May 15, 2020
Stay Connected - LeadingAge Illinois COVID-19 Resources
Stay up to date on state and federal COVID-19 information and updates by accessing the LeadingAge Illinois COVID-19 Resources page. You can also engage with other Illinois members through our listservs, connecting you with your peers by provider type. We have now added a COVID-19 listserv . Contact LeadingAge Illinois if you’d like more information about the listservs or would like to join one.

LeadingAge Holds Another Virtual News Conference: Older Lives Are Not Expendable
Yesterday, LeadingAge held another press conference to sound alarms that aging services providers still desperately need Personal Protective Equipment (PPE) and testing—and to question why the nation has still not prioritized our most vulnerable older Americans. The media event was the latest part of our aggressive media and messaging campaign to demand more from leaders.
Katie Smith Sloan, President and CEO of LeadingAge was joined by Adam Marles from LeadingAge PA, and Jim Bernardo from Presbyterian Senior Living, who offered the media a glimpse into what this pandemic is really like for members like you. Adam echoed one of the most important messages of the day, saying “I am outraged by talk of how lives are expendable. Older Americans’ lives are not expendable—they’re precious, just like yours or mine.”
Participating press including reporters from NBC, USA Today, Philadelphia Inquirer, The Washington Post, Barron’s, and others, including McKnight’s, which ran stories this morning that reflect our core messages well:

Materials from the media event are available now, including the recording ; remarks from Katie , Adam , and Jim ; and a final media statement offering key quotes from the event.
Illinois General Assembly Resumes Session in Springfield Next Week
The Illinois General Assembly (ILGA) announced they will return to Springfield to resume the legislative session next week in the capital city. The ILGA will resume Wednesday, May 20 through Friday, May 22. The House will meet at the local convention center, while the Senate will meet in their chamber at the State Capitol Building. Lobbyists and other stakeholders will have very limited access to either building or lawmakers on an in-person basis while they are in Springfield.
By being in Special Session, the Joint Senate and House Proclamation is restricting the issues to be considered by the ILGA as follows:
  • COVID-19 pandemic or other disasters;
  • State budget and its implementation;
  • Economic recovery, infrastructure projects and funding thereof;
  • Explanation, arguments for and against, and the form for constitutional amendments as required under the Illinois Constitutional Amendment Act;
  • Laws or authority scheduled to be repealed prior to June 1, 2021;
  • 2020 General Election and the State Board of Elections; and
  • Hospital assessment program.
LeadingAge Illinois policy staff will continue to keep you posted as the special session unfolds.
Governor Issues New Executive Order on Immunity from Civil Liability
Governor Pritzker issued a new Executive Order this week relating to immunity from civil liability for services provided by health care providers during the current pandemic. The new Order walks back the breadth of his initial Order granting immunity.  Interestingly, the Governor did not mention it in his daily 2:30 p.m. briefing.
On April 1, the Governor issued Executive Order 2020-19 .  That Order granted quite broad immunity from civil liability for long-term care settings, other health care facilities, and health care professionals and volunteers. This broad immunity appeared to extend to any action that occurred during the time of the pandemic, so long as the facility or provider was “rendering assistance to the state”, whether or not the medical care arose from COVID-19 cases. See the language from the April 1 Order below:
“Health Care Facilities, as defined in Section 1 of this Executive Order, shall be immune from civil liability for any injury or death alleged to have been caused by any act or omission by the Health Care Facility, which injury or death occurred at a time when a Health Care Facility was engaged in the course of rendering assistance to the State by providing health care services in response to the COVID-19 outbreak, unless it is established that such injury or death was caused by gross negligence or willful misconduct.”
Under the new Order, however, long-term care settings (skilled nursing care, assisted living and supportive living), hospitals and other health care facilities as well as health care professionals and volunteers have their immunity limited to care relating to COVID-19: 
“shall be immune from civil liability for any injury or death relating to the diagnosis, transmission, or treatment of COVID-19 alleged to have been caused by any act or omission by the Hospital or the Health Care Professional, which injury or death occurred at a time when a Hospital or Health Care Professional was rendering assistance to the State in response to the COVID-19 outbreak by providing health care services consistent with current guidance issued by IDPH. This section is inapplicable if it is established that such injury or death was caused by gross negligence or willful misconduct of such Hospital or Health Care Professional.”
LeadingAge Illinois will be discussing this Executive Order decision with the Illinois Department of Public Health and the Governor’s staff at our next meeting with them. 
LeadingAge Illinois Makes Funding Requests
LeadingAge Illinois has been meeting twice per week with the Governor’s Office, the Illinois Department of Public Health (IDPH) and the other long-term care associations on issues surrounding COVID-19. In addition to these meetings, we have met with various legislative caucuses and presented testimony before the Illinois Medicaid Work Group. 
Personal Protective Equipment (PPE), testing and staffing have been the central issues discussed lately in meetings. Yesterday, LeadingAge Illinois testified before the Illinois Medicaid Work Group to explain the increased costs providers are incurring related to COVID-19 and urge the State to provide relief.
The CARES Act provides $2.7 billion to Illinois. LeadingAge Illinois would like to see more of this funding and alike funding packages going to nursing homes, assisted living and supportive living.  LeadingAge Illinois outlined that  nursing homes  have incurred substantial costs, whether or not their buildings saw a significant outbreak of COVID-19. 

