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…)

Nominate Your Rising Leaders! 40 Under 40 Due Jan 31

The American Ambulance Association is seeking nominations for its inaugural Mobile Healthcare 40 Under 40! This is your opportunity to recognize exceptional rising leaders as the future of EMS. Nomination Instructions To submit a nomination, please complete the form below. Nominations are due January 31, 2020. Incomplete nominations cannot be considered. Timeline Nominations are due January 31, 2020. Incomplete nominations cannot be considered. Honorees will be selected by the AAA Membership Committee and announced in February 2020. Selection Process & Criteria Honorees will be selected based ONLY on the information provided in their nomination form. Nominees should have contributed to their organization, state ambulance association, AAA, other professional associations, and/or the EMS profession in an extraordinary way beyond faithful completion of job duties. Please be sure to include detail about the nominee’s impact to date and future promise. Please note that nominees must be under 41 on December 31, 2020 (meaning that they cannot turn 41 in 2020). No specific job role or title is required for consideration. Recognition Honorees will be recognized on the American Ambulance Association’s website and social media platforms. Winners will also receive complimentary registration to the 2020 AAA Annual Conference & Trade Show in Las Vegas, Nevada (more…)

July Brings Legal Changes for Employers in Many States

Oregon Statewide Transit Tax Important notice to ambulance service employers based in the state of Oregon: there is a new statewide transit tax taking effect on July 1, 2018. Beginning July 1st, employers must start withholding a tax of 1/10th of 1% from the wages of Oregon residents or from non-residents who perform services in Oregon. The Department of Revenue has published detailed information on the statewide tax with a list of available resources to assist employers with compliance. Iowa Lowers Standard for Positive Alcohol Tests Effective July 1, 2018, Iowa employers may lower their standard for taking employment action for positive alcohol tests from the old state standard of .04 to .02. Iowa has one of the strictest employment drug and alcohol testing requirements in the country. Employers are required to have a written policy that is distributed to all employees and job candidates for their review. Employers must establish a drug and alcohol awareness program alerting employees of the dangers of drug and alcohol use in the workplace, and most employees must be provided an option to enter a rehabilitation program instead of being disciplined. In addition, all supervisory staff must attend a two-hour initial drug and alcohol...

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SHRM: 65% of EEOC Cases Resolved Without Cause

If you ask most healthcare attorneys the best way for healthcare providers to avoid being sued is to listen to their patient, communicate clearly, and most importantly, be nice. The same can be said for employment related legal actions.  In a great article released by the Society of Human Resource Management (SHRM), suggests that over 65% of the cases filed with the Equal Employment Opportunity Commission (EEOC) were found to be resolved without “reasonable cause”. Just like with the provision of healthcare, employers can often avoid time consuming and costly employment litigation by making sure that the leadership and management team communicates clearly to employees about performance expectations, listens to employee concerns or feedback, and possibly most importantly, treats their employees nicely regardless of the message they are delivering. The employment relationship is just like any other human relationship. Those where there is mutual respect and appreciation yield the richest experience.

How to Stand Out Using Low-Cost Recruitment, Retention Strategies

Scrolling through Facebook, I regularly notice EMS providers seeking feedback from friends and colleagues. Someone will post, “Hey, I’m moving to this city. Does anybody know some good ambulance services that are hiring?” Plenty of people will respond, “This is a pretty good place.” Others share warnings such as, “Don’t work for Provider X.” Word of mouth can be valuable for any EMS. What current and former employees say about their positive work experience is a major benefit to recruitment and retention. In order to ensure a top-notch service to customers and to attract top-tier employees, recruitment and retention must be at the top of the to-do list. This is important for both public and private EMS departments. With negative word of mouth, unless somebody is desperate to get a job, “Provider X” in the example above won’t receive a second look from applicants. While some services use salary as a major recruitment and retention tool, it’s not the only way to stand out. There are various low-cost strategies to employ when it comes to recruiting and retaining employees. Moving on up Opportunities for advancement are one attractive benefit. In a fire service, providers often begin their tenure as a...

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HR Wrap-Up: A Look Back at 2016

As we wind up 2016 I thought it would be a good idea to review the year’s human resource and legal developments to ensure that our members are compliant and prepared for what faces them in 2017.  We knew that this was going to be an interesting year as we experienced the most unusual Presidential Election in our history.  It overshadowed everything else that occurred in 2016.  As the Obama administration comes to its final days, employers and ambulance providers saw some of the most sweeping regulatory changes. Fair Labor Standards Act (FLSA) The biggest change facing employers in 2016 was the Fair Labor Standards Act (FLSA) overtime changes.  The Department of Labor (DOL) issued updated regulations which were to become effective December 1, 2016, raising the minimum salary thresholds for the so called “white collar” exemptions.  Under the new regulations, the minimum salary would increase from $455 to $970 per week.  For those employees earning under the new amount, employers would need to decide if they are going to raise the salary level or pay the employee overtime for hours worked over 40 in one week.  The changes have not gone into effect yet as a 5th Circuit Judge...

