Some people who were infected by COVID-19 go on to have new or lingering symptoms—a condition known as long COVID. The U.S. Department of Labor (DOL) is committed to supporting workers with long COVID and their employers. To gather ideas on how to address workplace challenges related to long COVID, DOL’s Office of Disability Employment Policy, in collaboration with several other federal agencies, invite you to join a national online dialogue, “Understanding and Addressing Workplace Challenges Related to Long COVID.”

All ideas are welcome, but they are specifically looking for insight and shared experiences on:

Based on current conditions and low numbers of new COVID-19 cases, the Michigan Department of Health and Human Services (MDHHS) announced late last week that it is updating its COVID-19 Isolation & Quarantine guidance for Michigan residents, including for school settings.

This update does not change guidance for health care, long-term care, corrections and other high-risk settings, and these entities should continue to follow existing guidance. 

ISOLATION

• Any individual who tests positive for COVID-19 and/or displays COVID-19 symptoms (without an alternate diagnosis or negative COVID-19 test) should isolate regardless of vaccination status:
  • Isolate at home for the first five days (starting with the day after symptoms began or day after test was taken for those without symptoms); and
  • If symptoms have improved or no symptoms developed, return to normal activities, while wearing a well-fitted mask, for the next five days to protect others.

AND

• If individual has a fever, stay home until fever free for a period of 24 hours without the use of fever reducing medications before returning to normal activities while wearing a well-fitted mask, until the 10-day period is complete.

OR

• Isolate at home for 10 days if unwilling/unable to wear a mask.

QUARANTINE

Quarantine guidance may be adjusted to respond to and control outbreaks within unique settings as needed. Local leaders and individuals should work with their local health departments for outbreak response and follow additional quarantine recommendations as situations dictate to maintain a safer environment for community members.

• Individual is exposed to someone who is positive for COVID-19 and:

1. Exposure is to a personal/household contact:
   • Conduct symptom monitoring for 10 days; and
   • Test at least one time if possible three to seven days after exposure and if symptoms develop; and
   • Wear a well-fitting mask for 10 days from the date of last exposure to protect others (home quarantine is an alternative for those who are unable or unwilling to mask); and
   • Avoid unmasked activities or activities with higher risk of exposing vulnerable individuals for 10 days from the date of last exposure
2. Exposure is to other type of contact (from a community, social or work setting)
   • Conduct symptom monitoring for 10 days; and
   • Test if symptoms develop; and
   • Consider wearing a well-fitting mask around others for 10 days from the date of last exposure to protect others. At a minimum, wear a mask in settings with higher risk of exposing vulnerable individuals

Along with MDHHS' updated guidance, there may also be local isolation & quarantine guidance, policies and/or orders from local health departments, organizations and/or school districts that must be followed. Policies established by event organizers and businesses may be instituted to fit the specific needs of their customers and should be followed.

Click to view the full MDHHS Press Release.

1/4/22: Updated Isolation and Quarantine Guidance

The Michigan Department of Health and Human Services (MDHHS) updated its quarantine guidance for the general public to reflect the recent recommendations from the Centers for Disease Control and Prevention (CDC). 

If Tested Positive for COVID-19 (Isolate)

Regardless of vaccination status:

• Stay home for 5 days.
• If you have no symptoms or your symptoms are resolving after 5 days, you can leave your house.
• Continue to wear a mask around others for 5 additional days.
• If you have a fever, continue to stay home until your fever resolves.

If Exposed to Someone with COVID-19 (Quarantine)

If you: Have been boosted OR Completed the primary series of Pfizer or Moderna vaccine within the last 6 months OR Completed the primary series of J&J vaccine within the last 2 months

• Wear a mask around others for 10 days.
• Test on day 5, if possible.
• If you develop symptoms get a test and stay home.

If you: Completed the primary series of Pfizer or Moderna vaccine over 6 months ago and are not boosted OR Completed the primary series of J&J over 2 months ago and are not boosted OR Are unvaccinated

• Stay home for 5 days. After that continue to wear a mask around others for 5 additional days.
• If you can’t quarantine you must wear a mask for 10 days.
• Test on day 5 if possible.
• If you develop symptoms get a test and stay home. 

Notably, the CDC recommends a shortening of the quarantine and isolation duration for those who aren’t vaccinated or haven’t received their booster to five days followed by an additional five days of wearing a well-fitting mask around others. The updated guidance is specific to the general public and does not change the current guidance recommendations for congregate settings, early childcare or K-12 settings – these settings should continue to use existing guidelines and policies regarding quarantine and isolation. Guidance will continue to evolve as more information is learned from CDC.

Click to view the MDHHS press release.

Last week, MDHHS adopted updated CDC guidance on isolation and quarantine for healthcare workers. 

8/3/21: CDC Recommendations on Mask Wearing

The Centers for Disease Control and Prevention (CDC) updated information last week for fully vaccinated people, given new evidence on the B.1.617.2 (Delta) variant of COVID-19 currently circulating in the United States. The new guidance includes:

• Recommendation for fully vaccinated people to wear a mask in public indoor settings in areas of substantial or high transmission.
• Added information that fully vaccinated people might choose to wear a mask regardless of the level of transmission, particularly if they are immunocompromised or at increased risk for severe disease from COVID-19, or if they have someone in their household who is immunocompromised, at increased risk of severe disease or not fully vaccinated.
• Recommendation for fully vaccinated people who have a known exposure to someone with suspected or confirmed COVID-19 to be tested 3-5 days after exposure, and to wear a mask in public indoor settings for 14 days or until they receive a negative test result.
• Recommendation for universal indoor masking of all teachers, staff, students, and visitors to schools, regardless of vaccination status.

Click here for more information.

As of Monday, the guidance now affects over 30 counties - an increase from 10 when the CDC recommendations were issued last week.  Based on this guidance, individuals in affected areas - fully vaccinated or not - are advised to wear masks in public indoor settings because risk of transmission of the coronavirus is "high" or "substantial," according to the CDC.  The counties in these categories include:

Allegan, Alpena, Barry, Branch, Calhoun, Cass, Charlevoix, Clinton, Delta, Dickinson, Grand Traverse, Huron, Ingham, Ionia, Iosco, Iron, Jackson, Kalamazoo, Kalkaska, Livingston, Macomb, Mason, Montmorency, Muskegon, Oakland, Ontonagon, Presque Isle, Saginaw, Shiawassee, St. Joseph, Tuscola and Van Buren.

These counties are home to more than 4.5 million residents, or 46 percent of the state's population.  Michigan's seven-day average of new COVID-19 cases was 678 on Saturday, an increase from 241 two weeks before. 

Governor. Gretchen Whitmer has not indicated plans to reinstate a mask requirement - but has urged people to get vaccinated and wear a face covering when inside and among groups. As of Monday, 59.8% of Michigan residents age 16+ have received their initial dose of the vaccine, and 31.5% of residents age 12-15 have received their initial dose.

Click to view the page on the CDC website tracking areas of substantial or high transmission.

Find the vaccination location closest to you or

call 1-800-232-0233 (TTY 888-720-7489) for vaccine info.

7/28/21: CDC Updates Guidance for People who are Fully Vaccinated

The CDC has updated information for fully vaccinated people given new evidence on the B.1.617.2 (Delta) variant of COVID-19 currently circulating in the United States. The new guidance includes:

• Recommendation for fully vaccinated people to wear a mask in public indoor settings in areas of substantial or high transmission.
• Added information that fully vaccinated people might choose to wear a mask regardless of the level of transmission, particularly if they are immunocompromised or at increased risk for severe disease from COVID-19, or if they have someone in their household who is immunocompromised, at increased risk of severe disease or not fully vaccinated.
• Recommendation for fully vaccinated people who have a known exposure to someone with suspected or confirmed COVID-19 to be tested 3-5 days after exposure, and to wear a mask in public indoor settings for 14 days or until they receive a negative test result.
• Recommendation for universal indoor masking of all teachers, staff, students, and visitors to schools, regardless of vaccination status.

Click here for more information.

As expected, the US Centers for Disease Control and Prevention (CDC) on Friday offered updated guidance on wearing masks in indoor public spaces.  The recommendations no longer rely only on community transmission levels to determine the need for restrictions such as mask wearing. Instead, they direct counties to consider three measures to assess risk of the virus: levels can be low, medium, or high and are determined by looking at hospital beds being used, hospital admissions, and the total number of new COVID-19 cases in an area.

Based on these three factors, counties can calculate whether the risk to their residents is low, medium or high, according to the CDC, and only areas of high risk should require wearing a mask indoors in public.

Every home in the U.S. is eligible to order 4 at-⁠home COVID-⁠19 tests. The tests are completely free, and orders will usually ship in 7-12 days.  The federal government unveiled the website for ordering earlier this week.

Click to order your tests through https://www.covidtests.gov/

If you need a COVID-⁠19 test now, the site also offers connections to other testing resources for free testing locations in your area.

The Michigan Department of Health and Human Services (MDHHS) has also announced a pilot project with libraries across the state to offer free, at-home testing kits for Michiganders.  This week, nearly 5,500 test kits were shipped to 18 libraries in Calhoun, Clare, Newaygo, Oceana and Saginaw counties and the City of Detroit. Each site received 300 COVID-19 at-home test kits that each include one test. Additional kits will be shipped to these sites as needed and more libraries will be added to the distribution in the coming weeks. Information will be posted at Michigan.gov/coronavirus.

Click to view the full MDHHS Press Release.

Below are the link and passcode for the MDHHS recorded presentation for AFC & HFA Providers from January 12, 2022. The following topics are covered in this recorded presentation:

• Supplemental 4 COVID Vaccination Grant
• Isolation & Quarantine Updates for Healthcare Personnel
• COVID-19 Testing Update
• Understanding the Omicron Variant
• COVID-19 Therapeutics

As a reminder, the slides from all of the previous MDHHS presentations for AFC & HFA Providers can be accessed at www.michigan.gov/coronavirus. Click the RESOURCES down-arrow and select “For AFC & HFA Operators.”

Meeting Recording: Important COVID19 Updates for AFCs & HFAs January 12, 2022

Access Passcode: uHnR7!PU

12/9/20: BHDDA Webinar on COVID-19 Emergency Response

Behavioral Health and Developmental Disabiliites Administration Director Allen Jansen hosted a webinar with representatives from the Michigan Department of Health and Human Services to present the following topics: 

• COVID Epidemiology/COVID in Michigan Overview
• AFC HFA COVID Response Decision Tool
• A guidance document for the tool.

While the documents linked above apply primarily to residential settings, they offer helpful context on emergency response for all providers.

For questions about the event, please email:

MDHHS-COVID-AFC-HFA-Response@michigan.gov

The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), began distributing $7.5 billion in American Rescue Plan (ARP) Rural payments to providers and suppliers who serve rural Medicaid, Children's Health Insurance Program (CHIP), and Medicare beneficiaries. The objective is to provide relief to rural providers who historically operate on thin margins and have had their financial challenges further exacerbated during the pandemic. The average payment announced is approximately $170,700, with payments ranging from $500 to approximately $43 million. More than 40,000 providers in all 50 states, Washington, D.C., and six territories will receive ARP Rural payments.

For more information, please see the materials below:

• HHS Press Release
• State-by-state breakdown of the ARP Rural payments
• Public dataset of providers who have received ARP payments

Federal programs that expanded and extended unemployment benefits are expiring.

The week ending Sept. 4, 2021 is the last payable week of benefits from these programs that were established with the Coronavirus Aid, Relief and Economic Security (CARES) Act and continued under the American Rescue Plan Act:

• Pandemic Unemployment Assistance(PUA): for the self-employed, freelancers, independent contractors and others who don't qualify for regular unemployment benefits.
• Pandemic Emergency Unemployment Compensation (PEUC): Extends benefits after you run out of regular unemployment benefits.
• Pandemic Unemployment Compensation (PUC): The extra $300 a week for all eligible claimants.
• Mixed Earners Unemployment Compensation (MEUC): Provides an additional $100 per week to certain claimants who have earned at least $5,000 in net self-employment income.

Click to view additional information on these federal benefits programs.

4/17/21: Unemployment Extended Benefits Program Ends April 17

Due to the State of Michigan's lower unemployment rate, the U.S. Department of Labor notified the Michigan Unemployment Insurance Agency to confirm that our state's Extended Benefits (EB) program will no longer be payable after the week ending April 17, 2021. Extended Benefits are available when a Michigan's total unemployment rate averages 6.5% or higher for three consecutive months.

The Agency has begun notifying the 16,000 claimants currently receiving Extended Benefits to ensure they are aware that the week ending April 17, 2021, is the last payable week for these benefits.

Click here to read the press release.

4/9/20: DOL Guidance on Unemployment Insurance

The U.S. Chamber of Commerce has provided additional information regarding Unemployment Insurance (UI) benefits that were expanded under the CARES Act for those previously not eligible such as self-employed and independent contractors.

While there are many changes from the CARES Act, below are some basic points that are worth keeping mind:

• UI is still a state administered benefit, with federal requirements overlayed. In the case of the CARES Act, UI will still be provided through state agencies, in most cases after the state government signs an agreement with DOL. Thus, when determining eligibility requirements, it's best to consult your state's UI agency.
• To be eligible for UI benefits, an employee must be temporarily or permanently laid off or suffer a reduction in hours. They must also be able, available, and actively looking for work, although states have some flexibility in interpreting these requirements.  
• The highly publicized supplemental benefit of $600 expires on July 31, 2020. This additional amount is available to employees claiming traditional state UI benefits, those who were not previously eligible for UI but were made so under the CARES Act, and those who are claiming benefits because their hours have been reduced.
• Individuals who exhaust their traditional 26 weeks of state UI benefits are eligible for an additional 13 weeks (total of 39). If these weeks occur after July 31, 2020, the benefit will only be the traditional state UI benefit without the additional $600 unless Congress authorizes an extension.
• Unless a state programs says otherwise, an employee who is teleworking for pay, or taking paid leave is generally ineligible for regular UI benefits. The CARES Act states that employees receiving new Pandemic Unemployment Assistance are ineligible if they are getting paid leave benefits.

The Department of Labor's Employment and Training Administration (ETA) has authority for implementing the UI provisions of the CARES Act. They have issued the following sets of guidance.

• First ETA guidance from March 22: Talks about state flexibility to determine eligibility for UI
• Second guidance: Summarizes the major UI provisions
• Third guidance: Discusses the mechanics of the Federal Pandemic Unemployment Compensation program
• Fourth guidance: Discusses the Pandemic Unemployment Assistance program and includes clarifying examples

3/31/20: Unemployment Benefits Increased and Expanded

Governor Whitmer, under the federal CARES Act, signed an agreement between Michigan and the U.S. Department of Labor to implement Pandemic Unemployment Assistance and Compensation programs that grant benefits to workers who do not already qualify for state unemployment benefits. Workers include those that are self-employed, 1099-independent contractors, gig, and low-wage workers who can no longer work because of the pandemic. The agreement also increases weekly benefits for all unemployed workers by $600 a week and extends benefit payments from 26 to 39 weeks.

Click to view a press release from the Governor’s office, as well as view more details regarding the agreement.

Click to access the Department of Labor and Economic Opportunity (LEO) and view the application page.

3/25/20: Executive Order 2020-24

LATEST EXECUTIVE ORDER ATTEMPTS TO CLARIFY EMPLOYEE ELIGIBILITY FOR UNEMPLOYMENT BENEFITS AND IMPACT ON EMPLOYERS

Governor Whitmer signed Executive Order 2020-24 which clarifies how the expansion of eligibility for unemployment benefits during the COVID-19 will work. Additionally, it rescinds Executive Order 2020-10.

To mitigate the spread of COVID-19, protect the public health, and provide essential protections to vulnerable Michiganders, it is reasonable and necessary to temporarily suspend rules and procedures to expand eligibility for unemployment benefits and cost-sharing with employers.

Specifically, the EO indicates:

An individual on a leave of absence because of self-isolation or self-quarantine in response to elevated risk from COVID-19 due to being immunocompromised, displaying the symptoms of COVID-19, having contact in the last 14 days with someone with a confirmed diagnosis of COVID-19, the need to care for someone with a confirmed diagnosis of COVID-19, or a family care responsibility as a result of a government directive, must be considered to be unemployed unless the individual is already on sick leave or receives a disability benefit.

Additionally, relative to the impact on employer accounts:

Any benefit paid to a claimant that is laid off or placed on a leave of absence must not be charged to the account of the employer(s) who otherwise would have been charged but instead must be charged to the Unemployment Insurance Agency’s non-chargeable account. Effective March 25, 2020 at 11:59 pm, the benefits conferred on employers by this section are not available to employers determined to have misclassified workers.

Click to view the full Executive Order.

Governor Whitmer announced a package of proposed investments designed to help Michigan’s workers, businesses, and communities emerge from the COVID pandemic stronger than when we entered it.

