COVID-19 employee Travel FAQ

Over the last week, we have received several questions from AAA members about various COVID-19 impacts on EMS organizations.  As the infection numbers around the country are on the rise, many new issues have arisen that are posing issues with many EMS employers. Travel Orders What can I do when our employee voluntarily chooses to travel out of state and, due to state level travel orders which require mandatory quarantine for 14 days upon their return, the employee cannot work and is seeking to be paid emergency leave under the Families First Coronavirus Act (FFCRA) or take additional unpaid leave during the quarantine period? As an employer, you have several options.  One of the most important things to know is that your employee does have to abide by any federal, state, or local quarantine order.  However, this does not mean that the employer is helpless in addressing this the issue of employee voluntary travel.  The last few months have been incredibly trying on all of us, particularly those who are on the front lines battling the COVID-19 pandemic, it is understandable that employees are looking to take vacations out of state.  While this is understandable, the employee is still making...

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HHS Non-discrimination During COVID-19 Guidelines

The Department of Health and Human Services (HHS) released guidance today intended to ensure that any healthcare provider who has received financial assistance, especially during the COVID-19 pandemic,  are compliant with the non-discrimination provisions of Title VI of the Civil Rights Act of 1964.  Consistent with the Affordable Care Act Section 1557’s non-discrimination provisions, Title VI ensures that no individual is denied access to benefits or otherwise discriminated against on the basis of race, color, national origin, disability, age, or sex. HHS’ Office of Civil Rights (OCR) released this guidance to remind healthcare providers that Title VI prohibits both intentional and disproportionate or adverse impact discrimination.  Additionally, HHS is collecting nationwide data to identify the social, behavioral, and economic impacts on health disparities and vulnerable populations specific to the COVID-19 pandemic response.  The guidance specifically mentions ambulance service providers and suggests that they should: Adopt policies to prevent and address harassment or unlawful discrimination; Evaluate existing policies and procedures to ensure that their service delivery does not exclude or otherwise deny individuals based upon their belonging to a protected category; Ensure that individuals are not subject to excessive wait times based upon their racial or ethnic minority group; Provide services...

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Updated Interim CDC Guidance for EMS Services

The Centers for Disease Control (CDC) released updated Interim Guidance for Emergency Medical Services (EMS) Systems and 911 Public Safety Answer Points/Emergency Communication Center (PSAP/ECCs) in the United States During the Coronavirus Disease (COVID-19) Pandemic. The new twelve (12) page guidance is geared specifically for EMS and first responding agencies in response to the COVID-19 pandemic.  This is a summary of the highlights from the Interim Guidance and services are encouraged to review the document with your leadership team as this guidance impacts multiple aspects within an EMS organization. 1) Infection Prevention & Control (IPC) Practices The CDC recommends that EMS agencies use additional infection prevention and control practices during the pandemic.  These practices are intended to augment your organization’s standard infection control practices with COVID-19 specific protective measures.  The recommendations include: 911 PSAPs Modified Call Queries CDC recommends the development of modified caller queries to be developed in collaboration with your local state public health officials and your medical director.  The modified caller queries are geared towards identifying if the call concerns an individual who may have COVID-19 symptoms.  Additionally, the recommendations include pre-arrival instructions to include facial coverings, if patient condition permits, and communications with responding units to...

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COVID-19 Contact Tracing Card Template

The American Ambulance Association recommends that you begin closely tracking all visitors to your facilities in order to facilitate COVID-19 contact tracing in the future, if needed. In addition to a sign-in log, you may wish to present all visitors with a business card listing contact information for your infection control officer. These cards make it easy for visitors to get in touch if they develop symptoms soon after entering your building. Moore EMS Consulting kindly developed these templates for your use: Contact Tracing Card Template Front Contact Tracing Card Template Back  ...

