October 21, 2020

COVID-19 Response, Guidance, and Actions Updated: October 14, 2020 Governor Wolf, Dr. Levine, and local leaders across the commonwealth have taken unprecedented actions to protect the health and safety of Pennsylvanians. These measures, based on the guidance of public health professionals, are necessary to slow the spread of the virus that causes COVID-19. Life has slowed and it has changed, but it has not stopped for the millions of Pennsylvanians who depend on the Department of Human Services. The essential functions of this department cannot stop. DHS has an obligation to do everything we can to ensure continuity of services and programs for people who need them. Many of these services are critical now more than ever, and we are working internally and with providers and partners around the commonwealth to make adjustments as necessary. We are putting processes in place to ensure continuity of coverage so individuals do not lose their health care, cash assistance or food assistance during this uncertain time. We will continue to update and reissue this document following each of our weekly calls. We hope that it is helpful to have all of these updates in one place, and we will note if new or updated guidance changes previous information. Thank you for your support and partnership, Teresa Miller Secretary of Human Services October 21, 2020 Call Frequency Survey We’ve noticed that attendance is declining, and we want to make sure these calls and the written updates are useful and informative. Your feedback will help inform this process. Please complete this survey by Wednesday, October 28. Thank you all again for taking the time to join us today and for all you are doing to serve the people of Pennsylvania. Affordable Care Act Call with Senator Casey Yesterday, I joined Senator Casey to discuss the Affordable Care Act’s impact on health care access in Pennsylvania, and the dangerous outlook of what would occur if the law was struck down. The Wolf Administration firmly believes that all Pennsylvanians should be able to access affordable, quality health care coverage. The Affordable Care Act makes that possible for nearly 1.3 million Pennsylvanians. I think we can all say that given what we are all currently living through, access to health care is even more critical. In 2009, the United States was facing the H1N1 or Swine Flu pandemic. At the time more than 15 percent of the country or 1 in 7 Americans lacked any form of health insurance. Ten percent of Pennsylvanians were uninsured at the time. At the time, Jeffrey Levi, a professor at George Washington University’s School of Public Health wrote for Health Affairs that “there is serious concern that people who are uninsured or underinsured might not seek treatment or might have trouble accessing care. During an infectious disease outbreak, ensuring that care is in place for all Americans is more vital than ever. Not only are patients at risk, but they risk further spreading the disease unless they receive proper care.” The Affordable Care Act was signed into law the next year, and through that, more than 20 million people around the country gained coverage because of the ACA. More than 1.4 million adults in Pennsylvania have been covered at some point since February 2015 because of the ACA. The Affordable Care Act has been life-changing for people who are able to purchase subsidized insurance through the individual market, for those who are covered because of Medicaid expansion, people with disabilities, and for the countless others who are able to stay on their parents’ health insurance plan until they turn 26, who are guaranteed comprehensive coverage because of the ACA’s essential health benefits, and who cannot face discrimination due to a pre-existing health condition. Without these protections, many of these people could not afford coverage or they were denied coverage altogether. In Pennsylvania, many went uninsured until 2015 when Governor Wolf accepted the Medicaid expansion. The ACA also includes a nondiscrimination provisions of accessibility requirements for medical diagnostic equipment to ensure things like all women can have access to a mammogram and all people can get a proper examination on an examination table. These protections were left out of the Americans with Disabilities Act. Medicaid expansion, in particular, is a lifeline when people need it most. If you aren’t healthy and taking care of medical needs, you can’t think about getting a job or moving forward. Medicaid expansion makes it possible for people to meet these most basic needs without fear of financial ruin. We’ve found that more than half of our Medicaid expansion population is working a job that does not offer comprehensive health benefits, and when people leave Medicaid coverage, many are doing so because their income is increasing. At this time last year, about 680,000 people had health care coverage because of Medicaid expansion. That number is up to more than 840,000 as of the end of September. When we talk about the Affordable Care Act, I usually say that we must protect and preserve the law not just for the people who need it today or those who’ve used it for a time to move on to other coverage – we must protect it for all who will need it in the future. This is that uncertain future that we talk about. What we are experiencing today – a global pandemic and economic crisis with historic unemployment – is not something we could have anticipated five, three, or even one year ago, but it is exactly why these programs are so vital. Approximately 160,000 people are on Medicaid expansion who were not this time last year. Their individual circumstances and stories are different, but many of them are probably in this position because of a lost job or lost income. They didn’t plan for this. They didn’t ask for this. But this is the reality we are all living in right now. Imagine being in that position – losing your job due to the economic realities of a pandemic, then losing your health care in the middle of that pandemic. With Medicaid expansion, there is relief and continuity when the unexpected happens. There is security of knowing you can go to your doctor for regular visits and screenings. A prescription will not further risk your financial stability. If you get sick, you are covered. As so much is uncertain, this security can make all the difference for people, and it’s something we need to emerge stronger through difficult times. If we lose the Affordable Care Act, the nearly 1.3 million people in Pennsylvania who have health insurance because of the ACA could lose that coverage, but the ripple effect will not stop there. Consumer protections like coverage up to age 26, no lifetime limits, essential health benefits, and coverage regardless of a pre-existing condition will end – leaving millions of people vulnerable. When you look beyond the political fighting over the ACA – you see the real stories of people whose lives and livelihoods were changed and, in many cases, saved because of the ACA and the health coverage gained through the law. These are the voices that we must focus on. They – and so many others – are at risk if these protections disappear. The Wolf Administration will never stop fighting for them, and if you are with us in this fight, I hope you will talk with Senator Casey and Senator Toomey and urge them to understand what is at stake here. Act 24 Reporting Requirements Some providers have received the Act 24 Cost Reporting Forms and received notification that the Interim Report was active within the web portal. DHS has extended the interim reporting due date for these providers to October 28. Providers that received Act 24 funds from OLTL will receive their reporting forms in the near future. The due date for submitting an Interim Report will be included as part of that communication. All providers that received Act 24 funding will be required to submit a final report. More detail on this report will be sent in late November. Regional Response Health Collaborative Program Update The Regional Response Health Collaboratives (RRHCs) continue to work closely with staff at the Department of Human Services, the Department of Health, and the Pennsylvania Emergency Management Agency and are an asset in supporting long-term care facilities across Pennsylvania facing this pandemic. To date, the RRHCs have been assigned more than 6,800 missions, primarily covering facility assessments, testing, consultations, and support with fitting personal protective equipment (PPE) – a 9 percent increase over last week’s report. The RRHCs have completed visits of long-term care facilities for the initial on-site visit requirement – helping these facilities assess readiness to respond to a COVID-19 outbreak and make adjustments to strengthen procedures as necessary. The RRHCs are beginning rounds of second visits to monitor progress and identify additional opportunities to strengthen COVID- 19 mitigation efforts, and 31 percent have had their second on-site visit. The RRHCs have conducted 243 total rapid response team deployments. The rapid response teams are deployed to assist with a current or potential outbreak and are an invaluable resource for those of us at the state level and facilities as they manage very stressful, time-sensitive situations with staff and residents. These teams work quickly to identify what is needed to stabilize these outbreaks and ensure continuity of care and operations as cases are managed. This resource is keeping people safe and strengthening what we are able to do for facilities across Pennsylvania, and I and all of us are grateful to the RRHCs for their continued partnership in this effort.

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