LeadingAge of Michigan, Annual Conference - PowerPoint Presentation

Slide1

LeadingAge of Michigan, Annual Conference

Monday, September 27

, 2021

Jay Calewarts, Director

Adult Foster Care and Camps Licensing Division

Protect People & Promote Business

Slide2

BCHS Org Chart

Slide3

What is new or has changed within the bureau?

Child Care Licensing

Workforce Background Checks

Qualified Interpreters

State Licensing Long Term Care Section

Nursing Homes and Hospital Long-Term Care Units

Homes for the Aged

Slide4

LARA-BCHS Web Site

www.Michigan.gov/bchs

Slide5

AFC and Camps Licensing Division Org Chart

Slide6

Office Closures

Have closed field offices in:

Kalamazoo

Mount Pleasant

Flint

Jackson

Ypsilanti

*Will be closing Pontiac office on September 30, 2021

Slide7

Staff Update

Grant Sutton retired, backfilled with Anthony Mullins

Crecendra Brown took management position with childcare

Derrick Britton transferred to Flint

Currently have two vacant AFC consultant position (1 in Lansing and 1 in Detroit)

Slide8

Administrative

Rules / Technical Assistance

Homes for the Aged - Current Rules

R 325.1924 Reporting of Incidents, Accidents, Elopement

R 325.1932 Resident Medications

Slide9

MDHHS Orders

MDHHS orders issued under authority of the Public Health Code can be found at:

www.michigan.gov/coronavirus

MDHHS orders that directly correlate to HFAs and AFCs

May 5

th

order

May 21

st

order

Discussed more in next slides

Slide10

MDHHS Orders

May 5

th

order

-

Testing in Skilled Nursing Facilities, Home for the Aged, and Adult Foster Care Facilities

Applies to all HFAs and AFCs with a licensed capacity of 13 or more residents

initial testing of all new or returning residents and newly hired staff when individual is unvaccinated and has not been tested in the 72 hours prior to intake or start date

Weekly testing of all unvaccinated staff

Test any resident or staff with symptoms

Weekly testing of all residents and staff (regardless of vaccination status) if positive case in facility until 14 days after last new positive

Slide11

MDHHS Orders

May 5

th

order

-

Testing in Skilled Nursing Facilities, Home for the Aged, and Adult Foster Care Facilities

Facility responsible for requesting, obtaining and maintaining vaccination records for all residents and staff

Asymptomatic individuals who have recovered from COVID-19 in the past 3 months are exempt from testing (Facility must maintain verification documents for minimum of 12 months).

Must develop protocol if staff or residents decline or are unable to be tested

Must follow CDC guidance on how to prevent transmission of the COVID-19 virus if a staff or resident tests positive

Slide12

Testing Info

Submitting a CLIA application (

Annotated CLIA Waiver

form to assist in completing the CLIA Waiver application)

MDHHS has issued a

Michigan Antigen Tests FAQCareStart COVID-19 Antigen

Instructions for Use

Training Video

showing howe to administer a

CareStart

COVID-19 test

MDHHS has

link

to request Antigen tests.

Slide13

MDHHS Orders

May 21

st

order

–

Requirements for Residential Care Facilities

Adopts Center for Medicare and Medicaid Services (CMS) guidance

QSO-20-39-NH

which was updated March 10, 2021

Outlines protocols for visitation

Outdoor visits still preferred when possible

Make efforts to allow communal dining and group activities for residents that are not isolating or under observation for COVID-19 symptoms

Slide14

MDHHS Orders

May 21

st

order

–

Requirements for Residential Care Facilities

All residents must socially distance and where a mask when an unvaccinated is present

Discusses notifications if resident or staff test positive

Requires contacting local health department after resident or staff test positive

Includes reporting requirements to MDHHS

Slide15

IPRAT Info

IPRAT –Infection Prevention Resource and Assessment Team

Can assist in training staff infection control

MDHHS-IPRAT@michigan.gov

More information can be found at

MDHHS IPRAT

Slide16

Licensing & MDHHS Orders

From a licensing standpoint, we cannot cite an MDHHS order. Instead, licensing makes sure facilities has a plan, polices and procedures on how to keep residents safe.

Licensing provides consultation which includes using MDHHS orders and CDC guidance as a benchmark when developing a facility plan, polices and procedures.

Licensing checks to make sure you are following your policies and procedures.

Slide17

MDHHS Rapid Response Staffing

3 agencies that may be able to assist with staffing shortages due to COVID if certain criteria is met.

