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IMLA COVID-19 Working Group

AK
Amanda Karras
Thu, Nov 4, 2021 3:41 PM

Dear IMLA COVID-19 Working Group:

The Biden administration announced details for two of the vaccine mandates today.  There is quite a bit to digest here, but I wanted to get this information out to you.

First, the interim final rule has been published by the DOL for the OSHA rule for private employers with 100 or more employees that also covers public employers with 100 or more employees that have a state OSHA approved state plan that covers state and local governments.  If you aren't sure if you are in a state with an OSHA-approved state plan, click here: https://www.osha.gov/stateplans/).

Second, CMS is announcing details of its requirement that health care workers at facilities participating in Medicare and Medicaid are fully vaccinated.

Here is the White House press release regarding both rules: https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/04/fact-sheet-biden-administration-announces-details-of-two-major-vaccination-policies/

OSHA Rule:

Here are some takeaways from the interim rule / guidance.  Local governments that are covered by the OSHA rule:

  • Need to ensure compliance by 1/4/22 (including developing a written mandatory vaccine policy and/or a vaccine policy that requires vaccines but has a testing / masking opt out), determine vaccination status, ensure accurate recordkeeping for vaccination / testing).
  • Fully vaccinated means 2 shots of Pfizer or Moderna or 1 shot of J&J by the January 4th deadline.
  • Must provide paid-time off for their employees to get vaccinated and sick leave for side effects as needed.
  • Do not need to pay or provide tests for employees who choose to get weekly tests in lieu of vaccination (though CBAs or other laws could apply to this).
  • Must ensure unvaccinated workers are masked (beginning 12/5).
  • According to the interim rule, to meet the definition of "mandatory vaccination policy", the policy must require vaccination of all employees (including new hires) except for "those employees (1) for whom a vaccine is medically contraindicated, (2) for whom medical necessity requires a delay in vaccination, or (3) those legally entitled to a reasonable accommodation under federal civil rights laws because they have a disability or sincerely-held religious beliefs, practices, or observances that conflict with the vaccination requirement. OSHA requires employers to implement a mandatory vaccination requirement, but provides an exemption for an alternative policy that allows employees to choose either to be fully vaccinated or to be regularly tested and wear a face covering."
  • The rule does not apply to employees who do not report to a workplace where other individuals such as coworkers or customers are present, employees while they are working from home, or employees who work exclusively outdoors.
    Failure to comply with the rule will subject employers to fines.

The OSHA interim final rule, can be found here: https://public-inspection.federalregister.gov/2021-23643.pdf.
A summary of the rule can be found here: https://www.osha.gov/sites/default/files/publications/OSHA4162.pdf
Here are the OSHA FAQs for the rule: https://www.osha.gov/coronavirus/ets2/faqs

Facilities Participating in Medicare / Medicaid

  • Must ensure all employees are fully vaccinated by 1/4/22 (2 shots of Pfizer or Moderna, 1 of J&J).
  • The requirements apply to: Ambulatory Surgical Centers, Hospices, Programs of All-Inclusive Care for the Elderly, Hospitals, Long Term Care facilities, Psychiatric Residential Treatment Facilities, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Home Health Agencies, Comprehensive Outpatient Rehabilitation Facilities, Critical Access Hospitals, Clinics (rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services), Community Mental Health Centers, Home Infusion Therapy suppliers, Rural Health Clinics/Federally Qualified Health Centers, and End-Stage Renal Disease Facilities.
  • This vaccination requirement applies to eligible staff working at a facility that participates in the Medicare and Medicaid programs, regardless of clinical responsibility or patient contact. The requirement includes all current staff as well as any new staff who provide any care, treatment, or other services for the facility and/or its patients. This includes facility employees, licensed practitioners, students, trainees, and volunteers. Additionally, this also includes individuals who provide care, treatment, or other services for the facility and/or its patients under contract or other arrangements.
  • The regulation also provides for exemptions based on recognized medical conditions or religious beliefs, observances, or practices. Facilities must develop a similar process or plan for permitting exemptions in alignment with federal law.
    Here is a press release from CMS on this rule: https://www.cms.gov/newsroom/press-releases/biden-harris-administration-issues-emergency-regulation-requiring-covid-19-vaccination-health-care

To view the interim final rule with comment period, visit: https://www.federalregister.gov/public-inspection/2021-23831/medicare-and-medicaid-programs-omnibus-covid-19-health-care-staff-vaccination

To view a list of frequently asked questions, visit: www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docxhttp://www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docx

Amanda Kellar Karras
Deputy General Counsel /
Director of Legal Advocacy
P: (202) 466-5424 x7116
Email: akarras@imla.org
[facebook icon]https://www.facebook.com/InternationalMunicipalLawyersAssociation/[twitter icon]https://twitter.com/imlalegal[linkedin icon]https://www.linkedin.com/company/international-municipal-lawyers-association-inc./

[logo]https://imla.org/
51 Monroe St. Suite 404
Rockville, MD, 20850
www.imla.orghttp://www.imla.org/
Plan Ahead!
IMLA's Mid-Year Seminar, April 8-11, 2022 in Washington DC!
IMLA's 87th Annual Conferencehttps://imla.org/annual-conference/, Oct. 19-23, 2022 in Portland, OR!

Dear IMLA COVID-19 Working Group: The Biden administration announced details for two of the vaccine mandates today. There is quite a bit to digest here, but I wanted to get this information out to you. First, the interim final rule has been published by the DOL for the OSHA rule for private employers with 100 or more employees that also covers public employers with 100 or more employees that have a state OSHA approved state plan that covers state and local governments. If you aren't sure if you are in a state with an OSHA-approved state plan, click here: https://www.osha.gov/stateplans/). Second, CMS is announcing details of its requirement that health care workers at facilities participating in Medicare and Medicaid are fully vaccinated. Here is the White House press release regarding both rules: https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/04/fact-sheet-biden-administration-announces-details-of-two-major-vaccination-policies/ OSHA Rule: Here are some takeaways from the interim rule / guidance. Local governments that are covered by the OSHA rule: * Need to ensure compliance by 1/4/22 (including developing a written mandatory vaccine policy and/or a vaccine policy that requires vaccines but has a testing / masking opt out), determine vaccination status, ensure accurate recordkeeping for vaccination / testing). * Fully vaccinated means 2 shots of Pfizer or Moderna or 1 shot of J&J by the January 4th deadline. * Must provide paid-time off for their employees to get vaccinated and sick leave for side effects as needed. * Do not need to pay or provide tests for employees who choose to get weekly tests in lieu of vaccination (though CBAs or other laws could apply to this). * Must ensure unvaccinated workers are masked (beginning 12/5). * According to the interim rule, to meet the definition of "mandatory vaccination policy", the policy must require vaccination of all employees (including new hires) except for "those employees (1) for whom a vaccine is medically contraindicated, (2) for whom medical necessity requires a delay in vaccination, or (3) those legally entitled to a reasonable accommodation under federal civil rights laws because they have a disability or sincerely-held religious beliefs, practices, or observances that conflict with the vaccination requirement. OSHA requires employers to implement a mandatory vaccination requirement, but provides an exemption for an alternative policy that allows employees to choose either to be fully vaccinated or to be regularly tested and wear a face covering." * The rule does not apply to employees who do not report to a workplace where other individuals such as coworkers or customers are present, employees while they are working from home, or employees who work exclusively outdoors. Failure to comply with the rule will subject employers to fines. The OSHA interim final rule, can be found here: https://public-inspection.federalregister.gov/2021-23643.pdf. A summary of the rule can be found here: https://www.osha.gov/sites/default/files/publications/OSHA4162.pdf Here are the OSHA FAQs for the rule: https://www.osha.gov/coronavirus/ets2/faqs Facilities Participating in Medicare / Medicaid * Must ensure all employees are fully vaccinated by 1/4/22 (2 shots of Pfizer or Moderna, 1 of J&J). * The requirements apply to: Ambulatory Surgical Centers, Hospices, Programs of All-Inclusive Care for the Elderly, Hospitals, Long Term Care facilities, Psychiatric Residential Treatment Facilities, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Home Health Agencies, Comprehensive Outpatient Rehabilitation Facilities, Critical Access Hospitals, Clinics (rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services), Community Mental Health Centers, Home Infusion Therapy suppliers, Rural Health Clinics/Federally Qualified Health Centers, and End-Stage Renal Disease Facilities. * This vaccination requirement applies to eligible staff working at a facility that participates in the Medicare and Medicaid programs, regardless of clinical responsibility or patient contact. The requirement includes all current staff as well as any new staff who provide any care, treatment, or other services for the facility and/or its patients. This includes facility employees, licensed practitioners, students, trainees, and volunteers. Additionally, this also includes individuals who provide care, treatment, or other services for the facility and/or its patients under contract or other arrangements. * The regulation also provides for exemptions based on recognized medical conditions or religious beliefs, observances, or practices. Facilities must develop a similar process or plan for permitting exemptions in alignment with federal law. Here is a press release from CMS on this rule: https://www.cms.gov/newsroom/press-releases/biden-harris-administration-issues-emergency-regulation-requiring-covid-19-vaccination-health-care To view the interim final rule with comment period, visit: https://www.federalregister.gov/public-inspection/2021-23831/medicare-and-medicaid-programs-omnibus-covid-19-health-care-staff-vaccination To view a list of frequently asked questions, visit: www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docx<http://www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docx> Amanda Kellar Karras Deputy General Counsel / Director of Legal Advocacy P: (202) 466-5424 x7116 Email: akarras@imla.org [facebook icon]<https://www.facebook.com/InternationalMunicipalLawyersAssociation/>[twitter icon]<https://twitter.com/imlalegal>[linkedin icon]<https://www.linkedin.com/company/international-municipal-lawyers-association-inc./> [logo]<https://imla.org/> 51 Monroe St. Suite 404 Rockville, MD, 20850 www.imla.org<http://www.imla.org/> Plan Ahead! IMLA's Mid-Year Seminar, April 8-11, 2022 in Washington DC! IMLA's 87th Annual Conference<https://imla.org/annual-conference/>, Oct. 19-23, 2022 in Portland, OR!
Attached image Attached image Attached image Attached image
AK
Amanda Karras
Thu, Nov 4, 2021 8:27 PM

A member is wondering (and so am I) how you all are analyzing the CMS rule with regard to ambulances.  The original press release stated: "The Biden-Harris Administration will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilitieshttps://www.cms.gov/Outreach-and-Education/Find-Your-Provider-Type/Facilities/Facilities-page to protect both them and patients from the virus and its more contagious Delta variant. "  And when you click on the link for facilities from that press release it lists ambulances under the definition.  However, the rule and FAQ from today do not list ambulances.  But they do mention the requirement applying to other services for the facility and/or its patients under contract or other arrangements. How are you all interpreting this as it relates to EMS employees/ the provision of ambulance services?

Thanks for any insight.

Amanda

Amanda Kellar Karras
Deputy General Counsel /
Director of Legal Advocacy
P: (202) 466-5424 x7116
Email: akarras@imla.org
[facebook icon]https://www.facebook.com/InternationalMunicipalLawyersAssociation/[twitter icon]https://twitter.com/imlalegal[linkedin icon]https://www.linkedin.com/company/international-municipal-lawyers-association-inc./

[logo]https://imla.org/
51 Monroe St. Suite 404
Rockville, MD, 20850
www.imla.orghttp://www.imla.org/
Plan Ahead!
IMLA's Mid-Year Seminar, April 8-11, 2022 in Washington DC!
IMLA's 87th Annual Conferencehttps://imla.org/annual-conference/, Oct. 19-23, 2022 in Portland, OR!

From: Amanda Karras akarras@imla.org
Sent: Thursday, November 4, 2021 11:41 AM
To: disasterrelief@lists.imla.org
Subject: [Disasterrelief] IMLA COVID-19 Working Group

Dear IMLA COVID-19 Working Group:

The Biden administration announced details for two of the vaccine mandates today.  There is quite a bit to digest here, but I wanted to get this information out to you.

First, the interim final rule has been published by the DOL for the OSHA rule for private employers with 100 or more employees that also covers public employers with 100 or more employees that have a state OSHA approved state plan that covers state and local governments.  If you aren't sure if you are in a state with an OSHA-approved state plan, click here: https://www.osha.gov/stateplans/).

Second, CMS is announcing details of its requirement that health care workers at facilities participating in Medicare and Medicaid are fully vaccinated.

Here is the White House press release regarding both rules: https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/04/fact-sheet-biden-administration-announces-details-of-two-major-vaccination-policies/

OSHA Rule:

Here are some takeaways from the interim rule / guidance.  Local governments that are covered by the OSHA rule:

  • Need to ensure compliance by 1/4/22 (including developing a written mandatory vaccine policy and/or a vaccine policy that requires vaccines but has a testing / masking opt out), determine vaccination status, ensure accurate recordkeeping for vaccination / testing).
  • Fully vaccinated means 2 shots of Pfizer or Moderna or 1 shot of J&J by the January 4th deadline.
  • Must provide paid-time off for their employees to get vaccinated and sick leave for side effects as needed.
  • Do not need to pay or provide tests for employees who choose to get weekly tests in lieu of vaccination (though CBAs or other laws could apply to this).
  • Must ensure unvaccinated workers are masked (beginning 12/5).
  • According to the interim rule, to meet the definition of "mandatory vaccination policy", the policy must require vaccination of all employees (including new hires) except for "those employees (1) for whom a vaccine is medically contraindicated, (2) for whom medical necessity requires a delay in vaccination, or (3) those legally entitled to a reasonable accommodation under federal civil rights laws because they have a disability or sincerely-held religious beliefs, practices, or observances that conflict with the vaccination requirement. OSHA requires employers to implement a mandatory vaccination requirement, but provides an exemption for an alternative policy that allows employees to choose either to be fully vaccinated or to be regularly tested and wear a face covering."
  • The rule does not apply to employees who do not report to a workplace where other individuals such as coworkers or customers are present, employees while they are working from home, or employees who work exclusively outdoors.
    Failure to comply with the rule will subject employers to fines.