They have dramatically seen increased costs for PPE that has not been provided by the State, incentives paid to direct care staff, bonuses paid to direct care staff, increased food costs and other various unforeseen spending pressures. To address the costs that facilities have seen, the associations propose a one-time supplemental payment to be negotiated for every occupied skilled nursing facility bed regardless of payer source. 
LeadingAge Illinois is requesting $68 million for a one-time supplemental payment, based on occupied beds, which amounts to $2,036 per bed . LeadingAge Illinois has stressed the vital role Assisted Living (AL) and Supportive Living (SL) communities play in the continuum of care. ALs and SLs are also experiencing higher than expected costs for supplies, staff and operations much like the financial difficulties being borne by skilled nursing facilities throughout Illinois. 
While the State normally provides funding for Supportive Living, these increased costs are not just for residents who are under the Medicaid program. Therefore, we have urged the administration to provide assistance in caring for all those in need of assisted living, regardless of payer source. 
We will continue to urge action on these requests in meetings and when the legislature returns to session next week. 
Contact Congress Today for Affordable Senior Housing Relief
Support LeadingAge’s affordable senior housing asks in the next COVID-19 relief package by contacting your representative and senators today. Congress has been working for weeks on the next funding package; now is the time to make sure your voice is heard for affordable senior housing.
Urge Congress to provide funding and support for affordable senior housing, including a $1.202 billion package of relief funds for affordable senior housing:
  • $845 million for COVID-19 costs for services, staffing, disinfecting, PPE, etc. Funds from the March 27 CARES Act will begin to make up for lost tenant rent revenue, but not help pay for other related costs.
  • $300 million for Service Coordinators, both to support existing Service Coordinators and to get new ones for the senior housing communities that do not have one.
  • $50 million for wireless internet installation and service fees in resident units and in community common spaces. The lack of internet access has slowed efforts to combat social isolation, engage residents with telehealth, and connect residents to needed supports.
  • $7 million for a one-year extension of HUD’s Integrated Wellness in Supportive Housing demonstration, whose funding for wellness nurses and service coordinators is set to end on September 30 without congressional action.
Update on Reporting COVID-19 Cases - Important
The Illinois Department of Public Health (IDPH) provided LeadingAge Illinois with an update on notifications of COVID-19 cases. Notification must be made to your local health department and IDPH by 5 pm the next calendar day. This is aligned with CMS mandated reporting. IDPH has said this verbally and they have not updated this in writing yet.
IDPH has put together a reporting protocol for reporting positive cases to the Department. In order to reconcile long term care case numbers vs. case numbers for others, they are asking that providers submit the following upon receipt of positive test results for either residents or staff:
  • Facility Name
  • Facility Address
  • Facility License #/CMS Provider # (14XXXXX)
  • Date Results Received
  • Number of Residents Testing Positive
  • Number of Staff Testing Positive
  • Total Number of Positive Tests (Residents + Staff)   
The information is to be submitted to the fax/email to which you routinely submit your incident reports. The IDPH Office of Healthcare Regulation only needs reports from facilities that the Office licenses and/or certifies (Assisted Living, Long Term Care). Separate reports must be submitted for each day positive reports are detected.
Supportive Living Update
There are a couple of items we wanted to updated Supportive Living members on today. 
MCO Service Planning:
The Illinois Department of Healthcare and Family Services (HFS) is pushing back the rollout of the transition for MCO service planning to July 1. If you have any questions, please contact Sara Reardon .
COVID Reporting for Today:
Kara Helton will be out of the office today. If you have any positive COVID-19 tests to report or questions, please contact Janene Brickey at 217.557.0593. 
Illinois Department on Aging Seeking Submissions for Making Your Mark Initiative
With May being Older Americans Month in Illinois, the Illinois Department on Aging (DoA) is encouraging all Illinoisans to Make Your Mark in the lives of our older adults.
Usually, during this month, there are senior events, fairs, and other activities. This year is obviously different and seniors are being engaged in other, creative ways.  In recognition of this, DoA is collecting stories of individuals you believe should be recognized as Making Their Mark; your employees, community partners, other older adults and even young adults who have been supporting seniors - individuals who have gone above and beyond during this ongoing situation. Many organizations are continuously finding new and creative ways to provide services for older Illinoisans, and DoA wants to recognize these dedicated workers and share their gratitude for a job well done.
If you have a story you’d like to submit highlighting initiatives or individuals who embody the spirit of Making Their Mark, please provide the following information:
Make Your Mark Submissions:
  • Name of your organization
  • Location of your organization
  • What or Who you see Making Their Mark
  • Make Your Mark story, positive feedback, or quotes from older adults or caregivers (3-4 sentences)
  • Photo (if available, and subject to social distancing and other health and safety precautions)
Send your submission to Michael Dropka before June 1. 
COVID-19 Updates and Q&A Webinars for Long-Term Care and Congregate Residential Settings
The Illinois Department of Public Health (IDPH) is hosting webinars to provide COVID-19 updates and answer questions from long-term care and congregate residential settings.

