Congress Funds the Government But Faces Another Shutdown Threat Before Christmas
NBC News | ByScott Wong and Syedah Asghar
WASHINGTON — Lawmakers averted a government shutdown 40 days before the election, but they’ll face another funding crunch right before the holidays and a new Congress and president take office.
Bipartisan negotiators have been trying to make progress on the 12 bills needed to fund federal agencies for the 2025 fiscal year.
Yet there's little time to pass those bills during the lame-duck session; House members and senators are scheduled to be in Washington for only five weeks between Election Day and the end of the year, and the two chambers haven’t reached agreement on any of the dozen measures, known as appropriations bills.
A more likely scenario is that Democrats and Republicans would strike an end-of-year deal on a massive, catchall omnibus spending package or punt the issue once again with another continuing resolution, or CR, that would extend funding into the new year on a short-term basis.
They’ll need a new funding agreement before federal funding runs out on Dec. 20.
House Speaker Mike Johnson, R-La., insisted this week that the days of the just-before-Christmas omnibus — loaded up with legislative priorities from both parties — are over.
“We are not going to return to the Christmas omnibus spending tradition, and that’s the commitment I’ve made to everyone,” Johnson told reporters after the House passed a stopgap funding measure Wednesday.
Pressed about whether he would promise not to put an omnibus on the floor in December, Johnson wouldn’t answer directly: “We’ve worked very hard to break that tradition ... and we’ll see what happens in December.”
Senior appropriators said Congress are likely to end up where they have before when they’ve faced a lame-duck, year-end funding deadline: with a sweeping omnibus spending package.
“I expect that we’ll negotiate an omnibus,” said Rep. Debbie Wasserman Schultz, D-Fla., a member of the Appropriations Committee, noting that Johnson had said there would be no more CRs, then a new CR passed Wednesday.
“The speaker, respectfully, doesn’t have the ability to draw lines in the sand when he can’t even control his own caucus. They continually need Democrats to actually get anything done, and we are governing from the minority,” she continued. “And so I’m pretty confident that at the end of the day, we’re going to make sure that we pass omnibus funding.”
Far more House Democrats than Republicans voted for Wednesday's CR that will prevent a shutdown from starting next week, continuing a pattern of the minority’s carrying must-pass legislation through the lower chamber this Congress.
House Appropriations Committee Chairman Tom Cole, R-Okla., predicted that the two parties could come to a deal and avoid a shutdown in December. But he said the results of the election will dictate what eventually happens…
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The Growing, Troublesome Issues Around Non-Solicitation Agreements In Home Care
Home Health Care News | By Audrie Martin
In August, Comfort Keepers was fined $500,000 and forced to remove language from its contracts restricting caregivers from accepting positions with home care clients up to one year after terminating employment.
That contract language, dubbed a non-solicitation agreement, is a widely used clause in home care contracts to protect providers’ businesses.
On its end, the Irvine, California-based Comfort Keepers is a large franchise that offers non-medical in-home support, including meal preparation, companionship and personal assistance.
The company required each client to execute a care agreement containing this language before receiving services. California Attorney General Rob Bonta concluded that this agreement violated California law by restraining worker mobility, as caregivers could not be hired by any Comfort Keepers client, not just the client to whom they were assigned to provide services.
In a statement issued to Home Health Care News, Comfort Keepers wrote, “We value Comfort Keepers caregivers, who are the heart and soul of each of our franchises and the Comfort Keepers brand. “As a service-based company, the quality of our care is rooted in the dedication and expertise of the caregivers who serve as employees. We invest significantly in their development to ensure the success of our services, the satisfaction of clients and the wellbeing of the caregivers. While this investment comes at a cost, we believe protecting the caregivers who become invaluable to our clients through their training and expertise is essential. Comfort Keepers is not seeking to limit or restrict any employee’s ability to earn a living; rather, we believe in a business’s right to protect its assets, ensuring the continued excellence of the care we provide.
Comfort Keepers maintains that direct hire provisions do not hinder workers from finding future employment. These provisions are designed to provide service-based businesses with compensation when the care recipient elects to hire a caregiver vetted, background-checked and trained by the agency in the form of a reasonable amount for the placement services it provided.
This is standard practice with service-based businesses across many industries. Furthermore, this is part of a larger and evolving issue being scrutinized by the U.S. Chamber of Commerce.”
Angelo Spinola, home health, home care and hospice chair at the Polsinelli law firm headquartered in Kansas City, Missouri, was involved in the case and told HHCN he thought the attorney general was incorrect in his position.
“They are applying a law that applies to non-compete agreements with employees to a client service agreement,” he said.
Non-compete and non-solicit agreements
In general, Spinola said that restrictive covenants are divided into confidentiality, non-compete and non-solicit agreements. These agreements are based on state laws, and certain states limit their use.