The Department of Labor and Economic Opportunity (LEO) has generated a  proposal, which would provide $2.1 billion in funding to educate workers and grow the middle class, support small businesses and create better jobs, and invest in Michignan communities. LEO also issued detailed descriptions of each of the 22 separate investments that collectively make up the governor’s package. The process of developing this proposal included stakeholder outreach, and next steps will include refining these proposals and moving them through the legislature.

Also this week, Interim Director Susan Corbin was chosen to be the permanent Director of DEO. From Director Corbin: As a career public servant, I appreciate the once in a generation opportunity offered by the passage of the American Rescue Plan to bring transformational change to our state, address longstanding structural challenges that were exasperated by the pandemic, while creating more shared prosperity and closing equity gaps. I look forward to working with all of you to help fulfill LEO’s mission of expanding economic opportunity and prosperity for all.

Click to view the investment announcement and supporting proposal.

The Employee Retention Credit (ERC) that was available during 2020 for a maximum per employee credit of $5,000 has been extended through December 31, 2021.  With the 2021 ERC, the maximum potential annual credit is as much as $28,000 per employee, so the dollars here are significant.  

Similar to the 2020 ERC, the 2021 ERC is available to those employers who experienced a full or partial suspension of operations due to governmental orders or saw a significant decline in gross receipts (comparing each calendar quarter in 2021 against the same calendar quarter in 2019) and were able to retain staff.  

Click here for more information on the recent guidance issued by the IRS and US Treasury related to the 2021 ERC for Q3 and Q4 of 2021.

August 2021: Guidance on Employee Retention Credit

The Treasury Department and Internal Revenue Service issued additional guidance on the employee retention credit. The guidance, Notice 2021-49, provides clarification for employers who pay qualified wages after June 30, 2021 and before January 1, 2022. The notice addresses changes made by the American Rescue Plan Act of 2021. Those changes include:

• Making the credit available to eligible employers that pay qualified wages after June 30, 2021 and before January 1, 2022;
• Expanding the definition of eligible employer to include recovery startup businesses;
• Modifying the definition of qualified wages for “severely financially distressed employers;” and
• Ensuring that the employee retention credit does not apply to qualified wages taken into account as payroll costs in connection with a shuttered venue grant.

Click to view Notice 2021-49.

5/13/20: IRS Reminders on Business Credits

The Internal Revenue Service recently reminded employers affected by COVID-19 about important credits available to them.

The employee retention credit is designed to encourage businesses to keep employees on their payroll. The refundable tax credit is 50% of up to $10,000 in wages paid by an eligible employer whose business has been financially impacted by COVID-19.

The credit is available to all employers regardless of size, including tax-exempt organizations. There are only two exceptions: State and local governments and their instrumentalities and small businesses who take small business loans.

Qualifying employers must fall into one of two categories:

1. The employer's business is fully or partially suspended by government order due to COVID-19 during the calendar quarter.
2. The employer's gross receipts are below 50% of the comparable quarter in 2019. Once the employer's gross receipts go above 80% of a comparable quarter in 2019, they no longer qualify after the end of that quarter.

Employers will calculate these measures each calendar quarter.

The paid sick leave credit is designed to allow business to get a credit for an employee who is unable to work (including telework) because of Coronavirus quarantine or self-quarantine or has Coronavirus symptoms and is seeking a medical diagnosis. Those employees are entitled to paid sick leave for up to 10 days (up to 80 hours) at the employee's regular rate of pay up to $511 per day and $5,110 in total.

The employer can also receive the credit for employees who are unable to work due to caring for someone with Coronavirus or caring for a child because the child's school or place of care is closed, or the paid childcare provider is unavailable due to the Coronavirus. Those employees are entitled to paid sick leave for up to two weeks (up to 80 hours) at 2/3 the employee's regular rate of pay or, up to $200 per day and $2,000 in total. 

Employers can be immediately reimbursed for the credit by reducing their required deposits of payroll taxes that have been withheld from employees' wages by the amount of the credit.

Click to view additional info posted on the IRS website.

The Small Business Administration launched a streamlined application portal to allow borrowers with Paycheck Protection Program (PPP) loans $150,000 or less secured through participating lenders to apply for forgiveness directly through the SBA. The portal is intended to simplify forgiveness for about 90% of loans by, among other things, skipping the step in Second Draw PPP loans of proving that revenues declined in a quarter by 25%. The portal will start accepting applications on August 4. SBA issued an Interim Final Rule to implement the new procedures.

It is suggested that borrowers consult with their lending institution to establish the best path for requesting forgiveness.

Click to view the full SBA News Release.

3/30/21: PPP Officially Extended

President Biden signed into law the two-month extension to apply for a Paycheck Protection Program (PPP) loan. In review, the legislation extends PPP through May 31 and allows 501(c)(6) organizations and others more time to pursue a second PPP loan. Further, if eligible organizations apply by May 31, the Small Business Administration will permit lenders an additional 30 days to process and approve any outstanding applications.

Eligibility criteria for a second PPP loan are as follows:

• The applicant received a first PPP loan and will or has used the loan only for authorized uses;
• The applicant employs no more than 300 people; and
• The applicant can demonstrate at least a 25-percent reduction in gross receipts between comparable quarters in 2019 and 2020.

The maximum loan amount of a second PPP loan is two-and-a-half times the average monthly 2019 or 2020 payroll costs, up to $2 million.

1/19/21: PPP Round 2 Updates

With a second round of Paycheck Protection Program loans officially on its way – this renewed PPP2 program is part of pandemic relief provisions signed into law on Dec. 27 – many organizations are eager to know if, when, and how this assistance could help their operations.  The U.S. Small Business Administration (SBA) announced plans to begin a tiered opening for round 2 of the Paycheck Protection Program (PPP) the week of Jan. 11.

• Paycheck Protection Program First Draw Borrower Application Form (revised 01-08-21)
• Paycheck Protection Program Second Draw Borrower Application Form (01-08-21)

Starting Monday, Jan. 11, only certain types of community financial institutions will be able to make first-draw PPP loans, and on Wednesday, they will be allowed to make second-draw PPP loans. The full PPP will then open up to all participating lenders “shortly thereafter” according to a statement from SBA.

Late Wednesday, Jan. 13, the U.S. Small Business Administration announced the final phase of opening the 2nd round of the Paycheck Protection Program (PPP) will be finalized by Tuesday, Jan. 19. The announcement said that small banks can start processing applications on Friday, Jan. 15 with all approved lenders – including large banks – able to begin taking applications on Tuesday, Jan. 19.

SBA also released guidance to lenders outlining the process by which an existing borrower under the first PPP could basically reapply for a higher amount first-draw than was initially approved if the borrower fully repaid the loan before Dec. 27 and no forgiveness payments have been made to the lender on that loan.

• Interim Final Rule on Paycheck Protection Program as Amended by Economic Aid Act (1/6/2021)
• Interim Final Rule on Second Draw Loans (1/6/2021)

For additional info, the Community Bankers of Michigan has also  created a helpful resource on the Paycheck Protection Program Round 2.

Top-line Overview of PPP First Draw Loans

Top-line Overview of PPP Second Draw Loans

1/8/21 New Details on PPP - Round 2

Earlier today, the Small Business Administration announced additional details on the second round of the Paycheck Protection Program.  To promote access to capital, initially only community financial institutions will be able to make First Draw PPP Loans on Monday, January 11, and Second Draw PPP Loans on Wednesday, January 13. Specific timing on when the PPP will open to all participating lenders is to be determined, but is likely to occur later in January.

Highlights include:

• Borrowers can set their loan covered period to be any length between 8 & 24 weeks to best meet their needs
• Loans will cover additional expenses, including operations expenditures, property damage costs, supplier costs, & worker protection expenditures
• The Program’s eligibility is expanded to include 501(c)(6)s, housing cooperatives, direct marketing organizations, among other types of organizations
• Greater flexibility for seasonal employees
• Certain existing PPP borrowers can request to modify their First Draw PPP Loan amount
• Certain existing PPP borrowers are now eligible to apply for a Second Draw PPP Loan
• A borrower is generally eligible for a Second Draw PPP Loan if the borrower:
  • Previously received a First Draw PPP Loan and will or has used the full amount only for authorized uses
  • Has no more than 300 employees; and
  • Can demonstrate at least a 25% reduction in gross receipts between comparable quarters in 2019 and 2020

Click to view additional information from the US Department of Treasury.

1/8/21 What Businesses Need to Know About Federal COVID Relief Package

Through an end-of-year pandemic relief package, Congress passed several changes to the Paycheck Protection Program (PPP) and created a “Second Draw” PPP for small businesses that have exhausted their initial loan. Other changes impact eligibility for initial PPP loans, the loan forgiveness process, and PPP loans' tax treatment.

Congress has made changes to other programs, including Economic Injury Disaster Loans (EIDL program), the employee retention tax credit, venue grant program, and SBA loan programs that will benefit small businesses. The U.S. Chamber of Commerce provided an updated document that includes everything small business owners need to know now.  Click to view the updated US Chamber document.

In March, President Biden signed the American Rescue Plan Act (ARPA) into law, enacting a $1.9 trillion COVID-19 relief package. The legislation includes a number of provisions that impact state and federal health care policies and programs, including the availability of enhanced federal funding for state Medicaid spending on HCBS.  ARPA provides states with a one-year, 10 percentage point increase in their federal medical assistance percentage (FMAP) - the share of state Medicaid spending paid for by the federal government - for certain Medicaid HCBS expenditures.

The enhanced federal funding affords Michigan an opportunity to make substantial investments in services and supports for older adults as well as those with physical disabilities, intellectual and developmental disabilities, and/or behavioral health needs. The Michigan Department of Health and Human Services (MDHHS) has developed a document serving as the State’s proposed HCBS Spending Plan, including high-impact initiatives that can be sustained primarily through one-time investments. This funding will be used to bolster the department’s efforts through the following three pillars:

1. Expansion of HCBS Services and Supports, including navigation, transitions, family care givers, diversion, and enhanced care models;
2. HCBS Workforce Development, retaining and building a high-quality network; and
3. HCBS Technology and Infrastructure Development, to enable more effective care coordination, access, and delivery.

Click to view the full plan document.

The Emergency Broadband Benefit is a Federal Communications Commission (FCC) program to help families and households struggling to afford internet service during the COVID-19 pandemic. This new benefit will connect eligible households to jobs, critical healthcare services, virtual classrooms, and so much more.

The Emergency Broadband Benefit will provide a discount of up to $50 per month towards broadband service for eligible households and up to $75 per month for households on qualifying Tribal lands. Eligible households can also receive a one-time discount of up to $100 to purchase a laptop, desktop computer, or tablet from participating providers if they contribute more than $10 and less than $50 toward the purchase price.

The Emergency Broadband Benefit is limited to one monthly service discount and one device discount per household.

Click for additional information, including eligibility criteria and application instructions.

The Michigan Occupational Safety and Health Administration (MIOSHA) filed COVID-19 emergency rules to align with Federal OSHA's Emergency Temporary Standard (ETS).

This action rescinds the emergency rules issued on May 24, 2021, and adopts the Federal OSHA ETS linked above. The updated rules focus on healthcare settings where known or suspected COVID-19 patients may be present, which have a higher exposure risk for employees and need continued protections to mitigate the spread of COVID-19.

The updated workplace rules are effective today, set to expire Dec. 22, 2021 - and allow employers in non-healthcare settings to use their best judgment in determining whether to maintain:

• Daily health screenings;
• Face covering requirements; and
• Social distancing requirements.

Nevertheless, MIOSHA strongly encourages workplaces to follow the available CDC and OSHA recommendations to mitigate hazards.

Non-healthcare settings should align policies with CDC guidelines to ensure they help contain the spread of COVID-19.

Non-healthcare employers should also consult updated Federal OSHA guidance. 

To request MIOSHA's consultation, education and training services, call 517-284-7720 or online at MIOSHA Request for Consultative Assistance. 

For more information about MIOSHA's safety and health guidelines to protect Michigan's workforce, visit Michigan.gov/COVIDWorkplaceSafety. Employers and employees with questions regarding workplace safety and health may contact MIOSHA using COVID-19 hotline at 855-SAFE-C19 (855-723-3219).

6/4/21: Updated MIOSHA Rules and MDHHS Orders

Earlier this week, Governor Whitmer announced updates to the Michigan Occupational Safety and Health Administration’s (MIOSHA) COVID-19 emergency rules, which took effect May 24. While the updated rules will expire on October 14, MIOSHA has the flexibility it needs to ensure consistency with public health guidelines and can rescind all or parts of the rules.   

Changes made under the latest version of the MIOSHA emergency rules include: 

• MIOSHA has removed the requirement for policies prohibiting in-person work for employees to the extent feasible (these rules are geared toward returning workers to the workplace).
• Workplace controls have been updated, including adding an exception to the social distancing and masking mandates for fully vaccinated persons (unless in a healthcare setting where patients may be present  and when using airplane or public transportation) – importantly, the rules state that employers are still able to require face coverings and social distancing for all employees regardless of vaccination status if that is a manner that is effective for the place of employment.
• Daily health screening requirements remain unchanged.
• Employers should continue to have and implement a written COVID-19 preparedness and response plan.  Click to download a revised template, developed by the Small Business association of Michigan (SBAM).   
• Training and recordkeeping requirements continue, with added “vaccination information sufficient for implementation” if you are excepting fully vaccinated employees from the masking and social distancing requirements. Caution is encouraged with respect to what medical information is being requested to confirm vaccination status and treating all medical information as confidential.

MDHHS  also  updated  its COVID-19 Gatherings and Face Masks epidemic order, eliminating outdoor capacity limits and increasing indoor social gatherings, including weddings, conferences and funerals, to 50% capacity. Under the new order, which goes into effect Tuesday, June 1, and continues through Thursday, July 1, masks will continue to be required indoors for individuals who are not yet vaccinated.  

• Sign that follows MDHHS guidelines requiring face coverings worn by unvaccinated individuals, developed by SBAM
• Sign that requires face coverings regardless of vaccination status (SBAM)

5/26/21: Recording Available from MIOSHA Webinar

Michigan COVID-19 Workplace Safety Director Sean Egan hosted a live webinar to discuss the updated MIOSHA Emergency Rules which included workplace requirements to establish safe and healthy work environments.

Watch the webinar and review the presentation.

Visit Michigan.gov/COVIDWorkplaceSafety for additional resources. 

5/24/21: Updated MIOSHA Emergency Rules

Updated Michigan Occupational Safety and Health Administration (MIOSHA) COVID-19 emergency rules were signed by Governor Gretchen Whitmer.  MIOSHA updated the rules to reflect Michigan Department of Health and Human Services (MDHHS) Emergency Orders and guidance from the federal Centers for Disease Control and Prevention (CDC). Changes made under the latest version of the MIOSHA workplace safety emergency rules are as follows: 

• MIOSHA has removed the requirement for policies prohibiting in-person work for employees to the extent feasible (these rules are geared toward returning workers to the workplace).
• Workplace controls have been updated, including adding an exception to the social distancing and masking mandates for fully vaccinated persons (unless in a healthcare setting where patients may be present  and when using airplane or public transportation) – importantly, the rules state that employers are still able to require face coverings and social distancing for all employees regardless of vaccination status if that is a manner that is effective for the place of employment.
• Daily health screening requirements remain unchanged.
• Employers should continue to have and implement a written COVID-19 preparedness and response plan in accordance with the updated rules.    
• Training and recordkeeping requirements continue, with added “vaccination information sufficient for implementation” if you are exempting fully vaccinated employees from the masking and social distancing requirements. Caution is encouraged with respect to what medical information is being requested to confirm vaccination status and treating all medical information as confidential.
• The rules have been revised to eliminate industry-specific requirements.
• Definitions like “close contact” and “fully vaccinated persons” have been updated to remain consistent with CDC recommendations.
• Cleaning requirements have also been updated to reflect changes in CDC recommendations.      

The emergency rules will expire on October 14, although MIOSHA has the ability to ensure consistency with public health guidelines and can rescind all or parts of the rules.  

Click to view the latest MIOSHA emergency rules.

Click to view the MIOSHA COVID-19 workplace safety webpage.

Earlier this month, the State's Return-to-Office Workgroup provided Gov. Gretchen Whitmer with their recommendations for how employers can begin to plan for a safe, phased reopening of offices. In addition to encouraging employers to be transparent and communicate frequently with employees on phased return-to-office plans, the workgroup's key recommendations can be found in their report.

Click to view the complete Recommendations from the Return to Office Workgroup.

5/14/21: MIOSHA Emergency Rule Update and Opportunity for Public Comment

The Michigan Occupational Safety and Health Administration (MIOSHA) has recently filed a Draft Rule with the Michigan Secretary of State.  The rules would extend many of MIOSHA’s COVID-19 Emergency Rules on a permanent basis.