Click here for slides from the May 13 session.
To register, click on dates below:
Webinar attendance is limited. If you cannot register or get in, email Michael Moore .
IDPH will be recording the webinars and sending out the links of the recordings.
Governor Pritzker’s Daily Press Conference Updates
Governor JB Pritzker is conducting daily press 2:30 p.m. conferences on COVID-19. Click here to listen daily.  LeadingAge Illinois monitors the briefings daily for information coming directly from the Governor and Dr. Ngozi Ezike, Director of the Illinois Department of Public Health (IDPH). 
We have been and will continue to clear up any inaccuracies stated by the Governor's Office as it relates to what is being experienced by our members. We have expressed these concerns in our frequent meetings with IDPH and the administration.  
Yesterday’s update included:
  • 3,239 new cases (87,937 total)
  • 138 new deaths (3,928 total). 
  • Curve has flattened and bending. 
  • 512,037 with 22,678 in the last 24 hours.
  • Positivity rate going down. 
  • 4,473
  • 1,132 in ICU
  • 689 on ventilators
Wednesday’s briefing focus was long-term care . It is the third time this has been a briefing focus. The other two were April 20 and April 29. The Governor gave a timeline of the State’s COVID-19 response since March. 
He said the State will pursue any “bad actors” to the fullest extent of the law, adding that anyone can file a complaint with IDPH on long term care facility issues, COVID-19 or otherwise. In regards to testing , the Governor reported that on April 20, IDPH began their plans to test all residents and staff at facilities without known outbreaks; allowing the identification early of the presence in facilities and isolate cases before widespread transmission. Testing is done in facilities that includes all employees when there is a known case. He noted that 30,000 tests occurred at 129 facilities. Through a contractual partnership with Quest Diagnostics, deliveries of tests have been made to facilities since May 5. Quest and IDPH are scaling up deliveries and maintaining the 48-hour results turnaround as dictated by the contractual agreement. 
Regarding Personal Protective Equipment (PPE) , the Governor said local health departments remain the first line of communication for PPE needs. The State has delivered PPE to all 102 Illinois counties. He said that the State stockpile has backup PPE for facilities, but the State is not the primary source for private businesses like nursing homes. The State cannot meet each request, but is doing everything in their power to protect residents, according to the Governor.  
To ensure facilities have a stockpile, the Governor said the Illinois Emergency Management Agency (IEMA) and IDPH have coordinated in an “unprecedented effort” to directly deliver PPE to the more than 1,200 long-term care facilities in the state. This delivery reportedly began on April 30 and the Governor reported that more than 85% of facilities have received them. Deliveries cover facilities with 200 residents and for those with over 200, they will get two shipments. The shipments include K95 masks, N95 masks, face shields, surgical masks, gloves, hand sanitizer and shoe covers. The Governor again reminded facilities that the State now has the N95 mask decontamination service that is free due to HHS coverage. Fed Ex transports masks door-to-door to get cleaned and they can be cleaned up to 20 times.
LeadingAge, Argentum and Other Associations Request Federal Liability Protections in Letter
LeadingAge and Argentum have joined in a coalition of association asking U.S. Senate Majority Leader Mitch McConnell for federal liability protections for all health care workers and facilities.

