All conversations and proceedings at any Board of Trustees, committee, or other formal meeting of

VALA or where VALA representatives are participating must abide by the constraints of antitrust laws. There shall be no discussion of

agreements or concerted actions that may restrain competition. Each participant is obligated to speak up for the purpose of preventing any

discussion falling outside the bounds of laws.

• Please mute your line when not speaking

• *6 can unmute telephone lines

• “Raise Your Hand” to be unmuted by host

• Use chat feature to also share questions/comments

• Discussion is being recorded to be shared on VALA’sHealth Alert webpage

• Statements and information shared are a “work in progress” and may change

• This program has been approved for Continuing Education for 1 Participant Hour by NAB/NCERS –Approval # 20210809-1-A68970-DL

• After completing the evaluation of today’s webinar, anyone wishing to receive CEUs may include their contact information to receive the CEU certificate.

• VALA Health Alert Webpage

• http://www.valainfo.org/healthalert

• Virginia Long-Term Care Task Force Webpage

• https://www.vdh.virginia.gov/coronavirus/health-professionals/virginia-long-term-care-task-force/

• Virginia Department of Social Services

• https://www.dss.virginia.gov/facility/alf.cgi

• Virginia Department of Medical Assistance Services

• Thomas Gates, Senior Advisor for Finance and Technology

• Bill Lessard, Director, Provider Reimbursement Division

• Jackson Lewis P.C.

• Courtney Malveaux, Attorney at Law

• Reopening Updates

• Personal Protective Equipment (PPE)

• Reporting of Supplies and Needs

• N95 Fit Test Training

• Funding Opportunities for Assisted Living Communities

• Department of Labor and Industry’s Workplace Safety Standards

• Additional COVID response updates

• VDSS Released Tips and Best Practices for Reopening: https://www.dss.virginia.gov/files/division/licensing/alf/intro_page/current_providers/notices/covid_19_tips_and_best_practices_for_alfs.pdf

• Communal Activities in ALFs

• Transportation in ALFs

• COVID-19 Mitigation Plans for ALFs

• Barber and Cosmetology Services in ALFs

• Communal Dining in ALFs

• Reopening to Visitors in ALFs

• Reporting of Supplies and Needs• https://arcg.is/nTOiP - VDSS COVID-19 Virginia PPE

Weekly Survey – Due EVERY Tuesday by 5 PM for the previous Monday through Sunday usage. Information used to distribute available supplies as needed.

• www.vhass.org - Virginia Healthcare Emergency Management Program - Continuous updates. Information used to distribute available supplies as needed.

• N95 Fit Test Training – additional dates added - FREEhttps://www.vdh.virginia.gov/emergency-preparedness/n95-respiratory-fit-testing-train-the-trainer/

• VALA continues to advocate in partnership with other organizations, including Argentum, for additional funding supports for ALFs

Eligible Costs

• Funding can be used for COVID-19 related costs associated with:

• Testing• Employee wages, overtime pay, and bonuses, • Employee benefits, • Contracted services expense,• Employee child care costs, if applicable,• Employee isolation housing, if applicable,• Costs related to screening visitors,• Personal protective equipment and supply costs,• Cleaning and housekeeping supplies, • Telehealth costs, • Resident transfer costs, and• Other COVID-19-related expenditures.

• Payments will be based on demonstrated / invoiced COVID-19 costs only.• Detailed invoicing instructions will be provided in August.

Payment Amounts

Initial communication from DMAS to providers will provide additional detail on maximum payment formula.

• Nursing Facilities will be eligible for a maximum payment calculated based on the following criteria:

• $27 per resident per day (less $20 Medicaid payment where appropriate)• $80 per resident per day during outbreaks• Additional support for periodic testing• Less payments received from Provider Relief Fund

• Assisted Living Facilities will be eligible for a maximum payment calculated based on the following criteria:

• A facility-based payment of up to $4,000 for each assisted living facility each month (July, August, September, & October)

• An additional daily payment for four months to each assisted living facility based on the number of auxiliary grant (AG) recipients residing in the facility

• This additional payment equivalent to $15.00 per AG resident per day

Draft Schedule for CARES Act Payments

• July 1, 2020

Eligible costs begin date. Nursing facilities and assisted living facilities should make sure they are documenting their COVID-19 related costs for future invoicing.

• Week of July 27th

DMAS awards administrative support contract. DMAS will contract with an external vendor to support communication with recipients, receipt of invoices, and review and audit of submissions.

• Early August

DMAS or Admin Vendor will send communications to nursing facilities and assisted living outlining the process for submission and necessary documentation, with enrollment, invoice and cost reporting/reconciliation forms.