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Final Rule for ACA Section 1557

On June 12, 2020, the Office of Civil Rights (OCR) of the Department of Health and Human Services (HHS) published the long-awaited final rule which significantly changes several of the anti-discrimination provisions of Section 1557 of the Affordable Care Act.  The final rule, which is a departure from the agency’s previous interpretation of the rules which were enacted 2016 during the Obama administration.  Since, the enactment of the 2016 rules, there have been numerous legal challenges to these provisions in federal court.  HHS believes that these final rules will reduce or eliminate provisions that they state were ineffective, unnecessary, and confusing and will save roughly covered entities roughly $2.9 billion in costs. 2016 Section 1557 Requirements Section 1557 of the ACA were the anti-discrimination provisions geared at ensuring all individuals had access to essential benefits.  When originally released in 2016, the Section 1557 rules prohibited discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs or activities, including discrimination on the basis of pregnancy, gender identity, and sex stereotyping.  The 2016 Rule also required that covered entities: Establish a written Grievance Procedure. Identify and maintain a Compliance Coordinator. Publish non-discrimination notices in the...

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EEOC Guidance on COVID-19 Antibody Testing

The Equal Employment Opportunity Commission (EEOC) issued updated guidance yesterday titled, What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws yesterday.  The updated guidance addresses employers who wish to require employees to have a COVID-19 antibody tests prior to re-entering the workplace.  The guidance consists of seventeen pages of Frequently Asked Questions (FAQ) to assist employers as they navigate this truly unprecedented time for employers and employees during a pandemic. The updated guidance alerts employers that they may not require employees to undergo COVID-19 antibody testing as this would constitute an unlawful “medical examination” under the Americans with Disabilities Act (ADA).  Under the ADA, employers are limited in the medical related inquiries that they can make of employees.  Medical related inquiries can be considered a Medical Examination and are strictly regulated under the ADA and the Rehabilitation Act.  Under the ADA, an employer “shall not require a medical examination and shall not make inquiries of an employee as to whether such employee is an individual with a disability or as to the nature and severity of the disability, unless such examination or inquiry is shown to be job-related and consistent with business necessity.”...

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USSC Upholds Equal Protection for Victims of Sex-Based Discrimination

Yesterday, the U.S. Supreme Court issued a decision that settles the greatly contested issue of whether Title VII of the Civil Rights Act’s protection against discrimination on the basis of sex, includes sexual orientation and gender identity.  The ruling stems from three cases, Altitude Express Inc. v. Zarda, Barstock v. Clayton County, Georgia, in which the plaintiffs were terminated following their employer learning that each were gay, and R.G. & G.R. Harris Funeral Homes Inc. v. Equal Employment Opportunity Commission, where the plaintiff was terminated after she informed her employer that she was going to undergo gender reassignment surgery. The decision, which was written by Judge Gorsuch essentially states that one cannot discriminate against an individual on the basis of their being gay or transgender and not offend Title VII’s prohibition on sex-based discrimination.  This ruling settles years of contradictory administrative interpretations and enforcement of sex-based discrimination under Title VII.  While most states have settled this issue by enacting state-level prohibitions on discrimination on the basis of sexual orientation or gender identity, this definitively ensures the protections of entire classes of individuals who were previously unprotected by the law. Employer are encouraged to revisit all policies, procedures, and practices to (more…)

FFCRA Summary of Temporary Final Regulations

Families First Coronavirus Response Act (FFCRA) Summary of Temporary Final Regulations Emergency Paid Family and Medical Leave Act (EPFMLA) Cannot Work or Telework Up to 12 weeks of job-protected leave Care for child due to school closure, childcare unavailable due to coronavirus Eligible Employees All employees on payroll for 30 days or more Amount of Pay After first 10 days, receive no less than 2/3 employee regular rate of pay. Not to exceed $200 per day, $10,000 in the aggregate Reinstatement/Return to Work Must reinstate to same or equivalent position Unless position was eliminated Emergency Paid Sick Leave Act (EPSLA) Cannot Work or Telework due to: Quarantine, advised to self-quarantine, seek diagnosis, preventative care or diagnosis for coronavirus (Quarantine order includes orders that advise citizens to shelter in place, stay at home, otherwise restrict their mobility) Caring for an individual who subject to quarantine or isolation order or advised to self-quarantine Eligible Employees All Employees Amount of Hours & Pay Full-time employees entitled to 80 hours (14 days) Part-Time entitled to average number of hours employee is scheduled per day over six-month period. Full pay, not to exceed $511 per day, $5,110 in the aggregate for employee Quarantine, self-quarantine, or...

