Update from Governor Abbott:
Executive Order on Statewide Essential Services and Activities Protocol
Governor Abbott issued an
Executive Order
implementing Essential Services and Activities Protocols statewide. The protocols direct all Texans to minimize non-essential gatherings and in-person contact with people who are not in the same household. The Governor’s Executive Order renews and amends
his previous order
enforcing federal social distancing guidelines for COVID-19, including closing schools and instructing Texans to avoid eating or drinking at bars and restaurants. The new order will remain in effect until April 30th, and all schools will remain closed until May 4th.
The Executive Order overrules any inconsistent county order. However, for anything not mentioned in GA-14, local jurisdictions still have the flexibility to issue orders that they consider more strict.
Waiver of Medical Cost-Sharing for Public Safety Employees
Governor Abbott
announced
yesterday that he waived certain statutory provisions to ensure public safety employees who contract COVID-19 during the course of their employment will be reimbursed for reasonable medical expenses related to their treatment of COVID-19. Because the nature of their duties has caused them to increase their risk of contracting COVID-19, the Governor has waived these statutory provisions so that public safety employees who contract COVID-19 are not also financially penalized.
Governor Abbott
announced
that the Center for Medicaid and Medicare Services (CMS) has approved the Section 1135 Medicaid Waiver submitted by the Texas Health and Human Services Commission (HHSC) on
March 26, 2020
. This approval grants Texas flexibility in administering Medicaid while the state continues to respond to COVID-19. Flexibilities granted under this waiver include:
- Extension of prior authorizations: For enrollees who have an existing prior authorization, CMS approves the state extending a prior authorization approved on or after March 1.
- Suspension of Level 1 and Level II PASRR assessments: All new nursing facility admissions may be treated as an exempted hospital discharge for 30 days. After 30 days, new admissions with a mental illness or intellectual disability should be reviewed as soon as resources are available.
- Fair hearing and appeals: CMS approves the extension of fair hearings up to 120 days (from 90 days) and Texas may choose to allow up 90 days for an enrollee to file an appeal.
- Provider enrollment:Texas may reimburse an out-of-state provider if: the service is provided out-of-state, the provider has an NPI on the claim, and the provider is enrolled in Medicare or another state’s Medicaid program.
- Texas may provisionally/temporarily enroll an out-of-state provider not enrolled in Medicare or another state’s Medicaid program and waive the application fee, finger print criminal background check, site visit, and in-state license requirement.Texas must collect information necessary to process claims, screen for state licensure in other states and screen against the OIG exclusion list. Texas must not issue temporary enrollments after the end of the public health emergency, not allow retroactive effective dates earlier than March 1, and Texas must cease payments to temporarily enrolled providers within 6 months of the end of the public health emergency (unless the provider competes a Texas Medicaid enrollment).
- Texas is granted a waiver to temporarily cease provider revalidation.
- CMS grants the above flexibilities for CHIP.
- Public notice: CMS grants Texas a waiver of public notice requirements
HHSC is continuing to work with CMS on additional flexibility requests that are associated with those approved already.
Licensing Barriers for Advance Practice Registered Nurses Removed
On March 28th, Governor Abbott waived certain regulations allowing for an expedited licensing reactivation process for Advanced Practice Registered Nurses (APRN) in Texas. Under these waivers, an APRN with a license that has been inactive for more than two years, but less than four years, will not have to pay a reactivation fee, complete continuing education credits, or complete the current practice requirements. For APRNs with a license that has been inactive for more than four years, the reactivation fee and continuing education requirements will be waived.
Certain Licensing Regulations for Pharmacists Waived
On March 28th, Governor Abbott waived certain licensing renewal regulations for Texas pharmacists, pharmacy technicians, and pharmacy technician trainees. With these waivers, the Governor is temporarily extending expiration dates for licenses and suspending continuing education requirements for pharmacists.
HHSC Requests Section 1135 Waiver to Support Health Care Workforce in Medicaid Program
On March 29th, the Texas Health and Human Services Commission (HHSC) submitted a Section 1135 waiver to the Centers for Medicare and Medicaid Services requesting flexibility in administering Medicaid to mitigate potential health care workforce shortages during the COVID-19 outbreak. If approved, the federal flexibilities would include:
- Allowing fully trained, qualified nurse aides to provide home health and hospice services even if they have not been employed and paid as an aide within the preceding 24 months, which will help expand the eligible pool of direct care workers and help providers facing any critical staffing shortages.
- Allowing non-clinical staff to provide feeding assistance to residents in nursing facilities without completing the required 16-hour training course. Since group meals are no longer served due to social distancing, additional feeding assistants are needed for one-on-one assistance. These assistants would be supervised and assigned only to non-complex cases.