• Mid-August

Invoices Start Being Accepted / Facilities Enroll for Payment. Facilities can submit invoices and necessary support documentation for costs incurred during July, 2020. Facilities will also have to document funds received from the Provider Relief Fund and DMAS's $20 per diem increase to calculate allowable expenses. Facilities will also have to submit required documentation for enrollment to be paid under this program. Please note, even if a nursing facility is already enrolled as a Medicaid provider, they will have to enroll separately to be paid under this CRF-funded program.

Draft Schedule Continued

Late August / Early September

DMAS begins making payments. DMAS will process payments on a rolling basis every two weeks following the initial submissions as they are processed by the support vendor.

October 31, 2020

Eligible costs end date. Facilities should submit no costs incurred after October 31 for reimbursement. DMAS and vendor will not accept documentation for costs incurred after this date.

December 1

Final documentation due.

Late December / Early January

DMAS makes final payments.

• Adoption of Workplace Safety Standards

© 2020 Jackson Lewis P.C.

VOSH Emergency Temporary Standard for COVID-19

08.10.2020

Please submit questions via the chat box on the webinar control panel.

Courtney.Malveaux@jacksonlewis.com

804-212-2862

Courtney Malveaux

• Background on new standard

• Requirements for all employers

• “Medium Hazard” employers

• “High Hazard” and “Very High Hazard” employers

Background on Emergency Temporary Standard

• VOSH enforces Virginia occupational safety and health law (Title 40.1) for:

• Most private sector employers

• All state and local employers

• OSHA enforces the federal Occupational Safety and Health Act for:

• Federal employers and property

• Maritime industry

Jackson Lewis P.C. 19

Virginia Occupational Safety and Health (“VOSH”)

Virginia is a “State Plan” State that governs most of its own workplaces

• The Virginia Safety and Health Codes Board approves OSHA regulations

• It approved a first-in-the-nation Emergency Standard for COVID-19 on July 15, 2020

• Arose in response to Governor’s Executive Orders

• Effective date to be determined (likely by end of July 2020)

• Six-month duration, with potential permanent standard to follow

• Will “sunset” upon expiration of Governor’s State of Emergency

Jackson Lewis P.C. 20

VOSH Standard for COVID-19

Virginia Passed a First-In-Nation COVID-19 Standard

Requirements for All Employers Under VOSH Jurisdiction

• Hazard assessment for all job tasks (“Very High,” “High,” “Medium” and “Low”)

• Policies/procedures for employees to report COVID symptoms

• Prohibit known/suspected cases at worksites

• “Flexible” sick leave policies

• System to receive reports of positive tests (within past 14 days) by:

• Employees (including temps and contract employees)

• Subcontractors

• Mandatory handwashing stations and hand sanitizer “where feasible”

• Employers must assess risk levels of employees and suppliers before entry

• Building and facility owners must notify employer tenants of COVID-19 cases

Jackson Lewis P.C. 22

What Is In the Virginia Standard?

General requirements for all employers

• Employers must notify:

• VA Dept. of Health of COVID-19 positive tests; and

• VA Dept. of Labor and Industry (DOLI) of “hot spots”: 3 COVID-19 positive tests within a two-week period

• Hazard assessments for all job tasks

• Infectious disease preparedness and response plans within 60 days

Jackson Lewis P.C. 23

What Is In the Virginia Standard?

General requirements for all employers (cont’d)

• “Good faith” if actual compliance with mandatory/nonmandatory provisions of CDC guidance (if equivalent/greater protection)

• Nondiscrimination for:

• Raising/reporting concerns

• Voluntary PPE use

• Reasonable work refusals

Jackson Lewis P.C. 24

What Is In the Virginia Standard?

General requirements for all employers (cont’d)

• No required contact within 6’ of known/suspected cases

• Minimal contact with others (e.g., office setting)

• Minimal contact through engineering controls, such as:

• Floor-to-ceiling barriers

• Telecommuting

• Staggered shifts

• Remote delivery

• Mandatory social distancing

• Face coverings

Jackson Lewis P.C. 25

What Is In the Virginia Standard?

These requirements apply to all “Low Hazard” employers with:

Requirements for “Medium Hazard” Employers

• More than minimal contact within 6’ of others

• May include operations/services in:

• Poultry/seafood/meat processing

• Agriculture

• Manual labor

• Commercial transportation

• School campuses

• Daycare/after school care

• Restaurants/bars

• Grocery/convenience stores

Jackson Lewis P.C.