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FFCRA Emergency Paid Leave Posting

Families First Coronavirus Response Act (FFCRA) Emergency Paid Leave Posting As many of you are aware, the Families First Coronavirus Response Act (FFCRA) Emergency Paid Family & Medical Leave Act and Emergency Paid Sick Leave provisions become effective tomorrow, April 1st.  I had hoped that the U.S. DOL would have published draft Regulations by the close of business today and prior to April 1st to give employers an indication as to how these provisions will be administered by the U.S. DOL.  As of the time of this email, the U.S. DOL has not published anything aside from the Frequently Asked Question (FAQs).  The U.S. DOL published FIELD ASSISTANCE BULLETIN No. 2020-1 that states that they will not bring enforcement actions against any employer who is out of compliance provided they can demonstrate that they have made a reasonable good faith effort to comply with the law.  We will make sure that we notify you as soon as the draft Regulations are published to ensure your organization is compliant. In the meantime, covered employers are required to post the Federal Employee Notice or the Non-Federal Employee Notice  in the same locations that they post similar notices by April 1, 2020.  Additionally,...

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Updated U.S. DOL Definition of Health Care Provider & Emergency Responders

The United States Department of Labor (U.S. DOL) has recently published an updated version of the Families First Coronavirus Response Act (FFCRA) Frequently Asked Questions (FAQ) that provide further insight into which employees are included in the definition of “health care provider” and “emergency responder”. After the final language of the FFCRA was released, there were numerous questions about which EMS agency employees were considered “emergency responders” and potentially subject to being excluded from the group of employees eligible for Emergency Paid Family and Medical Leave and Emergency Paid Sick Leave.  The U.S. DOL has provided clarification in FAQ numbers, 55-57 respectively. 55. Who is a “health care provider” for purposes of determining individuals whose advice to self-quarantine due to concerns related to COVID-19 can be relied on as a qualifying reason for paid sick leave? The term “health care provider,” as used to determine individuals whose advice to self-quarantine due to concerns related to COVID-19 can be relied on as a qualifying reason for paid sick leave, means a licensed doctor of medicine, nurse practitioner, or other health care provider permitted to issue a certification for purposes of the FMLA. 56. Who is a “health care provider” who may...

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EMS Agencies Can Take Advantage of Accelerated or Advanced Payment Opportunities from CMS

The Centers for Medicare and Medicaid Services (CMS) has expanded the Accelerated and Advance Payment Program to a broader group of Medicare Part A providers and Part B suppliers in an effort to provide financial relief and to increase cash flow to providers of services and suppliers impacted by the 2019 Novel Coronavirus (COVID-19) pandemic. To be eligible to participate in the Accelerated and Advanced Payment Program, providers and suppliers must meet the following criteria: Have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s/supplier’s request form; Not be in bankruptcy; Not be under active medical review or program integrity investigation; and Not have any outstanding delinquent Medicare overpayments. Qualified providers and supplies will be asked to request a specific amount using an Accelerated or Advance Payment Request form provided on each MAC’s website. Generally, most providers and suppliers will be able to request up to 100% of the Medicare payment amount for a three-month period.  Payment is typically processed in about seven (7) days.  Ambulance providers and suppliers can utilize these accelerated or advanced payments to ease cash flow disruptions during the COVID-19 public health emergency.  To access these payments, select...

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Coronavirus (COVID-19) Impacts on the EMS Workplace

There has been a great deal activity and press coverage over the past few weeks relative to the Coronavirus (COVID-19). This activity has generated several questions from EMS organizations regarding how to handle the impact on the workplace. Healthcare workers have been identified by the Occupational Safety and Health Administration (OSHA) as a group of workers who are at an increased risk of exposure to COVID-19. There are many steps EMS organizations can take to best prepare their workplace and protect their personnel. EMS agencies are already required to follow and maintain OSHA’s Infection Control Standards for Bloodborne and Airborne Pathogens (29 CFR 1910.1030). If EMS organizations and their employees are diligent in maintaining these standards, they will already be doing nearly everything that is being recommended for employers to combat the spread of COVID-19. The Centers for Disease Control (CDC) released their Interim Guidance for Businesses and Employers, which includes additional practical recommendations for employers to utilize to further combat the spread of COVID-19, including: Actively encouraging sick employees to stay home; Separating sick employees from the rest of the workforce; Encouraging workers to stay home when sick, respiratory etiquette, and hand hygiene by all employees; Performing routine environmental (more…)