The OSHA interim final rule, can be found here: https://public-inspection.federalregister.gov/2021-23643.pdf.
A summary of the rule can be found here: https://www.osha.gov/sites/default/files/publications/OSHA4162.pdf
Here are the OSHA FAQs for the rule: https://www.osha.gov/coronavirus/ets2/faqs

Facilities Participating in Medicare / Medicaid

  • Must ensure all employees are fully vaccinated by 1/4/22 (2 shots of Pfizer or Moderna, 1 of J&J).
  • The requirements apply to: Ambulatory Surgical Centers, Hospices, Programs of All-Inclusive Care for the Elderly, Hospitals, Long Term Care facilities, Psychiatric Residential Treatment Facilities, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Home Health Agencies, Comprehensive Outpatient Rehabilitation Facilities, Critical Access Hospitals, Clinics (rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services), Community Mental Health Centers, Home Infusion Therapy suppliers, Rural Health Clinics/Federally Qualified Health Centers, and End-Stage Renal Disease Facilities.
  • This vaccination requirement applies to eligible staff working at a facility that participates in the Medicare and Medicaid programs, regardless of clinical responsibility or patient contact. The requirement includes all current staff as well as any new staff who provide any care, treatment, or other services for the facility and/or its patients. This includes facility employees, licensed practitioners, students, trainees, and volunteers. Additionally, this also includes individuals who provide care, treatment, or other services for the facility and/or its patients under contract or other arrangements.
  • The regulation also provides for exemptions based on recognized medical conditions or religious beliefs, observances, or practices. Facilities must develop a similar process or plan for permitting exemptions in alignment with federal law.
    Here is a press release from CMS on this rule: https://www.cms.gov/newsroom/press-releases/biden-harris-administration-issues-emergency-regulation-requiring-covid-19-vaccination-health-care

To view the interim final rule with comment period, visit: https://www.federalregister.gov/public-inspection/2021-23831/medicare-and-medicaid-programs-omnibus-covid-19-health-care-staff-vaccination

To view a list of frequently asked questions, visit: www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docxhttp://www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docx

Amanda Kellar Karras
Deputy General Counsel /
Director of Legal Advocacy
P: (202) 466-5424 x7116
Email: akarras@imla.orgmailto:akarras@imla.org
[facebook icon]https://www.facebook.com/InternationalMunicipalLawyersAssociation/[twitter icon]https://twitter.com/imlalegal[linkedin icon]https://www.linkedin.com/company/international-municipal-lawyers-association-inc./

[logo]https://imla.org/
51 Monroe St. Suite 404
Rockville, MD, 20850
www.imla.orghttp://www.imla.org/
Plan Ahead!
IMLA's Mid-Year Seminar, April 8-11, 2022 in Washington DC!
IMLA's 87th Annual Conferencehttps://imla.org/annual-conference/, Oct. 19-23, 2022 in Portland, OR!

A member is wondering (and so am I) how you all are analyzing the CMS rule with regard to ambulances. The original press release stated: "The Biden-Harris Administration will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilities<https://www.cms.gov/Outreach-and-Education/Find-Your-Provider-Type/Facilities/Facilities-page> to protect both them and patients from the virus and its more contagious Delta variant. " And when you click on the link for facilities from that press release it lists ambulances under the definition. However, the rule and FAQ from today do not list ambulances. But they do mention the requirement applying to other services for the facility and/or its patients under contract or other arrangements. How are you all interpreting this as it relates to EMS employees/ the provision of ambulance services? Thanks for any insight. Amanda Amanda Kellar Karras Deputy General Counsel / Director of Legal Advocacy P: (202) 466-5424 x7116 Email: akarras@imla.org [facebook icon]<https://www.facebook.com/InternationalMunicipalLawyersAssociation/>[twitter icon]<https://twitter.com/imlalegal>[linkedin icon]<https://www.linkedin.com/company/international-municipal-lawyers-association-inc./> [logo]<https://imla.org/> 51 Monroe St. Suite 404 Rockville, MD, 20850 www.imla.org<http://www.imla.org/> Plan Ahead! IMLA's Mid-Year Seminar, April 8-11, 2022 in Washington DC! IMLA's 87th Annual Conference<https://imla.org/annual-conference/>, Oct. 19-23, 2022 in Portland, OR! From: Amanda Karras <akarras@imla.org> Sent: Thursday, November 4, 2021 11:41 AM To: disasterrelief@lists.imla.org Subject: [Disasterrelief] IMLA COVID-19 Working Group Dear IMLA COVID-19 Working Group: The Biden administration announced details for two of the vaccine mandates today. There is quite a bit to digest here, but I wanted to get this information out to you. First, the interim final rule has been published by the DOL for the OSHA rule for private employers with 100 or more employees that also covers public employers with 100 or more employees that have a state OSHA approved state plan that covers state and local governments. If you aren't sure if you are in a state with an OSHA-approved state plan, click here: https://www.osha.gov/stateplans/). Second, CMS is announcing details of its requirement that health care workers at facilities participating in Medicare and Medicaid are fully vaccinated. Here is the White House press release regarding both rules: https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/04/fact-sheet-biden-administration-announces-details-of-two-major-vaccination-policies/ OSHA Rule: Here are some takeaways from the interim rule / guidance. Local governments that are covered by the OSHA rule: * Need to ensure compliance by 1/4/22 (including developing a written mandatory vaccine policy and/or a vaccine policy that requires vaccines but has a testing / masking opt out), determine vaccination status, ensure accurate recordkeeping for vaccination / testing). * Fully vaccinated means 2 shots of Pfizer or Moderna or 1 shot of J&J by the January 4th deadline. * Must provide paid-time off for their employees to get vaccinated and sick leave for side effects as needed. * Do not need to pay or provide tests for employees who choose to get weekly tests in lieu of vaccination (though CBAs or other laws could apply to this). * Must ensure unvaccinated workers are masked (beginning 12/5). * According to the interim rule, to meet the definition of "mandatory vaccination policy", the policy must require vaccination of all employees (including new hires) except for "those employees (1) for whom a vaccine is medically contraindicated, (2) for whom medical necessity requires a delay in vaccination, or (3) those legally entitled to a reasonable accommodation under federal civil rights laws because they have a disability or sincerely-held religious beliefs, practices, or observances that conflict with the vaccination requirement. OSHA requires employers to implement a mandatory vaccination requirement, but provides an exemption for an alternative policy that allows employees to choose either to be fully vaccinated or to be regularly tested and wear a face covering." * The rule does not apply to employees who do not report to a workplace where other individuals such as coworkers or customers are present, employees while they are working from home, or employees who work exclusively outdoors. Failure to comply with the rule will subject employers to fines. The OSHA interim final rule, can be found here: https://public-inspection.federalregister.gov/2021-23643.pdf. A summary of the rule can be found here: https://www.osha.gov/sites/default/files/publications/OSHA4162.pdf Here are the OSHA FAQs for the rule: https://www.osha.gov/coronavirus/ets2/faqs Facilities Participating in Medicare / Medicaid * Must ensure all employees are fully vaccinated by 1/4/22 (2 shots of Pfizer or Moderna, 1 of J&J). * The requirements apply to: Ambulatory Surgical Centers, Hospices, Programs of All-Inclusive Care for the Elderly, Hospitals, Long Term Care facilities, Psychiatric Residential Treatment Facilities, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Home Health Agencies, Comprehensive Outpatient Rehabilitation Facilities, Critical Access Hospitals, Clinics (rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services), Community Mental Health Centers, Home Infusion Therapy suppliers, Rural Health Clinics/Federally Qualified Health Centers, and End-Stage Renal Disease Facilities. * This vaccination requirement applies to eligible staff working at a facility that participates in the Medicare and Medicaid programs, regardless of clinical responsibility or patient contact. The requirement includes all current staff as well as any new staff who provide any care, treatment, or other services for the facility and/or its patients. This includes facility employees, licensed practitioners, students, trainees, and volunteers. Additionally, this also includes individuals who provide care, treatment, or other services for the facility and/or its patients under contract or other arrangements. * The regulation also provides for exemptions based on recognized medical conditions or religious beliefs, observances, or practices. Facilities must develop a similar process or plan for permitting exemptions in alignment with federal law. Here is a press release from CMS on this rule: https://www.cms.gov/newsroom/press-releases/biden-harris-administration-issues-emergency-regulation-requiring-covid-19-vaccination-health-care To view the interim final rule with comment period, visit: https://www.federalregister.gov/public-inspection/2021-23831/medicare-and-medicaid-programs-omnibus-covid-19-health-care-staff-vaccination To view a list of frequently asked questions, visit: www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docx<http://www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docx> Amanda Kellar Karras Deputy General Counsel / Director of Legal Advocacy P: (202) 466-5424 x7116 Email: akarras@imla.org<mailto:akarras@imla.org> [facebook icon]<https://www.facebook.com/InternationalMunicipalLawyersAssociation/>[twitter icon]<https://twitter.com/imlalegal>[linkedin icon]<https://www.linkedin.com/company/international-municipal-lawyers-association-inc./> [logo]<https://imla.org/> 51 Monroe St. Suite 404 Rockville, MD, 20850 www.imla.org<http://www.imla.org/> Plan Ahead! IMLA's Mid-Year Seminar, April 8-11, 2022 in Washington DC! IMLA's 87th Annual Conference<https://imla.org/annual-conference/>, Oct. 19-23, 2022 in Portland, OR!
Attached image Attached image Attached image Attached image Attached image
SK
Stephen Kemp
Thu, Nov 4, 2021 8:31 PM

For those cities directly providing ambulance services to individuals and receiving Medicare or Medicaid payments. I think they may be covered, particularly in places like here in Arizona where certified paramedics who are defined as health care providers by statute ride on the ambulance and provide medical treatment.  In other cities, such as Avondale where I am at, we have private ambulances, even if our paramedics ride on the ambulance, the private company handles the billing and receives the money, so we may be exempt

From: Amanda Karras akarras@imla.org
Sent: Thursday, November 4, 2021 1:27 PM
To: disasterrelief@lists.imla.org
Subject: [Disasterrelief] Re: IMLA COVID-19 Working Group

⚠ This email arrived from an external source. Please exercise caution when opening attachments or clicking on links. ⚠

A member is wondering (and so am I) how you all are analyzing the CMS rule with regard to ambulances.  The original press release stated: “The Biden-Harris Administration will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilitieshttps://www.cms.gov/Outreach-and-Education/Find-Your-Provider-Type/Facilities/Facilities-page to protect both them and patients from the virus and its more contagious Delta variant. “  And when you click on the link for facilities from that press release it lists ambulances under the definition.  However, the rule and FAQ from today do not list ambulances.  But they do mention the requirement applying to other services for the facility and/or its patients under contract or other arrangements. How are you all interpreting this as it relates to EMS employees/ the provision of ambulance services?

Thanks for any insight.

Amanda

Amanda Kellar Karras
Deputy General Counsel /
Director of Legal Advocacy
P: (202) 466-5424 x7116
Email: akarras@imla.orgmailto:akarras@imla.org
[facebook icon]https://www.facebook.com/InternationalMunicipalLawyersAssociation/[twitter icon]https://twitter.com/imlalegal[linkedin icon]https://www.linkedin.com/company/international-municipal-lawyers-association-inc./

[logo]https://imla.org/
51 Monroe St. Suite 404
Rockville, MD, 20850
www.imla.orghttp://www.imla.org/
Plan Ahead!
IMLA’s Mid-Year Seminar, April 8-11, 2022 in Washington DC!
IMLA’s 87th Annual Conferencehttps://imla.org/annual-conference/, Oct. 19-23, 2022 in Portland, OR!

From: Amanda Karras <akarras@imla.orgmailto:akarras@imla.org>
Sent: Thursday, November 4, 2021 11:41 AM
To: disasterrelief@lists.imla.orgmailto:disasterrelief@lists.imla.org
Subject: [Disasterrelief] IMLA COVID-19 Working Group

Dear IMLA COVID-19 Working Group:

The Biden administration announced details for two of the vaccine mandates today.  There is quite a bit to digest here, but I wanted to get this information out to you.

First, the interim final rule has been published by the DOL for the OSHA rule for private employers with 100 or more employees that also covers public employers with 100 or more employees that have a state OSHA approved state plan that covers state and local governments.  If you aren’t sure if you are in a state with an OSHA-approved state plan, click here: https://www.osha.gov/stateplans/https://www.osha.gov/stateplans/).

Second, CMS is announcing details of its requirement that health care workers at facilities participating in Medicare and Medicaid are fully vaccinated.

Here is the White House press release regarding both rules: https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/04/fact-sheet-biden-administration-announces-details-of-two-major-vaccination-policies/https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/04/fact-sheet-biden-administration-announces-details-of-two-major-vaccination-policies/

OSHA Rule:

Here are some takeaways from the interim rule / guidance.  Local governments that are covered by the OSHA rule:

  • Need to ensure compliance by 1/4/22 (including developing a written mandatory vaccine policy and/or a vaccine policy that requires vaccines but has a testing / masking opt out), determine vaccination status, ensure accurate recordkeeping for vaccination / testing).
  • Fully vaccinated means 2 shots of Pfizer or Moderna or 1 shot of J&J by the January 4th deadline.
  • Must provide paid-time off for their employees to get vaccinated and sick leave for side effects as needed.
  • Do not need to pay or provide tests for employees who choose to get weekly tests in lieu of vaccination (though CBAs or other laws could apply to this).
  • Must ensure unvaccinated workers are masked (beginning 12/5).
  • According to the interim rule, to meet the definition of “mandatory vaccination policy”, the policy must require vaccination of all employees (including new hires) except for “those employees (1) for whom a vaccine is medically contraindicated, (2) for whom medical necessity requires a delay in vaccination, or (3) those legally entitled to a reasonable accommodation under federal civil rights laws because they have a disability or sincerely-held religious beliefs, practices, or observances that conflict with the vaccination requirement. OSHA requires employers to implement a mandatory vaccination requirement, but provides an exemption for an alternative policy that allows employees to choose either to be fully vaccinated or to be regularly tested and wear a face covering.”
  • The rule does not apply to employees who do not report to a workplace where other individuals such as coworkers or customers are present, employees while they are working from home, or employees who work exclusively outdoors.
    Failure to comply with the rule will subject employers to fines.