Individuals can submit written comment about MIOSHA's proposed COVID-19 rule through May 26, the day of a virtual public hearing about the plan.

Michigan COVID-19 Workplace Safety Director Sean Egan has indicated that afterthe hearing, MIOSHA officials will review comments and consider editing the draft. Then, they'll submit it to the legislature's Joint Committee on Administrative Rules, which will have 15 session days to take more comments and act on the rule.

Committee members could choose to do nothing, which would mean the rule is adopted and filed with the Secretary of State. They could propose changes, which would send the rule back to MIOSHA for another round of work. They also could object to it and introduce bills to block its enactment.

Egan has indicated it is  possible the current draft is not what MIOSHA will send to the legislature.  Stay tuned - given today's announcement by the Governor, it is likely this will be addressed again in the days ahead.  Incompass Michigan will continue to monitor the situation and keep you informed.

Click to view additional information on the public hearing, and instructions for public comment.

10/14/20: MIOSHA Issues Emergency Rules

Michigan Occupational Safety and Health Administration (MIOSHA) issued emergency rules which clarify the safety requirements employers must follow to protect their employees from COVID-19.

Under the emergency rules, businesses that resume in-person work must have a written COVID-19 preparedness and response plan, and provide thorough training to their employees that covers workplace infection-control practices, the proper use of personal protection equipment (PPE), steps workers must take to notify the business or operation of any symptoms of COVID-19 or a suspected or confirmed diagnosis of COVID-19, and how to report unsafe working conditions, among others. MIOSHA’s emergency rules implement workplace safeguards for all Michigan businesses and specific requirements for industries, including manufacturing, construction, retail, health care, exercise facilities, restaurants and bars. Additionally, the rules establish workplace safety requirements and employers should coordinate these requirements with the Department of Health and Human Services (DHHS) emergency orders that restrict gathering sizes, require face coverings in public spaces and childcare facilities, place capacity limitations on stores, bars and other public venues and provide safer workplaces.

Click to view the MIOSHA Emergency Rules.

Download the COVID-19 MIOSHA Emergency Rules Infographic.

The U.S. Department of Health and Human Services, through the Health Resources and Services Administration (HRSA) released revised reporting requirements for recipients of Provider Relief Fund (PRF) payments. This announcement includes expanding the amount of time providers will have to report information, aims to reduce burdens on smaller providers, and extends key deadlines for expending PRF payments for recipients who received payments after June 30, 2020. The revised reporting requirements will be applicable to providers who received one or more payments exceeding, in the aggregate, $10,000 during a single Payment Received Period from the PRF General, Targeted, and/or Skilled Nursing Facility and Nursing Home Infection Control Distributions.

For more information, click on the links below:

• HHS Press Release
• Post-Payment Notice of Reporting Requirements
• Provider Relief Fund Reporting Requirements and Auditing

10/21/20: MDHHS Updates Communications on Enhanced Provider Relief Fund - Phase 3

MDHHS is also notifying providers that the US Department of Health and Human Services (HHS) has published additional information about the Phase 3 distribution for the Provider Relief Fund. MDHHS sent Letter L 20-62 to providers on October 21, 2020 with information on HHS’s newest eligibility criteria for applying for the Provider Relief Fund. In addition to that new information, HHS has shared the following updates:

• Expanding the pool of eligible provider types
• Clarifying that providers who do not bill Medicare or Medicaid are able to apply
• Clarifying reporting guidelines for providers

The application for Phase 3 funding is due November 6.

HHS has scheduled an informational webinar addressing changes to the Provider Relief Fund for November 2, 2020 at 3 pm. Providers can visit https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/for-providers/index.html to register for the webinar, read about the newest updates, and to apply for funding.

10/6/20: New Phase 3 Provider Relief Funding

Late last week, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced $20 billion in new funding for providers on the frontlines of the coronavirus pandemic. Under this Phase 3 General Distribution allocation, providers that have already received Provider Relief Fund payments will be invited to apply for additional funding that considers financial losses and changes in operating expenses caused by the coronavirus. Previously ineligible providers, such as those who began practicing in 2020 will also be invited to apply, and an expanded group of behavioral health providers confronting the emergence of increased mental health and substance use issues exacerbated by the pandemic will also be eligible for relief payments.

The HHS announcement indicates the following with respect to eligibility:

HHS is making a large number of providers eligible for Phase 3 General Distribution funding, including:

• Providers who previously received, rejected or accepted a General Distribution Provider Relief Fund payment. Providers that have already received payments of approximately 2% of annual revenue from patient care may submit more information to become eligible for an additional payment.
• Behavioral Health providers, including those that previously received funding and new providers.

Providers will have from October 5, 2020 through November 6, 2020 to apply for Phase 3 General Distribution funding. HHS’s top priority is ensuring as many providers possible have an opportunity to apply. HHS will continue to host webinars to assist providers through the application process and the call center is also available to address questions.

Click to view the full HHS announcement.

A few key points regarding the application process:

• Providers must register in the Portal and enter their Tax Identification Number (TIN). Recognized TINs will be automatically validated and the provider may re-enter portal to complete the application.  This includes TINs from a state-provided 3rd party list and TINs that were previously verified in prior PRF distributions.
• Providers are encouraged to submit their applications as soon as possible to expedite the calculation and distribution of payments.  Providers should apply if they have lost revenues and/or increased expenses attributable to COVID-19 that have not been reimbursed by other sources.
• It will be necessary to submit a new application because the application form has been updated to include the financial impact of COVID-19.

Click to view the application and attestation portal.

8/28/20: Provider Relief Fund Application Deadline Extended to September 13

HHS has extended the application deadline for provider relief funds to Sunday, September 13. Incompass Michigan members are strongly encouraged to apply. Please note there is only one portal open to ALL eligible providers, regardless of billing. The portal is referred to on the HHS website as the “Provider Relief Fund Phase 2 General Distribution.”

8/18/20: MDHHS Issues L Letter on Provider Relief Fund

The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), has allocated additional funds targeted to Medicaid and Children’s Health Insurance Program (CHIP) providers through the Provider Relief Fund for appropriate expenses and lost revenue due to COVID-19. This funding is available as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

As reported in previous Info Alerts and Updates, on July 31, HHS extended the deadline for the application process and modified the eligibility criteria and application process to August 28. The Michigan Department of Health and Human Services (MDHHS) is encouraging eligible providers to apply to HRSA for this funding opportunity.

Starting August 10, certain Medicare providers were given another opportunity to receive additional Provider Relief Fund payments. The re-opened application portal allows providers who received nominal automatic payments from the first general distribution, but did not apply for additional funds by the initial June 3 deadline or returned these automatic payments, to apply and receive additional payments totaling two percent of net patient revenue. These eligible providers may submit their application for possible funds through the HHS portal by August 28, 2020.

Click to view the "L Letter" from MDHHS to all Medicaid and CHIP providers.

8/12/20: HHS Provider Relief Fund Update

Funds are still available through this program that provides payments to a wide range of healthcare providers for expenses and lost revenue due to COVID-19. Yesterday, the US Dept. of Health and Human Services and Health Resources and Services Administration (HRSA) held a stakeholder call to provide updates about the Provider Relief Fund, as well as an “ask” to help share this information among provider association constituencies.

Information and resources reviewed during the call are available through the links below.  Two important updates are included:

• If an organization received a Phase 1 Payment from the fund, as a result of billing for services through Medicare, it was initially determined that the organization was ineligible - this has changed.  If your organization received a small amount of funds already, you can now apply for additional funding up to 2% of revenue. Find out more and apply by August 28, 2020. bit.ly/30zECa5
• There will be another webcast Thursday, Aug 13 at 3:00pm ET about the CARES Act Provider Relief Fund. This is specifically geared toward provider organizations. Learn about the expanded application and who is eligible to apply. Register now to save your spot: https://bit.ly/3fIlD2w

Click to view the step by step provider guide reviewed during yesterday's call.

Click to view the Provider Relief Fund Stakeholder Toolkit.

Click to view the Provider Relief Fund Application and Attestation Portal.

If you encounter challenges with the application, call the Provider Support Line at (866) 569-3522; for TTY, dial 711

8/3/20: HHS Extends Application Deadline  for Medicaid Providers

As part of their efforts to provide financial relief to healthcare providers impacted by the coronavirus disease 2019 (COVID-19), last Friday the Department of Health and Human Services (HHS) announced an application deadline extension for the Phase 2 general distribution to Medicaid, Medicaid managed care, Children's Health Insurance Program (CHIP) and dental providers. HHS also plans to allow certain Medicare providers who experienced challenges in the Phase 1 Medicare General Distribution application period a second opportunity to receive funding. Both groups will have until Friday, August 28, 2020 to apply.  From the HHS Announcement:

In June, HHS announced the opening of Phase 2 of the General Distribution – a $15 billion allocation – wherein eligible Medicaid, Medicaid managed care, CHIP and dental providers could begin applying for funding of up to 2 percent of reported revenue from patient care. Since the announcement, HHS has posted resources and hosted a number of webinars targeted at providers and provider organizations to answer questions and assist eligible providers with the application process. The initial deadline of July 20, 2020, was extended to August 3, 2020, based on provider feedback that they learned about the program too close to the deadline and needed more time to complete their application. By giving providers until August 28, 2020 to apply, HHS is hopeful it has struck the right balance in terms of providing as much flexibility as possible, recognizing the constraints on smaller practices already operating on thin margins with limited administrative staff. HHS will also soon be providing a more simplified application form in response to ongoing dialogue focused on improving the provider experience.

Click to view the HHS Provider Relief Fund Portal.

The Health Resources & Services Administration has also clarified one of the FAQs to specifically indicate that disability service providers are eligible:
Are healthcare providers that only bill Medicaid or CHIP through a waiver eligible for the Medicaid, CHIP, and Dental Providers Distribution? (Modified 7/30/2020)
Yes. Healthcare providers that bill for services in Medicaid or CHIP that are covered under either a waiver or state plan, including disability service providers and other providers of Medicaid-funded home and community-based services (HCBS) (e.g., day habilitation, HCBS waiver program services), are eligible for the Medicaid, CHIP, and Dental Providers Distribution if they otherwise meet the other eligibility criteria.
 
Click to view the FAQs. 

MDHHS Director Hertel signed an Emergency Order that updated requirements for residential care facilities. The main change made under the order issued Friday is requiring residents to wear face masks when they are not eating or drinking around any individual who is not fully vaccinated. The MDHHS Order on Residential Care Facilities took immediate effect.

To view the Emergency Order, please click here.

To view an FAQ on the MDHHS Emergency Order on Residential Care Facilities, please click here. 

10/26/20: MDHHS Emergency Order - Residential Care Facilities

MDHHS Director Robert Gordon issued an emergency order yesterday that updates and further expands requirements for residential care facilities, while also permitting indoor visitation in residential care facilities in certain circumstances.

The emergency order continues to limit communal dining and internal and external group activities consistent with the Centers for Medicare and Medicaid Services guidance. Additionally, the order requires quick notification in the event an employee or resident is confirmed as positive for COVID-19. New under the order are visitation rules linked to the risk level of the county. A list of county risk levels is available on the MI Safe Start Map. Indoor visitation is now allowed in areas where the current risk level is A, B, C, or D, so long as the facilities have had no new cases, including those involving residents or staff, originating within the prior 14 days. Indoor visitation is not allowed when the county is at risk level E, which means there is an elevated incidence growth rate with average daily cases per million greater than 150, or a positivity rate greater than 20 percent. It is also prohibited if the local health department has determined that it would be unsafe. Outdoor visitation is allowed throughout the state as long as the facility assures that the outdoor visitation area allows for at least six feet between all persons and adequate protection from weather elements is provided. 

Click to view the MDHHS Emergency Order.

One of the provisions of the American Rescue Plan Act (ARPA) that was signed into law on March 11, 2021 is new government COBRA subsidies (100% of the COBRA premium payment) that will be provided through September 30, 2021 for COBRA premium payments for workers (and their covered spouse and dependents) when the worker is subject to involuntary termination or a reduction of hours. Employers will receive the reimbursement for the premium subsidies in payroll tax credits (similar to the FFCRA).

COBRA generally applies to all private-sector group health plans maintained by employers that had at least 20 employees on more than 50 percent of its typical business days in the previous calendar year. Additionally, COBRA also applies to plans sponsored by state and local governments. The law does not apply, however, to plans sponsored by the federal government or by churches and certain church-related organizations.

This is a reminder that employers covered by COBRA are required to update their COBRA Notices or provide a separate notice regarding the subsidy to all eligible employees by May 31, 2021. The model notices are available here: https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/cobra/premium-subsidy

Individuals who are still within their COBRA maximum coverage period, and previously experienced an involuntary termination or reduction in hours, but did not elect COBRA, or those who elected and subsequently dropped COBRA coverage, must also be given the opportunity to elect COBRA to take advantage of the subsidy available under ARPA.

To the extent it has not already been done, covered employers should work with their COBRA administrators or employee benefits attorney to identify those eligible employees who need the notice and ensure they receive that notice. 

It is important to note that this subsidy does not apply to workers who voluntarily terminated their employment or who are on COBRA for one of the other qualifying reasons. Additionally, in no event is an individual eligible for more than the COBRA maximum coverage period measured from the date of the original qualifying event.

The Michigan Department of Health and Human Services (MDHHS) revised its Emergency Order for COVID-19 testing in long-term care facilities across the state to reflect current guidance from the Centers for Medicare and Medicaid Services. 

Changes under the COVID-19 testing order for skilled nursing facilities, homes for the aged and adult foster care facilities licensed to care for 13 or more individuals no longer require fully vaccinated staff to be routinely tested. This order is effective immediately. Testing continues to be required under the following circumstances: 

• Initial testing of all new or returning residents to a facility covered by this order and newly hired staff when the individual is unvaccinated and has not been tested in the 72 hours prior to intake or start date.  
• Testing any resident or staff member with symptoms of COVID-19 or suspected exposure to COVID-19, regardless of that individual's vaccination status.   
• Weekly testing of all residents and staff in facilities experiencing an outbreak (any facility-acquired positive cases among residents or staff) until 14 days after the last new positive case, regardless of vaccination. 
• Weekly testing of all unvaccinated staff. 

To view the MDHHS Emergency Order on Testing in Skilled Nursing Facilities, Homes for the Aged, and Adult Foster Care Facilities, please click here.

To view a press release from MDHHS, please click here.

The American Rescue Plan Act of 2021 (ARP) allows small and midsize employers, and certain governmental employers, to claim refundable tax credits that reimburse them for the cost of providing paid sick and family leave to their employees due to COVID-19, including leave taken by employees to receive or recover from COVID-19 vaccinations. The ARP tax credits are available to eligible employers that pay sick and family leave for leave from April 1, 2021, through September 30, 2021.

An eligible employer is any business, including a tax-exempt organization, with fewer than 500 employees. An eligible employer also includes a governmental employer, other than the federal government and any agency or instrumentality of the federal government that is not an organization described in section 501(c)(1) of the Internal Revenue Code.

Click for additional information, including credit amounts, how they are calculated, and steps for claiming the credit.

The Institute on Community Integration’s Research and Training Center on Community Living for Persons with intellectual and Developmental Disabilities at the University of Minnesota, in partnership with the National Alliance for Direct Support Professionals, conducted a survey of approximately 9,000 direct support professionals (DSPs) from across the country about their experiences supporting people with intellectual and developmental disabilities (IDD) during the COVID-19 pandemic. This is a six-month follow-up report to the initial report completed in April 2020 and is the largest study conducted on the direct support workforce.

Key findings include:

• Nearly half (47%) said they had been exposed to COVID-19 at work and their exposure was higher in congregate facilities than in individual or family homes.
• 97% of workers self-identified as essential workers, but only 30% received salary augmentations.
• Black/African American DSPs were paid less per hour than white DSPs, and a higher percentage of Black/African American DSPs worked 40 or more additional hours per week.

Click here for Michigan specific data.

Click here to access the full report.

The American Rescue Plan Act is the latest and largest in a series of federal COVID-19 relief bills. This broad-based legislation includes significant funding and grant opportunities for human services providers facing unanticipated COVID-19-related expenses and increased demand for services.

Examples of opportunities include:

• CCBHC Expansion Grants: Two-year grants of up to $2 million per year are expected to be available to up to 200 providers to expand the Certified Community Behavioral Health Clinic (CCBHC) program to additional sites
• State Mental Health and Addiction Treatment Block Grants: Funding to address mental health and substance use disorders, for community-based behavioral health services and for behavioral health workforce education
• Grants to Community-Based Providers: Funding to address increased community behavioral health needs worsened by the COVID-19 public health emergency. Some uses specified include promoting care coordination among local entities, providing telehealth services and establishing or expanding preventive and crisis intervention services.