The coalition members signing onto the letter also included American Assisted Living Nurses Association (AALNA), American Health Care Association (AHCA), National Center Assisted Living (NCAL), American Senior Housing Association (ASHA), American Medical Director’s Association (AMDA) Society for Post-Acute and Long-Term Care Medicine, National Association for Home Care and Hospice, National Hospice and Palliative Care Organization (NHPCO), Visiting Nurses Association of American (VNAA) and Elevating Home. 
The coalition requested that Congress act to provide our members with reasonable liability protections during this health crisis by expanding the protections in section 3215 of the CARES Act to all health care professionals and front-line facilities. The hearing this week was in the U.S. Senate Judiciary Committee and a recording is available here
Standing with Seniors Campaign
LeadingAge Illinois asks members to support the “ Standing with Seniors ” campaign. Argentum is working to get 500,000 letters sent to U.S. Capitol Hill on behalf of senior living. Please get involved in this effort.
Heroes Act Update 
At the request of U.S. House leadership, LeadingAge released a media statemen t on the Heroes Act, supporting the proposed measure as a good start and seeks additional provisions in a final relief bill. The media statement highlights requests for: (a) $100 billion emergency fund specifically for aging services providers; (b) significant investments in Personal Protective Equipment (PPE) and testing for aging services providers; (c) $1.2 billion investment in relief for HUD-assisted affordable housing; and (d) reimbursement for home health telehealth services. LeadingAge posted an article on provisions of the proposal that would affect nursing homes this week. A manager’s amendmen t came out recently also. Stay tuned as this issue unfolds. 
CMS Announces Additional Blanket Waivers
CMS announced additional blanket waivers on May 11. LeadingAge has highlighted the updates to Home Health and Hospice Blanket Waiver charts.
CMS Issues Nursing Homes Best Practices Toolkit to Combat COVID-19
CMS released a new toolkit developed to aid nursing homes, Governors, states, departments of health, and other agencies who provide oversight and assistance to these facilities, with additional resources to aid in the fight against the coronavirus disease 2019 (COVID-19) pandemic within nursing homes.

The toolkit builds upon previous actions taken by the Centers for Medicare & Medicaid Services (CMS), which provide a wide range of tools and guidance to states, healthcare providers and others during the public health emergency. The toolkit is comprised of best practices from a variety of front line health care providers, Governors’ COVID-19 task forces, associations and other organizations, and experts, and is intended to serve as a catalogue of resources dedicated to addressing the specific challenges facing nursing homes as they combat COVID-19.
Source: CMS
Paycheck Protection Program Guidance on Certification of Need: New Information, Unanswered Questions
The Department of the Treasury and the Small Business Administration on May 13 added an item to their  l iving FAQ document for Paycheck Protection Program   questions related to the certification of need for PPP loans. Summarized below, this new guidance (question 46 in the linked document) provides some clarity for PPP borrowers but leaves some questions unaddressed, particularly for those who borrowed more than $2 million.