The OSHA interim final rule, can be found here: https://public-inspection.federalregister.gov/2021-23643.pdfhttps://public-inspection.federalregister.gov/2021-23643.pdf.
A summary of the rule can be found here: https://www.osha.gov/sites/default/files/publications/OSHA4162.pdfhttps://www.osha.gov/sites/default/files/publications/OSHA4162.pdf
Here are the OSHA FAQs for the rule: https://www.osha.gov/coronavirus/ets2/faqshttps://www.osha.gov/coronavirus/ets2/faqs

Facilities Participating in Medicare / Medicaid

  • Must ensure all employees are fully vaccinated by 1/4/22 (2 shots of Pfizer or Moderna, 1 of J&J).
  • The requirements apply to: Ambulatory Surgical Centers, Hospices, Programs of All-Inclusive Care for the Elderly, Hospitals, Long Term Care facilities, Psychiatric Residential Treatment Facilities, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Home Health Agencies, Comprehensive Outpatient Rehabilitation Facilities, Critical Access Hospitals, Clinics (rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services), Community Mental Health Centers, Home Infusion Therapy suppliers, Rural Health Clinics/Federally Qualified Health Centers, and End-Stage Renal Disease Facilities.
  • This vaccination requirement applies to eligible staff working at a facility that participates in the Medicare and Medicaid programs, regardless of clinical responsibility or patient contact. The requirement includes all current staff as well as any new staff who provide any care, treatment, or other services for the facility and/or its patients. This includes facility employees, licensed practitioners, students, trainees, and volunteers. Additionally, this also includes individuals who provide care, treatment, or other services for the facility and/or its patients under contract or other arrangements.
  • The regulation also provides for exemptions based on recognized medical conditions or religious beliefs, observances, or practices. Facilities must develop a similar process or plan for permitting exemptions in alignment with federal law.
    Here is a press release from CMS on this rule: https://www.cms.gov/newsroom/press-releases/biden-harris-administration-issues-emergency-regulation-requiring-covid-19-vaccination-health-carehttps://www.cms.gov/newsroom/press-releases/biden-harris-administration-issues-emergency-regulation-requiring-covid-19-vaccination-health-care

To view the interim final rule with comment period, visit: https://www.federalregister.gov/public-inspection/2021-23831/medicare-and-medicaid-programs-omnibus-covid-19-health-care-staff-vaccinationhttps://www.federalregister.gov/public-inspection/2021-23831/medicare-and-medicaid-programs-omnibus-covid-19-health-care-staff-vaccination

To view a list of frequently asked questions, visit: www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docxhttp://www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docx

Amanda Kellar Karras
Deputy General Counsel /
Director of Legal Advocacy
P: (202) 466-5424 x7116
Email: akarras@imla.orgmailto:akarras@imla.org
[facebook icon]https://www.facebook.com/InternationalMunicipalLawyersAssociation/[twitter icon]https://twitter.com/imlalegal[linkedin icon]https://www.linkedin.com/company/international-municipal-lawyers-association-inc./

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Plan Ahead!
IMLA’s Mid-Year Seminar, April 8-11, 2022 in Washington DC!
IMLA’s 87th Annual Conferencehttps://imla.org/annual-conference/, Oct. 19-23, 2022 in Portland, OR!

For those cities directly providing ambulance services to individuals and receiving Medicare or Medicaid payments. I think they may be covered, particularly in places like here in Arizona where certified paramedics who are defined as health care providers by statute ride on the ambulance and provide medical treatment. In other cities, such as Avondale where I am at, we have private ambulances, even if our paramedics ride on the ambulance, the private company handles the billing and receives the money, so we may be exempt From: Amanda Karras <akarras@imla.org> Sent: Thursday, November 4, 2021 1:27 PM To: disasterrelief@lists.imla.org Subject: [Disasterrelief] Re: IMLA COVID-19 Working Group ⚠ This email arrived from an external source. Please exercise caution when opening attachments or clicking on links. ⚠ ________________________________ A member is wondering (and so am I) how you all are analyzing the CMS rule with regard to ambulances. The original press release stated: “The Biden-Harris Administration will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilities<https://www.cms.gov/Outreach-and-Education/Find-Your-Provider-Type/Facilities/Facilities-page> to protect both them and patients from the virus and its more contagious Delta variant. “ And when you click on the link for facilities from that press release it lists ambulances under the definition. However, the rule and FAQ from today do not list ambulances. But they do mention the requirement applying to other services for the facility and/or its patients under contract or other arrangements. How are you all interpreting this as it relates to EMS employees/ the provision of ambulance services? Thanks for any insight. Amanda Amanda Kellar Karras Deputy General Counsel / Director of Legal Advocacy P: (202) 466-5424 x7116 Email: akarras@imla.org<mailto:akarras@imla.org> [facebook icon]<https://www.facebook.com/InternationalMunicipalLawyersAssociation/>[twitter icon]<https://twitter.com/imlalegal>[linkedin icon]<https://www.linkedin.com/company/international-municipal-lawyers-association-inc./> [logo]<https://imla.org/> 51 Monroe St. Suite 404 Rockville, MD, 20850 www.imla.org<http://www.imla.org/> Plan Ahead! IMLA’s Mid-Year Seminar, April 8-11, 2022 in Washington DC! IMLA’s 87th Annual Conference<https://imla.org/annual-conference/>, Oct. 19-23, 2022 in Portland, OR! From: Amanda Karras <akarras@imla.org<mailto:akarras@imla.org>> Sent: Thursday, November 4, 2021 11:41 AM To: disasterrelief@lists.imla.org<mailto:disasterrelief@lists.imla.org> Subject: [Disasterrelief] IMLA COVID-19 Working Group Dear IMLA COVID-19 Working Group: The Biden administration announced details for two of the vaccine mandates today. There is quite a bit to digest here, but I wanted to get this information out to you. First, the interim final rule has been published by the DOL for the OSHA rule for private employers with 100 or more employees that also covers public employers with 100 or more employees that have a state OSHA approved state plan that covers state and local governments. If you aren’t sure if you are in a state with an OSHA-approved state plan, click here: https://www.osha.gov/stateplans/<https://www.osha.gov/stateplans/>). Second, CMS is announcing details of its requirement that health care workers at facilities participating in Medicare and Medicaid are fully vaccinated. Here is the White House press release regarding both rules: https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/04/fact-sheet-biden-administration-announces-details-of-two-major-vaccination-policies/<https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/04/fact-sheet-biden-administration-announces-details-of-two-major-vaccination-policies/> OSHA Rule: Here are some takeaways from the interim rule / guidance. Local governments that are covered by the OSHA rule: * Need to ensure compliance by 1/4/22 (including developing a written mandatory vaccine policy and/or a vaccine policy that requires vaccines but has a testing / masking opt out), determine vaccination status, ensure accurate recordkeeping for vaccination / testing). * Fully vaccinated means 2 shots of Pfizer or Moderna or 1 shot of J&J by the January 4th deadline. * Must provide paid-time off for their employees to get vaccinated and sick leave for side effects as needed. * Do not need to pay or provide tests for employees who choose to get weekly tests in lieu of vaccination (though CBAs or other laws could apply to this). * Must ensure unvaccinated workers are masked (beginning 12/5). * According to the interim rule, to meet the definition of “mandatory vaccination policy”, the policy must require vaccination of all employees (including new hires) except for “those employees (1) for whom a vaccine is medically contraindicated, (2) for whom medical necessity requires a delay in vaccination, or (3) those legally entitled to a reasonable accommodation under federal civil rights laws because they have a disability or sincerely-held religious beliefs, practices, or observances that conflict with the vaccination requirement. OSHA requires employers to implement a mandatory vaccination requirement, but provides an exemption for an alternative policy that allows employees to choose either to be fully vaccinated or to be regularly tested and wear a face covering.” * The rule does not apply to employees who do not report to a workplace where other individuals such as coworkers or customers are present, employees while they are working from home, or employees who work exclusively outdoors. Failure to comply with the rule will subject employers to fines. The OSHA interim final rule, can be found here: https://public-inspection.federalregister.gov/2021-23643.pdf<https://public-inspection.federalregister.gov/2021-23643.pdf>. A summary of the rule can be found here: https://www.osha.gov/sites/default/files/publications/OSHA4162.pdf<https://www.osha.gov/sites/default/files/publications/OSHA4162.pdf> Here are the OSHA FAQs for the rule: https://www.osha.gov/coronavirus/ets2/faqs<https://www.osha.gov/coronavirus/ets2/faqs> Facilities Participating in Medicare / Medicaid * Must ensure all employees are fully vaccinated by 1/4/22 (2 shots of Pfizer or Moderna, 1 of J&J). * The requirements apply to: Ambulatory Surgical Centers, Hospices, Programs of All-Inclusive Care for the Elderly, Hospitals, Long Term Care facilities, Psychiatric Residential Treatment Facilities, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Home Health Agencies, Comprehensive Outpatient Rehabilitation Facilities, Critical Access Hospitals, Clinics (rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services), Community Mental Health Centers, Home Infusion Therapy suppliers, Rural Health Clinics/Federally Qualified Health Centers, and End-Stage Renal Disease Facilities. * This vaccination requirement applies to eligible staff working at a facility that participates in the Medicare and Medicaid programs, regardless of clinical responsibility or patient contact. The requirement includes all current staff as well as any new staff who provide any care, treatment, or other services for the facility and/or its patients. This includes facility employees, licensed practitioners, students, trainees, and volunteers. Additionally, this also includes individuals who provide care, treatment, or other services for the facility and/or its patients under contract or other arrangements. * The regulation also provides for exemptions based on recognized medical conditions or religious beliefs, observances, or practices. Facilities must develop a similar process or plan for permitting exemptions in alignment with federal law. Here is a press release from CMS on this rule: https://www.cms.gov/newsroom/press-releases/biden-harris-administration-issues-emergency-regulation-requiring-covid-19-vaccination-health-care<https://www.cms.gov/newsroom/press-releases/biden-harris-administration-issues-emergency-regulation-requiring-covid-19-vaccination-health-care> To view the interim final rule with comment period, visit: https://www.federalregister.gov/public-inspection/2021-23831/medicare-and-medicaid-programs-omnibus-covid-19-health-care-staff-vaccination<https://www.federalregister.gov/public-inspection/2021-23831/medicare-and-medicaid-programs-omnibus-covid-19-health-care-staff-vaccination> To view a list of frequently asked questions, visit: www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docx<http://www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docx> Amanda Kellar Karras Deputy General Counsel / Director of Legal Advocacy P: (202) 466-5424 x7116 Email: akarras@imla.org<mailto:akarras@imla.org> [facebook icon]<https://www.facebook.com/InternationalMunicipalLawyersAssociation/>[twitter icon]<https://twitter.com/imlalegal>[linkedin icon]<https://www.linkedin.com/company/international-municipal-lawyers-association-inc./> [logo]<https://imla.org/> 51 Monroe St. Suite 404 Rockville, MD, 20850 www.imla.org<http://www.imla.org/> Plan Ahead! IMLA’s Mid-Year Seminar, April 8-11, 2022 in Washington DC! IMLA’s 87th Annual Conference<https://imla.org/annual-conference/>, Oct. 19-23, 2022 in Portland, OR!
Attached image Attached image Attached image Attached image Attached image
JG
Jacqueline Ganier
Thu, Nov 4, 2021 9:19 PM

What about that the proposed rule states:

        “[T]his IFC directly regulates the following providers and suppliers, listed in numerical order of the relevant CFR sections being revised in this rule:
  • Ambulatory Surgical Centers
  • Hospices
  • Psychiatric residential treatment facilities
  • Programs of All-Inclusive Care for the Elderly
  • Hospitals
  • Long Term Care Facilities
  • Intermediate Care Facilities for Individuals with Intellectual Disabilities
  • Home Health Agencies
  • Comprehensive Outpatient Rehabilitation Facilities
  • Critical Access Hospitals
  • Clinics, rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services
  • Community Mental Health Centers
  • Home Infusion Therapy suppliers
  • Rural Health Clinics/Federally Qualified Health Centers
  • End-Stage Renal Disease Facilities
    “This IFC directly applies only to the Medicare- and Medicaid-certified providers and suppliers listed above.”

Regards,

Jacqueline
Jacqueline Ganier
City of Mesa
Assistant City Attorney III
P.O. Box 1466
Mesa, AZ 85211-1466
(480) 644-3335

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From: Stephen Kemp skemp@avondaleaz.gov
Sent: Thursday, November 4, 2021 1:31 PM
To: Amanda Karras akarras@imla.org; disasterrelief@lists.imla.org
Subject: [Disasterrelief] Re: IMLA COVID-19 Working Group

WARNING: This email came from an External Sender – Use caution when clicking links, opening attachments, or responding to requests for information.

For those cities directly providing ambulance services to individuals and receiving Medicare or Medicaid payments. I think they may be covered, particularly in places like here in Arizona where certified paramedics who are defined as health care providers by statute ride on the ambulance and provide medical treatment.  In other cities, such as Avondale where I am at, we have private ambulances, even if our paramedics ride on the ambulance, the private company handles the billing and receives the money, so we may be exempt

From: Amanda Karras <akarras@imla.orgmailto:akarras@imla.org>
Sent: Thursday, November 4, 2021 1:27 PM
To: disasterrelief@lists.imla.orgmailto:disasterrelief@lists.imla.org
Subject: [Disasterrelief] Re: IMLA COVID-19 Working Group

⚠ This email arrived from an external source. Please exercise caution when opening attachments or clicking on links. ⚠

A member is wondering (and so am I) how you all are analyzing the CMS rule with regard to ambulances.  The original press release stated: “The Biden-Harris Administration will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilitieshttps://urldefense.proofpoint.com/v2/url?u=https-3A__www.cms.gov_Outreach-2Dand-2DEducation_Find-2DYour-2DProvider-2DType_Facilities_Facilities-2Dpage&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=vyDRhEVMA12Fk2uKdX30PUzUWL8oxnllBnGMEYV-juI&e= to protect both them and patients from the virus and its more contagious Delta variant. “  And when you click on the link for facilities from that press release it lists ambulances under the definition.  However, the rule and FAQ from today do not list ambulances.  But they do mention the requirement applying to other services for the facility and/or its patients under contract or other arrangements. How are you all interpreting this as it relates to EMS employees/ the provision of ambulance services?

Thanks for any insight.

Amanda

Amanda Kellar Karras
Deputy General Counsel /
Director of Legal Advocacy
P: (202) 466-5424 x7116
Email: akarras@imla.orgmailto:akarras@imla.org
[facebook icon]https://urldefense.proofpoint.com/v2/url?u=https-3A__www.facebook.com_InternationalMunicipalLawyersAssociation_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=dYa_2iyRi4pmzLOZDHML6v-5lGAWFof9evekp8adZUo&e=[twitter icon]https://urldefense.proofpoint.com/v2/url?u=https-3A__twitter.com_imlalegal&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=g5qPLopFrYXDSW2jkpyDeBgxDJegzFdtAKWMvvZa_xU&e=[linkedin icon]https://urldefense.proofpoint.com/v2/url?u=https-3A__www.linkedin.com_company_international-2Dmunicipal-2Dlawyers-2Dassociation-2Dinc._&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=FDNafFD-32lJJ3WMOJHuNeyGEPogVY9K4vSunlmmOvw&e=

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51 Monroe St. Suite 404
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Plan Ahead!
IMLA’s Mid-Year Seminar, April 8-11, 2022 in Washington DC!
IMLA’s 87th Annual Conferencehttps://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_annual-2Dconference_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=rNrR5VWk8S9V6dI_MOHHHHV4Ox-bTtw_Qpnb-Sy9ANM&e=, Oct. 19-23, 2022 in Portland, OR!