Download the American Rescue Plan Act Guide for more information and begin preparing your organization for these opportunities today.

3/10/21: New Federal COVID Relief Moves Forward

Congress passed the the American Rescue Plan Act of 2021 on a 220-211 party-line vote and the bill was signed into law by President Biden yesterday. This legislation targets businesses and individuals in need resulting from the COVID-19 pandemic. Significantly, the bill includes $12.7 billion to support a 10 percent increase in the Federal Medical Assistance Percentage (the federal share of Medicaid) for Home and Community Based Services. The increase will be in effect from April 1, 2021 to March 31, 2022, and is intended to “supplement not supplant” state funding of HCBS services. This has the potential to benefit disability service providers and the people they serve.

Additional analysis of the bill is forthcoming.  In the interim, the U.S Chamber of Commerce is hosting a webinar today at 12:00 Noon ET to discuss the American Rescue Plan and small businesses.  Register for it here.

Michigan Department of Health and Human Services (MDHHS) issued updated L-Letters addressing premium pay and non-emergency medical transportation.

L-Letter 21-30 serves as notice that the COVID-19 Premium Pay announced in Letters L 20-28,L 20-42, L 20-67, and L 21-02 has been extended through September 2021 by the passage of Public Act 2 of 2021, and the extension applies to MDHHS programs and service codes that include community living supports, prevocational services, skill building - and supported employment.

The temporary Premium Pay for services provided March 1, 2021 through September 30, 2021 is intended to cover a $2.25 per hour increase in direct care worker wages, along with an additional $0.27 per hour for agencies to cover their additional costs associated with implementing this increase. These amounts are to be paid in addition to the wage the direct care worker was earning prior to April 1, 2020 and recorded separately from base pay. The $2.25 per hour Premium Pay must be applied entirely to direct care worker wages. The $2.25 and $0.27 per hour amounts may be implemented by an equivalent as divided per billing unit. One example of “an equivalent as divided per billing unit” is, for programs billing in 15-minute increments, the payment would be $0.56 per 15-minute unit for the direct care worker, and $0.0675 per 15-minute unit for the additional agency cost.

Click to view the full text of L-Letter 21-30, and the accompanying list of service codes.

MDHHS also issued L-Letter 21-25, to remind Medicaid providers, transportation brokers, and other stakeholders that non-emergency medical transportation (NEMT) is covered for trips to and from vaccine services, including the COVID-19 vaccine. Medicaid beneficiaries who need access to these important services may request NEMT through the standard NEMT processes outlined in the L-Letter.

To protect the health and safety of beneficiaries and transportation providers during the COVID-19 public health emergency, specific protocols remain in place. Transportation providers must follow the Centers for Disease Control and Prevention (CDC) recommended guidance located at https://www.cdc.gov/coronavirus/2019-ncov/index.html. Additional protocols are described in the L-Letter.

Click to view the full text of L-Letter 21-25, incluidng transportation protocols.

October 28, 2020: MDHHS Communications on DCW Wage Increase

The Michigan Department of Health and Human Services (MDHHS) issued communications confirming the $2/hour increase for direct care worker wages through December 31, 2020 - but also reiterating that as of this writing, the increase will end January 1, 2021.

Click to view this MDHHS letter.

MDHHS also issued letter L 20-67 - COVID-19 Response: Premium Pay. This letter was sent to Home Help Individual Providers, PIHPs, CMHSPs, ICOs, and MI Choice Waiver Agencies - again providing notice that the COVID-19 Premium Pay announced in previous L Letters has been extended to December 31, 2020, and the extension will be paid through Medicaid funds:

The temporary Premium Pay for services provided April 1, 2020 to December 31, 2020 is intended to cover a $2.00 per hour increase in direct care worker wages, along with a $.24 per hour increase for agencies to cover their additional costs associated with implementing this increase. These amounts are to be paid in addition to the wage the direct care worker was earning since March 1, 2020 and recorded separately from base pay. The $2.00 per hour Premium Pay must be applied entirely to direct care worker wages. The $2.00 and $.24 per hour amounts may be implemented by an equivalent as divided per billing unit. One example of “an equivalent as divided per billing unit” is, for programs billing in 15-minute increments, the payment would be $.50 per 15-minute unit for the direct care worker, and $.06 per 15-minute unit for the additional agency cost.

This extension applies to MDHHS programs and service codes listed in L 20-67, including Community Living Support, Prevocational Services, and Skill Building.  Unfortunately, Supported Employment is not included in the service codes eligible for this increase.  Incompass Michigan, in partnership with several other statewide associations, will continue to advocate for extension of this increase beyond 12/31/20.  With the support of our members, we will also urge both the legislature and MDHHS to expand eligible service codes to include vocational services.

Click to view the full text of L 20-67, and its accompanying list of service codes.

July 29, 2020: UPDATE: MDHHS Issues New Memo on Premium Pay

It has come to our attention that the Department has issued a new clarification memo on July 29, indicating that "there was now no restriction on the place of service for the wage increase to be paid. Staff who provide the approved services in facilities and other non-home settings now qualify for the increase. This only applies to the July – September Premium Pay increase."

Click to view the full text of the new Premium Pay memo, dated July 29.

This does not appear to align with previous communications from BHDDA leadership, including the following guidance, issued in Q & A format:

INCOMPASS MICHIGAN QUESTION: The $2/hour increase referenced in MDHHS L Letter 20-28 seems to apply to all direct care workers providing skill building, irrespective of setting.  The use of the term "in-home" has confused the issue for providers, but it is my understanding this will not be limited to those workers only - which would be extremely inequitable and challenging to administer. L 20-28 appears to cover the period from April 1 - June 30. This is also the period outlined in one of the Stabilization Plans confirmed as approved by the Department, which specifically references a DCW Premium Pay Increase for skill building as a "provider type" eligible for reimbursement. The "provider type" language includes references to settings other than in-home. Will MDHHS issue clarification in writing on this? 

BHDDA RESPONSE: All service codes approved for the Premium Pay regardless of place of service are eligible.

Incompass Michgan will continue to seek final clarification and equitable implementation of the direct care worker premium pay, work with our statewide association partners to promote a more consistent approach, and address the additional questions raised by today's guidance.

July 23, 2020: MDHHS Issues Premium Pay Place of Service Clarification

Confirming information presented last week, the Michigan Department of Health and Human Services (MDHHS) has issued official notice confirming that all service codes approved for premium pay are eligible for the increase, regardless of place of service.

All individuals who received the premium pay increase from April 1st through June 30th will continue to receive that increase from July 1st through September 30th per Public Act 123 of 2020.  Prepaid Inpatient Health Plans will receive the funding for the extended pay increase in their September, Medicaid capitation payment.  With this funding extension, all the allowable service codes that were previously approved, remain approved and there is now no restriction on the place of service.  Every effort should be made to continue to pay this wage increase as the State builds the funding into the capitation payment. 

Click to view the full text of the July 23 official notice.

Click to view the original MDHHS listing of eligible service codes, issued in May.

July 20, 2020: BHDDA Issues Clarification on Premium Pay and Resumption of Services

Earlier this month, Incompass Michigan and MALA requested clarification from the Michigan Department of Health and Human Services (MDHHS) on a number of issues relevant to our respective members.  On Friday, a response was received from the Behavioral Health and Developmental Disabilities Administration (BHDDA).  The issues and BHDDA responses are outlined below.

ISSUE - Premium pay for direct care workers.

• The $2/hour increase referenced in MDHHS L Letter 20-28 seems to apply to all direct care workers providing skill building, irrespective of setting.  The use of the term "in-home" has confused the issue for providers, but it is our understanding this will not be limited to those workers only - which would be extremely inequitable and challenging to administer.    L 20-28 appears to cover the period from April 1 - June 30.  This is also the period outlined in one of the Stabilization Plans confirmed as approved by the Department, which specifically references a DCW Premium Pay Increase for skill building as a "provider type" eligible for reimbursement.  The "provider type" language includes references to settings other than in-home.  Will MDHHS issue clarification in writing on this? 

BHDDA response: All service codes approved for the Premium Pay regardless of place of service are eligible.

• SB 690 appears to continue this increase from July 1 through September 30, referencing "direct care workers employed by the department of health and human services, its contractors, and its subcontractors who received a $2.00 per hour state-funded wage increase beginning in April 2020."  With no reference to setting, it is our understanding that this includes all DCW in eligible service codes.  Is this accurate?

BHDDA response: All service codes approved for the Premium Pay regardless of place of service are eligible.

• How does the wage increase affect provider staff supporting programs that were not open until July, including vocational and day programs?

BHDDA response: If approved services were provided anytime during the approved dates, the Premium Pay would be applicable.

ISSUE - Lack of clarity on a timeline for resumption of non residential services throughout the state.

• Will MDHHS issue clarification on when each region is allowed to resume services, based on alignment with the MI Safe Start Plan?

BHDDA response: BH services are deemed essential and should be provided via face to face or telehealth as approved and appropriate.  Please refer to the MI Safe Start Plan, the contracting CMH and the individual plan of service for further guidance and direction. 

• Will MDHHS issue clarification on residents leaving the premises of residential service settings to receive nonresidential services, and whether or not this varies by setting?

BHDDA response: per the BHDDA guidance issued on July 8^th, “Individuals living in a care facility should not be prohibited from exiting their home where they would otherwise have freedom of movement to go out into the community. Individuals should also continue to have access to home and community-based services, based on the Individual Plan of Service and those services necessary to maintain behavioral or psychiatric stability.”

May 20, 2020: Update on Premium Pay Increase for Direct Care Workers

Michigan Department of Health and Human Services indicated that with the release of Medicaid L-Letter 20-28, the PIHPs are authorized to provide designated direct care workers with a $2.00 an hour Premium Pay increase for the period of April 1, 2020 to June 30, 2020. PIHPs will receive increased capitation payments in June to cover the cost of this Premium Pay. 

PIHPs are expected to ensure payment of the $2.00 per hour Premium Pay to direct care workers for every hour worked by the caregiver for face-to-face, in-home services provided from April 1, 2020 through June 30, 2020. The specific services impacted include community living supports and skill building.

Click to view the complete MDHHS memo, and list of impacted services.

PIHPs must direct funding for the $2.00 per hour Premium Pay increase to provider agencies, including the additional $0.24 per hour administrative costs, when contracting with agencies to deliver covered services so they can administer Premium Pay payments in accordance with L 20-28. 

Unfortunately, the increase does not cover supported employment or clubhouse services - although the majority of this type of programming has been suspended during this time due to the pandemic. Incompass Michigan will continue to advocate for inclusion of these services moving forward, and join other statewide organizations in support of making these increases permanent.

May 12, 2020: MDHHS Issues Notice of Premium Pay

The Michigan Department of Health and Human Services has issued L 20-28 – COVID-19 Response:  Premium Pay. This letter was sent to All Providers and Centers for Independent Living.  

Effective April 1, 2020, through June 30, 2020, in response to the COVID-19 state of emergency, a temporary hourly wage increase (referred to as “Premium Pay”) will be applied to payment for in-home direct care workers providing certain services under several program areas, including Community Living Supports, Prevocational Services, and Skill Building.

The temporary Premium Pay for services provided in April, May and June 2020 is intended to cover a $2.00 per hour increase in direct care worker wages, along with a $.24 per hour increase for agencies to cover their additional costs associated with implementing this increase. These amounts are to be paid in addition to the wage the direct care worker was earning since April 1, 2020 and recorded separately from base pay. The $2.00 per hour Premium Pay must be applied entirely to direct care worker wages. The $2.00 and $.24 per hour amounts may be implemented by an equivalent as divided per billing unit. One example of “an equivalent as divided per billing unit” is, for programs billing in 15-minute increments, the payment would be $.50 per 15-minute unit for the direct care worker, and $.06 per 15-minute unit for the additional agency cost.

Click to view the complete letter L 20-28 on Premium Pay.

Sean Egan, Michigan COVID-19 Workplace Safety Director, hosted a live Q & A about the new Return-to-Office Workgroup and answered your most pressing questions about the recommendations this workgroup will develop for a phased return to office work amidst the pandemic.

View the full video and the presentation for additional information.

Learn more about the State's Return-to-Office Workgroup.

Make sure you check out Michigan.gov/COVIDWorkplaceSafety – the one-stop-shop for employer, employee workplace safety resources including the MIOSHA Emergency Rules, posters, videos, fact sheets and industry specific requirements.

Information specific to coronavirus outbreaks, the Michigan Department of Health and Human Services Epidemic Orders and COVID-19 vaccination can be found at Michigan.gov/coronavirus and Michigan.gov/COVIDvaccine.

The Michigan House of Representatives concurred in two supplemental funding bills the Senate passed, which allocate a portion of the federal COVID-19 relief funds. The House concurred in the Senate substitutes for House Bills 4047 and 4048, which allocate a total of more than $4.25 billion. 

The House first concurred in House Bill 4047 by a margin of 85-25. HB 4047 contains $2.31 billion gross spending, of which $632 million is General Fund (GF). Of the $2.31 billion, a total of $1.395 billion in federal funds is provided to the Michigan Department of Health and Human Services (MDHHS), with $55 million GF dollars. The bill includes an extension of the direct care worker wage increase through September 30, 2021 at a level of $2.25 per hour, and expands coverage to include direct support employees and job coaches who work in supported employment arrangements.  The bill is linked, with relevant sections excerpted below.

Additionally, a total of $600 million for food assistance program benefits is contained in the bill, as is $207.5 million federal funding for COVID-19 testing and $110.2 million federal funds for vaccine distribution.

The House also concurred in House Bill 4048, the school aid supplemental, by a vote of 77 to 33.  The total spending under HB 4048 is approximately $1.9 billion. The bill includes $650 million in ESSER formula funds to schools. However, HB 4048 also appropriates $840.7 million in ESSER funds, whose deployment is contingent on the Governor signing House Bill 4049. For the School Aid Fund, $136 million would be distributed to districts to provide equity to districts where the per-pupil allocation is less than $450.

The House also passed House Bill 4049, which is tie-barred to House Bill 4048. HB 4049 would provide that the Director of MDHHS cannot issue an emergency public health order that closes a school to in-person instruction or that prohibits a qualified sporting event during a coronavirus epidemic. This tie-bar was controversial in both the House and Senate. Democrats argue it is holding additional support to schools hostage because it is asking the Governor to relinquish executive authority, something she has stated she will not do. However, Republicans argue that it gives power to local officials if certain metrics are exceeded, a more local and appropriate approach.

This represents a big step forward for advocates of wage equity for the direct care workforce, and Incompass Michigan is grateful to stakeholder partners across the state who have worked tirelessly on this issue; appreciative of our legislative affairs team at MHSA; and special thanks to our members who participated in our online advocacy campaign.  Your voices were heard and acknowledged on this issue.  It is hoped the Governor will sign the supplemental budget bill enacting the wage increase extension and expansion in the days ahead - stay tuned.

Click to view HB 4047.

Sections relevant to the direct care worker wage increase:

Sec. 251. (1) From the funds appropriated in part 1 for COVID-19 direct care worker hazard pay adjustment, the department of health and human services shall provide sufficient funding, including any applicable federal match, to increase the wages paid to direct care workers described in subsection (2) by $2.25 per hour above the rates paid on March 1, 2020 beginning March 1, 2021 through September 30, 2021.

(6) From the funds appropriated in part 1 for COVID-19 direct care worker hazard pay adjustment, a direct care wage increase of $2.25 per hour shall be provided to direct support employees and job coaches who work in supported employment arrangements and who were not eligible for any COVID-19 direct care worker pay adjustment under any other subsection of this section. 

Are you in need of Personal Protection Equipment (PPE) including face masks, face shields, gloves and goggles as your business transitions to more in-person operations over the coming weeks? Pure Michigan Business Connect is offering a procurement program to assist businesses in accessing non-medical grade Personal Protection Equipment (PPE) to keep their employees and customers safe as they begin resuming in-person operations, as is required by Executive Order.

Click here to get started.

The Michigan House of Representative passed Senate Bill 748 by a margin of 97 to 5 and is now on its way to Governor Gretchen Whitmer, where she is expected to sign the supplemental. SB 748 provides $465.07 million in funding relief to businesses, employees and health care workers most negatively impacted by the COVID-19 pandemic. Highlights:

• $220 million GF/GP will allow the Department of Labor and Economic Opportunity (LEO) to provide a temporary extension of unemployment benefits from 20 weeks to 26 weeks from January 1, 2021 through April 1, 2021;
• more than $127.9 million gross funding will support the MI Department of Health and Human Services (MDHHS), including $22.55 million for coronavirus testing of vulnerable populations in nursing homes, adult foster care, homes for the aged, community testing sites, homeless and domestic violence locations;
• MDHHS is also required to dedicate no less than $48.7 million to establish sufficient health system capacity to manage the administration of COVID-19 vaccines to all Michigan residents through funding to local health departments and health care providers;
• An extension of the existing wage increase for Direct Care Workers until February 28, 2021. 