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 Video: Employee Feedback Tears & Fears

American Ambulance Association’s human resources expert, Scott Moore, delves into strategies for managing unprofessional responses to the feedback you provide your employees. A must-watch for supervisory and management staff of all levels! Have a question for Scott? AAA members, submit your requests today via our HR & Operations Consultation form!

ACA Section 1557: Final Rule Published that Affect Healthcare Providers

This past July, the AAA advised our members about new Section 1557 Non-Discrimination provisions of the Affordable Care Act (ACA) impacting ambulance providers that became effective on July 18, 2016.  On May 13, 2016, the Department of Health & Human Services (HHS) published the Final Rule aimed at improving access to care and eliminating discrimination and inequities in the provision of healthcare services.  At that time we identified several provisions in the new rules that we felt ambulance providers might have difficulty complying with.  The AAA requested some guidance from the Office of Civil Rights (OCR) regarding these challenges and had some dialogue with representatives from that office this past week. Please be sure to review the July Advisory on the AAA Website for a detailed explanation of the rule requirements.   As a brief review, the new ACA Section 1557 rules build off of existing Title VII and other discrimination laws that extend protections to previously underserved or under-represented groups of people with regard to healthcare.  The new Regulations prohibit discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs or activities.  In addition, the Regulations provide discrimination protections on the basis of...

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Coming soon for AAA members: Employee Background Screening

Attention AAA members! The American Ambulance Association is teaming up with Sterling Backcheck, the country’s largest and best-respected employee background screening company. AAA members receive deeply discounted pricing, as all background checks for AAA members are treated as one “client.” (Learn more about the Sterling Backcheck difference.)

Performance Reviews, Feedback from the Court

One of the hottest debates in Human Resources is the efficacy or usefulness performing Annual Performance Evaluations on employees. For the most part, many employees feel that the process is not a true reflection of their performance. At many companies Performance Evaluations are months behind and when they are finally done, little effort is committed to the process to make it worthwhile. Despite this, almost every ambulance company has some form of performance evaluation process. However, a recent decision from the US Court of Appeals for the 1st Circuit has elevated the importance Performance Evaluations and should serve as an alert to employers to pay more attention to the process. John Ray III was an eight year associate with the law firm Ropes & Gray in Boston in 2008 when the firm informed him that he would not be considered for partner and was given six months to find a new job. Ray filed charges with the Equal Employment Opportunity Commission alleging racial discrimination for not advancing him to partner. This past August the court found that Ropes & Gray had not illegally discriminated against Ray and that he had not been promoted to partner because of a clearly defined...

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HUD Program Gives 50% Mortgage Discounts to EMTs & Paramedics

Are you familiar with the Department of Housing and Urban Development’s Good Neighbor Next Door program? Please share this with your medics, if you haven’t already. Good Neighbor Next Door Law enforcement officers, pre-Kindergarten through 12th grade teachers, firefighters and How the Program Works Eligible Single Family homes located in revitalization areas are listed exclusively for sale through the Good Neighbor Next Door Sales program. Properties are available for purchase through the program for seven days. How to Participate in Good Neighbor Next Door Check the listings for your state. Follow the instructions to submit your interest in purchasing a specific home. If more than one person submits an offer on a single home a selection will be made by random lottery. You must meet the requirements for a law enforcement officer, teacher, firefighter or emergency medical technician and comply with HUD’s regulations for the program. HUD requires that you sign a second mortgage and note for the discount amount. No interest or payments are required on this “silent second” provided that you fulfill the three-year occupancy requirement.The number of properties available is limited and the list of available properties changes weekly. To learn more, please see our Good Neighbor Sales Frequently (more…)

Podcast: Word on the Street Previews AAA 2015

Lee Ann Pond, Rob Lawrence

This week, Word on the Street podcaster Rob Lawrence previews the American Ambulance Association Annual Conference & Tradeshow over at EMS World. Thanks to Rob for the great discussion featuring AAA’s senior vice president of government affairs, Tristan North, Lee Ann Pond, chief administrative officer of the Richmond Ambulance Authority (RAA), and Dan Fellows, RAA fleet manager.