Home Health Providers, Staff in For ‘Rude Awakening’ Following Public Health Emergency Expiration

Though it sometimes may not feel like it, the expiration of the public health emergency (PHE) will, one day, come.

And when it does, that will have ramifications on home health providers specifically, and home-based care more generally. With the declaration came a handful of waivers and flexibilities meant to alleviate the harsh impacts of the pandemic for home health providers.

The Biden Administration extended the PHE for another three months on Friday, but providers will need to prepare for the day it will eventually come to an end. 

The PHE was originally declared in March of 2020, retroactive to Jan. 27, 2020. This past April, the U.S. Department of Health & Human Services (HHS) extended the emergency status for 90 additional days, to July 15.

Concerns around waivers and flexibilities

Along with the PHE declaration came a number of regulatory waivers and flexibilities meant to streamline health care processes and ease the overall burden of the pandemic for providers.

One of these waivers made it possible for any of the disciplines — nursing, physical therapy (PT), occupational therapy (OT), or speech language pathologists — to conduct home health admissions based on the needs of the patient.

If the PHE ends, this waiver is not expected to become permanent, according to Cindy Krafft, the co-owner and co-founder of the consulting firm Kornetti & Krafft Health Care Solutions.

“It has deeper regulatory issues and stuff that would have to be dealt with, but it is still allowable in the waiver situation,” she told Home Health Care News. “The reason I think it’s going to be a challenge is the current staffing situation in home health. We know that several agencies are at crisis levels and the ability to move admissions to therapy and take some of that off of nursing, when appropriate, has become routine.”...

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HOPE BETA Test Recruitment

CMS and their contractor, Abt Associates, are recruiting additional Medicare-certified hospice providers to participate in a beta test of the draft hospice patient assessment instrument called Hospice Outcomes & Patient Evaluation (HOPE). Recruitment is ongoing. Training will occur mid-July 2022, with data collection slated to begin in August 2022 and continue through fall 2022. The detailed recruitment announcement is available on CMS's Hospice QRP Provider and Stakeholder Engagement webpage. Those interested in participating should email [email protected]. The HOPE development work is conducted under CMS contract number 75FCMC18D0014 and task order number 75FCMC19F0001.

Renewal of Public Health Emergency (PHE) for COVID-19

On July 15, 2022, Secretary Xavier Becerra, Secretary of Health and Human Services, renewed the PHE for COVID-19. The renewal is for 90 days, through October 14, 2022. The renewal states:

Renewal of Determination That a Public Health Emergency Exists
As a result of the continued consequences of the Coronavirus Disease 2019 (COVID-19) pandemic, on this date and after consultation with public health officials as necessary, I, Xavier Becerra, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective July 20, 2021, the January 31, 2020, determination by former Secretary Alex M. Azar II, that he previously renewed on April 21, 2020, July 23, 2020, October 2, 2020, and January 7, 2021, and that I renewed on April 15, 2021, July 19, 2021, October 15, 2021, January 14, 2022, and April 12, 2022, that a public health emergency exists and has existed since January 27, 2020, nationwide.

Reconciliation Bill Update

From the Partnership for Medicaid Home-Based Care

The bill that could carry additional HCBS funding – is moving along.  The closed-door reconciliation negotiations between Senate Majority Leader Chuck Schumer (D-NY) and Sen. Joe Manchin (D-WV) took a turn subsequent to the Department of Labor releasing data showing inflation at a 40-year high of 9.1 percent.  As a result, it looks like the Senate is considering a smaller reconciliation bill that would include drug pricing provisions and a short extension of ACA subsidies.   

Sen. Manchin told Majority Leader Schumer that until the August reports on interest and inflation rates are released, the two should not pursue a reconciliation package that includes climate change spending and tax increases.  He reiterated his opposition to the House-passed Build Back Better Act and stressed that the reconciliation package should focus on financial and energy security. 

Sen. Manchin’s spokesperson declined to comment on whether the Senator supports the inclusion of $150 billion for home- and community-based services but reiterated his concerns about inflation and his commitment to “lower healthcare costs for seniors and working families.”