While Incompass Michigan is grateful for the extension of the increase for two months, we must begin another round of advocacy that the legislature direct MDHHS to provide this increase to all direct care workers - specifically including vocational services; and that the legislature appropriate funds to extend the $2/hour direct care worker wage increase on a permanent basis.

To view Senate Bill 748, please click here.

To view the Senate Fiscal Agency (SFA) analysis, please click here. 

December 18: Michigan Senate Passes Supplemental Budget

The Michigan Senate passed a COVID-relief supplemental funding bill after days of negotiations. Senate Bill 748mprovides $465.07 million in funding relief to businesses, employees and health care workers most negatively impacted by the COVID-19 pandemic. Of the total funding, $443.3 million comes from the state’s General Fund/General Purpose (GF/GP) dollars while $21.7 million is federal dollars. Highlights of how the $465.07 million is distributed include:

• $220 million GF/GP will allow the Department of Labor and Economic Opportunity (LEO) to provide a temporary extension of unemployment benefits from 20 weeks to 26 weeks from January 1, 2021 through April 1, 2021;
• more than $127.9 million gross funding will support the MI Department of Health and Human Services (MDHHS), including $22.55 million for coronavirus testing of vulnerable populations in nursing homes, adult foster care, homes for the aged, community testing sites, homeless and domestic violence locations;
• MDHHS is also required to dedicate no less than $48.7 million to establish sufficient health system capacity to manage the administration of COVID-19 vaccines to all Michigan residents through funding to local health departments and health care providers;
• An extension of the existing wage increase for Direct Care Workers until February 28, 2021. 

While Incompass Michigan is grateful for the extension of the increase for two months, we must begin another round of advocacy that the legislature direct MDHHS to provide this increase to all direct care workers - specifically including vocational services; and that the legislature appropriate funds to extend the $2/hour direct care worker wage increase on a permanent basis.

Senate Bill 748 passed the Senate 35-2, and now requires concurrence from the House. This action is expected today during the House’s final day of the 100^th Legislature. While Senate Bill 748 garnered wide bipartisan support in the Senate and is presumed to garner similar support in the House, Governor Gretchen Whitmer's Office has been relatively silent on the contents of the bill, stating  they are still reviewing details of the supplemental. 

To view Senate Bill 748, please click here.

To view the Senate Fiscal Agency (SFA) analysis, please click here. 

December 8: Governor's Update on COVID-19

Earlier this week, Governor Gretchen Whitmer’s Administration provided a live update on COVID-19 vaccines, operations and the administration’s supplemental request. Participants in the webinar included the state’s Chief Medical Executive Dr. Joneigh Khaldun, the state’s Budget Director Chris Kolb, and Governor Whitmer’s Chief Operating Officer Trish Foster. 

The presentations from Dr. Khaldun and Budget Director Kolb are linked below, along with other materials provided by the Governor’s office on COVID-19 and COVID-19 vaccines:

• Budget Director Chris Kolb’s PowerPoint Presentation
• Dr. Joneigh Khaldun’s PowerPoint Presentation
• December 7, 2020 Partner Letter about COVID-19 from Dr. Khaldun
• COVID-19 Vaccine Talking Points

December 3: Governor Whitmer Calls for COVID Relief

Governor Gretchen Whitmer issued Coronavirus supplemental recommendations for fiscal year 2021 - including funding for the Michigan Department of Health and Human Services. These funds will be used to continue critical Coronavirus response activities that can no longer be funded with Coronavirus Relief Funds after December 30 under federal law.  When and if the federal government provides additional aid to support all these activities, those funds will be spent in place of state funds, following appropriation by the Legislature.

In addition to the funding requests contained in the attached detail, the Governor has previously called for $100 million (see below) for an economic stimulus plan that will provide direct financial support half to families and half to small businesses that have been hit hardest by the pandemic.

Click to view the full detail of the Governor's supplemental recommendations.

Earlier this week the Governor sent a separate letter to Legislative leadership, requesting the Legislature to pass $100 million in relief for families and small businesses hit hardest by the COVID-19 pandemic. 

The Governor also called upon the Legislature to pass legislation that will extend unemployment benefits from 20 weeks to 26 weeks permanently. Earlier in the fall, the Legislature passed a bill that extended unemployment benefits to 26 weeks, but it has a sunset that expires at the end of 2020. Additionally, in the letter she called for the Legislature to codify the Department of Health and Human Services (DHHS) Emergency Order requiring masks be worn in public indoor places and large outdoor gatherings.  Stay tuned.

Click here to schedule a free tier-one COVID-19 safety consultation and earn a "Proud Participant of the COVID-19 Workplace Safety Ambassador Program" window decal as a part of the new MIOSHA Ambassador program partnership with NSF International and the Michigan Occupational Safety and Health Administration (MIOSHA). 

For more in-depth assessments of COVID-19 workplace safety requirements, you can also schedule a free tier-two visit with a MIOSHA Ambassador through the Consultation, Education and Training (CET) Division via phone 800-866-4674. 

As businesses move forward, operating in new ways in the midst of this global pandemic, many are rethinking how their employees are compensated. In the pre-Covid world, compensation fell into two main categories: direct compensation (salary, hourly, commission and bonuses) and indirect compensation (benefits). In the new world, businesses may need to rethink their compensation packages.

The Small Business Association of Michigan (SBAM), in partnership with Ahola Corporation, recently posted an article on rethinking compensation, and the process  of hiring and retaining talent in this new world order.  

Click to view the SBAM article on Compensation Planning.

As part of the state’s continued efforts to slow the increasing spread of COVID-19, the Michigan Department of Health and Human Services (MDHHS) and Michigan Department of Technology, Management and Budget (DTMB) have announced the statewide rollout of the COVID-19 exposure notification app MI COVID Alert. 

The anonymous, no cost and voluntary app, piloted in Ingham County and on the campus of Michigan State University last month, lets users know whether they may have recently been exposed to COVID-19.  Users can confidentially submit a positive test result into the app and alert others in recent proximity that they may have also been exposed to the virus. 

When a person tests positive for COVID-19, they receive a randomly generated PIN from the local health department or State of Michigan case investigators that allows them to share their test results anonymously on the app. MI COVID Alert uses randomly generated phone codes and low energy Bluetooth technology instead of GPS location to protect privacy while looking back in time to determine close contact with other phones that have the app. If someone was in close contact with another person who submitted a positive COVID-19 test result, the close contact will receive a push notification once the positive test result is entered into the system. A notification means the app user was possibly within six feet for at least 15 minutes of someone who tested positive.

Click to view additional information about the app.

The Michigan Department of Health and Human Services (MDHHS) issued an update to the Medicaid policy COVID-Response: Relaxing Face-to-Face Requirement. The purpose of this bulletin is to expand the flexibility related to face-to-face requirements of in-person communications. MDHHS issued Bulletin MSA 20-12, COVID-19 Response: Relaxing Face-to-Face Requirement, on March 18, which provided guidance to allow flexibility of in-person communication requirements to protect the health and welfare of beneficiaries and providers while maintaining access to vital services during the COVID-19 pandemic.

Given the circumstances of the pandemic, this policy is intended to be time-limited, and MDHHS will notify providers of its termination. During this time, providers may use telephonic or simultaneous audio and video technology for program functions that require in-person communication so long as the beneficiary or legal representative provides verbal or written consent to these “virtual”methods. Examples of in-person communication that can be conducted using virtual methods include initial assessments, person-centered planning, home visits, case management, and provider assessment and monitoring.  This guidance does not apply to personal care services or other services that support Activities of Daily Living (ADL). Personal care services and ADL services are necessary to sustain the life of the beneficiary and cannot be completed via virtual methods.

Click to view Bulletin Number MSA 20-30, which contains the full text of the proposed policy - which also includes instructions for submitting public comment.

March 19: State Policy Updates

Michigan Department of Health and Human Services (MDHHS) issued Medicaid Services Administration Bulletin 20-12, to allow flexibility related to in-person communication requirements to protect the health and welfare of beneficiaries and providers while maintaining access to vital services during the COVID-19 pandemic.

Click to view bulletin MSA 20-12.

March 20: Medicaid Bulletin 20-13

Michigan Department of Health and Human Services (MDHHS) issued Medicaid Bulletin 20-13, further clarifying that all codes on the telemedicine database will be allowed for the service delivery method telephonic (audio) only. A period of public comment was also opened today, with comments due by April 24.

Click to view MSA Bulletin 20-13, and information about how to submit comments.

Recent events will continue to spur the need for rapid transitions to virtual and remote service delivery. This is a shared need across training providers, job developers, employers, and job seekers. While educators, businesses, students, and workers across the country find new and innovative ways to adapt to this need, the TechHire TA team has compiled resources to assist in identifying key approaches and strategies being utilized by organizations across the country.

The Workforce GPS website has added links to summaries from Peer Learning Group call discussions held in the first half of 2020 that explore virtual instruction and job placement strategies, as well as approaches to providing remote participants with supportive services.

Click to view the Workforce GPS page with links to helpful resources.

Linked below for your convenience are the four (4) new Michigan statutes pertaining to COVID-19 that went into effect on Thursday, October 22, 2020.

House Bill 6030 provides immunity to employers from personal injury COVID claims provided the employers comply with all applicable laws, regulations, orders, etc. relating to COVID-19 precautions. Thus, if employers are complying with CDC guidance and all federal, state, and local required mitigation measures, they are protected from lawsuits if employees get COVID. 

House Bill 6031 and House Bill 6101 make similar changes to Michigan’s Occupational Safety and Health Act (meaning COVID contraction at work does not violate MIOSHA as long as employers are complying with all applicable laws, regulations, orders, etc. relating to COVID-19 precautions).

House Bill 6032 sets return to work requirements for employees with COVID symptoms and/or exposures, and then codifies that employers cannot discipline, discharge, or retaliate against employees who comply with the return to work guidelines. This gives employers clear guidance on what to do when an employee has symptoms.

During a session that stretched into the early morning hours, the Michigan Legislature passed two significant packages of bills dealing with COVID-19 business liability protections and unemployment benefits, which are now heading to Governor Whitmer for her signature.

• COVID-19 Business Liability Protections: The bills provide legal immunity to businesses, nonprofits, and others who follow federal and state rules and regulations related to COVID-19.
• Unemployment: Due to the Michigan Supreme Court decision on denying the Governor’s state of emergency orders, legislation was needed to address COVID-19 related unemployment benefits such as continuing “non-charging” employers. The legislation also authorizes increased flexibility for employers participating in the WorkShare program and ensure individuals filing an initial state claim for unemployment could receive up to 26 weeks of benefits.

Other bills approved Tuesday and Wednesday morning would:

• Extend the validity of expired driver’s licenses through the end of the year
• Allow governments to continue holding public meetings remotely
• Regulate nursing homes based on recommendations from the Michigan Nursing Homes COVID-19 Preparedness Task Force
• Continue temporary allowance of electronic signatures on official documents
• Restore legal liability exemptions for pharmacists, nurses and physicians assistants who perform COVID-19 testing. 

The Michigan Supreme Court (MSC) ruled late Friday that Governor Gretchen Whitmer lacks “the authority to declare a 'state of emergency' or a 'state of disaster” under the 1976 Emergency Management Act (EMA) after April 30, and that the 1945 Emergency Powers of Governor Act (EPGA) is in violation of the Constitution because it “purports to delegate to the executive branch the legislative powers of state government.” The MSC voted 4-3 against Gov. Whitmer, has been issuing Executive Orders to address the COVID-19 pandemic under the EPGA for several months. 

The MSC also stated in their conclusion that “the EPGA is in violation of the Constitution of our state because it purports to delegate to the executive branch the legislative powers of state government - including its plenary police powers - and to allow the exercise of such powers indefinitely. As a consequence, the EPGA cannot continue to provide a basis for the Governor to exercise emergency powers."

Click to view the full opinion, with the conclusion of the opinion on page 52.

Incompass Michgan, and our legislative affairs team at MHSA, will continue to communicate with state leaders as this situation develops, and update our members accordingly. 

A statement in response from Gov. Whitmer contended the ruling doesn’t take effect for 21 days. After that, she indicated she’ll use “alternative sources of authority” to “control the spread of the virus.”  The governor did not elaborate, but the state Health Department, which she controls, also has issued emergency orders that remain in place and unchallenged, and incorporate elements of the governor's directives on masks, worker safety and other business regulations.  MDHHS Director Robert Gordon has signed 19 such orders since March, some of them reinforcing Whitmer's executive orders.

Click to view the full press release from Gov. Whitmer.

MDHHS also issued a statement in response to the ruling, via message on Saturday to staff and stakeholders, from Director Gordon and Dr. Joneigh Kaldun - indicating "the ruling does nothing to change our commitment to protecting public health and saving lives during the pandemic...  Our work continues. And while there will be more to say in coming days about the legal framework, what is right for public health has not changed. For you, your loved ones, and everyone in our state, these truths remain: wear masks, keep 6 feet of social distance, wash hands, and get a flu shot this year."

Click to view the full text of the MDHHS Message to staff and stakeholders.

Governor Whitmer noted that more than 60,000 Michiganders have submitted applications for the new Futures for Frontliners program in its first two weeks since launch. Futures for Frontliners provides a tuition-free pathway to college or a technical certificate to essential workers who do not have a college degree, including those who lack a high school diploma.  

Click to view additional information about eligibility criteria.

April 29: Futures for Frontliners Program

The Governor announced the Futures for Frontliners program, which provides a tuition-free pathway to college or a technical certificate to essential workers who don’t have a college degree. This includes workers staffing hospitals and nursing homes, grocery stores, providing childcare to critical infrastructure workers, manufacturing personal protection equipment, protecting public safety, picking up trash, or delivering supplies.

Governor Whitmer highlighted Futures for Frontliners is the first of its kind initiative in the United States and was inspired by the federal government’s support of soldiers returning from World War II by providing educational opportunities. The Governor also indicated she looks forward to working on enacting her proposal with the bipartisan legislative coalition that helped pass the Michigan Reconnect Grant Program last month, which offers adults over 25 without college degrees tuition-free access to community college.

Click to view the Futures for Frontliners Press Release.

The Michigan Department of Health and Human Services (MDHHS) issued a proposed policy pursuant to the flexibilities afforded by federal authorities to attend to the COVID-19 emergency.  The purpose of this policy is to provide temporary flexibility for providers within Michigan’s Medicaid specialty behavioral health delivery system to meet the needs of beneficiaries through alternative means while protecting the health and wellness of both parties. The provisions cited in the policy reflect specific program and operational modifications by specialty population/authority served within Michigan’s Medicaid specialty behavioral health delivery system.

Among the modifications proposed:

• PIHPs and CMHSPs must follow current telehealth policy provisions included in recently released bulletins, as well as any comprehensive telehealth policies that are promulgated in the future.
• The PIHP will ensure the person-centered service plan is modified to allow for additional supports and/or services to respond to the COVID-19 pandemic, and extend pre-existing person-centered service plans and their amendments.
• Allow temporary service limitations to be exceeded for requirements regarding amount, duration, and prior authorization to address health and welfare issues presented by the COVID-19 emergency.

School districts and vocational rehabilitation agencies have been reminded of their responsibility to work together to help students with disabilities transition to adulthood, including during the COVID-19 pandemic.  In a letter this week to special education and vocational rehabilitation administrators across the nation, officials from the U.S. Department of Education said that while the coronavirus might alter how services are delivered, the expectations for transition remain.

“Recognizing that COVID-19 has resulted in students accessing educational services differently than in the past, whether it be virtually, in-person or a hybrid approach, the importance of the provision of transition and pre-employment transition services has not changed,” wrote Mark Schultz, commissioner of the Rehabilitative Service Administration, and Laurie VanderPloeg, director of the Office of Special Education Programs.

In addition to the letter, the Education Department also recently released an updated 60-page transition guide that’s meant to help students with disabilities and their families understand the years-long process and the options available to them as they prepare to leave public education.

Last week, a district federal court in New York overturned some provisions of the interim Families First Coronavirus Relief Act (FFCRA) rules. These interim rules for the FFCRA were written swiftly, within two weeks of the law. The rules have a shelf life of 12/31/20, but given the uncertainty created by COVID-19, there is some anticipation that it may be extended. In the meantime, employers that are covered under these rules need to consider updating their policies.

A recent posting by the Small Business Association and the American Society of Employers summarizes the changes employers should be aware of, and potential impact on current employer policies.

Click to view the SBAM / ASE article.

April 7: DOL Updates Guidance on FFCRA

The Department of Labor has updated their Families First Coronavirus Response Act (FFCRA) Q&A sheet by adding some questions clarifying the documentation that can be required to substantiate FFCRA leave, and when a federal, state, or local quarantine or isolation may apply for FFCRA purposes. 