27

Requirements for “Medium” Hazard Employers

What is a “Medium Hazard” Employer?

• May include operations/services in:

• Food banks

• Drug stores/pharmacies

• Manufacturing settings

• Construction (indoor and outdoor)

• Correctional facilities

• Work performed in customer premises (homes or businesses)

• Retail stores

• Call centers

Jackson Lewis P.C. 28

Requirements for “Medium” Hazard Employers

What is a “Medium Hazard” Employer? (cont’d)

• May include operations/services in:

• Package processing settings

• Veterinary settings

• Personal care, personal grooming, salons and spas

• Sports venues

• Homeless shelters

• Fitness, gym and exercise facilities

• Airports

• Train/bus stations

• Healthcare settings that does not involve exposure to known/suspected cases

Jackson Lewis P.C. 29

Requirements for “Medium Hazard” Employers

What is a “Medium Hazard” Employer? (cont’d)

• When feasible:

• Telework

• Staggered shifts

• Eliminate personal meetings, travel

• Physical barriers

• Implement telework and staggered shifts

• Social distancing

• Deliver services/products remotely or by curbside pickup or delivery

• Reconfigure spaces where employees congregate

Jackson Lewis P.C. 30

Requirements for “Medium Hazard” Employers?

“Medium” Hazard Employers Must:

• Infectious Disease Preparedness and Response Plan (exception for ten or fewer employees)

• Designated person for implementation

• Employee involvement

• Hazard assessment by job tasks and potential exposure sources

• Employees with other jobs

• Employees’ individual risk factors

• Outbreak contingency plans to cover:

• Absenteeism

• Enhanced workplace control measures

• Crosstraining/continued operation plans

• Interrupted supply chains/delayed deliveries

Jackson Lewis P.C. 31

Requirements for “Medium Hazard” Employers

Requirements for “Medium Hazard” employers

• Prescreening/surveying before each work shift

• Provide face coverings to visitors with suspected cases and employees who can’t social distance

• Infection prevention

• Handwashing

• Cleaning/disinfecting

• Managing/educating visitors

Jackson Lewis P.C. 32

Requirements for “Medium Hazard” Employers

Requirements for “Medium Hazard” employers

• Identification/isolation of known/suspected cases

• Plan to address subcontractors, temp/contract employee providers, other visitors

• Antiretaliation protections for employees who raise concerns

• Assess, require and communicate PPE use beyond General Industry

Jackson Lewis P.C. 33

Requirements for “Medium Hazard” Employers

Requirements for “Medium Hazard” employers

• Written certification to verify workplace hazard assessment that:

• Identifies evaluated workplace

• Certifies evaluation completion with date(s)

• Ensure air handling systems that:

• Are maintained according to manufacturers’ instructions

• Comply with minimum American National Standards Institute (ANSI)/American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) Standards

Jackson Lewis P.C. 34

Requirements for “Medium Hazard” Employers

Requirements for “Medium Hazard” employers

• Employee COVID training within 30 days on:

• New VOSH standard

• CDC guidelines (mandatory and nonmandatory)

• Signs/symptoms/methods of transmission

• Risk factors for underlying health conditions

• Asymptomatic/Presymptomatic spread

• Safe and healthy work practices

• PPE

• Antidiscrimination

• Infectious Disease Preparedness and Response Plan

• Retraining

Jackson Lewis P.C. 35

Requirements for “Medium Hazard” Employers

Requirements for “Medium Hazard” employers

Requirements for “High Hazard” and “Very High Hazard” Employers

• Airborne Infection Isolation Rooms for patients

• Autopsy suites for postmortem activities

• CDC Biosafety Level 3 requirements for handling infected specimens

• Limitation of non-employee access

• Signage to report symptoms

• Psychological/behavioral support

• Respiratory protection program

Jackson Lewis P.C. 37

Additional Requirements for “High Hazard” Employers

Requirements for “High Hazard” employers

Thank you.

Courtney M. Malveaux, Esq.804.212-2862

Courtney.Malveaux@jacksonlewis.com

Represents Employers In:

• OSHA Citations

• Regulatory and Employment Matters

• Government Affairs

Regulatory Background:

• Virginia Labor Commissioner

• VA Safety and Health Codes Board

• President, National Association of

Government Labor Officials

• Additional COVID response updates

• Open Discussion/Questions

Questions?Comments?

Contact VALA…Judy Hackler

VALA Executive Director(804) 332-2111

www.valainfo.org jhackler@valainfo.org

VALA Health Alert Webpagehttp://www.valainfo.org/healthalert