In the News

Notice of Proposed Rule: Employee or Independent Contractor Classification Under the Fair Labor Standards Act, RIN 1235-AA43

On October 13, 2022, the U.S. Department of Labor published a Notice of Proposed Rulemaking (NPRM) to revise the Department’s guidance on how to determine who is an employee or independent contractor under the Fair Labor Standards Act (FLSA). The NPRM proposes to rescind a prior rule, Independent Contractor Status Under the Fair Labor Standards Act (2021 IC Rule),  that was published on January 7, 2021 and replace it with an analysis for determining employee or independent contractor status that is more consistent with the FLSA as interpreted by longstanding judicial precedent. The Department believes that its proposed rule would reduce the risk that employees are misclassified as independent contractors, while providing added certainty for businesses that engage (or wish to engage) with individuals who are in business for themselves.

The initial deadline for interested parties to submit comments on the NPRM was November 28, 2022. On October 26, 2022, the Department published a notice in the Federal Register, extending the deadline to submit comments by 15 days. The Department encourages interested parties to submit comments on this proposal by December 13, 2022 (the new deadline). The full text of the NPRM, as well as information on the deadline for submitting comments and the procedures for submitting comments, can be found at Federalregister.gov. The NPRM’s comment period closes at 11:59 p.m. ET on December 13, 2022.

Anyone who submits a comment (including duplicate comments) should understand and expect that the comment, including any personal information provided, will become a matter of public record and will be posted without change to www.regulations.gov. The Wage and Hour Division posts comments gathered and submitted by a third-party organization as a group under a single document ID number on www.regulations.gov, including any personal information provided.

 

Revised Guidance for Staff Vaccination Requirements

The Centers for Medicare & Medicaid Services (CMS) released QSO-23-02-ALLRevised Guidance for Staff Vaccination Requirements. CMS is revising its guidance and survey procedures for all provider types related to assessing and maintaining compliance with the staff vaccination regulatory requirements.

To learn more and view the memo, visit the Policy & Memos to States and Regions website

 

CareAcademy Training System Discount for AHH Members & Partners 

CareAcademy provides high-quality, state-approved training for home health agencies, home care agencies, franchise systems, and payors that increases learner knowledge for better health outcomes. With easy-to-use, web-based courses and a robust administrator platform, CareAcademy offers education and compliance solutions for home care and home health organizations of all sizes, small agencies to multi-state enterprises. Tailored training packages are available with a 10% discount for APTA Home Health members; please schedule a time to learn more: https://careacademy.com/apta/

 

RSV, Other Viruses Making it Hard to Find a Bed in Children’s Hospitals 

Washington Post | By Fenit Nirappil and Ariana Eunjung Cha

Children’s hospitals are under strain in the United States as they care for unusually high numbers of kids infected with RSV and other respiratory viruses.

It’s the latest example of how the pandemic has upended the usual seasonal patterns of respiratory illnesses, denying a respite for health-care professionals ahead of a potential hectic winter as the coronavirus, influenza and other viruses collide.

Respiratory syncytial virus, a common cause of cold-like illness in young children known as RSV, started surging in late summer, months before its typical season from November to early spring. This month, the United States has been recording about 5,000 cases per week, according to federal data, which is on par with last year but far higher than October 2020, when more coronavirus restrictions were in effect and very few people were getting RSV.

“It’s very hard to find a bed in a children’s hospital — specifically an intensive care unit bed for a kid with bad pneumonia or bad RSV because they are so full,” said Jesse Hackell, a doctor who chairs the committee on practice and ambulatory medicine for the American Academy of Pediatrics.

Nearly three-quarters of pediatric hospital beds are occupied, according to federal health data. Rhode Island, the District of Columbia and Delaware report more than 94 percent of pediatric beds occupied. Maine, Arizona, Texas, Kentucky, Oklahoma and Missouri reported between 85 and 90 percent of beds occupied. The data is limited to facilities that report the information.