Documents to Substantiate Leave – (DOL Questions 15 and 16 – limits such documentation to the information identified by the IRS for employers to keep in order to claim the tax credit).  According to the IRS, employers can substantiate eligibility for the FFCRA credits by receiving a written request from the employee that includes name; dates for which leave is requested; statement of the COVID-19 related reason they are requesting leave and written support for such reason; and a statement that they are unable to work, including by means of telework, for such reason.

According to the DOL, this is the extent of the documentation you may require. Thus, when reading the DOL and IRS FAQs together, a doctor’s note cannot be required by the employer to use FFCRA leave.  It is suggested employers update any FFCRA forms or policies accordingly. 

Federal State or Local Quarantine or Isolation Order – (DOL Question 60) – The DOL states that “For purposes of the FFCRA, a Federal, State, or local quarantine or isolation order includes quarantine or isolation orders, as well as shelter-in-place or stay-at-home orders, issued by any Federal, State, or local government authority that cause you to be unable to work (or to telework) even though your employer has work that you could perform but for the order. You may not take paid sick leave for this qualifying reason if your employer does not have work for you as a result of a shelter-in-place or a stay-at-home order.” 

The FAQ seems to indicate that this FFCRA purpose would only apply if the employer was still open and had work for the employee to do, but the employee was specifically impacted by the Shelter-in-Place order and was required to stay home and unable to telework. Therefore, if the Shelter-in-Place order resulted in a reduction of work and the employer had to close or no longer had work for the employees to do, then the guidance seems to indicate the FFCRA would not apply. 

You can find the updated DOL Q&A here: https://www.dol.gov/agencies/whd/pandemic/ffcra-questions

You can find the IRS FAQs about the tax credit and what an employer needs to prove FFCRA leave for tax credits here: https://www.irs.gov/newsroom/covid-19-related-tax-credits-for-required-paid-leave-provided-by-small-and-midsize-businesses-faqs

The National Council for Nonprofits reported that the President signed the Protecting Nonprofits from Catastrophic Cash Flow Strain Act (S.4209), the bill to override the Labor Department requirement that self-insured nonprofits must pay 100 percent of benefits costs upfront and get reimbursed by their states later. The Council joined with the National Association of State Workforce Agencies in issuing a joint statement on the bill signing and legislation. Scott B. Sanders, Executive Director of the association of government bodies, said, “NASWA is appreciative that Congress has listened to our members and corrected the statutes governing the fairness of the CARES Act on the treatment of claims paid on behalf of nonprofits across the nation.” Tim Delaney of the National Council of Nonprofits reminded, “The new law is just a partial fix to a serious problem, however, because self-insuring nonprofits and governments still must pay 50 percent of unemployment bills.  We urge Congress to fix this second half of the problem this month.” Read the joint statement. 

Federal and state unemployment laws allow local governments, charitable nonprofits, and federally recognized tribes to elect the “reimbursable method” (also called “self-insuring” and opting to be “reimbursing employers”). This means the employers do not make regular contributions (“contributing employers) to the state unemployment trust fund, but instead reimburse the state for the full costs of unemployment benefits the state has paid to former employees. The CARES Act provides that the federal government will cover 50 percent of the costs of benefits paid to employees laid off or furloughed due to reasons related to COVID-19. Department of Labor guidance issued on April 27, 2020 interpreted the CARES Act provision to require self-insured employers to pay 100 percent of the benefits costs upfront and receive 50 percent reimbursement at a later date. The Protecting Nonprofits from Catastrophic Cash Flow Strain Act removes the full prepayment requirement.

Across the country, more small businesses report reopening and have cautious optimism about the future despite concerns about a resurgence of the coronavirus, according to the latest MetLife & U.S. Chamber of Commerce Small Business Coronavirus Impact Poll.  

The survey focused on the ongoing impact from the coronavirus. This month, more small businesses say they are open, mostly due to an increase in businesses saying they are fully open. Small businesses that temporarily closed at some point since the pandemic began are more likely to say that they reopened this month (69%) than in late May (43%). This month, 86% of small businesses surveyed report they are either fully (52%) or partially (34%) open, up seven points from 79% in May.

Still, most small businesses are concerned about financial hardship due to prolonged closures (70%) and more than half worry about having to permanently close (58%). This month, more expressed concern over the lack of guidance on proper reopening procedures, up eight percentage points from late May (56% vs. 48% in May). Though small businesses are pressing onward, concern over a second wave remains high. Two-thirds of small businesses (65%) are concerned about having to close again or stay closed if there is a second wave of COVID-19. Concern is particularly high among small businesses that already had to temporarily close (85%).

55% of small businesses report good overall health, statistically similar to what was seen in late May (53%). In comparison, 65% reported being in good health in the first quarter of this year.

Click to download a copy of the report.

Earlier today, the Center for Medicare and Medicaid Services (CMS) issued guidance pertaining to the Home and Community Based Services (HCBS) settings rule, in response to the COVID-19 public health emergency:

CMS recognizes that its impact has necessitated changes to states’ ongoing efforts to comply with the HCBS settings criteria. States’ stay-at-home and/or safer-at-home orders and the process of social distancing have made it difficult, if not impossible, for states to accurately evaluate how an individual is experiencing community integration in current HCBS settings.These necessary directives have seriously impacted not only the measurement of community integration for individuals, but the intent of the Settings Rule to ensure that individuals with disabilities and older adults have the opportunity to be active participants in their communities.

On May 9, 2017, in recognition of the reform efforts underway across the country, CMS issued guidance extending the time frame for states to demonstrate compliance with the settings requirements to March 17, 2022. This extension permitted states and providers an additional three years to demonstrate true community integration of individuals receiving Medicaid HCBS. In light of impacts discussed above from COVID-19, and to ensure the continued delivery of quality Medicaid HCBS to beneficiaries, CMS will allow states an additional year, through March 17, 2023, to complete implementation of activities required to demonstrate compliance with the settings criteria.

Incompass Michigan is represented on the Department of Health and Human Services HCBS Implementation Advisory Group, and will continue to keep members posted regarding this development.

Click to view the full text of the CMS guidance, and accompanying FAQ.

Incompass Michigan is represented on the Department of Health and Human Services HCBS Implementation Advisory Group, and will continue to keep members posted regarding this development.  The following communication was received from the MDHHS HCBS Transition Team on July 15:

The extension of the March 17, 2022 deadline will not impact the timeline that has been identified in the current Statewide Transition Plan submitted to the Centers for Medicare and Medicaid Services on July 7, 2020 and posted at the MDHHS HCBS webpage at https://www.michigan.gov/mdhhs/0,5885,7-339-71547_2943-334724--,00.html

Michigan Department of Health and Human Services (MDHHS) is committed to working with providers towards coming into compliance with the federal home and community-based settings requirement as specified in the Statewide Transition Plan.  This includes: 

• Continuing to assess residential and non-residential settings for compliance;

• Implementing remedial strategy for non-compliant settings; 

• Identifying settings that will require Heightened Scrutiny;  

• Collecting evidence from settings that meet Heightened Scrutiny;  

• Reviewing and submitting evidence for Heightened Scrutiny to CMS for review; 

• Notifying settings of CMS’ Heightened Scrutiny decision; 

• Transitioning individuals from settings that cannot meet the federal home and community-based settings requirement to compliant settings; and 

• Conducting ongoing monitoring of residential and non-residential settings for compliance. 

Any questions regarding this communication should be directed to the HCBS Transition team at HCBSTransition@michigan.gov

June 19: Heightened Scrutiny Status Update

The following message was distributed this week by the Michigan Department of Health and Human Services HCBS Transition Team, relative to the process being developed for the Heightened Scrutiny Review Committee (HSRC) to provide input to MDHHS on the evidence gathered regarding compliance with the settings rule:

In light of recent events including the COVID-19 pandemic, we would like to provide an update on the status of preparation for HSRC reviews.

Our heightened scrutiny reviewers from Michigan State University conducted initial HS reviews starting at the end of 2019 in order to ensure the HS process would work as envisioned.  Their observations allowed us to make refinements to both the HS data collection process and the planned process for HSRC reviews.  As of early March, MSU’s data collection work has been on hold due to COVID-19 and we have been formulating a process to allow that work to resume safely.

We have also been engaged in designing a webpage to host the HSRC reviews.  The system will be designed to notify HSRC members when HS cases are ready for review, the deadline that each review is due, and to send reminders prior to the due dates. HSRC reviewers will log into this website to view case information, setting evidence collected by MSU, and to provide feedback on each case. There will be a training on the use of this webpage for HSRC members prior to the start of case reviews. HSRC reviews will begin after completion of the Region 5 HS review as they will be the first region to use the refined data collection process, which will allow for a more focused dataset that reduces inclusion of information that is not relevant to the HS process.  We expect the Region 5 review to conclude in September of this year.  We will provide additional updates to committee members regarding HSRC reviews as those updates become available.

April 9: Update on Heightened Scrutiny

The following memo was received from the HCBS Transition Team at the Michigan Department of Health and Human Services:

Please see the first attached memo for information regarding the HCBS Heightened Scrutiny process during the COVID-19 state of emergency order from Governor Whitmer. Please share this information with providers in your networks.

MDHHS BHDDA expects to have additional information as we continue to work with our partners at MSU to develop a plan to gather information related to the HS review process in a way that is safe for all involved and we will share that information as it becomes available.

The second attachment is information  developed for dissemination to stakeholders that outlines the actions taken by the state of Michigan related to the COVID 19 virus. This is not intended to be an exhaustive list but  we are moving along for your  awareness.

Click to view the Heightened Scrutiny memo.

Click to view an outline of actions taken by the state of Michigan related to the COVID 19 virus.

Earlier this week, the Michigan Department of Health and Human Services (MDHHS) issued guidance in response to the Governor’s Office lifting Executive Order 2020-21 (COVID-19). This guidance is directed to Pre-Paid Inpatient Health Plans (PIHPs), Community Health Service Programs (CMHSPs), provider agencies, direct care workers that provide home and community behavioral health care and supports, and residential care facilities that serve individuals with serious mental illness and individuals with intellectual and developmental disabilities.  The guidance includes the following:

The behavioral health needs of individuals residing in a care facility must be provided with a person-centered approach that includes the ability for individuals to engage in activities in the community as currently permitted in the COVID-19 context. In order to continue to mitigate the spread of the virus that causes COVID-19, it is still recommended that residents be encouraged to consistently remain at least six feet from people from outside the individual’s household and wear face covering when with other individuals consistent with current public health recommendations. Individuals living in a care facility should not be prohibited from exiting their home where they would otherwise have freedom of movement to go out into the community. Individuals should also continue to have access to home and community-based services, based on the Individual Plan of Service and those services necessary to maintain behavioral or psychiatric stability.

Click to view the full text of the guidance.

In addition, the Centers for Medicare and Medicaid Services (CMS) has added to their FAQ page in a manner that seems to address this issue.  The relevant excerpt (Page 41 of the document) appears below:

Therefore, states should strive to return individuals who were removed from their Medicaid-funded HCBS settings during the public health emergency to the community, and should consider what steps they can take to help individuals with disabilities who may require assistance in order to avoid unjustified institutionalization or segregation.

Click to view the full text of the CMS FAQ page.

A recent national survey of behavioral health crisis service providers reveals that the demand for crisis services is increasing during COVID-19, while workers continue to be overwhelmed by fewer available resources for the people they serve. This survey included mobile crisis providers, crisis residential programs, and crisis calls centers across the country.

A report released by Incompass Michigan member TBD Solutions, in conjunction with other leading mental health organizations, analyzed the responses of nearly 600 crisis providers, including 241 mobile crisis providers, 205 crisis residential programs, and 151 crisis call centers, revealing a crisis system being used more frequently by individuals with more complex challenges aggravated by COVID-19. 

While the initial survey revealed the greatest concerns around health care and a lack of critical supplies, this survey found issues with care coordination and supervisor concerns about the health and safety of their staff as the most pressing matters. 

“With the longer-term effects of COVID-19 taking shape, we expect to see more people accessing behavioral health crisis services for the first time,” says Travis Atkinson, Crisis Systems Consultant with TBD Solutions. “It is imperative that communities dedicate the necessary resources to assure crisis services are ready and accessible when people need them, even in times of economic drought. These services keep people in community-based care while decreasing the need for more costly and restrictive treatment options.”

Click to view the Impact Survey Report.

Governor Whitmer signed Executive Directive 2020-7, which directs the Department of Licensing and Regulatory Affairs (LARA) to begin developing rules that will require implicit bias training as part of the knowledge and skills necessary for licensure, registration and renewal of licenses and registrations of health professionals in Michigan. Implicit bias training was one of the recommendations made by the Michigan Coronavirus Task Force on Racial Disparities, which Governor Whitmer created in response to the devastating and disproportionate impact the pandemic has had on communities of color. 

“The existing health disparities highlighted during the coronavirus pandemic have made it clear that there is more work to do to ensure people of color have the same access to the same quality of health care as everyone else,” said Lt. Governor Garlin Gilchrist II, chair of the Michigan Coronavirus Task Force on Racial Disparities. “By providing awareness to health care workers on how to recognize and mitigate implicit bias, we can help them carry out their mission of providing the best health care to every patient they serve.” 

As of July 5, Black Michiganders represented 14% of the state population, but 40% of confirmed COVID-19 deaths in which the race of the patient was known. COVID-19 is over four times more prevalent among Black Michiganders than among white Michiganders. 

Click to view the full text of Executive Directive 2020-7.

As reported in previous Incompass Michigan Updates and Info Alerts, over the past several weeks, the federal stimulus bill, the federal Department of Health and Human Services (HHS), and the Center for Medicare and Medicaid Services (CMS) announced a number of financing resources designed to ensure the fiscal strength of Medicaid providers and small businesses. It is the objective of these resources to be a key component of fiscal stability for providers within Michigan’s behavioral health system. The major financing resources cited in these announcements are:

• Medicaid dollars that are managed by the Prepaid Inpatient Health Plans (PIHP), as part of their required system stabilization plans
• Federal funding available via the Enhanced Provider Relief Fund 
• Loan dollars available through the Paycheck Protection Program

Since the announcement of these resources, payers, providers, and statewide associations - including Incompass Michigan - have sought clarity from the Behavioral Health and Developmental Disabilities Administration around how these funds relate. Earlier today, BHDDA issued the following guidance: 

A provider can receive funding through all three of these funding sources. However, the Medicaid dollars that a provider receives, as part of the PIHP stabilization program of their payer and any federal dollars received by the provider via the Provider Relief Fund cannot pay for the same expenditure. Doing so would be, in the vernacular, double dipping.  

The providers can use dollars from these two sources to supplement each other, thus covering the full cost of their operations, within the requirements and limits of each program. Given the time and other financial limitations of both of these programs, uncovered costs, from the use 

of one of these programs, may remain, which can be covered by the other. For example, if the Medicaid stabilization funds via the PIHP cover 60% of a service’s cost, the Provider Relief Fund dollars can be used to cover the balance of the costs, within the limits of that program.  

Funds received under the Paycheck Protection Program (PPP) are considered a loan, with a corresponding liability, the debt obligation. As with any loan, its proceeds are not considered income and are not to be considered in reducing the fiscal gap for which the Medicaid provider stabilization funds nor the Provider Relief Fund are intended to address.   

However, when and if an organization’s PPP loan is forgiven, in whole or in part, then the liability is removed for that portion of the loan and the forgiven portion of the loan proceeds becomes revenue. Given that this loan forgiveness may occur after the distribution of the Medicaid provider stabilization and Provider Relief Funds, the determination of the amount of the Medicaid provider stabilization and Provider Relief Fund dollars received by a provider which may need to be returned to the payer, will be carried out via a cost settlement process between the payer and provider. 

Click to view the full text of the BHDDA guidance.

The U.S. Small Business Administration (SBA), in consultation with the Department of the Treasury, posted a revised, borrower-friendly Paycheck Protection Program (PPP) loan forgiveness application implementing the PPP Flexibility Act of 2020.  In addition to revising the full forgiveness application, SBA also published a new EZ version of the forgiveness application that applies to borrowers that:

• Are self-employed and have no employees; OR
• Did not reduce the salaries or wages of their employees by more than 25%, and did not reduce the number or hours of their employees; OR 
• Experienced reductions in business activity as a result of health directives related to COVID-19, and did not reduce the salaries or wages of their employees by more than 25%.

The EZ application requires fewer calculations and less documentation for eligible borrowers.  Details regarding the applicability of these provisions are available in the instructions to the new EZ application form.  

As reported in previous Updates and Info Alerts, borrowers may use the original 8-week covered period (if their loan was made before June 5, 2020) or an extended 24-week covered period.  Both applications give borrowers this option.

Click here to view the EZ Forgiveness Application.

Click here to view the Full Forgiveness Application.

