers.  The updated information includes:

HHS has also posted FAQs on their website providing additional information that providers may find useful. Those FAQs can be found at https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/faqs/index.html. Please note that the FAQs specific to Medicaid and CHIP providers are near the bottom of the FAQ page under the header, “Medicaid Targeted Distribution.”

 

Federal Civil Rights Resolution Makes Clear Hospital Visitor Policies Nationwide Must Accommodate Patients with Disabilities During  COVID-19 Pandemic

WASHINGTON, D.C. – Today, in response to the first federal complaint challenging discriminatory hospital “no-visitor” policies, the Office for Civil Rights (OCR) at the U.S. Department of Health & Human Services announced a resolution making clear that federal law requires hospitals and the state agencies overseeing them to modify policies to ensure patients with disabilities can safely access the in-person supports needed to benefit from medical care during the COVID-19 pandemic.

Strict no-visitor policies put in place at hospitals have prevented patients with disabilities from safely receiving support from family members or staff necessary for them to effectively communicate with medical personnel or otherwise receive equal access to medical treatment. No-visitor policies have disproportionately impacted Black people with disabilities, who have higher rates of infection and hospitalization. Accommodations to these policies are required by federal civil rights laws.

The complaint was filed against the State of Connecticut by national disability organizations The Arc of the United States, Center for Public Representation, and CommunicationFIRST, together with Connecticut-based organizations Disability Rights Connecticut, The Arc of Connecticut and Independence Northwest: Center for Independent Living of Northwest CT. The groups alleged that Connecticut’s COVID-19 no-visitor policy denied people with disabilities equal access to medical care and effective communication, deprived them of their right to make informed decisions and provide informed consent, and resulted in harms such as unnecessary physical and chemical restraints. The groups filed a separate complaint against Hartford Hospital  regarding its discriminatory treatment of 73-year-old “Patient G.S.,” who has speech and short-term memory disabilities but was not allowed access to in-person supports necessary for her to communicate, which was also recently resolved and publicly announced today.

“We are thrilled that this resolution will help prevent other patients around the country from having to experience the discrimination, physical pain, and emotional harm endured by Patient G.S.,” said Tauna Szymanski, Executive Director of CommunicationFIRST. “Ensuring states and hospitals safely balance public health concerns with the obligation to ensure patients with disabilities can communicate effectively has been a top priority for CommunicationFIRST during the pandemic.”

“Today’s resolution sets a national precedent for how states and hospitals can ensure their policies comply with federal disability laws,” said Alison Barkoff, Director of Advocacy at the Center for Public Representation. “The COVID-19 crisis has laid bare the discrimination that people with disabilities face in accessing healthcare. We appreciate OCR’s leadership and collaboration with us to ensure people with disabilities can access the care they need.”

Highlights from the hospital policy announced by OCR and Connecticut include that it:

  • Requires all hospitals and other health care facilities to allow designated persons (family members, staff, or others) to support any disabled patient that may need such support;
  • Requires hospitals to provide available personal protective equipment (PPE) to support persons to keep them safe;
  • Includes procedures for screening support persons for COVID-19 symptoms and for supporters to safely take breaks and leave and re-enter the hospital; and
  • Encourages hospitals to mitigate the risk associated with support persons supporting COVID-19-positive patients.

“Many with intellectual and developmental disabilities are being deprived of basic rights during the COVID-19 pandemic, and we have already seen dire consequences from this discriminatory treatment. We thank OCR for today’s resolution and will continue to fight for the health and well-being of all people with disabilities,” said Peter Berns, CEO, The Arc.