In The News

How the U.S. Will Revamp Family Caregiver Support

Hospice News / By Jim Parker

Without family caregivers, many hospice patients would be unable to receive care in their homes.

To help keep patients at home — the lowest-cost setting of care — the federal government recently unveiled a National Strategy to Support Family Caregivers, which has more than two decade’s worth of advocacy behind it.

The U.S. Department of Health and Human Services (HHS) announced the strategy late last month. It includes close to 350 federal programs to assist the more than 53 million Americans who care for seriously ill or disabled loved ones in their homes, according to the U.S. Administration for Community Living (ACL), an HHS sub-agency.

The strategy also contains 150 recommendations for state and local government, as well as the private sector.

Support for family caregivers is an important step towards controlling health care costs, particularly for Medicare and Medicaid, according to Greg Link, director of the Office for Supportive and Caregiver Services at ACL.

“The value of family caregiving is estimated to be about $470 billion per year. If these family caregivers were to suddenly disappear, the health care system as we know it likely would be on the hook for that additional $470 billion of support and service,” Link told Hospice News. “We have an opportunity through some of the data, research, and actions that are in the strategy to get closer to understanding the real dollar value of caregiving, and also what a relatively small investment in supporting caregivers could ultimately save the health care system.”

The strategy is built on five pillars: increasing awareness of and outreach to family caregivers, advancing partnerships with those individuals, ensuring their financial and workplace security, strengthening services and support, and expanding research and evidence-based practices.

HHS has opened up a public comment period on the strategy to solicit feedback from stakeholders, meaning that hospice and palliative care providers have an opportunity to give input. The department plans to update the policies every two years and will use that feedback to shape some of those changes.

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Palliative Care and Hospice Education and Training Act (PCHETA) Action Needed

Many thanks to those who have already signed your respective state letter asking our Senators to support S. 4260, the Palliative Care and Hospice Education and Training Act (PCHETA). 

As we enter the final week for sign-on, we wanted to send another reminder and encourage you all to please push this far and wide to your networks and anyone who may be interested in joining. You are welcome to share this on your organization’s social media accounts as well!

Here is the form to sign on the letter

The deadline to join is October 19, 4:00 pm MT.

Again, the purpose of these letters is to demonstrate to Senators that individuals in their states support the bill and request they cosponsor PCHETA. More than 60 organizations support this legislation, but many Senators need to hear from their constituents that this issue is important back home.

We also encourage you to use the Hospice Action Network’s Action Alert to send an email to our Senators, asking them to cosponsor PCHETA. 


DOL Targets Home Care with Proposed Independent Contractor Rule

McKnight’s Home Care | By Diane Eastabrook
Home care agencies beware: The Department of Labor is poised to release a proposed rule today that will make it easier for the department to find that caregivers have been misclassified as independent contractors, rather than employees.
Labor Secretary Marty Walsh said the proposed rule will provide better guidance to employers and help them avoid misclassifying employees. 
“While independent contractors have an important role in our economy, we have seen in many cases that employers misclassify their employees as independent contractors, particularly among our nation’s most vulnerable workers,” Walsh said in a statement. “Misclassification deprives workers of their federal labor protections, including their right to be paid their full, legally earned wages. The Department of Labor remains committed to addressing the issue of misclassification.”
In a statement, the DOL singled out home care as one of nearly a dozen industries where worker misclassification is a problem. The DOL will focus on whether a worker is economically dependent upon the entity sourcing the client for work or if the worker is in, in fact, in business for themselves, Polsinelli Law, which represents home care providers, said. The current test, which has been in effect since early last year, analyzes five factors but places emphasis on two factors: the nature and degree of control over work and the worker’s opportunity to profit or lose money based on personal initiative or investment.
“The new proposed rule will focus on the ‘economic reality’ of the worker’s situation, ultimately asking: Are they economically dependent upon the registry/entity sourcing the client for work (and therefore an employee) or are they in business for themselves (and therefore an independent contractor),” the law firm continued in a recent email alert. 
Polsinelli said the proposed rule will also focus on whether the worker is integral to a firm’s business. For instance, if the business is matching a caregiver with a client, then the caregiver is integral to that business and should be classified as an employee.

The Notice is available here

Comments on the proposed rule are due on or before November 28, 2022.  As reported by NAHC, if the rule is finalized as written, the impact on the home-based care industry could be significant.


Renewal of Public Health Emergency Determination

On October 13, 2022, Secretary Xavier Becerra, Secretary of Health and Human Services, renewed the PHE for COVID-19. The renewal is for 90 days, through January 11, 2023. The renewal states:

"As a result of the continued consequences of the Coronavirus Disease 2019 pandemic, on this date and after consultation with public health officials as necessary, I, Xavier Becerra, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective October 13, 2022, the January 31, 2020, determination by former Secretary Alex M. Azar II, that he previously renewed on April 21, 2020, July 23, 2020, October 2, 2020, and January 7, 2021, and that I renewed on April 15, 2021, July 19, 2021, October 15, 2021, January 14, 2022, April 12, 2022, and July 15, 2022, that a public health emergency exists and has existed since January 27, 2020, nationwide."


CDC Expands Recommendations for Use of Bivalent COVID-19 Booster

Last Wednesday, the CDC expanded recommendations for the use of Pfizer-BioNTech COVID-19 bivalent vaccine for ages 5 through 11 years old and Moderna COVID-19 bivalent vaccine for ages 6 through 17 years old. The “updated boosters” vaccines target multiple strains of COVID-19—the original strain of the virus and 2 of the Omicron variants (BA.4 and BA.5).

The updated boost doses for this age group are already available for those seeking Moderna and arriving this week for Pfizer. Various providers will be offering the bivalent boost dose for this age group including local pharmacies, doctor’s offices and health departments.
Individuals may choose to receive either the Moderna or Pfizer bivalent booster, regardless of which primary series vaccine or original booster dose they received. The current monovalent vaccine is no longer available for those 5 and older for use as a booster but remains available to complete the primary series.

Those who are eligible to receive a bivalent booster dose right now include:

  • Moderna Booster: Individuals 6 years of age and older if it has been at least 2 months since they completed their primary vaccination series or received a booster dose.
  • Pfizer-BioNTech: Individuals 5 years of age and older if it has been at least 2 months since they completed their primary vaccination series or received a booster dose.
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