In The News

Study confirms that therapy makes a difference across all post-acute care populations

The Therapy Outcomes in Post-Acute Care Settings (TOPS) student, as reported previously, found that people who receive the highest amount of therapy intervention have the lowest re-hospitalization rates. People who receive the highest amount of therapy intervention have the highest improvement in function.

Conversely, people who receive the lowest amount of therapy intervention have the highest re-hospitalization rates. People who receive the lowest amount of therapy intervention have the least improvement in function. 

See APTA and AOTA Joint StatementTOPS Summary  and the new 
TOPS Chartbook which presents great data and graphics from the study


A New Guide on Universal Screening for Health-Related Social Needs from the Accountable Health Communities Model

Participants in the Accountable Health Communities Model use the Accountable Health Communities Health-Related Social Needs Screening Tool to quickly identify health-related social needs, such as food insecurity, housing instability, and lack of access to transportation, among community-dwelling Medicare and Medicaid beneficiaries. The Screening Tool enables staff to take the next step of connecting beneficiaries with community resources that can address their unmet needs. A new user guide can help health care or social service providers in a wide range of clinical settings use the Screening Tool. The guide also provides key insights for implementing universal screening for health-related social needs based on the experiences of organizations participating in the Accountable Health Communities Model.

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EEOC Issues COVID-19 Vaccine Guidance for Employers

From SESCO Management Consultants

The U.S. Equal Employment Opportunity Commission (EEOC) has issued new COVID-19 vaccine guidance for employers. The new guidance addresses topics the EEOC either left unclear or did not expressly resolve in earlier publications.


- Information about an employee’s vaccination status is considered “confidential medical information” under the Americans with Disabilities Act (ADA).

- Like all medical information, information about an employee’s vaccination status must be kept confidential and stored separately from the employee’s personnel file. Unfortunately, with this general rule in mind, the EEOC has not yet offered guidance for employers on how to easily identify the vaccination status of employees at the workplace to enforce ongoing mask mandates for non-vaccinated workers (e.g., via a badge or other outward identifier).

Employer Inquiries

- Employers may ask employees whether they obtained the vaccine from a third party in the community (pharmacy, personal doctor, etc.), and this question is not a “disability-related inquiry.”

- Employers may ask employees to provide documentation or other confirmation of the vaccination from such sources without the request being a “disability-related inquiry.”

Vaccinating Subsets of Employees

- Employers may offer vaccinations to certain groups of employees and not to others (e.g., assembly versus office workers), so long as the employer does not discriminate in the offering based on a protected class.

Vaccine Incentives

- Employers may offer incentives to employees who voluntarily receive the vaccine from a third-party vaccine provider (health department, pharmacy, personal medical provider, etc.).

- Employers may offer incentives to employees to voluntarily provide documentation that they received the vaccine from a third-party vaccine provider.

- Employers may offer incentives to employees who voluntarily receive a vaccination administered by the employer or its agent, so long as the incentive is not “so substantial as to be coercive.” One gap in the guidance provided by the EEOC is any further discussion of what constitutes a "coercive" incentive. What is so substantial as to be coercive and thus no longer voluntary under the ADA? Hopefully, the EEOC will further clarify this question but an incentive under $500 would likely be permissible. This was a central issue in the EEOC’s prior efforts to delineate regulations covering permissible incentives related to employer-sponsored wellness plans under the ADA. Although the EEOC had released new Trump-era wellness regulations in January 2021, they had not yet been published in the Federal Register when President Biden took office, and so they were withdrawn.

- Employers may not offer an incentive to an employee in return for the employee’s family member getting vaccinated by the employer or its agent.

- Employers may offer to vaccinate family members without offering the employee an incentive. However, employers must not require employees to have their family members get vaccinated and must not penalize employees if their family members decide not to do so. Employers must also ensure all medical information obtained from family members during the screening process is used only for the purpose of providing the vaccination, is kept confidential and is not provided to any managers, supervisors or others who make employment decisions for the employees.