From: Amanda Karras <akarras@imla.orgmailto:akarras@imla.org>
Sent: Thursday, November 4, 2021 11:41 AM
To: disasterrelief@lists.imla.orgmailto:disasterrelief@lists.imla.org
Subject: [Disasterrelief] IMLA COVID-19 Working Group

Dear IMLA COVID-19 Working Group:

The Biden administration announced details for two of the vaccine mandates today.  There is quite a bit to digest here, but I wanted to get this information out to you.

First, the interim final rule has been published by the DOL for the OSHA rule for private employers with 100 or more employees that also covers public employers with 100 or more employees that have a state OSHA approved state plan that covers state and local governments.  If you aren’t sure if you are in a state with an OSHA-approved state plan, click here: https://www.osha.gov/stateplans/https://urldefense.proofpoint.com/v2/url?u=https-3A__www.osha.gov_stateplans_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=PoDIhHfggj_Ptb2ET-ZhtA0N7wPrgJcuYZbV4vVhukw&e=).

Second, CMS is announcing details of its requirement that health care workers at facilities participating in Medicare and Medicaid are fully vaccinated.

Here is the White House press release regarding both rules: https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/04/fact-sheet-biden-administration-announces-details-of-two-major-vaccination-policies/https://urldefense.proofpoint.com/v2/url?u=https-3A__www.whitehouse.gov_briefing-2Droom_statements-2Dreleases_2021_11_04_fact-2Dsheet-2Dbiden-2Dadministration-2Dannounces-2Ddetails-2Dof-2Dtwo-2Dmajor-2Dvaccination-2Dpolicies_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=CvNNEdPPFp_6ECXmYPSHJyBS5yJAue0ARciUJFak2ug&e=

OSHA Rule:

Here are some takeaways from the interim rule / guidance.  Local governments that are covered by the OSHA rule:

  • Need to ensure compliance by 1/4/22 (including developing a written mandatory vaccine policy and/or a vaccine policy that requires vaccines but has a testing / masking opt out), determine vaccination status, ensure accurate recordkeeping for vaccination / testing).
  • Fully vaccinated means 2 shots of Pfizer or Moderna or 1 shot of J&J by the January 4th deadline.
  • Must provide paid-time off for their employees to get vaccinated and sick leave for side effects as needed.
  • Do not need to pay or provide tests for employees who choose to get weekly tests in lieu of vaccination (though CBAs or other laws could apply to this).
  • Must ensure unvaccinated workers are masked (beginning 12/5).
  • According to the interim rule, to meet the definition of “mandatory vaccination policy”, the policy must require vaccination of all employees (including new hires) except for “those employees (1) for whom a vaccine is medically contraindicated, (2) for whom medical necessity requires a delay in vaccination, or (3) those legally entitled to a reasonable accommodation under federal civil rights laws because they have a disability or sincerely-held religious beliefs, practices, or observances that conflict with the vaccination requirement. OSHA requires employers to implement a mandatory vaccination requirement, but provides an exemption for an alternative policy that allows employees to choose either to be fully vaccinated or to be regularly tested and wear a face covering.”
  • The rule does not apply to employees who do not report to a workplace where other individuals such as coworkers or customers are present, employees while they are working from home, or employees who work exclusively outdoors.
    Failure to comply with the rule will subject employers to fines.

The OSHA interim final rule, can be found here: https://public-inspection.federalregister.gov/2021-23643.pdfhttps://urldefense.proofpoint.com/v2/url?u=https-3A__public-2Dinspection.federalregister.gov_2021-2D23643.pdf&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=ac9z7niYxn6YdfAfmkFswWopHYL53W3mYqLxCXvLSWc&e=.
A summary of the rule can be found here: https://www.osha.gov/sites/default/files/publications/OSHA4162.pdfhttps://urldefense.proofpoint.com/v2/url?u=https-3A__www.osha.gov_sites_default_files_publications_OSHA4162.pdf&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=GaNYAj4X_o5ZRQ4APY07Jc20Lx_rEREhDUx7PIQdVIQ&e=
Here are the OSHA FAQs for the rule: https://www.osha.gov/coronavirus/ets2/faqshttps://urldefense.proofpoint.com/v2/url?u=https-3A__www.osha.gov_coronavirus_ets2_faqs&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=JhtCtAdwL4LXtkWEfhFDqkd0xNkoEcwABZPmVVILoIY&e=

Facilities Participating in Medicare / Medicaid

To view the interim final rule with comment period, visit: https://www.federalregister.gov/public-inspection/2021-23831/medicare-and-medicaid-programs-omnibus-covid-19-health-care-staff-vaccinationhttps://urldefense.proofpoint.com/v2/url?u=https-3A__www.federalregister.gov_public-2Dinspection_2021-2D23831_medicare-2Dand-2Dmedicaid-2Dprograms-2Domnibus-2Dcovid-2D19-2Dhealth-2Dcare-2Dstaff-2Dvaccination&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=u1kv4e0bkndhGMvgBNAry1K_3fGyytheQf_57cn-uqU&e=

To view a list of frequently asked questions, visit: www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docxhttps://urldefense.proofpoint.com/v2/url?u=http-3A__www.cms.gov_files_document_cms-2Domnibus-2Dstaff-2Dvax-2Drequirements-2D2021.docx&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=zLobubZISUMC6RPcv2Ha7r8Or5NNDCihcybIM2G803E&e=

Amanda Kellar Karras
Deputy General Counsel /
Director of Legal Advocacy
P: (202) 466-5424 x7116
Email: akarras@imla.orgmailto:akarras@imla.org
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51 Monroe St. Suite 404
Rockville, MD, 20850
www.imla.orghttps://urldefense.proofpoint.com/v2/url?u=http-3A__www.imla.org_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=VGnel2Ub9V364i9hxKbNOm5-F7-3CrOFldGXRVbWRH0&e=
Plan Ahead!
IMLA’s Mid-Year Seminar, April 8-11, 2022 in Washington DC!
IMLA’s 87th Annual Conferencehttps://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_annual-2Dconference_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=rNrR5VWk8S9V6dI_MOHHHHV4Ox-bTtw_Qpnb-Sy9ANM&e=, Oct. 19-23, 2022 in Portland, OR!

What about that the proposed rule states: “[T]his IFC directly regulates the following providers and suppliers, listed in numerical order of the relevant CFR sections being revised in this rule: * Ambulatory Surgical Centers * Hospices * Psychiatric residential treatment facilities * Programs of All-Inclusive Care for the Elderly * Hospitals * Long Term Care Facilities * Intermediate Care Facilities for Individuals with Intellectual Disabilities * Home Health Agencies * Comprehensive Outpatient Rehabilitation Facilities * Critical Access Hospitals * Clinics, rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services * Community Mental Health Centers * Home Infusion Therapy suppliers * Rural Health Clinics/Federally Qualified Health Centers * End-Stage Renal Disease Facilities “This IFC directly applies only to the Medicare- and Medicaid-certified providers and suppliers listed above.” Regards, Jacqueline Jacqueline Ganier City of Mesa Assistant City Attorney III P.O. Box 1466 Mesa, AZ 85211-1466 (480) 644-3335 THE INFORMATION CONTAINED IN THIS ELECTRONIC MAIL MESSAGE IS CONFIDENTIAL AND INTENDED ONLY FOR THE USE OF THE INDIVIDUAL(S) OR ENTITY NAMED ABOVE AND MAY BE ATTORNEY-CLIENT PRIVILEGED. IF THE READER OF THIS MESSAGE IS NOT THE INTENDED RECIPIENT OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERY OF THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS MESSAGE IS STRICTLY PROHIBITED. IF YOU RECEIVED THIS MESSAGE IN ERROR, PLEASE IMMEDIATELY NOTIFY THE SENDER AT (480) 644-2343 AND DELETE THE MESSAGE. From: Stephen Kemp <skemp@avondaleaz.gov> Sent: Thursday, November 4, 2021 1:31 PM To: Amanda Karras <akarras@imla.org>; disasterrelief@lists.imla.org Subject: [Disasterrelief] Re: IMLA COVID-19 Working Group WARNING: This email came from an External Sender – Use caution when clicking links, opening attachments, or responding to requests for information. For those cities directly providing ambulance services to individuals and receiving Medicare or Medicaid payments. I think they may be covered, particularly in places like here in Arizona where certified paramedics who are defined as health care providers by statute ride on the ambulance and provide medical treatment. In other cities, such as Avondale where I am at, we have private ambulances, even if our paramedics ride on the ambulance, the private company handles the billing and receives the money, so we may be exempt From: Amanda Karras <akarras@imla.org<mailto:akarras@imla.org>> Sent: Thursday, November 4, 2021 1:27 PM To: disasterrelief@lists.imla.org<mailto:disasterrelief@lists.imla.org> Subject: [Disasterrelief] Re: IMLA COVID-19 Working Group ⚠ This email arrived from an external source. Please exercise caution when opening attachments or clicking on links. ⚠ ________________________________ A member is wondering (and so am I) how you all are analyzing the CMS rule with regard to ambulances. The original press release stated: “The Biden-Harris Administration will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilities<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.cms.gov_Outreach-2Dand-2DEducation_Find-2DYour-2DProvider-2DType_Facilities_Facilities-2Dpage&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=vyDRhEVMA12Fk2uKdX30PUzUWL8oxnllBnGMEYV-juI&e=> to protect both them and patients from the virus and its more contagious Delta variant. “ And when you click on the link for facilities from that press release it lists ambulances under the definition. However, the rule and FAQ from today do not list ambulances. But they do mention the requirement applying to other services for the facility and/or its patients under contract or other arrangements. How are you all interpreting this as it relates to EMS employees/ the provision of ambulance services? Thanks for any insight. Amanda Amanda Kellar Karras Deputy General Counsel / Director of Legal Advocacy P: (202) 466-5424 x7116 Email: akarras@imla.org<mailto:akarras@imla.org> [facebook icon]<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.facebook.com_InternationalMunicipalLawyersAssociation_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=dYa_2iyRi4pmzLOZDHML6v-5lGAWFof9evekp8adZUo&e=>[twitter icon]<https://urldefense.proofpoint.com/v2/url?u=https-3A__twitter.com_imlalegal&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=g5qPLopFrYXDSW2jkpyDeBgxDJegzFdtAKWMvvZa_xU&e=>[linkedin icon]<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.linkedin.com_company_international-2Dmunicipal-2Dlawyers-2Dassociation-2Dinc._&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=FDNafFD-32lJJ3WMOJHuNeyGEPogVY9K4vSunlmmOvw&e=> [logo]<https://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=AuhG2P416s6BsItofCLBZx7Vr9Po1Ou7aPMwXp1zZ2k&e=> 51 Monroe St. Suite 404 Rockville, MD, 20850 www.imla.org<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.imla.org_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=VGnel2Ub9V364i9hxKbNOm5-F7-3CrOFldGXRVbWRH0&e=> Plan Ahead! IMLA’s Mid-Year Seminar, April 8-11, 2022 in Washington DC! IMLA’s 87th Annual Conference<https://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_annual-2Dconference_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=rNrR5VWk8S9V6dI_MOHHHHV4Ox-bTtw_Qpnb-Sy9ANM&e=>, Oct. 19-23, 2022 in Portland, OR! From: Amanda Karras <akarras@imla.org<mailto:akarras@imla.org>> Sent: Thursday, November 4, 2021 11:41 AM To: disasterrelief@lists.imla.org<mailto:disasterrelief@lists.imla.org> Subject: [Disasterrelief] IMLA COVID-19 Working Group Dear IMLA COVID-19 Working Group: The Biden administration announced details for two of the vaccine mandates today. There is quite a bit to digest here, but I wanted to get this information out to you. First, the interim final rule has been published by the DOL for the OSHA rule for private employers with 100 or more employees that also covers public employers with 100 or more employees that have a state OSHA approved state plan that covers state and local governments. If you aren’t sure if you are in a state with an OSHA-approved state plan, click here: https://www.osha.gov/stateplans/<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.osha.gov_stateplans_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=PoDIhHfggj_Ptb2ET-ZhtA0N7wPrgJcuYZbV4vVhukw&e=>). Second, CMS is announcing details of its requirement that health care workers at facilities participating in Medicare and Medicaid are fully vaccinated. Here is the White House press release regarding both rules: https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/04/fact-sheet-biden-administration-announces-details-of-two-major-vaccination-policies/<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.whitehouse.gov_briefing-2Droom_statements-2Dreleases_2021_11_04_fact-2Dsheet-2Dbiden-2Dadministration-2Dannounces-2Ddetails-2Dof-2Dtwo-2Dmajor-2Dvaccination-2Dpolicies_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=CvNNEdPPFp_6ECXmYPSHJyBS5yJAue0ARciUJFak2ug&e=> OSHA Rule: Here are some takeaways from the interim rule / guidance. Local governments that are covered by the OSHA rule: * Need to ensure compliance by 1/4/22 (including developing a written mandatory vaccine policy and/or a vaccine policy that requires vaccines but has a testing / masking opt out), determine vaccination status, ensure accurate recordkeeping for vaccination / testing). * Fully vaccinated means 2 shots of Pfizer or Moderna or 1 shot of J&J by the January 4th deadline. * Must provide paid-time off for their employees to get vaccinated and sick leave for side effects as needed. * Do not need to pay or provide tests for employees who choose to get weekly tests in lieu of vaccination (though CBAs or other laws could apply to this). * Must ensure unvaccinated workers are masked (beginning 12/5). * According to the interim rule, to meet the definition of “mandatory vaccination policy”, the policy must require vaccination of all employees (including new hires) except for “those employees (1) for whom a vaccine is medically contraindicated, (2) for whom medical necessity requires a delay in vaccination, or (3) those legally entitled to a reasonable accommodation under federal civil rights laws because they have a disability or sincerely-held religious beliefs, practices, or observances that conflict with the vaccination requirement. OSHA requires employers to implement a mandatory vaccination requirement, but provides an exemption for an alternative policy that allows employees to choose either to be fully vaccinated or to be regularly tested and wear a face covering.” * The rule does not apply to employees who do not report to a workplace where other individuals such as coworkers or customers are present, employees while they are working from home, or employees who work exclusively outdoors. Failure to comply with the rule will subject employers to fines. The OSHA interim final rule, can be found here: https://public-inspection.federalregister.gov/2021-23643.pdf<https://urldefense.proofpoint.com/v2/url?u=https-3A__public-2Dinspection.federalregister.gov_2021-2D23643.pdf&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=ac9z7niYxn6YdfAfmkFswWopHYL53W3mYqLxCXvLSWc&e=>. A summary of the rule can be found here: https://www.osha.gov/sites/default/files/publications/OSHA4162.pdf<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.osha.gov_sites_default_files_publications_OSHA4162.pdf&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=GaNYAj4X_o5ZRQ4APY07Jc20Lx_rEREhDUx7PIQdVIQ&e=> Here are the OSHA FAQs for the rule: https://www.osha.gov/coronavirus/ets2/faqs<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.osha.gov_coronavirus_ets2_faqs&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=JhtCtAdwL4LXtkWEfhFDqkd0xNkoEcwABZPmVVILoIY&e=> Facilities Participating in Medicare / Medicaid * Must ensure all employees are fully vaccinated by 1/4/22 (2 shots of Pfizer or Moderna, 1 of J&J). * The requirements apply to: Ambulatory Surgical Centers, Hospices, Programs of All-Inclusive Care for the Elderly, Hospitals, Long Term Care facilities, Psychiatric Residential Treatment Facilities, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Home Health Agencies, Comprehensive Outpatient Rehabilitation Facilities, Critical Access Hospitals, Clinics (rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services), Community Mental Health Centers, Home Infusion Therapy suppliers, Rural Health Clinics/Federally Qualified Health Centers, and End-Stage Renal Disease Facilities. * This vaccination requirement applies to eligible staff working at a facility that participates in the Medicare and Medicaid programs, regardless of clinical responsibility or patient contact. The requirement includes all current staff as well as any new staff who provide any care, treatment, or other services for the facility and/or its patients. This includes facility employees, licensed practitioners, students, trainees, and volunteers. Additionally, this also includes individuals who provide care, treatment, or other services for the facility and/or its patients under contract or other arrangements. * The regulation also provides for exemptions based on recognized medical conditions or religious beliefs, observances, or practices. Facilities must develop a similar process or plan for permitting exemptions in alignment with federal law. Here is a press release from CMS on this rule: https://www.cms.gov/newsroom/press-releases/biden-harris-administration-issues-emergency-regulation-requiring-covid-19-vaccination-health-care<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.cms.gov_newsroom_press-2Dreleases_biden-2Dharris-2Dadministration-2Dissues-2Demergency-2Dregulation-2Drequiring-2Dcovid-2D19-2Dvaccination-2Dhealth-2Dcare&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=yHfE1CPXyb7AggKUhBVy4Cd6vQQ3kxPfwwyaOuOf0-s&e=> To view the interim final rule with comment period, visit: https://www.federalregister.gov/public-inspection/2021-23831/medicare-and-medicaid-programs-omnibus-covid-19-health-care-staff-vaccination<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.federalregister.gov_public-2Dinspection_2021-2D23831_medicare-2Dand-2Dmedicaid-2Dprograms-2Domnibus-2Dcovid-2D19-2Dhealth-2Dcare-2Dstaff-2Dvaccination&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=u1kv4e0bkndhGMvgBNAry1K_3fGyytheQf_57cn-uqU&e=> To view a list of frequently asked questions, visit: www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docx<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.cms.gov_files_document_cms-2Domnibus-2Dstaff-2Dvax-2Drequirements-2D2021.docx&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=zLobubZISUMC6RPcv2Ha7r8Or5NNDCihcybIM2G803E&e=> Amanda Kellar Karras Deputy General Counsel / Director of Legal Advocacy P: (202) 466-5424 x7116 Email: akarras@imla.org<mailto:akarras@imla.org> [facebook icon]<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.facebook.com_InternationalMunicipalLawyersAssociation_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=dYa_2iyRi4pmzLOZDHML6v-5lGAWFof9evekp8adZUo&e=>[twitter icon]<https://urldefense.proofpoint.com/v2/url?u=https-3A__twitter.com_imlalegal&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=g5qPLopFrYXDSW2jkpyDeBgxDJegzFdtAKWMvvZa_xU&e=>[linkedin icon]<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.linkedin.com_company_international-2Dmunicipal-2Dlawyers-2Dassociation-2Dinc._&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=FDNafFD-32lJJ3WMOJHuNeyGEPogVY9K4vSunlmmOvw&e=> [logo]<https://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=AuhG2P416s6BsItofCLBZx7Vr9Po1Ou7aPMwXp1zZ2k&e=> 51 Monroe St. Suite 404 Rockville, MD, 20850 www.imla.org<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.imla.org_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=VGnel2Ub9V364i9hxKbNOm5-F7-3CrOFldGXRVbWRH0&e=> Plan Ahead! IMLA’s Mid-Year Seminar, April 8-11, 2022 in Washington DC! IMLA’s 87th Annual Conference<https://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_annual-2Dconference_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=rNrR5VWk8S9V6dI_MOHHHHV4Ox-bTtw_Qpnb-Sy9ANM&e=>, Oct. 19-23, 2022 in Portland, OR!
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SK
Stephen Kemp
Thu, Nov 4, 2021 9:49 PM