May 15: PPP Loan FAQs

The Small Business Administration (SBA), in consultation with the Department of the Treasury, intends to provide timely additional guidance to address borrower and lender questions concerning the implementation of the Paycheck Protection Program (PPP), established by section 1102 of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act or the Act). The resulting FAQ document will be updated on a regular basis. 

Borrowers and lenders may rely on the guidance provided in this document as SBA’s interpretation of the CARES Act and of the Paycheck Protection Program Interim Final Rules (“PPP Interim Final Rules”).  

Of recent interest to Incompass Michigan members is Q40:

40. Question: Will a borrower’s PPP loan forgiveness amount (pursuant to section 1106 of the CARES Act and SBA’s implementing rules and guidance) be reduced if the borrower laid off an employee, offered to rehire the same employee, but the employee declined the offer?

Answer: No. As an exercise of the Administrator’s and the Secretary’s authority under Section 1106(d)(6) of the CARES Act to prescribe regulations granting de minimis exemptions from the Act’s limits on loan forgiveness, SBA and Treasury intend to issue an interim final rule excluding laid-off employees whom the borrower offered to rehire (for the same salary/wages and same number of hours) from the CARES Act’s loan forgiveness reduction calculation. The interim final rule will specify that, to qualify for this exception, the borrower must have made a good faith, written offer of rehire, and the employee’s rejection of that offer must be documented by the borrower. Employees and employers should be aware that employees who reject offers of re-employment may forfeit eligibility for continued unemployment compensation.

Click to vew the SBA's list of Frequently Asked Questions.

April 9: Additional Resources on Cares Act Relief Programs

From the Small Business Administration Customer Service Center:

Our nation's small businesses and private, nonprofit organizations are facing an unprecedented economic disruption due to the COVID-19 outbreak. The SBA is experiencing a large volume of applications for the Economic Injury Disaster Loan. Due to current appropriations for this program, the SBA will make initial loan disbursements for two months of working capital up to a maximum of $15,000 per applicant. This is in addition to the Advance of up to $10,000 each small business and non-profit is eligible to receive. By doing this, the SBA will ensure it is supporting the greatest number of applicants during this difficult time.

Additional options available to help small businesses, include the recently launched Paycheck Protection Program for payroll costs. The Paycheck Protection Program offers loans of up to $10 million at a 1% interest rate. These loans mature in two years, but the amount of the loan used for payroll and certain operating expenses in the first 8 weeks after loan disbursement may be forgiven if the business uses a minimum of 75% of the loan for payroll.

Click to view a PPT outlining CARES Act Loan Programs.

Click to view a recording of the National Council for Nonprofits webinar: Federal Coronavirus Relief Bills: What Do They Mean for Nonprofits?

Click to view the National Council for Nonprofits webinar slides.

March 19: SBA Economic Injury Disaster Loans Now Available in Michigan

The U.S. Small Business Administration (SBA) approved Michigan's request for a statewide Economic Injury Disaster Loan (EIDL) declaration, creating the opportunity for small businesses to access low-interest loans from the SBA.

Visit the SBA site to apply.

Quick Reference Sheet

View this pdf to learn more about the SBA EIDL – Economic Injury Disaster Loans process, including what forms you will need to complete.

*Non-profits are eligible

As the COVID-19 pandemic continues, America’s frontline workers are still valiantly reporting to their job sites and risking their personal health to keep the economy in motion and the rest of us safe. But to adequately protect these workers, their households, and the communities where they live, employers, policymakers, and other leaders must first agree on exactly who the frontline workforce is.

A recent Brookings article outlines the need for further clarification.  Using a a mix of Department of Homeland Security definitions and Bureau of Labor Statistics data, they found 50 million people who qualify as frontline workers—a majority of the 90 million people employed in America’s essential industries. The article brief builds off of and updates an initial analysis of essential industries from the onset of the COVID-19 pandemic by highlighting how frontline workers earn lower wages, are less educated, and are more likely to be people of color than national averages.

Their size and composition only underscore the need to protect frontline workers. Without more specific definitions, it will be hard to prioritize their safety and determine the cost and eligibility for pandemic-specific benefits, such as additional equipment, insurance, sick leave, hazard pay, and other protections.

Click to view the full text of the Brookings article.

Due to the COVID-19 pandemic, day and employment service providers, people with disabilities and family members have had to quickly adjust to changes in how services and supports are provided. The publications and resources provided through the Institute for Community Inclusion (ICI) at the University of Massachusetts in Boston have been developed to help guide professionals, individuals, and families through this challenging time as we develop new approaches to providing day and employment services and supporting community life engagement.

During this time, we are all learning how to best support the people we serve. ICI welcomes your feedback and ideas as we all work together to provide services that help people to continue to work toward their goals while staying safe and healthy.

Click to view the ICI web page for COVID-19 Publications and Resources.

As indicated by BHDDA Deputy Director, Allen Jansen, during our weekly webinar, documents were issued by the Michigan Department of Health and Human Services (MDHHS) that reflect the stability plan for the Pre-paid Inpatient Health Plans (PIHPs) provider networks and the requisite contract language that supports the approach that is being taken.

This guidance represents a big step forward in the association's advocacy for issuing retainer payments.  It indicates that PIHPs are required to take all necessary steps to ensure that an adequate provider network is in place to meet the needs of eligible beneficiaries.   It also states that MDHHS will allow PIHPs to engage in contracting methods to ensure stability that includes sub-capitation arrangements, retro-active rate adjustments, cost-reimbursement arrangements or other alternative funding structures based on historical funding. 

Incompass Michigan will continue to advocate for timely, equitable and consistent issuance of stabilization funding moving forward.

Click to view the stability plan documents.

May 15: Important Guidance from CMS on Retainer Payments

The Centers for Medicare & Medicaid Services released a new CMS Informational Bulletin (CIB) to provide states guidance on how to temporarily modify provider payment methodologies and capitation rates under their Medicaid managed care contracts to address the impacts of the public health emergency while preserving systems of care and access to services for Medicaid beneficiaries. This guidance provides several options that states can consider under their Medicaid managed care contracts, including:

1. Adjusting managed care capitation rates exclusively to reflect temporary increases in Medicaid fee-for-service (FFS) provider payment rates where an approved state directed payment requires plans to pay FFS rates;
2. Requiring managed care plans to make certain retainer payments allowable under existing authorities to certain habilitation and personal care providers to maintain provider capacity and access to services; and
3. Utilizing state directed payments to require managed care plans to temporarily enhance provider payment under the contract.

This guidance provides clear direction for the issuance of retainer payments, increasing rates retroactively, based on actual utilization over a defined rating period. Amounts can then be adjusted to cover what would have been billed during the emergency.

Click to view the CMS Guidance.

The Rehabilitation Services Administration (RSA), within the U.S. Department of Education’s (Department) Office of Special Education and Rehabilitative Services, recently issued a Questions and Answers document in response to inquiries concerning the administration of State Vocational Rehabilitation (VR) Services, as grantees seek to provide continuity of operations for individuals with disabilities in the current COVID-19 environment.

“Telephone, online or other alternative means may be used in place of providing VR and supported employment services face-to-face, including ongoing support services, during the unprecedented COVID-19 pandemic,” reads the 10-page document, which officials said is designed to address questions from vocational rehabilitation agencies. “(The Rehabilitation Services Administration) strongly encourages VR agencies to use remote or virtual service delivery strategies when physical offices are closed to ensure the continuity of service delivery to individuals with disabilities.”

Services that can be provided remotely include job coaching, follow-along and the assessment of employment stability, among others, the guidance indicates. Vocational rehabilitation agencies and providers are urged to communicate with the individuals they serve about the switch to virtual supports and document adjustments in their individualized plans for employment as needed.

Federal officials also indicated that career counseling for youth with disabilities seeking subminimum wage employment as well as those with disabilities already working in such environments can happen over the phone or via web-based platforms.  Vocational rehabilitation agencies also remain responsible for providing pre-employment transition services to students with disabilities.

Click to view the RSA Q&A document.

March 27: RSA Seeks Continuity of VR Operations

The Office of Special Education and Rehabilitative Services’ Rehabilitation Services Administration (RSA) announced the U.S. Department of Education has released an initial frequently-asked questions document related to implementing performance accountability provisions under title I of the Workforce Innovation and Opportunity Act (WIOA) as State Vocational Rehabilitation (VR) agencies seek to provide continuity of operations for individuals with disabilities in the COVID-19 environment.

OSERS/RSA will continue to work with state and local leaders to identify any additional areas where it can provide information to support stakeholders in their important work.

MDHHS issued the COVID-19 Response Fee Schedule which outlines coverage of codes to allow flexibility to protect the health and welfare of beneficiaries and providers while maintaining access to vital services during the COVID-19 pandemic. This database reflects codes and coverage changes that are intended to be time-limited, and MDHHS will notify providers of its termination (please note, this change in termination of coverage has been updated to align with recent policy updates). 

This fee schedule can be found at www.michigan.gov/medicaidproviders  >>>  Billing & Reimbursement >>> Provider Specific Information>>> COVID-19 Response. 

The Department encourage providers to revisit this fee schedule as updates to coverage have been made in response to recent policy changes.

The State of Michigan's Coronavirus website now includes a COVID-19 Test Finder:  

Content is provided and maintained by Castlight: COVID-19 Resource Center. Testing sites are not endorsed or vetted by MDHHS.

Individuals who require assistance accessing this content are encouraged to contact the COVID-19 Hotline at 888-535-6136 or email COVID19@Michigan.gov for more information.

Please note: Testing criteria for Coronavirus Disease (COVID-19) has been expanded in Michigan to include individuals with mild symptoms and essential workers still reporting to work in person, whether they have symptoms or not. Please call the testing site or your health care provider before you go for testing.

Click to view the COVID-19 Test Finder.

After the governor issued Executive Order 2020-70, the Department of Labor and Economic Opportunity highlighted requirements for employers and provided further guidance on best practices to help protect Michigan workers and reduce the spread of COVID-19.  

“We must take aggressive action to reduce COVID-19 exposure in order to prevent a second spike in cases,” Gov. Gretchen Whitmer said. “The only way we can safely reopen businesses, including our job providers in the construction industry, is to be smart about protecting our workforce. We’re ensuring employers understand how to protect their employees and customers, and we continue to save lives.” 

Governor Whitmer signed an Executive Order preventing health care providers from discriminating in certain ways, when deciding who to treat and who not to treat, if demand exceeds availability.  

"No person should be denied medical care on the basis of stereotypes, assessments of quality of life, or judgments about a person’s relative 'worth,'" the order said. "Including judgments about a person’s worth based on the presence or absence of disabilities."

Medical decision making must not be made based on stigmas or stereotypes like age, color, criminal history, gender identity, sexual orientation, poverty, religion, height, weight, immigration status and incarceration status.

Click to view Executive Order 2020-64.

Governor Whitmer hosted a Disability Tele-Town Hall.  Also featured were messages from the Small Business Association of Michigan, Autism Alliance of Michgan Arc of Michigan, MI Protection and Advocacy Services, and Special Olympics.

Click to view the recording.

Click to view the transcript.

The US House of Representatives approved a $484 billion coronavirus relief package to restart the depleted PPP loan program, and to provide funds for hospitals and coronavirus testing; and it moved to ramp up oversight of the sprawling federal response to the pandemic as well. The package, passed by a vote of 388 to 5, is being described as an interim step, resulting from heated negotiations after funding lapsed for the Paycheck Protection Program (PPP) - a small-business loan program created by the stimulus plan that had been overwhelmed by demand soon after it launched. The measure replenished that program, providing $320 billion.

The Michigan Nonprofit Association has compiled a quick checklist for those who have not yet applied for the PPP.  Click to view the checklist.

If you have applied, and have not yet been funded, you are encouraged to follow up with your financial institution as soon as possible for an update on the status of your application.

April 22: APPENDIX K UPDATE

The Behavioral Health and Developmental Disabilities Administration indicated that Appendix K was submitted for the period of March 2020 to January 2021.

The Appendix K application included requests to for several flexibilities and supports regarding Home and Community Base Services, including a request to increase pay for Direct Care Workers as “premium pay” for persons providing CLS (formerly called “hazard pay”); and retainer payments to be provided, by CMHs and PIHPs, to provider organizations (using a formula to be determined. MDHHS asked for payments to be allowed if FFS revenue to a provider organization drops below 75% of historic funding levels).

Click to view the full press release on the Appendix K application.

Unfortunately, this flexibility will apply only to those organizations and settings providing 1915(c ) services, and not apply to the bulk of the providers of Medicaid behavioral health services  - which occur via 1915(i), 1915(b), and state plan services.  

Incompass Michigan immediately issued a formal request to BHDDA for swift and decisive action by the Department to correct this inequity, lest business continuity and mission sustainability of Michigan's provider network be damaged beyond repair: 

Without requested fiscal protection through retainer payments, providers are being forced to suspend services, and furlough or lay off staff for an indefinite and potentially sustained period  - even though the funds to pay them are in the possession of the PIHPs and CMHs as prepaid capitation revenues.

The flexibility embedded in the Appendix K application must be extended to the full system through both a Medicaid State Plan Amendment (SPA) and a Section 1115 amendment in the very near future. 

Click to view the full text of the letter to BHDDA.

April 21: APPENDIX K Submitted

Below is a summary of a recent update from the leadership of the Behavioral Health and Developmental Disabilities Administration on issues related to the COVID-19 pandemic.

Appendix K: Appendix K was submitted for a period March 2020 to January 2021.

The Appendix K application included requests to: allow the period  contained in an initial authorization to be extended beyond typical; allow non-vocational supports to be provided in home settings; allow higher number of private duty nursing hours; expansion of settings, beyond HCBS-compliant sites, to include hotels, shelters, etc.; relax provider qualifications to reduce initial staff training requirements; level of care timeline development relaxation; request to increase pay for Direct Care Workers as “premium pay” for persons providing CLS (formerly called “hazard pay”); allow for CLS supports to be provided in hospitals and nursing facilities; retainer payments to be provided, by CMHs and PIHPs, to provider organizations (using a formula to be determined. MDHHS asked for payments to be allowed if FFS revenue to a provider organization drops below 75% of historic funding levels); revise site inspection timeframe; allow providers, outside of what HCBS normally allows, to isolate clients, limit out-of-home visits, limit visitors when persons served have COVID symptoms.

A press release summarizing the Appendix K contents will be issued later this week.  Incompass Michigan will share information with members as soon as this is issued.

PPE: MDHHS has obtained approval to have the state release, from the state cache of PPE, gloves, face shields, and surgical masks and ship them to sites as identified by the state’s PIHPs. MDHHS is developing a weekly distributing process for PPE for the foreseeable future.

Making permanent changes made during pandemic: MDHHS is starting to think through what, of the current changes put in place to respond to the pandemic, should be retained after the pandemic. Such changes could include the use of telehealth approaches as well as a number of relaxed requirements included in the Section 1135 and Appendix K waiver applications.

Coordinating crisis lines: BHDDA will soon issue a document that links the numerous hot, warm, and crisis lines that have been established to assist Michiganders in dealing with the pandemic  (as well as those lines in place prior to the pandemic) and methods for linking these lines to local crisis lines, run by the CMH system.

CCBHC: While CMS has not, as yet, provided formal notice to Michigan regarding its CCBHC expansion application, BHDDA is working with its counterparts from across the country as to how CCBHC was woven into a state’s Medicaid behavioral health program.

New GF dollar distribution: The distribution formula for the new ($5 million) in GF will be issued in the next few days.

Click to view the Appendix K Application, and accompanying cover letter from MDHHS.

As evidence mounts that the COVID-19 pandemic is taking an emotional toll on Michiganders, two federal grants have been awarded to the Michigan Department of Health and Human Services (MDHHS) Behavioral Health and Developmental Disabilities Administration (BHDDA).

One grant was awarded by the Substance Abuse and Mental Health Services Administration (SAMHSA), an agency within the U.S. Department of Health and Human Services. The other was awarded by the Federal Emergency Management Agency (FEMA) in partnership with SAMHSA, with funds distributed through the Michigan State Police. Together, the two grants provide nearly $2.5 million to better address mental health needs during the COVID-19 disaster.

The SAMHSA Emergency COVID-10 grant will provide BHDDA with $2 million to assist Michiganders living with mental health and/or substance use disorders, as well as those with less severe mental illness, including health care professionals. MDHHS will partner with five Community Mental Health Services Programs (CMHSPs) that were identified as having the greatest need relative to the COVID-19 crisis:

• Au Sable Valley Community Mental Health Authority (serving Iosco, Ogemaw and Oscoda counties)
• Detroit Wayne Integrated Health Network
• Genesee Health System
• HealthWest (serving Muskegon County)
• Saginaw County Community Mental Health Authority

Click to view the full press release.

