Council of State Home Care & Hospice Association Annual Meeting Resources 

From July 25th - July 28th, HHAC attended the in-person Council of State Home Care & Hospice Associations annual conference and have subsequently obtained a copy of the slides for the most significant presentations to share with our members. Presentations included lots of great information on national news, trends, outlooks, and pending legislation, including:

• FY2022 Hospice – Now Final- Rule Highlights
• FY2022 Home Health Proposed Rule Highlights
• First Year PDGM Data
• Median Profit Margins for Home Health and Hospice
• Value-Based-Purchasing Insights

Members Click Here for access to the following presentations: 

• Medicare Update by SimiTree
• National and State Update: Hot Topics and We Honor Veterans Program by NAHC & NHPCO
• Legislative Outlook by Liberty Partners Group
• Industry Perspective by BKD

Vaccination Rates Improving, Particularly Among the Seniors, but Herd Immunity is a Moving Target

As reported by Kaiser Healthcare News, on August 3rd, the United States hit another milestone with 90% of people 65 and older being at least partially vaccinated against the disease. That’s more than 49 million seniors vaccinated. Overall, 70% of adults have been inoculated, at least partly, and nearly 68% of people over 12.

Despite improved vaccination rates, another article by Medscape Medical News, reported that, “Because the Delta variant of SARS-CoV-2 spreads more easily than the original virus, the proportion of the population that needs to be vaccinated to reach herd immunity could be upwards of 80% or more, experts say. The original SARS-CoV-2 virus required an estimated 67% of the population to be vaccinated to achieve herd immunity. For Delta, those threshold estimates go well over 80% and may be approaching 90%.”

Denver Mandates COVID-19 Vaccination for Healthcare Workers, Educators & Others

ORDER WHEREAS, on March 12, 2020, the Mayor of the City and County of Denver declared a state of local disaster emergency pursuant to C.R.S. § 24-33.5-701, et seq., due to the risk of spread of the COVID-19 virus.

WHEREAS, according to the federal Centers for Disease Control (“CDC”), COVID-19 continues to pose a serious risk, especially to individuals who are not fully vaccinated, and certain safety measures remain necessary to protect against COVID-19 cases and deaths.

WHEREAS, vaccination is the most effective way to prevent transmission and limit COVID-19 hospitalizations and deaths.

WHEREAS, this Order is based upon evidence of continued community transmission of COVID19, in particular the rise of Delta variant cases, within the City and County of Denver.

WHEREAS, the primary intent of this Order is to continue to protect the community from COVID19 and to increase vaccination rates to reduce transmission of COVID-19 long-term, so that the community is safer and the COVID-19 pandemic can come to an end. All provisions of this Order shall be interpreted to effectuate this intent.

Due to the recent surge of Delta variant COVID-19 cases and epidemiological evidence that shows low rates of vaccination fuel increased rates of community transmission, this Order hereby requires personnel of the following entities, or types of entities, to be fully vaccinated by September 30, 2021:

• the City and County of Denver;
• care facilities;
• hospitals;
• clinical settings;
• limited healthcare settings;
• shelters for people experiencing homelessness, including day and overnight shelters;
• correctional facilities, including jails, detention centers and community corrections sites and residences;
• schools, including post-secondary and higher education;
• childcare centers and services;
• any entity providing home care to patients; and
• any entity providing first responder services.

This Order further requires the entities or types of entities listed above to ensure that all personnel are fully vaccinated by September 30, 2021, and to ensure that all personnel hired thereafter are vaccinated. Until a person’s vaccination status is ascertained, that person must be treated as not fully vaccinated. Personnel who decline to provide vaccination status must also be treated as unvaccinated. The entities, or types of entities listed above, with the exception of hospitals, must complete their initial ascertainment of full vaccination status for all personnel by September 30, 2021 and must maintain corresponding records that are available to the health authority upon request. Hospitals may meet their ascertainment of full vaccination status in conjunction with meeting their flu and other vaccination requirements.

“Personnel” means employees of the entities or types of entities listed above, as well as individuals who provide services onsite and/or in the field to or on behalf of the entities or types of entities listed above on a contractual or volunteer basis. Entities and individuals who provide onsite services to or on behalf of the Denver International Airport on a contractual basis shall not be considered “personnel” for purposes of this Order. Employers shall provide reasonable accommodations for any personnel who have medical or religious exemptions from the COVID19 vaccination.

“Employees” of the City and County of Denver shall mean all persons in the employ of the City and County of Denver, including on-call employees; interns (paid or unpaid); volunteers; appointed officers, board members and commissioners; elected officials; at-will appointees of elected officials and the Department of Aviation; hearing officers appointed by the Career Service Board; employees of the Denver County Court including judges and magistrates; and employees of the Independent Monitor’s Office, City Council, Library Commission, the Denver Public Library, and the Civil Service Commission.

“Care facilities” means nursing facilities, assisted living residences, intermediate care facilities and group homes.

“Childcare centers and services” does not include foster care.

“Clinical settings” means ambulance service centers, urgent care centers, non-ambulatory surgical structures, clinics, dentist offices, doctor offices, and non-urgent care medical structures.

“Fully vaccinated” means two weeks after a person’s second dose in a two-dose series and two weeks after a single-dose vaccine.

“Limited healthcare settings” means those locations where healthcare services are provided including but not limited to acupuncture, audiology services, services by hearing aid providers, chiropractic care, massage therapy, naturopathic care, occupational therapy services, optometry, ophthalmology, physical therapy, and speech language pathology services.

This Order shall be effective immediately and shall remain in effect until rescinded, superseded, or amended in writing by the Executive Director of DDPHE.

Issued by: Robert M. McDonald

Public Health Administrator, City & County of Denver Executive Director, Denver Dept of Public Health & Environment

COVID-19 Updates (08/05/2021)

As Reported by NHPCO

CDC Says 7-day Average of Daily U.S. Covid Cases Surpassed Peak Last Summer

CNBC reports, “The seven-day average of daily coronavirus cases in the U.S. surpassed the peak seen last summer when the nation didn’t have an authorized Covid-19 vaccine, CDC Director Dr. Rochelle Walensky said Monday, citing data published over the weekend. U.S. Covid cases, based on a seven-day moving average, reached 72,790 on Friday, according to data compiled by the Centers for Disease Control and Prevention. That’s higher than the peak in average daily cases seen last summer, when the country was reporting about 68,700 new cases per day, according to the CDC.”

U.S. Pediatric COVID-19 Cases Up 64% in One Week

“COVID-19 vaccine initiations rose in U.S. children for the second consecutive week, but new pediatric cases jumped by 64% in just 1 week, according to new data. As of July 22, the total number of reported cases was over 4.12 million in 49 states, the District of Columbia, New York City, Puerto Rico, and Guam, and there have been 349 deaths in children in the 46 jurisdictions reporting age distributions of COVID-19 deaths.” Read the full article from Medscape Medical News.

Lambda Variant Shows Vaccine Resistance

Reuters reports, “The Lambda variant of the coronavirus, first identified in Peru and now spreading in South America, is highly infectious and more resistant to vaccines than the original version of the virus [that] emerged from Wuhan, China, Japanese researchers have found. In a paper posted on Wednesday on bioRxiv ahead of peer review, the researchers warn that with Lambda being labeled a ‘Variant of Interest’ by the World Health Organization, rather than a ‘Variant of Concern,’ people might not realize it is a serious ongoing threat.”