My concern is both the executive order directing drafting of the rule and the other language referenced at the end of the rule.  I think that if you do not receive Medicare or Medicaid money you are not likely a provider and not subject to the rule

From: Jacqueline Ganier Jacqueline.Ganier@mesaaz.gov
Sent: Thursday, November 4, 2021 2:20 PM
To: Stephen Kemp skemp@avondaleaz.gov; Amanda Karras akarras@imla.org; disasterrelief@lists.imla.org
Cc: Jim Smith Jim.Smith@mesaaz.gov
Subject: RE: IMLA COVID-19 Working Group

⚠ This email arrived from an external source. Please exercise caution when opening attachments or clicking on links. ⚠

What about that the proposed rule states:

        “[T]his IFC directly regulates the following providers and suppliers, listed in numerical order of the relevant CFR sections being revised in this rule:
  • Ambulatory Surgical Centers
  • Hospices
  • Psychiatric residential treatment facilities
  • Programs of All-Inclusive Care for the Elderly
  • Hospitals
  • Long Term Care Facilities
  • Intermediate Care Facilities for Individuals with Intellectual Disabilities
  • Home Health Agencies
  • Comprehensive Outpatient Rehabilitation Facilities
  • Critical Access Hospitals
  • Clinics, rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services
  • Community Mental Health Centers
  • Home Infusion Therapy suppliers
  • Rural Health Clinics/Federally Qualified Health Centers
  • End-Stage Renal Disease Facilities
    “This IFC directly applies only to the Medicare- and Medicaid-certified providers and suppliers listed above.”

Regards,

Jacqueline
Jacqueline Ganier
City of Mesa
Assistant City Attorney III
P.O. Box 1466
Mesa, AZ 85211-1466
(480) 644-3335

THE INFORMATION CONTAINED IN THIS ELECTRONIC MAIL MESSAGE IS CONFIDENTIAL AND INTENDED ONLY FOR THE USE OF THE INDIVIDUAL(S) OR ENTITY NAMED ABOVE AND MAY BE ATTORNEY-CLIENT PRIVILEGED.  IF THE READER OF THIS MESSAGE IS NOT THE INTENDED RECIPIENT OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERY OF THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS MESSAGE IS STRICTLY PROHIBITED.  IF YOU RECEIVED THIS MESSAGE IN ERROR, PLEASE IMMEDIATELY NOTIFY THE SENDER AT (480) 644-2343 AND DELETE THE MESSAGE.

From: Stephen Kemp <skemp@avondaleaz.govmailto:skemp@avondaleaz.gov>
Sent: Thursday, November 4, 2021 1:31 PM
To: Amanda Karras <akarras@imla.orgmailto:akarras@imla.org>; disasterrelief@lists.imla.orgmailto:disasterrelief@lists.imla.org
Subject: [Disasterrelief] Re: IMLA COVID-19 Working Group

WARNING: This email came from an External Sender – Use caution when clicking links, opening attachments, or responding to requests for information.

For those cities directly providing ambulance services to individuals and receiving Medicare or Medicaid payments. I think they may be covered, particularly in places like here in Arizona where certified paramedics who are defined as health care providers by statute ride on the ambulance and provide medical treatment.  In other cities, such as Avondale where I am at, we have private ambulances, even if our paramedics ride on the ambulance, the private company handles the billing and receives the money, so we may be exempt

From: Amanda Karras <akarras@imla.orgmailto:akarras@imla.org>
Sent: Thursday, November 4, 2021 1:27 PM
To: disasterrelief@lists.imla.orgmailto:disasterrelief@lists.imla.org
Subject: [Disasterrelief] Re: IMLA COVID-19 Working Group

⚠ This email arrived from an external source. Please exercise caution when opening attachments or clicking on links. ⚠

A member is wondering (and so am I) how you all are analyzing the CMS rule with regard to ambulances.  The original press release stated: “The Biden-Harris Administration will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilitieshttps://urldefense.proofpoint.com/v2/url?u=https-3A__www.cms.gov_Outreach-2Dand-2DEducation_Find-2DYour-2DProvider-2DType_Facilities_Facilities-2Dpage&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=vyDRhEVMA12Fk2uKdX30PUzUWL8oxnllBnGMEYV-juI&e= to protect both them and patients from the virus and its more contagious Delta variant. “  And when you click on the link for facilities from that press release it lists ambulances under the definition.  However, the rule and FAQ from today do not list ambulances.  But they do mention the requirement applying to other services for the facility and/or its patients under contract or other arrangements. How are you all interpreting this as it relates to EMS employees/ the provision of ambulance services?

Thanks for any insight.

Amanda

Amanda Kellar Karras
Deputy General Counsel /
Director of Legal Advocacy
P: (202) 466-5424 x7116
Email: akarras@imla.orgmailto:akarras@imla.org
[facebook icon]https://urldefense.proofpoint.com/v2/url?u=https-3A__www.facebook.com_InternationalMunicipalLawyersAssociation_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=dYa_2iyRi4pmzLOZDHML6v-5lGAWFof9evekp8adZUo&e=[twitter icon]https://urldefense.proofpoint.com/v2/url?u=https-3A__twitter.com_imlalegal&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=g5qPLopFrYXDSW2jkpyDeBgxDJegzFdtAKWMvvZa_xU&e=[linkedin icon]https://urldefense.proofpoint.com/v2/url?u=https-3A__www.linkedin.com_company_international-2Dmunicipal-2Dlawyers-2Dassociation-2Dinc._&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=FDNafFD-32lJJ3WMOJHuNeyGEPogVY9K4vSunlmmOvw&e=

[logo]https://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=AuhG2P416s6BsItofCLBZx7Vr9Po1Ou7aPMwXp1zZ2k&e=
51 Monroe St. Suite 404
Rockville, MD, 20850
www.imla.orghttps://urldefense.proofpoint.com/v2/url?u=http-3A__www.imla.org_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=VGnel2Ub9V364i9hxKbNOm5-F7-3CrOFldGXRVbWRH0&e=
Plan Ahead!
IMLA’s Mid-Year Seminar, April 8-11, 2022 in Washington DC!
IMLA’s 87th Annual Conferencehttps://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_annual-2Dconference_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=rNrR5VWk8S9V6dI_MOHHHHV4Ox-bTtw_Qpnb-Sy9ANM&e=, Oct. 19-23, 2022 in Portland, OR!

From: Amanda Karras <akarras@imla.orgmailto:akarras@imla.org>
Sent: Thursday, November 4, 2021 11:41 AM
To: disasterrelief@lists.imla.orgmailto:disasterrelief@lists.imla.org
Subject: [Disasterrelief] IMLA COVID-19 Working Group

Dear IMLA COVID-19 Working Group:

The Biden administration announced details for two of the vaccine mandates today.  There is quite a bit to digest here, but I wanted to get this information out to you.

First, the interim final rule has been published by the DOL for the OSHA rule for private employers with 100 or more employees that also covers public employers with 100 or more employees that have a state OSHA approved state plan that covers state and local governments.  If you aren’t sure if you are in a state with an OSHA-approved state plan, click here: https://www.osha.gov/stateplans/https://urldefense.proofpoint.com/v2/url?u=https-3A__www.osha.gov_stateplans_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=PoDIhHfggj_Ptb2ET-ZhtA0N7wPrgJcuYZbV4vVhukw&e=).

Second, CMS is announcing details of its requirement that health care workers at facilities participating in Medicare and Medicaid are fully vaccinated.

Here is the White House press release regarding both rules: https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/04/fact-sheet-biden-administration-announces-details-of-two-major-vaccination-policies/https://urldefense.proofpoint.com/v2/url?u=https-3A__www.whitehouse.gov_briefing-2Droom_statements-2Dreleases_2021_11_04_fact-2Dsheet-2Dbiden-2Dadministration-2Dannounces-2Ddetails-2Dof-2Dtwo-2Dmajor-2Dvaccination-2Dpolicies_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=CvNNEdPPFp_6ECXmYPSHJyBS5yJAue0ARciUJFak2ug&e=

OSHA Rule:

Here are some takeaways from the interim rule / guidance.  Local governments that are covered by the OSHA rule:

  • Need to ensure compliance by 1/4/22 (including developing a written mandatory vaccine policy and/or a vaccine policy that requires vaccines but has a testing / masking opt out), determine vaccination status, ensure accurate recordkeeping for vaccination / testing).
  • Fully vaccinated means 2 shots of Pfizer or Moderna or 1 shot of J&J by the January 4th deadline.
  • Must provide paid-time off for their employees to get vaccinated and sick leave for side effects as needed.
  • Do not need to pay or provide tests for employees who choose to get weekly tests in lieu of vaccination (though CBAs or other laws could apply to this).
  • Must ensure unvaccinated workers are masked (beginning 12/5).
  • According to the interim rule, to meet the definition of “mandatory vaccination policy”, the policy must require vaccination of all employees (including new hires) except for “those employees (1) for whom a vaccine is medically contraindicated, (2) for whom medical necessity requires a delay in vaccination, or (3) those legally entitled to a reasonable accommodation under federal civil rights laws because they have a disability or sincerely-held religious beliefs, practices, or observances that conflict with the vaccination requirement. OSHA requires employers to implement a mandatory vaccination requirement, but provides an exemption for an alternative policy that allows employees to choose either to be fully vaccinated or to be regularly tested and wear a face covering.”
  • The rule does not apply to employees who do not report to a workplace where other individuals such as coworkers or customers are present, employees while they are working from home, or employees who work exclusively outdoors.
    Failure to comply with the rule will subject employers to fines.