The Michigan Department of Education (MDE) produced four major guidance documents for local school districts, created in collaboration with other state agencies, Michigan educators, stakeholders, and major education organizations in the state. Click below to view each document: 

• MDE, the Michigan Department of Agriculture and Rural Development (MDARD), and MDHHS created a document for best practices on school food service safety.  
• MDE and MDHHS created a document to help families navigating extended time away from school. There are a number of strategies to use at home to help children settle into time away from school and into new routines, and to reduce worry and anxiety. The strategies are universal, meaning they work for children with and without disabilities.  

• Learning at a Distance Guidance was developed with the endorsement of every major education association in the state, with representation from each as thought partners or task force members.    

• MDE’s Office of Special Education (OSE) created Guidance for Compliance With the Individuals with Disabilities Education Act and the Michigan Administrative Rules for Special Education During the COVID-19 Pandemic. This guidance document is designed to assist districts in meeting the IDEA Part B and MARSE.

ACCSES, ANCOR, APSE, The Arc, and Easterseals have drafted a letter to Congressional leadership about the very critical and specific needs of the disability community, service providers and the workforce. 

We urge Congress to focus on the needs of people with disabilities in the fourth COVID-19 bill, before it is too late. In order to address these needs, the service system, the providers who provide those services and the workforce that supports them must be invested in. The priorities outlined below, highlight the need for a $20 billion investment for the provision of home and community based services, and support of the workforce providing those services. As the fourth piece of legislation moves forward, we urge Congress to ensure that these crucial elements are included in the next COVID-19 legislative package:

1. Increased funding for home and community-based services

2. Access to PPE for direct care workers

3. Increased production of PPE and ventilators nationally

4. Technical fixes to the recovery rebate and paid leave provisions of other COVID-19 legislation to ensure inclusion and equity for the disability community

5. Include charitable nonprofits serving people with disabilities with up to 1,500 employees in the Paycheck Protection Program and EIDL Loan program.

Click to view the full text of the letter.

The health and safety of essential staff is critical during our battle against COVID-19. Updated resources are now available to assist employers in their actions to provide a healthy and safe workplace.

Following are Michigan.gov, OSHA and CDC resource links to workplace health and safety best practices.

Michigan.gov Employer and Employees Coronavirus 

https://www.michigan.gov/coronavirus/0,9753,7-406-98178_98179---,00.html

 

OSHA's Preparing Workplaces for COVID-19

https://www.osha.gov/Publications/OSHA3990.pdf

 

CDC Cleaning and Disinfecting Your Facility 

https://www.cdc.gov/coronavirus/2019-ncov/prepare/disinfecting-building-facility.html

 

Interim Guidance for Businesses and Employers to Plan and Respond to Coronavirus Disease 2019 (COVID-19),

https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html

County Health Departments should be referenced to determine if there are additional local requirements for maintaining healthy and safe workplaces.

If you would like more information on your health and safety program, contact Gloria McMullan

More than 40 states across the country have been submitting Section 1135 Medicaid waivers to the federal Centers for Medicare and Medicaid Services (CMS) to allow these states to exercise flexibility in the Medicaid program, in response to the COVID-19 pandemic. Michigan’s application and the CMS response are linked below.

Click to view Michigan's 1135 Waiver Application.

Click to view the CMS response and approval.

It is our understanding that a second waiver application, known as Appendix K - also used to provide states with flexibility in the Medicaid program - is being prepared, and is expected to be submitted to CMS later this week.  Through the Appendix K, states can request temporary flexibility to make changes to a range of HCBS policies and practices. Stay tuned for additional information and analysis.

The Michigan Department of Health and Human Services (MDHHS) announced it is suspending program coverage closures for all Medicaid programs beginning March 16, 2020 and will be in effect through the month of April 2020 or until the first of the month following the termination of the Governor’s Declaration of a State of Emergency Order (2020-04, COVID-19), whichever is later. Medicaid coverage will only be closed if the individual moves out of state, requests that their benefits close, or they become deceased. 

This temporary suspension of closures applies to Medicaid, MIChild, Healthy Michigan Plan (HMP), and individuals who have active coverage through a met deductible (i.e., spend down). Individuals who meet their deductible during the declared health emergency period will remain open until the end of the health emergency. 

Click to view Medicaid Bulletin MSA 20-19 - Suspending All Medicaid Closures.

The Small Business Association (SBAM) is part of the coalition behind www.MIPaycheckProtection.com - a new web resource bringing details of the Paycheck Protection Program to small businesses across Michigan.

Visit this site if you have questions about your qualifications for the PPP and for assistance finding a lender.

The Workforce Innovation Technical Assistance Center (WINTAC) has created a list of resources to help VR programs that are operating by distance and providing services remotely during the COVID-19 crisis. They will be building on these resources daily, so providers are encouraged to check back frequently. The resources include a link specific to Community Rehabilitation Providers.

Click to access the COVID-19 Resources.

Click to access the Resources on Distance Service Delivery.

Disability:IN has compiled resources to support disability inclusion work during COVID-19. The compilation of resources is guided by two broad principles:

1. Designing and implementing responses to COVID-19 that are based on facts, objective evidence, and science; and

2. Ensuring that responses are meaningful by taking into consideration the functional needs of all employees, including individuals with disabilities through the provision of reasonable accommodations, including accessible websites, online systems, mobile apps and other forms of information and communication technologies.

Click to view the Disability:IN COVID-19 Resource Page.

The Behavioral Health and Developmental Disabilities Administration (BHDDA) issued a memo addressing rounding policies for tele-practice during COVID-19 mitigation.

It has come to our attention that telephone and other telecommunication devices as the mode of connection to consumers can be a challenge given the current time duration and rounding rules. Important telecommunication appointments with the consumer may be as brief as five minutes as individuals may be uncomfortable with speaking on the phone/computer or might be hesitant to use up their pre-paid telephone minutes or limited data plans.

To accommodate reporting and billing of these brief contacts with the consumer we are implementing the following requirement: 1. The CPT rounding rules, which use the time duration mid-point, will be applied to all timed codes. Based on the CPT rounding rules, to report a 15-minute code, eight minutes of service are required. The HCPCS rules require 15 minutes of service. During the COVID-19 emergency the HCPCS rounding rules will be suspended and all timed codes will follow the CPT rounding rules. 2. All time spent on planning and documentation required for the service provided is to be included in the total direct time for the service that is reported to the state.

Click to view the COVID-19 Rounding Rules Memo.

APSE conducted a national webinar titled: The Move to Virtual Services: Supporting Direct Service Staff.

Join presenter Jennifer White with Able Opportunities, Inc., to learn successful tips and concrete strategies to support and care for your teams and job seekers during the COVID-19 situation.

Click to view the APSE recording.

March 29: Updated APSE Training on Remote Service Options

The Association of People Supporting Employment First (APSE) conducted a one-hour webinar on Strategies for Providing Remote Employment Supports. The discussion included:

• How do we continue to support and promote Employment First during the Coronavirus (COVID-19) public health crisis?
• Does this create opportunities for us to try new ways of doing business to assure the health and safety of supported workers, their employers and direct support workers?

A recording of the webinar will be available next week.

Click to view the PPT from the APSE Webinar.

Click to view a recording of the APSE Webinar.

U.S. AbilityOne Commission will be temporarily lowering the direct labor hour (DLH) ratio requirement to support AbilityOne nonprofit agencies through the pandemic. Per the newly released memo from the Commission about the ratio requirement, nonprofit agencies will be allowed to operate at a ratio as low as 35 percent for the remainder of FY20 (through September 30, 2020), if needed.

To receive the limited exception to the 75 percent DLH ratio requirement, AbilityOne nonprofit agencies must send notification to the Commission through their designated Central Nonprofit Agency (CNA).

Click to view the AbilityOne memorandum.

Send the requested information or any questions to regulatoryinfo@sourceamerica.org

The Behavioral Health and Developmental Disabilities Administration (BHDDA) issued the following COVID-19 Michigan Clubhouse Guidance and Rate Information:

As outlined in the Essential Services guidance issued March 25, 2020 by the Behavioral Health and Developmental Disabilities Administration (BHDDA), this is to clarify that Psychosocial Rehabilitation (Clubhouses) are a specialty behavioral health service in the Medicaid Provider Manual (MPM). As such, services provided through Clubhouses such as impacting supports coordination by and to peers are essential to sustain and protect life, and therefore must continue to be provided under the Governor’s Stay Home Stay Safe Order.
At the same time, we realize the current funding model of cost-per-unit for Clubhouses is based on regular operation and requires high intensity member attendance and contact to generate revenue. The current situation is drastically undercutting Clubhouses ability to maintain services.
Given this, changing the payment process to reimburse Clubhouses and ensure they continue to be viable and maintain operations during this crisis is imperative. Allowable methods include increasing unit costs, sub-capitation arrangements or cost-reimbursement arrangements.
As a reminder, Clubhouses are an approved service to be provided through telehealth or virtually during this crisis.

Click to view the full text of the Clubhouse guidance.

Section 2302 of the CARES Act provides that the payment and deposit of the employer’s share of the social security portion of FICA tax and the employer’s share of the social security portion of RRTA tax for deposits that are due to be made during the period beginning on March 27, 2020, and ending before January 1, 2021, is not due before December 31, 2021 (for the first 50 percent of the liability), and December 31, 2022 (for the remaining 50 percent of the liability).

Under this provision, an employer is treated as having timely made these required deposits of FICA and RRTA taxes if all such deposits are made not later than the applicable due dates. This deferral of payment does not apply to employers that have had indebtedness forgiven under either section 1106 or 1109 of the CARES Act.

Click to view additional info about this option.

The Paycheck Protection Program (PPP), authorized under the Coronavirus Aid, Relief, and Economic Security Act, is designed to provide a direct incentive for small businesses to keep their workers on payroll by providing each small business a loan up to $10 million for payroll and certain other expenses. 

If all employees are kept on payroll for eight weeks, SBA will forgive the portion of the loans used for payroll, rent, mortgage interest, or utilities. Up to 100 percent of the loan is forgivable. Small businesses and eligible nonprofit organizations, Veterans organizations, and Tribal businesses described in the Small Business Act, as well as individuals who are self-employed or are independent contractors, are eligible if they also meet program size standards.

Click to view a Fact Sheet on the PPP issued by the US Dept. fo Treasury.

Click to view the PPP Application Form.

The CARES Act (Pub. L. 116-136) defined a number of programs that charitable nonprofits will be eligible to apply for. The National Council for Nonprofits has developed a chart that provides information on those loan options, eligibility criteria, terms, and application information. It is important to note that the chart is neither financial nor legal advice for any specific organization. It is an analysis of the new law before any rules or regulations.

The chart includes the PPP loans outlined above, referred to as 7(a); the Economic Injury Disaster Loans, or 7(b); and a Mid Sized Loan Program for those employers with over 500 employees.

Click to view the eligibility chart.

The Michigan Licensing and Regulatory Affairs Agency (LARA) issued guidance through an FAQ document addressing challenging issues relative to the increased need for staffing due to the pandemic. The guidance addresses TB testing, CPR and First Aid Training, references and verification of education, and also acknowledges direct care workers as essential workers caring for vulnerable adults.

Click to view the LARA FAQs.

Governor Whitmer has signed Senate Bill 151, a supplemental that includes $150 million dollars to help fight and mitigate the spread of COVID-19. The bill, however, also contains $80 million in specific line-item vetoes as the Governor and legislative leaders re-prioritize state general fund dollars. 

Click to view the list of vetoes contained within each department.

Click to view SB 151 in its entirety.

In light of the Public Health Emergency concerning the coronavirus disease 2019 (COVID-19), the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) is providing this bulletin to ensure that entities covered by civil rights authorities keep in mind their obligations under laws and regulations that prohibit discrimination on the basis of race, color, national origin, disability, age, sex, and exercise of conscience and religion in HHS-funded programs.

Click here to read the Bulletin.

The Michigan Economic Development Corporation’s Pure Michigan Business Connect program is expanding its free, online procurement platform by now including donations from suppliers capable of filling health and human service needs across a broad range of product and service categories. The platform will provide direct access to businesses within the state providing supplies including personal protection equipment, food, medical devices, paper products, cleaning equipment and more.

The Pure Michigan Business Connect virtual procurement and donation assistance platform will give Michigan service providers and municipalities access to introductions with businesses within the state to source critical supplies needed to serve individual patients, staff or members of the community impacted by the COVID-19 outbreak.

Click to view the complete Business Connect announcement.

Service providers seeking access to supplies and suppliers who have items to support COVID-19 response efforts can learn more by visiting https://pmbc.connect.space/covid19/forms.

The Behavioral Health and Developmental Disabilities Administration (BHDDA) issued documents providing perspective and clarification on clinically essential face-to-face services, essential services, and infection control. Guidance on essential services in response to the Stay Home, Stay Safe Executive Order includes:

The clinical rationale for the use of virtual methods vs home-based or clinic-based intervention given the Governor’s Stay Home Stay Safe Order should be based upon the behavioral health needs of the individual and whether or not a home-based or clinic-based intervention is essential to maintain the individual’s health and safety and at home and in the least restrictive environment.

Click to view the guidance on essential face to face services.

Click to view the guidance on essential services and virtual delivery.

Click to view the guidance on infection control.

Behavioral Health and Developmental Disabilities Administration (BHDDA) has established a COVID-19 Encounter Code Chart. The chart clearly delineates which codes can be used with the methods described in the face-to-face guidance as well as those that do not apply.  This chart is considered effective as of March 1, 2020 to support the many efforts that have already been undertaken in the field.

Click to view the BHDDA Memo.

Click to view the COVID-19 Encounter Code Chart.

It is important to note that Skill Building and Supported Employment are designated as allowable - form March 1 until 30 days following the termination of the Governor’s Declaration of a State of Emergency Order (2020-04, COVID-19).

The Michigan Unemployment Insurance Agency (UIA) has conducted a webinar on the financial impact of COVID-19 on businesses, including helpful resources on the Work Share Program, and Employer Filed Claims.

Click to view the PPT from the webinar.

Treasury, IRS and Labor announce plan to implement Coronavirus-related paid leave for workers and tax credits for small and midsize businesses to swiftly recover the cost of providing Coronavirus-related leave.

Click here to read more.

Summary PDF of Families First Coronavirus Response Act 

March 18: Families First Coronavirus Response Act

The U.S. Senate approved the Families First Coronavirus Response Act, and it was later signed into law by the President. Major provisions will:

• establish a federal emergency paid leave benefits program to provide payments to employees taking unpaid leave due to the coronavirus outbreak,
• expand unemployment benefits and provide grants to states for processing and paying claims,
• require employers to provide paid sick leave to employees.

Click to view a comprehensive FAQ document, along with an overview of covered employers, duration of leave, qualifying reasons for leave, required wage replacement, and applicability of employer tax credits.

Click to view the full text of the law.

The following information on Unemployment Claims was provided by Incompass Michigan Associate Member The 501 Alliance:

The separation reason an employee selects when filing a claim for unemployment benefits may have an impact on whether or not your employer account will be charged.
The following directions apply if your organization is impacted by the executive order to “stay-at-home” and you need to place your employees on a temporary leave or reduce their hours.
From the separation reasons that are listed on the electronic claim form, employees should first select either Temporary Shut Down or Hours Reduced/Working Part time based on the circumstances that apply to their job. They should then select one of the two options listed below:

1. Layoff/Temporary Leave Due to COVID-19 – You are not working because you were laid off or placed on a temporary leave because of a reduction in the work force, plant shut down, or the company closed or limited operations due to the COVID-19 government directive. 
2. Reduced Work Hours Due to COVID-19 – You are working less than your regular hours because your employer has reduced your hours due to a COVID-19 government directive to limit operations.

Frequently Asked Questions Regarding Furloughs and Other Reductions in Pay and Hours Worked Issues

https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/whdfs70.pdf

Free Recorded Webinar "The Coronavirus: Helping Employers Through New and Developing Workplace Issues"

• Secretary of Health and Human Services Secretary Alex Azar announced the expansion of telehealth access for Medicare beneficiaries to combat COVID-19. Medicaid already provides a great deal of flexibility to states that wish to use telehealth services in their programs. States can cover telehealth using various methods of communication such as telephonic, video technology commonly available on smart phones and other devices. No federal approval is needed for state Medicaid programs to reimburse providers for telehealth services in the same manner or at the same rate that states pay for face-to-face services. Clarification from MDHHS on covered telehealth services is expected later this week.
• SourceAmerica issued an update relative to AbilityOne contractors, and meeting obligations to provide quality goods and services to government customers. 
  Click to view the Source America Update on Coronavirus from CEO Vince Loose.

Michigan Department of Health and Human Services letter regarding covered services related to COVID-19

Click here to read the letter.

Updates to Existing Policy: Federally Qualified Health Center and Rural Health Clinic Policy Changes

Click to read the Bulletin.