SESCO Management Consultants will continue to monitor and report on developments with respect to the COVID-19 pandemic and will post updates in the firm’s COVID-19 Resource Center as additional information becomes available.

SESCO retainer clients and members of select associations can call or email SESCO to discuss specific industry, state and/or company questions and concerns. Those receiving these alerts that are not SESCO clients can contact SESCO by phone, fax or email to explore support options. 


Exclusive: U.S. to give ransomware hacks similar priority as terrorism

Christopher Bing  

The U.S. Department of Justice is elevating investigations of ransomware attacks to a similar priority as terrorism in the wake of the Colonial Pipeline hack and mounting damage caused by cyber criminals, a senior department official told Reuters.

Internal guidance sent [last] Thursday to U.S. attorney's offices across the country said information about ransomware investigations in the field should be centrally coordinated with a recently created task force in Washington...

Last month, a cyber criminal group that the U.S. authorities said operates from Russia, penetrated the pipeline operator on the U.S. East Coast, locking its systems and demanding a ransom. The hack caused a shutdown lasting several days, led to a spike in gas prices, panic buying and localized fuel shortages in the southeast. read more

Colonial Pipeline decided to pay the hackers who invaded their systems nearly $5 million to regain access, the company said.

The DOJ guidance specifically refers to Colonial as an example of the "growing threat that ransomware and digital extortion pose to the nation."

"To ensure we can make necessary connections across national and global cases and investigations, and to allow us to develop a comprehensive picture of the national and economic security threats we face, we must enhance and centralize our internal tracking," said the guidance seen by Reuters and previously unreported.

Read Full Article


Top Democrats jump-start push to offer a health care 'public option,' a Biden promise

NBC News
Rep. Frank Pallone and Sen. Patty Murray are trying to craft a government-provided insurance option to compete with private plans and extend coverage.
May 26, 2021, 9:45 AM EDT
WASHINGTON — Two Democratic committee chairs overseeing health care policy are seeking to jump-start a legislative push to craft a "public option" to compete with private insurers.
House Energy and Commerce Chair Frank Pallone, D-N.J., and Senate Health, Education, Labor and Pensions Chair Patty Murray, D-Wash., wrote a letter to interested parties on Wednesday seeking their input by July 31 on how to structure a government-provided plan.
"We believe bold steps are necessary in order to achieve universal coverage and lower health care costs," the chairs write. "Health care affordability remains a challenge for many American families despite the fact that the United States spends more on health care than any other country."
Pallone and Murray touted the Affordable Care Act's successes at extending coverage but noted that "tens of millions of American still remain uninsured or underinsured."
A "public option" was one of President Joe Biden's campaign promises, billed as a moderate alternative to rival Bernie Sanders' plan to scrap private coverage and put all Americans in Medicare. But Biden has not included the policy in his economic rescue and stimulus proposals so far, instead seeking to infuse cash in the ACA exchanges and invest in Covid-19 vaccines.
But the Democrats are signaling it is still a priority, and aim to introduce a bill by the end of this year, a Murray aide said.
It will be a daunting task for Democrats, who have paper-thin margins in Congress and not much hope of winning Republican support. They are likely to face an assault from health industry groups, including insurers who won't want to compete with the government, as well as doctors and hospitals who would complain about likely reductions in reimbursement rates.
In their letter, Murray and Pallone requested information that would help them on the design and scope of the legislation, including whether the federal public option should be made available to all individuals or more targeted.
And in a statement, they cited a recent Morning Consult/Politico poll that shows 68 percent of Americans favor a public option, "where people can choose from a government-run health program or private insurance."

Recently, Democrats have offered competing bills for a public option, which was considered in the 2010 Affordable Care Act legislation and dropped after some party defections.
Sen. Michael Bennet, D-Colo., and Sen. Tim Kaine, D-Va., introduced the Medicare-X Choice Act, which would set up a Medicare-style public option. And Sen. Sheldon Whitehouse, D-R.I., and Sherrod Brown, D-Ohio., introduced the CHOICE Act to add a public option to the Affordable Care Act.


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