The OSHA interim final rule, can be found here: https://public-inspection.federalregister.gov/2021-23643.pdfhttps://urldefense.proofpoint.com/v2/url?u=https-3A__public-2Dinspection.federalregister.gov_2021-2D23643.pdf&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=ac9z7niYxn6YdfAfmkFswWopHYL53W3mYqLxCXvLSWc&e=.
A summary of the rule can be found here: https://www.osha.gov/sites/default/files/publications/OSHA4162.pdfhttps://urldefense.proofpoint.com/v2/url?u=https-3A__www.osha.gov_sites_default_files_publications_OSHA4162.pdf&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=GaNYAj4X_o5ZRQ4APY07Jc20Lx_rEREhDUx7PIQdVIQ&e=
Here are the OSHA FAQs for the rule: https://www.osha.gov/coronavirus/ets2/faqshttps://urldefense.proofpoint.com/v2/url?u=https-3A__www.osha.gov_coronavirus_ets2_faqs&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=JhtCtAdwL4LXtkWEfhFDqkd0xNkoEcwABZPmVVILoIY&e=

Facilities Participating in Medicare / Medicaid

To view the interim final rule with comment period, visit: https://www.federalregister.gov/public-inspection/2021-23831/medicare-and-medicaid-programs-omnibus-covid-19-health-care-staff-vaccinationhttps://urldefense.proofpoint.com/v2/url?u=https-3A__www.federalregister.gov_public-2Dinspection_2021-2D23831_medicare-2Dand-2Dmedicaid-2Dprograms-2Domnibus-2Dcovid-2D19-2Dhealth-2Dcare-2Dstaff-2Dvaccination&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=u1kv4e0bkndhGMvgBNAry1K_3fGyytheQf_57cn-uqU&e=

To view a list of frequently asked questions, visit: www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docxhttps://urldefense.proofpoint.com/v2/url?u=http-3A__www.cms.gov_files_document_cms-2Domnibus-2Dstaff-2Dvax-2Drequirements-2D2021.docx&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=zLobubZISUMC6RPcv2Ha7r8Or5NNDCihcybIM2G803E&e=

Amanda Kellar Karras
Deputy General Counsel /
Director of Legal Advocacy
P: (202) 466-5424 x7116
Email: akarras@imla.orgmailto:akarras@imla.org
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51 Monroe St. Suite 404
Rockville, MD, 20850
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Plan Ahead!
IMLA’s Mid-Year Seminar, April 8-11, 2022 in Washington DC!
IMLA’s 87th Annual Conferencehttps://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_annual-2Dconference_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=rNrR5VWk8S9V6dI_MOHHHHV4Ox-bTtw_Qpnb-Sy9ANM&e=, Oct. 19-23, 2022 in Portland, OR!

My concern is both the executive order directing drafting of the rule and the other language referenced at the end of the rule. I think that if you do not receive Medicare or Medicaid money you are not likely a provider and not subject to the rule From: Jacqueline Ganier <Jacqueline.Ganier@mesaaz.gov> Sent: Thursday, November 4, 2021 2:20 PM To: Stephen Kemp <skemp@avondaleaz.gov>; Amanda Karras <akarras@imla.org>; disasterrelief@lists.imla.org Cc: Jim Smith <Jim.Smith@mesaaz.gov> Subject: RE: IMLA COVID-19 Working Group ⚠ This email arrived from an external source. Please exercise caution when opening attachments or clicking on links. ⚠ ________________________________ What about that the proposed rule states: “[T]his IFC directly regulates the following providers and suppliers, listed in numerical order of the relevant CFR sections being revised in this rule: * Ambulatory Surgical Centers * Hospices * Psychiatric residential treatment facilities * Programs of All-Inclusive Care for the Elderly * Hospitals * Long Term Care Facilities * Intermediate Care Facilities for Individuals with Intellectual Disabilities * Home Health Agencies * Comprehensive Outpatient Rehabilitation Facilities * Critical Access Hospitals * Clinics, rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services * Community Mental Health Centers * Home Infusion Therapy suppliers * Rural Health Clinics/Federally Qualified Health Centers * End-Stage Renal Disease Facilities “This IFC directly applies only to the Medicare- and Medicaid-certified providers and suppliers listed above.” Regards, Jacqueline Jacqueline Ganier City of Mesa Assistant City Attorney III P.O. Box 1466 Mesa, AZ 85211-1466 (480) 644-3335 THE INFORMATION CONTAINED IN THIS ELECTRONIC MAIL MESSAGE IS CONFIDENTIAL AND INTENDED ONLY FOR THE USE OF THE INDIVIDUAL(S) OR ENTITY NAMED ABOVE AND MAY BE ATTORNEY-CLIENT PRIVILEGED. IF THE READER OF THIS MESSAGE IS NOT THE INTENDED RECIPIENT OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERY OF THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS MESSAGE IS STRICTLY PROHIBITED. IF YOU RECEIVED THIS MESSAGE IN ERROR, PLEASE IMMEDIATELY NOTIFY THE SENDER AT (480) 644-2343 AND DELETE THE MESSAGE. From: Stephen Kemp <skemp@avondaleaz.gov<mailto:skemp@avondaleaz.gov>> Sent: Thursday, November 4, 2021 1:31 PM To: Amanda Karras <akarras@imla.org<mailto:akarras@imla.org>>; disasterrelief@lists.imla.org<mailto:disasterrelief@lists.imla.org> Subject: [Disasterrelief] Re: IMLA COVID-19 Working Group WARNING: This email came from an External Sender – Use caution when clicking links, opening attachments, or responding to requests for information. For those cities directly providing ambulance services to individuals and receiving Medicare or Medicaid payments. I think they may be covered, particularly in places like here in Arizona where certified paramedics who are defined as health care providers by statute ride on the ambulance and provide medical treatment. In other cities, such as Avondale where I am at, we have private ambulances, even if our paramedics ride on the ambulance, the private company handles the billing and receives the money, so we may be exempt From: Amanda Karras <akarras@imla.org<mailto:akarras@imla.org>> Sent: Thursday, November 4, 2021 1:27 PM To: disasterrelief@lists.imla.org<mailto:disasterrelief@lists.imla.org> Subject: [Disasterrelief] Re: IMLA COVID-19 Working Group ⚠ This email arrived from an external source. Please exercise caution when opening attachments or clicking on links. ⚠ ________________________________ A member is wondering (and so am I) how you all are analyzing the CMS rule with regard to ambulances. The original press release stated: “The Biden-Harris Administration will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilities<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.cms.gov_Outreach-2Dand-2DEducation_Find-2DYour-2DProvider-2DType_Facilities_Facilities-2Dpage&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=vyDRhEVMA12Fk2uKdX30PUzUWL8oxnllBnGMEYV-juI&e=> to protect both them and patients from the virus and its more contagious Delta variant. “ And when you click on the link for facilities from that press release it lists ambulances under the definition. However, the rule and FAQ from today do not list ambulances. But they do mention the requirement applying to other services for the facility and/or its patients under contract or other arrangements. How are you all interpreting this as it relates to EMS employees/ the provision of ambulance services? Thanks for any insight. Amanda Amanda Kellar Karras Deputy General Counsel / Director of Legal Advocacy P: (202) 466-5424 x7116 Email: akarras@imla.org<mailto:akarras@imla.org> [facebook icon]<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.facebook.com_InternationalMunicipalLawyersAssociation_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=dYa_2iyRi4pmzLOZDHML6v-5lGAWFof9evekp8adZUo&e=>[twitter icon]<https://urldefense.proofpoint.com/v2/url?u=https-3A__twitter.com_imlalegal&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=g5qPLopFrYXDSW2jkpyDeBgxDJegzFdtAKWMvvZa_xU&e=>[linkedin icon]<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.linkedin.com_company_international-2Dmunicipal-2Dlawyers-2Dassociation-2Dinc._&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=FDNafFD-32lJJ3WMOJHuNeyGEPogVY9K4vSunlmmOvw&e=> [logo]<https://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=AuhG2P416s6BsItofCLBZx7Vr9Po1Ou7aPMwXp1zZ2k&e=> 51 Monroe St. Suite 404 Rockville, MD, 20850 www.imla.org<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.imla.org_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=VGnel2Ub9V364i9hxKbNOm5-F7-3CrOFldGXRVbWRH0&e=> Plan Ahead! IMLA’s Mid-Year Seminar, April 8-11, 2022 in Washington DC! IMLA’s 87th Annual Conference<https://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_annual-2Dconference_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=rNrR5VWk8S9V6dI_MOHHHHV4Ox-bTtw_Qpnb-Sy9ANM&e=>, Oct. 19-23, 2022 in Portland, OR! From: Amanda Karras <akarras@imla.org<mailto:akarras@imla.org>> Sent: Thursday, November 4, 2021 11:41 AM To: disasterrelief@lists.imla.org<mailto:disasterrelief@lists.imla.org> Subject: [Disasterrelief] IMLA COVID-19 Working Group Dear IMLA COVID-19 Working Group: The Biden administration announced details for two of the vaccine mandates today. There is quite a bit to digest here, but I wanted to get this information out to you. First, the interim final rule has been published by the DOL for the OSHA rule for private employers with 100 or more employees that also covers public employers with 100 or more employees that have a state OSHA approved state plan that covers state and local governments. If you aren’t sure if you are in a state with an OSHA-approved state plan, click here: https://www.osha.gov/stateplans/<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.osha.gov_stateplans_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=PoDIhHfggj_Ptb2ET-ZhtA0N7wPrgJcuYZbV4vVhukw&e=>). Second, CMS is announcing details of its requirement that health care workers at facilities participating in Medicare and Medicaid are fully vaccinated. Here is the White House press release regarding both rules: https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/04/fact-sheet-biden-administration-announces-details-of-two-major-vaccination-policies/<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.whitehouse.gov_briefing-2Droom_statements-2Dreleases_2021_11_04_fact-2Dsheet-2Dbiden-2Dadministration-2Dannounces-2Ddetails-2Dof-2Dtwo-2Dmajor-2Dvaccination-2Dpolicies_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=CvNNEdPPFp_6ECXmYPSHJyBS5yJAue0ARciUJFak2ug&e=> OSHA Rule: Here are some takeaways from the interim rule / guidance. Local governments that are covered by the OSHA rule: * Need to ensure compliance by 1/4/22 (including developing a written mandatory vaccine policy and/or a vaccine policy that requires vaccines but has a testing / masking opt out), determine vaccination status, ensure accurate recordkeeping for vaccination / testing). * Fully vaccinated means 2 shots of Pfizer or Moderna or 1 shot of J&J by the January 4th deadline. * Must provide paid-time off for their employees to get vaccinated and sick leave for side effects as needed. * Do not need to pay or provide tests for employees who choose to get weekly tests in lieu of vaccination (though CBAs or other laws could apply to this). * Must ensure unvaccinated workers are masked (beginning 12/5). * According to the interim rule, to meet the definition of “mandatory vaccination policy”, the policy must require vaccination of all employees (including new hires) except for “those employees (1) for whom a vaccine is medically contraindicated, (2) for whom medical necessity requires a delay in vaccination, or (3) those legally entitled to a reasonable accommodation under federal civil rights laws because they have a disability or sincerely-held religious beliefs, practices, or observances that conflict with the vaccination requirement. OSHA requires employers to implement a mandatory vaccination requirement, but provides an exemption for an alternative policy that allows employees to choose either to be fully vaccinated or to be regularly tested and wear a face covering.” * The rule does not apply to employees who do not report to a workplace where other individuals such as coworkers or customers are present, employees while they are working from home, or employees who work exclusively outdoors. Failure to comply with the rule will subject employers to fines. The OSHA interim final rule, can be found here: https://public-inspection.federalregister.gov/2021-23643.pdf<https://urldefense.proofpoint.com/v2/url?u=https-3A__public-2Dinspection.federalregister.gov_2021-2D23643.pdf&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=ac9z7niYxn6YdfAfmkFswWopHYL53W3mYqLxCXvLSWc&e=>. A summary of the rule can be found here: https://www.osha.gov/sites/default/files/publications/OSHA4162.pdf<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.osha.gov_sites_default_files_publications_OSHA4162.pdf&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=GaNYAj4X_o5ZRQ4APY07Jc20Lx_rEREhDUx7PIQdVIQ&e=> Here are the OSHA FAQs for the rule: https://www.osha.gov/coronavirus/ets2/faqs<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.osha.gov_coronavirus_ets2_faqs&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=JhtCtAdwL4LXtkWEfhFDqkd0xNkoEcwABZPmVVILoIY&e=> Facilities Participating in Medicare / Medicaid * Must ensure all employees are fully vaccinated by 1/4/22 (2 shots of Pfizer or Moderna, 1 of J&J). * The requirements apply to: Ambulatory Surgical Centers, Hospices, Programs of All-Inclusive Care for the Elderly, Hospitals, Long Term Care facilities, Psychiatric Residential Treatment Facilities, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Home Health Agencies, Comprehensive Outpatient Rehabilitation Facilities, Critical Access Hospitals, Clinics (rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services), Community Mental Health Centers, Home Infusion Therapy suppliers, Rural Health Clinics/Federally Qualified Health Centers, and End-Stage Renal Disease Facilities. * This vaccination requirement applies to eligible staff working at a facility that participates in the Medicare and Medicaid programs, regardless of clinical responsibility or patient contact. The requirement includes all current staff as well as any new staff who provide any care, treatment, or other services for the facility and/or its patients. This includes facility employees, licensed practitioners, students, trainees, and volunteers. Additionally, this also includes individuals who provide care, treatment, or other services for the facility and/or its patients under contract or other arrangements. * The regulation also provides for exemptions based on recognized medical conditions or religious beliefs, observances, or practices. Facilities must develop a similar process or plan for permitting exemptions in alignment with federal law. Here is a press release from CMS on this rule: https://www.cms.gov/newsroom/press-releases/biden-harris-administration-issues-emergency-regulation-requiring-covid-19-vaccination-health-care<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.cms.gov_newsroom_press-2Dreleases_biden-2Dharris-2Dadministration-2Dissues-2Demergency-2Dregulation-2Drequiring-2Dcovid-2D19-2Dvaccination-2Dhealth-2Dcare&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=yHfE1CPXyb7AggKUhBVy4Cd6vQQ3kxPfwwyaOuOf0-s&e=> To view the interim final rule with comment period, visit: https://www.federalregister.gov/public-inspection/2021-23831/medicare-and-medicaid-programs-omnibus-covid-19-health-care-staff-vaccination<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.federalregister.gov_public-2Dinspection_2021-2D23831_medicare-2Dand-2Dmedicaid-2Dprograms-2Domnibus-2Dcovid-2D19-2Dhealth-2Dcare-2Dstaff-2Dvaccination&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=u1kv4e0bkndhGMvgBNAry1K_3fGyytheQf_57cn-uqU&e=> To view a list of frequently asked questions, visit: www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docx<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.cms.gov_files_document_cms-2Domnibus-2Dstaff-2Dvax-2Drequirements-2D2021.docx&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=zLobubZISUMC6RPcv2Ha7r8Or5NNDCihcybIM2G803E&e=> Amanda Kellar Karras Deputy General Counsel / Director of Legal Advocacy P: (202) 466-5424 x7116 Email: akarras@imla.org<mailto:akarras@imla.org> [facebook icon]<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.facebook.com_InternationalMunicipalLawyersAssociation_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=dYa_2iyRi4pmzLOZDHML6v-5lGAWFof9evekp8adZUo&e=>[twitter icon]<https://urldefense.proofpoint.com/v2/url?u=https-3A__twitter.com_imlalegal&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=g5qPLopFrYXDSW2jkpyDeBgxDJegzFdtAKWMvvZa_xU&e=>[linkedin icon]<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.linkedin.com_company_international-2Dmunicipal-2Dlawyers-2Dassociation-2Dinc._&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=FDNafFD-32lJJ3WMOJHuNeyGEPogVY9K4vSunlmmOvw&e=> [logo]<https://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=AuhG2P416s6BsItofCLBZx7Vr9Po1Ou7aPMwXp1zZ2k&e=> 51 Monroe St. Suite 404 Rockville, MD, 20850 www.imla.org<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.imla.org_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=VGnel2Ub9V364i9hxKbNOm5-F7-3CrOFldGXRVbWRH0&e=> Plan Ahead! IMLA’s Mid-Year Seminar, April 8-11, 2022 in Washington DC! IMLA’s 87th Annual Conference<https://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_annual-2Dconference_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=rNrR5VWk8S9V6dI_MOHHHHV4Ox-bTtw_Qpnb-Sy9ANM&e=>, Oct. 19-23, 2022 in Portland, OR!
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NS
Nicholas Spiropoulos
Thu, Nov 4, 2021 11:13 PM