- Allowing individuals with intellectual disabilities in the Home and Community-based Services and Intermediate Care Facility programs to temporarily receive their same services in either setting. This will give providers greater flexibility to meet staffing and resource challenges while continuing to provide critical services in both programs.
If granted, the Section 1135 Medicaid waiver flexibility would remain in place for as long as necessary during the public health emergency.
Expanded Health Care Capacities in Texas and Executive Orders to Expand Quarantines and Protect Public Safety
Governor Abbott held a press conference yesterday where he provided new information on the state’s health care capacity and issued additional Executive Orders. The Governor announced that hospital beds available for COVID-19 patients have doubled over the past week. He also detailed the joint effort between the state, the Texas Military Department (TMD), and the U.S. Army Corps of Engineers (USACE) to identify and equip additional locations to serve as health care facilities if hospital capacity is exhausted. The first of these sites will be the Kay Bailey Hutchison Convention Center in Dallas.
During the press conference, the Governor issued two new Executive Orders to protect public safety and further combat the spread of COVID-19 in Texas. In the first Executive Order (GA-12) announced today, the Governor mandated a 14-day quarantine for road travelers arriving in Texas from any location in Louisiana. The self-quarantine procedure will mirror the process outlined in the Governor's previous Executive Order requiring mandatory self-quarantine for air travelers from the New York Tri-State Area and New Orleans, Louisiana. This mandated quarantine will not apply to travel related to commercial activity, military service, emergency response, health response, or critical infrastructure functions.
In the second Executive Order (GA-13) announced today, the Governor prohibited the release of individuals in custody for or with a history of offenses involving physical violence or the threat of physical violence. This Executive Order comes in response to concerns of the release or anticipated release of individuals because of COVID-19 who are deemed a danger to society.
The Governor also issued a proclamation regarding his prior Executive Order mandating a self-quarantine for individuals arriving from the New York Tri-State Area and New Orleans, Louisiana. The Executive Order now includes air travelers arriving from the following states and cities:
- California
- Louisiana
- Washington
- Atlanta, Georgia
- Chicago, Illinois
- Detroit, Michigan
- Miami, Florida
Information on Essential Travels to Louisiana
Louisiana is considered a ‘hot spot’ due to the high numbers of coronavirus cases. Governor Abbott said the order does not apply to travel related to commercial activity, military service, emergency response, health response, or critical infrastructure functions. The order went into effect at noon on March 30th.
If you or your Company falls within the essential services categories as defined by Texas Executive Order GA-14, you and your employees are automatically exempt from the travel-related quarantine requirement and are not required to apply for an exemption via this form.
As required by Governor Abbott’s Executive Orders GA-11 and GA-12, the Texas Division of Emergency Management will determine, on a case-by-case basis, whether the self-quarantine order applies to individuals traveling in connection with commercial activity, military service, emergency response, health response, or critical-infrastructure functions.
Comfort Food Care Packages for Texas Youth and Families
Governor Abbott announced the
Comfort Food Care Package (CFCP) program
to provide meals for at-risk youth and families in communities across Texas as the state responds to COVID-19. As part of the program, participating restaurants offer CFCPs for patrons to purchase on behalf of families and youth in need. Each care package contains enough food to feed a family of 5 to 6 and will be delivered to recipients’ homes. The program is a partnership between the Governor's Public Safety Office, the Texas network of Family and Youth Success Programs (formerly called Services to At-Risk Youth), Favor Delivery, and the Texas Restaurant Association.
The Comfort Food Care Package program utilizes the following steps:
- Participating restaurants list CFCPs on their online ordering system for customers to purchase on behalf of at-risk families and youth in the community.
- Customers add CFCPs to their orders and purchase.
- Family and Youth Success Programs identify families and shelters who have the most need and work with participating restaurants and Favor to get the meals delivered.
Families interested in utilizing the CFCP program should contact their local Family and Youth Success Program for more information. Restaurants interested in participating in the program can sign up on the
Texas Restaurant Association website
.
Financial Housing Assistance
Governor Abbott and the Texas Department of Housing and Community Affairs (TDHCA) have taken initial action to provide
tenant-based rental assistance
for Texans experiencing financial hardship due to COVID-19. The Governor has waived statutes relating to the U.S. Department of Housing and Urban Development’s (HUD) HOME Investments Partnership program which would allow Texas greater flexibility to use program funds to help certain Texans pay their rent. In addition, TDHCA has sent a letter to HUD requesting federal waivers to allow greater flexibility to Texas to reprogram these funds for that purpose. If these waivers are granted, Texas will reprogram these funds to provide financial housing assistance to certain Texans enduring economic hardships related to COVID-19.
