HCAOA The Voice Summer 2020

15 Spring/Summer 2020 MEMBER NEWS 15 HCAOA The Voice Another positive and permanent change our industry is expe - riencing is an increased focus on legal compliance. The home care industry was already a frequent target for litigation and government audits before the coronavirus outbreak. The recent trend of increased regulation at a state and municipal level made it even more difficult for agencies to stay compliant. COVID-19 put this trend on steroids, with an unprecedented volume of legislation that has far-reaching implications on home care agencies. These include the Family First Coronavirus Response Act (FFCRA), the Paycheck Protection Program (PPP), the Coronavirus Aid, Relief, and Economic Security Act (CARES), and the proposed Health and Economic Recovery Omnibus Emergency Solutions Act (HEROES Act), state and municipal leave, unemployment, safety, and shelter in place laws as well as a cornucopia of revised and conflicting guidance that resulted in a lot of change and confusion related to the providers’ legal responsibilities. Historically, rapid changes in the law resulting in varying legal interpretations lead to an increase in lawsuits. Similar to the myriad of cases that started being filed at the end of 2015 resulting from modifications to the companionship and live-in exemptions, agencies are anticipating a post-pandemic surge of COVID-19 related litigation. The difference now is that many operators are better prepared because they have focused on compliance efforts and litigation armoring in anticipation of these legal challenges. Another positive change that appears permanent is the increased recognition of home health and home care services’ importance within the health care continuum. Lawmakers and society at large better understand the value of keeping seniors safe at home and the tangential benefits that come with the same. The industry rallied together like never before to speak with one voice to influence the legislative decision-making process directly and finally take its seat at the negotiating table with the insurers and acute care providers. Home care providers are now recognized as health care providers, essential services, and first responders in numerous federal and state laws and city ordinances. We can directly and proactively influence legislation and regulation for the betterment of our industry rather than responding to ill-informed legislation retroactively. Concerning the overall financial picture, many agencies have experienced an initial downtick of service requests due to COVID-19 as a result of people isolating from others. In some cases, clients have suspended services temporarily, whereas others have canceled services altogether. We expect that this decrease in revenue will be temporary. Indeed, some agencies have experienced an increase in revenue from specific clients by transitioning those clients to shelter in place programs. The client is kept safer by extending the service hours and minimizing the caregiver’s outside exposure via conversion to extended shift or live-in services. Further, several agencies are rebounding nicely as shelter in place orders are lifting, and new client opportunities are developing. The unfortunate COVID-19 outbreaks at several senior living facilities and other group care settings have highlighted that it’s safest for seniors to receive care in their homes. The home care industry was already experiencing a surge in demand as our population ages, and the current societal shift towards social distancing is likely to accelerate that growth. While there are positive changes that will mark our industry for the long-haul, there are significant challenges and uncertainties ahead that require vigilant preparation and narrowing the playing field. The unfortunate truth is that there will likely be further consolida - tion of the industry due to the economic backlash of COVID-19 that many agencies do not have the financial resources to survive. The federal government has provided temporary relief for some. However, the impact of a consumer unemployment rate expected to approach 20% by the end of May will carry long term repercus - sions, particularly as it relates to the ability to pay for private duty agency services. The generous unemployment benefits provided to caregivers under the CARES Act has also lead to a workforce shortage for many employers as some employees are choosing the increased pay offered under this program over available work. How this issue ultimately gets resolved is not yet clear and may come too late for many home care agencies. Although we face challenging times ahead, we are confident that this industry has the determination and grit to come out of this pandemic stronger than ever, and that’s a great thing, for a healthy and better home care industry results in a healthier and better world for everyone. Stay safe and keep your head up! The work you are doing is needed now more than ever before. Angelo Spinola is a shareholder with Littler Mendelson, P.C., focusing on employment law. Clayton Nedza is a Homecare Toolkit Coordinator with Littler Mendelson, P.C. “Home care providers are now recognized as health care providers, essential services, and first responders in numerous federal and state laws and city ordinances. We can directly and proactively influence legislation and regulation for the betterment of our industry rather than responding to ill- informed legislation retroactively.”