Non-solicitation agreements in home care are meant to prevent clients from hiring a caregiver directly and cutting out the agency. These agreements protect the agency’s business without restricting the caregivers’ mobility, providers believe. If the contract is violated, the agency may seek legal action and sometimes request damages…
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Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings Rulemaking
Occupational Safety and Health Administration
. . . On August 30, 2024, OSHA published in the Federal Register a Notice of Proposed Rulemaking (NPRM) for Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings. This is a significant step toward a federal heat standard to protect workers. The proposed standard would apply to all employers conducting outdoor and indoor work in all general industry, construction, maritime, and agriculture sectors where OSHA has jurisdiction. The standard would require employers to create a plan to evaluate and control heat hazards in their workplace. It would clarify employer obligations and the steps necessary to effectively protect employees from hazardous heat. The ultimate goal is to prevent and reduce the number of occupational injuries, illnesses, and fatalities caused by exposure to hazardous heat.
OSHA encourages the public to participate by submitting comments. Your input will help us develop a final rule that adequately protects workers, is feasible for employers, and is based on the best available evidence. The NPRM is available on the Federal Register web page at https://federalregister.gov/d/2024-14824 and at www.regulations.gov, which is the Federal e-Rulemaking Portal. You may submit comments and attachments electronically at www.regulations.gov, Docket No. OSHA-2021-0009. Follow the instructions online for making electronic submissions. Comments must be submitted by December 30, 2024. When submitting comments or recommendations, commenters should explain their rationale and, if possible, provide data and information to support their comments or recommendations.
All comments, including any personal information you provide, will be placed in the public docket without change and, with the exception of copyrighted materials, will be publicly available online at www.regulations.gov. Therefore, OSHA cautions commenters about submitting information they do not want to be made available to the public or submitting materials that contain personal information (either about themselves or others) such as Social Security Numbers and birthdates. All comments and submissions are listed in the www.regulations.gov index; however, some information (e.g., copyrighted material) is not publicly available to read or download through that website. All submissions, including copyrighted material, are available for inspection at the OSHA Docket Office. Contact the OSHA Docket Office at 202-693-2350 (TTY number: 877-889-5627) for assistance in locating docket submissions.
For more information on how to provide comments at this stage of the process, visit https://www.osha.gov/laws-regs/rulemakingprocess#v-nav-tab2.
See fact sheet at https://www.osha.gov/sites/default/files/publications/heat-rulemaking-factsheet.pdf |
Available Now: Free At-Home COVID-19 Tests, Including More Accessible Option
ACL Updates
Starting today, every U.S. household can order free at-home COVID-19 tests through a partnership between the U.S. Department of Health and Human Services Administration for Strategic Preparedness and Response (ASPR) and the United States Postal Service (USPS). These tests will detect the currently circulating COVID-19 variants and are intended for use through the end of 2024. Each order will include four tests.
One of the available options is the Orasure InteliSwab test, which is more accessible for people who are blind or have low vision, as well as people who have low manual dexterity.
For more information, including ordering instructions and information about the features that make the InteliSwab test more accessible, please visit ACL.gov/AccessibleTests.
About the Program
This round of ordering follows six previous opportunities to obtain free over-the-counter COVID-19 tests through this program. Since the program began in the winter of 2021, ASPR and USPS have distributed more than 900 million tests, free of charge, to American households nationwide.
These efforts complement ASPR’s ongoing distribution of free COVID-19 tests to long-term care facilities, low-income senior housing, aging and disability networks, and other community organizations to support older adults and people with disabilities living in the community, uninsured individuals, and underserved communities. More than 1 billion over-the-counter tests have been provided to date through this community access program.
In addition to collaborating with USPS on ordering and distribution of free COVID-19 tests, ASPR previously invested approximately $600 million across 12 domestic COVID-19 test manufacturers to strengthen the nation’s capacity to manufacture these tests, reduce reliance on overseas manufacturing, secure millions of new over-the-counter tests for future use, and improve preparedness for COVID-19 and other pandemic threats of the future.
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As CMS Cuts Payments, Home Health Patients Are Seeing Reduced Access To Care
Home Health Care News | By Joyce Famakinwa
Patients are receiving less access to Medicare-certified home health care in recent years, according to a new data analysis.
The data analysis – which comes from the Partnership for Quality Home Healthcare (PQHH) and CareJourney by Arcadia – examines Medicare home health fee-for-service claims from 2022 through 2023, in order to determine access to care, and how it has been impacted by payment rate cuts.
An analysis of 2022 data found that almost 35% of patients who leave the hospital, and receive a home health discharge, don’t access this care within a seven-day period.
Additionally, the findings show that patients who didn’t receive home health care had a death rate that was 41% higher than patients who accessed this care in a timely manner.
“There’s abundant data from all over the place about what kind of impact home health care has on a patient’s outcomes, their ability to stay out of the hospital, readmission rates, all of those things,” PQHH CEO Joanne Cunningham told Home Health Care News. “This was yet another confirming data point that actually looked at mortality rates. I found that very interesting, and not surprising at all for the home health provider community.”
The analysis also found that, in 2023, access to home health care led to a 34% decrease in hospital readmission rates. Despite this benefit, 35.7% of Medicare patients that were directed to receive this care after a hospitalization did not.
Plus, the home health referral rejection rate has seen a major increase, jumping from 49% in 2020 to 71% in 2022.
Broadly, the referral rejection rate tracks how often providers turn down new referrals, generally due to staffing or capacity constraints.
One of the main takeaways from the analysis was that these access-to-care issues are related to cuts made to home health care’s base rate in recent years…
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