The rule due to be published tomorrow doesn’t say anything about ambulances. Its not as broad as the press release indicated it would/could be.
My take is that the facilities as noted (and copied below) are the entities to which the rule is applicable. Our emergency services department does not provide any of these services and we run no treatment centers, we are ambulance only.  The way I read it is that it doesn’t apply to my jurisdiction, but I see Steven’s email below that it might apply if ambulances are run from the hospitals, etc.

Nicholas Spiropoulos | Matanuska-Susitna Borough Attorney | nspiropoulos@matsugov.usmailto:nspiropoulos@matsugov.us | (907) 861-8677

From: Jacqueline Ganier Jacqueline.Ganier@mesaaz.gov
Sent: Thursday, November 4, 2021 1:20 PM
To: Stephen Kemp skemp@avondaleaz.gov; Amanda Karras akarras@imla.org; disasterrelief@lists.imla.org
Cc: Jim Smith Jim.Smith@mesaaz.gov
Subject: [Disasterrelief] Re: IMLA COVID-19 Working Group

[EXTERNAL EMAIL - CAUTION: Do not open unexpected attachments or links.]
What about that the proposed rule states:

        “[T]his IFC directly regulates the following providers and suppliers, listed in numerical order of the relevant CFR sections being revised in this rule:

·      Ambulatory Surgical Centers

·      Hospices

·      Psychiatric residential treatment facilities

·      Programs of All-Inclusive Care for the Elderly

·      Hospitals

·      Long Term Care Facilities

·      Intermediate Care Facilities for Individuals with Intellectual Disabilities

·      Home Health Agencies

·      Comprehensive Outpatient Rehabilitation Facilities

·      Critical Access Hospitals

·      Clinics, rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services

·      Community Mental Health Centers

·      Home Infusion Therapy suppliers

·      Rural Health Clinics/Federally Qualified Health Centers

·      End-Stage Renal Disease Facilities
“This IFC directly applies only to the Medicare- and Medicaid-certified providers and suppliers listed above.”

Regards,

Jacqueline
Jacqueline Ganier
City of Mesa
Assistant City Attorney III
P.O. Box 1466
Mesa, AZ 85211-1466
(480) 644-3335

THE INFORMATION CONTAINED IN THIS ELECTRONIC MAIL MESSAGE IS CONFIDENTIAL AND INTENDED ONLY FOR THE USE OF THE INDIVIDUAL(S) OR ENTITY NAMED ABOVE AND MAY BE ATTORNEY-CLIENT PRIVILEGED.  IF THE READER OF THIS MESSAGE IS NOT THE INTENDED RECIPIENT OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERY OF THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS MESSAGE IS STRICTLY PROHIBITED.  IF YOU RECEIVED THIS MESSAGE IN ERROR, PLEASE IMMEDIATELY NOTIFY THE SENDER AT (480) 644-2343 AND DELETE THE MESSAGE.

From: Stephen Kemp <skemp@avondaleaz.govmailto:skemp@avondaleaz.gov>
Sent: Thursday, November 4, 2021 1:31 PM
To: Amanda Karras <akarras@imla.orgmailto:akarras@imla.org>; disasterrelief@lists.imla.orgmailto:disasterrelief@lists.imla.org
Subject: [Disasterrelief] Re: IMLA COVID-19 Working Group

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For those cities directly providing ambulance services to individuals and receiving Medicare or Medicaid payments. I think they may be covered, particularly in places like here in Arizona where certified paramedics who are defined as health care providers by statute ride on the ambulance and provide medical treatment.  In other cities, such as Avondale where I am at, we have private ambulances, even if our paramedics ride on the ambulance, the private company handles the billing and receives the money, so we may be exempt

From: Amanda Karras <akarras@imla.orgmailto:akarras@imla.org>
Sent: Thursday, November 4, 2021 1:27 PM
To: disasterrelief@lists.imla.orgmailto:disasterrelief@lists.imla.org
Subject: [Disasterrelief] Re: IMLA COVID-19 Working Group

⚠ This email arrived from an external source. Please exercise caution when opening attachments or clicking on links. ⚠

A member is wondering (and so am I) how you all are analyzing the CMS rule with regard to ambulances.  The original press release stated: “The Biden-Harris Administration will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilitieshttps://urldefense.proofpoint.com/v2/url?u=https-3A__www.cms.gov_Outreach-2Dand-2DEducation_Find-2DYour-2DProvider-2DType_Facilities_Facilities-2Dpage&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=vyDRhEVMA12Fk2uKdX30PUzUWL8oxnllBnGMEYV-juI&e= to protect both them and patients from the virus and its more contagious Delta variant. “  And when you click on the link for facilities from that press release it lists ambulances under the definition.  However, the rule and FAQ from today do not list ambulances.  But they do mention the requirement applying to other services for the facility and/or its patients under contract or other arrangements. How are you all interpreting this as it relates to EMS employees/ the provision of ambulance services?

Thanks for any insight.

Amanda

Amanda Kellar Karras
Deputy General Counsel /
Director of Legal Advocacy

P: (202) 466-5424 x7116
Email: akarras@imla.orgmailto:akarras@imla.org

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[logo]https://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=AuhG2P416s6BsItofCLBZx7Vr9Po1Ou7aPMwXp1zZ2k&e=

51 Monroe St. Suite 404
Rockville, MD, 20850

www.imla.orghttps://urldefense.proofpoint.com/v2/url?u=http-3A__www.imla.org_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=VGnel2Ub9V364i9hxKbNOm5-F7-3CrOFldGXRVbWRH0&e=

Plan Ahead!

IMLA’s Mid-Year Seminar, April 8-11, 2022 in Washington DC!
IMLA’s 87th Annual Conferencehttps://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_annual-2Dconference_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=rNrR5VWk8S9V6dI_MOHHHHV4Ox-bTtw_Qpnb-Sy9ANM&e=, Oct. 19-23, 2022 in Portland, OR!

From: Amanda Karras <akarras@imla.orgmailto:akarras@imla.org>
Sent: Thursday, November 4, 2021 11:41 AM
To: disasterrelief@lists.imla.orgmailto:disasterrelief@lists.imla.org
Subject: [Disasterrelief] IMLA COVID-19 Working Group

Dear IMLA COVID-19 Working Group:

The Biden administration announced details for two of the vaccine mandates today.  There is quite a bit to digest here, but I wanted to get this information out to you.

First, the interim final rule has been published by the DOL for the OSHA rule for private employers with 100 or more employees that also covers public employers with 100 or more employees that have a state OSHA approved state plan that covers state and local governments.  If you aren’t sure if you are in a state with an OSHA-approved state plan, click here: https://www.osha.gov/stateplans/https://urldefense.proofpoint.com/v2/url?u=https-3A__www.osha.gov_stateplans_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=PoDIhHfggj_Ptb2ET-ZhtA0N7wPrgJcuYZbV4vVhukw&e=).

Second, CMS is announcing details of its requirement that health care workers at facilities participating in Medicare and Medicaid are fully vaccinated.

Here is the White House press release regarding both rules: https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/04/fact-sheet-biden-administration-announces-details-of-two-major-vaccination-policies/https://urldefense.proofpoint.com/v2/url?u=https-3A__www.whitehouse.gov_briefing-2Droom_statements-2Dreleases_2021_11_04_fact-2Dsheet-2Dbiden-2Dadministration-2Dannounces-2Ddetails-2Dof-2Dtwo-2Dmajor-2Dvaccination-2Dpolicies_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=CvNNEdPPFp_6ECXmYPSHJyBS5yJAue0ARciUJFak2ug&e=

OSHA Rule:

Here are some takeaways from the interim rule / guidance.  Local governments that are covered by the OSHA rule:

  • Need to ensure compliance by 1/4/22 (including developing a written mandatory vaccine policy and/or a vaccine policy that requires vaccines but has a testing / masking opt out), determine vaccination status, ensure accurate recordkeeping for vaccination / testing).
  • Fully vaccinated means 2 shots of Pfizer or Moderna or 1 shot of J&J by the January 4th deadline.
  • Must provide paid-time off for their employees to get vaccinated and sick leave for side effects as needed.
  • Do not need to pay or provide tests for employees who choose to get weekly tests in lieu of vaccination (though CBAs or other laws could apply to this).
  • Must ensure unvaccinated workers are masked (beginning 12/5).
  • According to the interim rule, to meet the definition of “mandatory vaccination policy”, the policy must require vaccination of all employees (including new hires) except for “those employees (1) for whom a vaccine is medically contraindicated, (2) for whom medical necessity requires a delay in vaccination, or (3) those legally entitled to a reasonable accommodation under federal civil rights laws because they have a disability or sincerely-held religious beliefs, practices, or observances that conflict with the vaccination requirement. OSHA requires employers to implement a mandatory vaccination requirement, but provides an exemption for an alternative policy that allows employees to choose either to be fully vaccinated or to be regularly tested and wear a face covering.”
  • The rule does not apply to employees who do not report to a workplace where other individuals such as coworkers or customers are present, employees while they are working from home, or employees who work exclusively outdoors.
    Failure to comply with the rule will subject employers to fines.

The OSHA interim final rule, can be found here: https://public-inspection.federalregister.gov/2021-23643.pdfhttps://urldefense.proofpoint.com/v2/url?u=https-3A__public-2Dinspection.federalregister.gov_2021-2D23643.pdf&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=ac9z7niYxn6YdfAfmkFswWopHYL53W3mYqLxCXvLSWc&e=.
A summary of the rule can be found here: https://www.osha.gov/sites/default/files/publications/OSHA4162.pdfhttps://urldefense.proofpoint.com/v2/url?u=https-3A__www.osha.gov_sites_default_files_publications_OSHA4162.pdf&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=GaNYAj4X_o5ZRQ4APY07Jc20Lx_rEREhDUx7PIQdVIQ&e=
Here are the OSHA FAQs for the rule: https://www.osha.gov/coronavirus/ets2/faqshttps://urldefense.proofpoint.com/v2/url?u=https-3A__www.osha.gov_coronavirus_ets2_faqs&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=JhtCtAdwL4LXtkWEfhFDqkd0xNkoEcwABZPmVVILoIY&e=

Facilities Participating in Medicare / Medicaid

To view the interim final rule with comment period, visit: https://www.federalregister.gov/public-inspection/2021-23831/medicare-and-medicaid-programs-omnibus-covid-19-health-care-staff-vaccinationhttps://urldefense.proofpoint.com/v2/url?u=https-3A__www.federalregister.gov_public-2Dinspection_2021-2D23831_medicare-2Dand-2Dmedicaid-2Dprograms-2Domnibus-2Dcovid-2D19-2Dhealth-2Dcare-2Dstaff-2Dvaccination&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=u1kv4e0bkndhGMvgBNAry1K_3fGyytheQf_57cn-uqU&e=

To view a list of frequently asked questions, visit: www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docxhttps://urldefense.proofpoint.com/v2/url?u=http-3A__www.cms.gov_files_document_cms-2Domnibus-2Dstaff-2Dvax-2Drequirements-2D2021.docx&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=zLobubZISUMC6RPcv2Ha7r8Or5NNDCihcybIM2G803E&e=

Amanda Kellar Karras
Deputy General Counsel /
Director of Legal Advocacy

P: (202) 466-5424 x7116
Email: akarras@imla.orgmailto:akarras@imla.org

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51 Monroe St. Suite 404
Rockville, MD, 20850

www.imla.orghttps://urldefense.proofpoint.com/v2/url?u=http-3A__www.imla.org_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=VGnel2Ub9V364i9hxKbNOm5-F7-3CrOFldGXRVbWRH0&e=

Plan Ahead!

IMLA’s Mid-Year Seminar, April 8-11, 2022 in Washington DC!
IMLA’s 87th Annual Conferencehttps://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_annual-2Dconference_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=rNrR5VWk8S9V6dI_MOHHHHV4Ox-bTtw_Qpnb-Sy9ANM&e=, Oct. 19-23, 2022 in Portland, OR!