Several children’s hospitals in the D.C. area have been at capacity for weeks; 18 children were waiting for a room in the ICU on Tuesday at Children’s National in the District.

D.C. Realtor Kate Foster-Bankey was more attuned to RSV after she started hearing from clients whose children were afflicted with the virus in recent weeks, including one whose child was admitted to Children’s National.

Then her 3-year-old daughter Isabelle fell ill, becoming lethargic, complaining of a fast heartbeat and not eating. They waited two hours in the packed waiting room of a pediatric urgent-care center where Foster-Bankey, a mother of four, was used to seeing only a handful of patients.

During a follow-up visit Tuesday, Isabelle was transported by ambulance to the emergency room of a children’s hospital, where she tested positive for RSV and had to wait until the following morning for a bed.

“It sounds like in covid, we gutted our pediatric care,” said Foster-Bankey, 41. “Kids shouldn’t have to wait in a waiting room with a bunch of other sick kids for hours.”

At Connecticut Children’s Hospital, the emergency room is so full that patients are being triaged in hallways. Teens with bone fractures and appendicitis are being diverted or transferred to adult-care centers to create additional space for respiratory patients. Hospital officials are considering the possibility of enlisting the National Guard to set up tents and care for the influx of patients.

Over the past nine days, 110 children with RSV have come in to the emergency room, and at times as many as 25 children with RSV were waiting for an inpatient bed, said Juan Salazar, physician in chief at Connecticut Children’s. He said that for the first time in his career he has had to mandate doctors in other specialties such as endocrinology and rheumatology work with RSV patients — a situation reminiscent of the “all hands on deck” approach many adult hospitals took in March 2020, when the coronavirus began to sweep through the United States.

“During my tenure here I haven’t seen anything like this,” said Salazar, who has worked in infectious diseases for 30 years.

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Informal Caregiver Hours On The Rise, Highlighting Need For Home Care, Respite Services

Home Health Care News | By Joyce Famakinwa

More individuals are having to take on what’s known as the second or third shift — caregiving duties in addition to being employed.
 
At the same time, there has been an increase in Medicare Advantage (MA) plans offering home-based care, including respite services, coinciding with this rise of informal caregivers.
 
For context, informal caregivers are spouses, partners, friends or family members who assist with activities of daily living (ADLs) and possibly even medical tasks, according to San Francisco-based nonprofit Family Caregiver Alliance.
 
A new survey from Homethrive found that there has been a 151% increase in the number of employees spending more than 9 work hours weekly on caregiving compared to its last survey in 2021.
 
Homethrive’s survey examines how informal caregivers are balancing work life and their additional caregiving responsibilities. Two hundred informal caregivers — working in a variety of industries in the U.S. — were surveyed for the report.
 
“Unpaid family caregivers are unsung heroes,” Bonni Kaplan DeWoskin, vice president of marketing at Homethrive, said in a statement. “Our second annual ‘Employee Caregiving Survey’ reveals their workloads show no signs of letting up, and this underserved, yet growing population, is demanding help from their employers; they’re willing to leave their jobs unless they get it.”
 
The survey also found that there’s been a 79% increase in the number of employees spending more than five hours weekly on caregiving compared to last year.
 
The types of caregiving responsibilities that the survey respondents were taking on included grocery shopping, driving to doctor’s appointments or other services, housekeeping tasks, arranging or preparing meals and assisting with medications.
 
Additionally, more than a third of respondents either left work early, missed work days or had to change their work schedule to accommodate their caregiving duties.
 
Over half of respondents said they are concerned about the negative impact caregiving will have on their job performance.
 
In addition to those findings, surveyed individuals also expressed an interest in switching jobs if it would give them access to caregiving-coordination benefits, as two-thirds of respondents said they currently don’t have access to a caregiving support benefit.
 
Home care operators should view the Homethrive survey results as another proof point for their services. Professional caregivers can help family members care for loved ones and focus on their careers.

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