When borrowers applied for PPP loans, they certified that c urrent economic uncertainty makes this loan request necessary to support the ongoing operations of the Applicant .” The federal government had not issued guidance for borrowers on how this certification would be assessed, and with the safe harbor deadline coming quick (May 14), more information was needed so borrowers could determine whether to keep their PPP loans.
The May 13 FAQ addresses the certification and creates two categories for how it will be considered: loans in the amount above and below $2 million.
For PPP borrowers with $2 million or less in loans, the certification of need will be presumed in good faith for the purpose of loan forgiveness. Specifically, “ Any borrower that, together with its affiliates, received PPP loans with an original principal amount of less than $2 million will be deemed to have made the required certification concerning the necessity of the loan request in good faith.”
The government explains in the question that they are focused primarily on assessing the certification among borrowers with larger loans (e.g., more than $2 million in principal). Previously, the government had announced that all loans greater than $2 million would be audited before borrowers received loan forgiveness.
PPP borrowers with more than $2 million in principal will be able to demonstrate their need for the loan “ based on their individual circumstances in light of the language of the certification and SBA guidance .” This leaves questions as to how borrowers should expect to do this, as the FAQ does not specify any criteria borrowers should prepare to meet in this area. LeadingAge will continue to monitor for further guidance on this aspect of the program.
That said, there was some worry among borrowers about potential criminal penalties the government alluded to in previous FAQ responses. This new question lays those to rest by creating a mechanism for returning loan funds if borrowers are deemed to have not had an economic need in the first place.
Specifically, “ If SBA determines in the course of its review that a borrower lacked an adequate basis for the required certification concerning the necessity of the loan request, SBA will seek repayment of the outstanding PPP loan balance and will inform the lender that the borrower is not eligible for loan forgiveness. If the borrower repays the loan after receiving notification from SBA, SBA will not pursue administrative enforcement or referrals to other agencies based on its determination with respect to the certification concerning necessity of the loan request .”
In other words, borrowers deemed to have not needed a PPP loan will have an opportunity to refunds without criminal penalty.
Source: LeadingAge
Value First PPE Update
As the list and solutions for Personal Protective Equipment (PPE) continues to be an ever changing landscape, Value First encourage you to vet any email offerings you may receive for items. While there are many offers that are legitimate, members are encouraged to be wary of any offers that may seem too good. The FDA is finding a large amount of masks that are now being received in the US are not able to pass inspection.  Click here for more information on PPE updates and resources from Value First. 
LeadingAge Illinois HUD Member Call Recap
Several members received important updates and discussed issues on this week’s LeadingAge Illinois Monthly HUD Member Conference Call. The calls feature Linda Couch , Vice President of Housing Policy and Juliana Bilowich , Director, Housing Operations and Policy for LeadingAge, Washington, D.C.
Updates/Discussion Included:
LeadingAge continues to support and advocate for senior relief funds. They are asking for USDA resources for rural providers and resources to address the needs of HUD multifamily housing. LeadingAge is asking for a $1.202 billion package of relief funds for affordable senior housing.  There will be standalone bills in both the House and Senate for this. Members are asked to contact Congress today in regards to the current LeadingAge asks (see Contact Congress Today for Affordable Senior Housing Relief in today’s Top Stories). 
LeadingAge continues to advocate for WiFi and the Ask is $50 million. David Guthridge, Director of Affordable Housing at CJE SeniorLife, has proactively asked HUD for a solution to this issue. 
“Unfortunately, research links social isolation and loneliness to higher risks for a variety of physical and mental conditions, to include high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease, and even death,” explained Guthridge in a recent communication with HUD staff. “Conversely, people who engage in meaningful, productive activities with others tend to live longer, boost their mood, and have a sense of purpose. Activities and social interaction help maintain well-being and cognitive functions. CJE is presently reviewing the possibility of adding Wi-Fi to these buildings to counteract this isolation by providing connectivity through technology. However, these improvements are a cost that has not been anticipated. Wi-Fi has not been an approved sustainable, billable cost that is considered as necessary for buildings, as Utility Allowances have been.” 
HUD Communications:
HUD has slowed down their updates lately. At the onset of the emergency, they were updating their Multifamily FAQs weekly. The last update was May 1, about two weeks ago. HUD provided resources for food access that includes a listing of food pantries by zip code and how to apply for SNAP benefits. 
HUD also developed a document titled, “ Addressing Tenant Concerns During the COVID-19 National Emergency ,” which includes information on paying rent, entering into a repayment plan and options if residents are unable to pay rent at this time. 
Health and Safety:
Recognizing the physical, mental and emotional impact of this emergency, LeadingAge has monitored issues related to keeping residents healthy and safe. Many providers have been innovative in serving residents including adapting systems to do wellness checks, providing resources for food support and assisting with access to resident stimulus checks.  
Cleaning and Disinfecting:
HUD held a webinar in conjunction with the CDC intended for housing teams, maintenance and management. The focus was safety measures for residents. As states begin to reopen, this issue will be very important. 
These issues and more were discussed on the call. We hope members can join us in June for the next one. An invitation, includi ng date and time will be distributed soon. For more information, contact Jason Speaks.
NEW! Free Basic Care Aide Skill Competency Training Tool 
In response to COVID-19, CMS issued blanket waivers expanding the Nursing Assistant four-month rule, and several states lifted training and competency requirements for staff in skilled nursing or similar settings. Expedited training is a critical tool to assure you can take advantage of these waivers.