The rule due to be published tomorrow doesn’t say anything about ambulances. Its not as broad as the press release indicated it would/could be. My take is that the facilities as noted (and copied below) are the entities to which the rule is applicable. Our emergency services department does not provide any of these services and we run no treatment centers, we are ambulance only. The way I read it is that it doesn’t apply to my jurisdiction, but I see Steven’s email below that it might apply if ambulances are run from the hospitals, etc. Nicholas Spiropoulos | Matanuska-Susitna Borough Attorney | nspiropoulos@matsugov.us<mailto:nspiropoulos@matsugov.us> | (907) 861-8677 From: Jacqueline Ganier <Jacqueline.Ganier@mesaaz.gov> Sent: Thursday, November 4, 2021 1:20 PM To: Stephen Kemp <skemp@avondaleaz.gov>; Amanda Karras <akarras@imla.org>; disasterrelief@lists.imla.org Cc: Jim Smith <Jim.Smith@mesaaz.gov> Subject: [Disasterrelief] Re: IMLA COVID-19 Working Group [EXTERNAL EMAIL - CAUTION: Do not open unexpected attachments or links.] What about that the proposed rule states: “[T]his IFC directly regulates the following providers and suppliers, listed in numerical order of the relevant CFR sections being revised in this rule: · Ambulatory Surgical Centers · Hospices · Psychiatric residential treatment facilities · Programs of All-Inclusive Care for the Elderly · Hospitals · Long Term Care Facilities · Intermediate Care Facilities for Individuals with Intellectual Disabilities · Home Health Agencies · Comprehensive Outpatient Rehabilitation Facilities · Critical Access Hospitals · Clinics, rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services · Community Mental Health Centers · Home Infusion Therapy suppliers · Rural Health Clinics/Federally Qualified Health Centers · End-Stage Renal Disease Facilities “This IFC directly applies only to the Medicare- and Medicaid-certified providers and suppliers listed above.” Regards, Jacqueline Jacqueline Ganier City of Mesa Assistant City Attorney III P.O. Box 1466 Mesa, AZ 85211-1466 (480) 644-3335 THE INFORMATION CONTAINED IN THIS ELECTRONIC MAIL MESSAGE IS CONFIDENTIAL AND INTENDED ONLY FOR THE USE OF THE INDIVIDUAL(S) OR ENTITY NAMED ABOVE AND MAY BE ATTORNEY-CLIENT PRIVILEGED. IF THE READER OF THIS MESSAGE IS NOT THE INTENDED RECIPIENT OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERY OF THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS MESSAGE IS STRICTLY PROHIBITED. IF YOU RECEIVED THIS MESSAGE IN ERROR, PLEASE IMMEDIATELY NOTIFY THE SENDER AT (480) 644-2343 AND DELETE THE MESSAGE. From: Stephen Kemp <skemp@avondaleaz.gov<mailto:skemp@avondaleaz.gov>> Sent: Thursday, November 4, 2021 1:31 PM To: Amanda Karras <akarras@imla.org<mailto:akarras@imla.org>>; disasterrelief@lists.imla.org<mailto:disasterrelief@lists.imla.org> Subject: [Disasterrelief] Re: IMLA COVID-19 Working Group WARNING: This email came from an External Sender – Use caution when clicking links, opening attachments, or responding to requests for information. For those cities directly providing ambulance services to individuals and receiving Medicare or Medicaid payments. I think they may be covered, particularly in places like here in Arizona where certified paramedics who are defined as health care providers by statute ride on the ambulance and provide medical treatment. In other cities, such as Avondale where I am at, we have private ambulances, even if our paramedics ride on the ambulance, the private company handles the billing and receives the money, so we may be exempt From: Amanda Karras <akarras@imla.org<mailto:akarras@imla.org>> Sent: Thursday, November 4, 2021 1:27 PM To: disasterrelief@lists.imla.org<mailto:disasterrelief@lists.imla.org> Subject: [Disasterrelief] Re: IMLA COVID-19 Working Group ⚠ This email arrived from an external source. Please exercise caution when opening attachments or clicking on links. ⚠ ________________________________ A member is wondering (and so am I) how you all are analyzing the CMS rule with regard to ambulances. The original press release stated: “The Biden-Harris Administration will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilities<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.cms.gov_Outreach-2Dand-2DEducation_Find-2DYour-2DProvider-2DType_Facilities_Facilities-2Dpage&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=vyDRhEVMA12Fk2uKdX30PUzUWL8oxnllBnGMEYV-juI&e=> to protect both them and patients from the virus and its more contagious Delta variant. “ And when you click on the link for facilities from that press release it lists ambulances under the definition. However, the rule and FAQ from today do not list ambulances. But they do mention the requirement applying to other services for the facility and/or its patients under contract or other arrangements. How are you all interpreting this as it relates to EMS employees/ the provision of ambulance services? Thanks for any insight. Amanda Amanda Kellar Karras Deputy General Counsel / Director of Legal Advocacy P: (202) 466-5424 x7116 Email: akarras@imla.org<mailto:akarras@imla.org> [facebook icon]<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.facebook.com_InternationalMunicipalLawyersAssociation_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=dYa_2iyRi4pmzLOZDHML6v-5lGAWFof9evekp8adZUo&e=>[twitter icon]<https://urldefense.proofpoint.com/v2/url?u=https-3A__twitter.com_imlalegal&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=g5qPLopFrYXDSW2jkpyDeBgxDJegzFdtAKWMvvZa_xU&e=>[linkedin icon]<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.linkedin.com_company_international-2Dmunicipal-2Dlawyers-2Dassociation-2Dinc._&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=FDNafFD-32lJJ3WMOJHuNeyGEPogVY9K4vSunlmmOvw&e=> [logo]<https://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=AuhG2P416s6BsItofCLBZx7Vr9Po1Ou7aPMwXp1zZ2k&e=> 51 Monroe St. Suite 404 Rockville, MD, 20850 www.imla.org<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.imla.org_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=VGnel2Ub9V364i9hxKbNOm5-F7-3CrOFldGXRVbWRH0&e=> Plan Ahead! IMLA’s Mid-Year Seminar, April 8-11, 2022 in Washington DC! IMLA’s 87th Annual Conference<https://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_annual-2Dconference_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=rNrR5VWk8S9V6dI_MOHHHHV4Ox-bTtw_Qpnb-Sy9ANM&e=>, Oct. 19-23, 2022 in Portland, OR! From: Amanda Karras <akarras@imla.org<mailto:akarras@imla.org>> Sent: Thursday, November 4, 2021 11:41 AM To: disasterrelief@lists.imla.org<mailto:disasterrelief@lists.imla.org> Subject: [Disasterrelief] IMLA COVID-19 Working Group Dear IMLA COVID-19 Working Group: The Biden administration announced details for two of the vaccine mandates today. There is quite a bit to digest here, but I wanted to get this information out to you. First, the interim final rule has been published by the DOL for the OSHA rule for private employers with 100 or more employees that also covers public employers with 100 or more employees that have a state OSHA approved state plan that covers state and local governments. If you aren’t sure if you are in a state with an OSHA-approved state plan, click here: https://www.osha.gov/stateplans/<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.osha.gov_stateplans_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=PoDIhHfggj_Ptb2ET-ZhtA0N7wPrgJcuYZbV4vVhukw&e=>). Second, CMS is announcing details of its requirement that health care workers at facilities participating in Medicare and Medicaid are fully vaccinated. Here is the White House press release regarding both rules: https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/04/fact-sheet-biden-administration-announces-details-of-two-major-vaccination-policies/<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.whitehouse.gov_briefing-2Droom_statements-2Dreleases_2021_11_04_fact-2Dsheet-2Dbiden-2Dadministration-2Dannounces-2Ddetails-2Dof-2Dtwo-2Dmajor-2Dvaccination-2Dpolicies_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=CvNNEdPPFp_6ECXmYPSHJyBS5yJAue0ARciUJFak2ug&e=> OSHA Rule: Here are some takeaways from the interim rule / guidance. Local governments that are covered by the OSHA rule: * Need to ensure compliance by 1/4/22 (including developing a written mandatory vaccine policy and/or a vaccine policy that requires vaccines but has a testing / masking opt out), determine vaccination status, ensure accurate recordkeeping for vaccination / testing). * Fully vaccinated means 2 shots of Pfizer or Moderna or 1 shot of J&J by the January 4th deadline. * Must provide paid-time off for their employees to get vaccinated and sick leave for side effects as needed. * Do not need to pay or provide tests for employees who choose to get weekly tests in lieu of vaccination (though CBAs or other laws could apply to this). * Must ensure unvaccinated workers are masked (beginning 12/5). * According to the interim rule, to meet the definition of “mandatory vaccination policy”, the policy must require vaccination of all employees (including new hires) except for “those employees (1) for whom a vaccine is medically contraindicated, (2) for whom medical necessity requires a delay in vaccination, or (3) those legally entitled to a reasonable accommodation under federal civil rights laws because they have a disability or sincerely-held religious beliefs, practices, or observances that conflict with the vaccination requirement. OSHA requires employers to implement a mandatory vaccination requirement, but provides an exemption for an alternative policy that allows employees to choose either to be fully vaccinated or to be regularly tested and wear a face covering.” * The rule does not apply to employees who do not report to a workplace where other individuals such as coworkers or customers are present, employees while they are working from home, or employees who work exclusively outdoors. Failure to comply with the rule will subject employers to fines. The OSHA interim final rule, can be found here: https://public-inspection.federalregister.gov/2021-23643.pdf<https://urldefense.proofpoint.com/v2/url?u=https-3A__public-2Dinspection.federalregister.gov_2021-2D23643.pdf&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=ac9z7niYxn6YdfAfmkFswWopHYL53W3mYqLxCXvLSWc&e=>. A summary of the rule can be found here: https://www.osha.gov/sites/default/files/publications/OSHA4162.pdf<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.osha.gov_sites_default_files_publications_OSHA4162.pdf&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=GaNYAj4X_o5ZRQ4APY07Jc20Lx_rEREhDUx7PIQdVIQ&e=> Here are the OSHA FAQs for the rule: https://www.osha.gov/coronavirus/ets2/faqs<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.osha.gov_coronavirus_ets2_faqs&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=JhtCtAdwL4LXtkWEfhFDqkd0xNkoEcwABZPmVVILoIY&e=> Facilities Participating in Medicare / Medicaid * Must ensure all employees are fully vaccinated by 1/4/22 (2 shots of Pfizer or Moderna, 1 of J&J). * The requirements apply to: Ambulatory Surgical Centers, Hospices, Programs of All-Inclusive Care for the Elderly, Hospitals, Long Term Care facilities, Psychiatric Residential Treatment Facilities, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Home Health Agencies, Comprehensive Outpatient Rehabilitation Facilities, Critical Access Hospitals, Clinics (rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services), Community Mental Health Centers, Home Infusion Therapy suppliers, Rural Health Clinics/Federally Qualified Health Centers, and End-Stage Renal Disease Facilities. * This vaccination requirement applies to eligible staff working at a facility that participates in the Medicare and Medicaid programs, regardless of clinical responsibility or patient contact. The requirement includes all current staff as well as any new staff who provide any care, treatment, or other services for the facility and/or its patients. This includes facility employees, licensed practitioners, students, trainees, and volunteers. Additionally, this also includes individuals who provide care, treatment, or other services for the facility and/or its patients under contract or other arrangements. * The regulation also provides for exemptions based on recognized medical conditions or religious beliefs, observances, or practices. Facilities must develop a similar process or plan for permitting exemptions in alignment with federal law. Here is a press release from CMS on this rule: https://www.cms.gov/newsroom/press-releases/biden-harris-administration-issues-emergency-regulation-requiring-covid-19-vaccination-health-care<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.cms.gov_newsroom_press-2Dreleases_biden-2Dharris-2Dadministration-2Dissues-2Demergency-2Dregulation-2Drequiring-2Dcovid-2D19-2Dvaccination-2Dhealth-2Dcare&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=yHfE1CPXyb7AggKUhBVy4Cd6vQQ3kxPfwwyaOuOf0-s&e=> To view the interim final rule with comment period, visit: https://www.federalregister.gov/public-inspection/2021-23831/medicare-and-medicaid-programs-omnibus-covid-19-health-care-staff-vaccination<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.federalregister.gov_public-2Dinspection_2021-2D23831_medicare-2Dand-2Dmedicaid-2Dprograms-2Domnibus-2Dcovid-2D19-2Dhealth-2Dcare-2Dstaff-2Dvaccination&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=u1kv4e0bkndhGMvgBNAry1K_3fGyytheQf_57cn-uqU&e=> To view a list of frequently asked questions, visit: www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docx<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.cms.gov_files_document_cms-2Domnibus-2Dstaff-2Dvax-2Drequirements-2D2021.docx&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=zLobubZISUMC6RPcv2Ha7r8Or5NNDCihcybIM2G803E&e=> Amanda Kellar Karras Deputy General Counsel / Director of Legal Advocacy P: (202) 466-5424 x7116 Email: akarras@imla.org<mailto:akarras@imla.org> [facebook icon]<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.facebook.com_InternationalMunicipalLawyersAssociation_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=dYa_2iyRi4pmzLOZDHML6v-5lGAWFof9evekp8adZUo&e=>[twitter icon]<https://urldefense.proofpoint.com/v2/url?u=https-3A__twitter.com_imlalegal&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=g5qPLopFrYXDSW2jkpyDeBgxDJegzFdtAKWMvvZa_xU&e=>[linkedin icon]<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.linkedin.com_company_international-2Dmunicipal-2Dlawyers-2Dassociation-2Dinc._&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=FDNafFD-32lJJ3WMOJHuNeyGEPogVY9K4vSunlmmOvw&e=> [logo]<https://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=AuhG2P416s6BsItofCLBZx7Vr9Po1Ou7aPMwXp1zZ2k&e=> 51 Monroe St. Suite 404 Rockville, MD, 20850 www.imla.org<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.imla.org_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=VGnel2Ub9V364i9hxKbNOm5-F7-3CrOFldGXRVbWRH0&e=> Plan Ahead! IMLA’s Mid-Year Seminar, April 8-11, 2022 in Washington DC! IMLA’s 87th Annual Conference<https://urldefense.proofpoint.com/v2/url?u=https-3A__imla.org_annual-2Dconference_&d=DwMGaQ&c=1BXtvEoDZ8OoKVrbcaT-lZJhLYUUH2z16QxIUXkcxis&r=NN-xG6I0OzXRY-j_NqhaZZA0Ei3GGhjPJdKOIdHLpgE&m=YVwtFG2M8wnev82EVJTENawbxuv_UxAPn2W_lxzzh0SevqxM9iWqyEWqAotRLFfV&s=rNrR5VWk8S9V6dI_MOHHHHV4Ox-bTtw_Qpnb-Sy9ANM&e=>, Oct. 19-23, 2022 in Portland, OR!
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