More information can be found at

MDHHS Rapid Response Staffing

Slide18

MIOSHA Emergency Rules

FYI…Emergency

MIOSHA Rules

do apply to HFAs and AFCs

Adopts federal

OSHA requirements

Must develop and implement a COVID-19 plan (written plan for more that 10 employees)

Monitor points of entry and screen residents and visitors

Provide and ensure all employees wear facemasks over mouth and nose

Exceptions: employee alone in room, when eating or drinking and at least 6 feet away from others, when important to see employee’s mouth such as communicating with deaf, when cannot wear due to medical condition

Slide19

MIOSHA Emergency Rules

Must provide respirator (N-95) and gown/eye protection to staff when employee is exposed to person with suspected or confirmed COVID-19

Clean high touch areas once at least once a day

Provide alcohol based had rub or readily accessible hand wash facilities

Maximize outside air in ventilation

Use MERV-13 or higher filters

Screen employees start of their shift

See all requirements at

1910.502 - Healthcare. | Occupational Safety and Health Administration (osha.gov)

Slide20

Challenges to AFC and HFAs

Staff, Staff, Staff

Think of creative ways to recruit/retain staff

Training staff

Make sure staff is fully trained and competent in work assigned before working on their own

Keeping up with the constant changing of requirements

Keeping up with all the reporting requirements

Staff wearing masks entire shift

Try to allow time for mask breaks

Slide21

Staffing Investigations

Start by looking at assessment plans and documentation that shows resident needs

If resident is two person assist, then at minimum two staff are needed (possibly more depending on other residents needs).

Have enough staff or relationship with another AFC or staffing agency to cover when others quit, call in, etc.

Uptick in resident neglect and abuse from burnt out licensees and staff

Slide22

HFA Exemption

Currently approximately 207 HFA license exempt facilities

As of January 1, 2020, a facility not currently approved for an exemption can apply for two types of exemptions:

Person that provided room and person that provides supervised personal care are related and registered as Continuing Care Community

Person that provided room and the person that provided supervised personal care are not related and residents have option to select care of their choice

Existing exemptions can be granted to successor but successor has to reapply

HFA licensure exemption applications can be found at:

HFA_Exemption_Application_1_18_612626_7.pdf (michigan.gov)

Slide23

HFA Background Checks

Cap on Background Checks was supposed to start on 10/1/18

Because of IT/logistic issues, this took effect on July 1, 2020

40 checks for facilities with fewer than 100 beds

50 checks for facilities with 100 or more beds

Count resets each October 1st which is the start of the state fiscal year

Slide24

AFC Background Checks

Facility responsible for cost of Background checks of employees effective on July 1, 2020

Savings to the state intended to assist in relocating residents during a summary suspension when necessary

Slide25

HFA/AFC Background Checks

Staff should be affiliated with every facility that they may work at

Affiliate with other locations once approved for the first facility

Shouldn’t require a new print if employee resides in Michigan and prints within 1 year

If try to affiliate with another facility after a year, will require a new fingerprint

This is due to no federal rap back

If federal rap back implemented, then only would have to be continuously employed to affiliate with a new home (would not require a new fingerprint)

Slide26

HFA/AFC Background Checks

Have heard of area specific issues scheduling or fingerprint office being closed

Most are because of

Identogo

vendor staffing shortages

Reminder that new staff can work immediately if “under the supervision” of eligible employee and meets requirements of

MCL 400.734b

(6) for AFC or

MCL 333.20173a

(5) for HFA.

If larger employee had to print high number of employees could reach out to

Identogo

to see if they could do a site fingerprint

if you are interested in becoming a fingerprint vendor, you can request to be a partner with

Identogo

at

https://www.identogo.com/partners

Slide27

HFA/AFC Background Checks

Effective May 25, 2021, can no longer pay for fingerprint via credit card when setting up appointment

Providers can set up a No Charge Authorization Code (NCAC) with

Idemia

Allows providers to establish account that is backed by credit card and will only be charged when an applicant is printed

Should use FCE as Reason for fingerprinting for HFA and AFC

More info can on how to set up a NCAC can be found at

Information - Michigan Workforce Background Check (miltcpartnership.org)

Questions can be directed to

Idemia

Customer Service at 866-226-2952

Slide28

Questions & Answers

Email:

calewartsj@michigan.gov

BCHS-Help@michigan.gov

Lansing Office Address:611 W. Ottawa Street

Ottawa Building, 1

st

Floor

PO Box 30664

Lansing MI, 48909