Now, you can maximize your workforce and maintain quality standards with LeadingAge’s new  Basic Care Aide Skill Competency Training Tool . The new, free, 9-hour training will help you redeploy current staff, and train displaced workers and others new to our field.

Developed by EduCare©, this new program is designed specifically for the Basic Care Aide role and provides a foundation of skills for a variety of settings. The curriculum provides information on how to perform tasks, with the goal of ensuring that staff are well prepared to deliver person-centered care.

The program features an online training curriculum, with an additional two hours competency-based testing in the following content areas:
  • Resident Rights, Abuse Prevention and HIPAA
  • Emergency Procedures/ Site and Natural Hazards
  • Emergency Preparedness/Human Hazards
  • Infection Control Techniques
  • Coronavirus COVID-19
  • Personal Cares
  • Exercise and Ambulation
  • Lifting and Safe Transfers
  • Bedmaking and Positioning
  • Temperature and Treatment
  • Skin Care and Pressure Ulcer Prevention
  • Dining, Nutrition and Food Safety
  • Dementia Management and Abuse Prevention
  • Behavioral Health

The training tool is FREE to members and is  available now on the Learning Hub .
LeadingAge Partners with StoryCorps
LeadingAge has partnered a new project with StoryCorps, the nonprofit dedicated to building connections between people through storytelling. StoryCorps Connect provides older adults, their families, and caregivers a platform to conduct, record, and preserve meaningful interviews between loved ones during these challenging times.
The duo has worked together to create interview materials tailored to aging services providers and older adults. Use these materials to help plan your interview today:
This will help older adults across the country stay connected with family and friends and preserving your story for future generations.
LeadingAge Live Online Coronavirus Daily Member Update
LeadingAge is hosting daily live online updates each weekday afternoon. Subscribe to "LeadingAge Need to Know" via communications preferences in your MyLeadingAge account to receive email updates. Register for live online updates 5 days/week at 2:30 p.m. through May. You can find an archive of all member updates here

Also, if you’re a member of both LeadingAge Illinois and LeadingAge National, stay connected with other LeadingAge National Members and share information and resources through the MyLeadingAge Member Community: COVID-19 . This is a place to connect with your peers to share and discuss everyday practices related to the coronavirus. Take a moment now to log into your account and join the group to stay connected. LeadingAge also has a COVID-19 webpage with the latest updates, information and resources for members.
Upcoming LeadingAge Illinois Sessions:
May 19
10:15 a.m.
Free to LeadingAge Illinois Members