340-B Drug Pricing Program

What do I need to know about the 340B Program?

The 340B Program enables covered entities to stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services. Manufacturers participating in Medicaid agree to provide outpatient drugs to covered entities at significantly reduced prices. The program allows 340B hospitals to stretch limited federal resources to reduce the price of outpatient pharmaceuticals for patients and expand health services to the patients and communities they serve. Hospitals use 340B savings to provide free care for uninsured patients, offer free vaccines, provide services in mental health clinics, and implement medication management and community health programs. According to the Health Resources and Services Administration (HRSA), which is responsible for administering the 340B program, enrolled hospitals and other covered entities can achieve average savings of 25 to 50% in pharmaceutical purchases. Tax-exempt hospitals are required to publicly report on the ways in which they improve the health of the communities they serve yearly through the IRS Form 990 Schedule H, which is publicly available. In 2017, the most recent year for which this information is available, tax-exempt hospitals participating in the 340B drug savings program provided $64.3B in total benefits to their communities.

Is my healthcare organization eligible?

Eligible health care organizations/covered entities include HRSA-supported health centers and look-alikes, Ryan White clinics and State AIDS Drug Assistance programs, Medicare/Medicaid Disproportionate Share Hospitals, children’s hospitals, and other safety net providers. See the full list of eligible organizations/covered entities. To participate in the 340B Program, eligible organizations/covered entities must register and be enrolled with the 340B program and comply with all program requirements. Once enrolled, covered entities are assigned a 340B identification number that vendors verify before allowing an organization to purchase 340B discounted drugs.

What if my organization’s eligibility changed over the past year?

Covered entities must recertify their eligibility every year and notify the Office of Pharmacy Affairs whenever there is a change in their eligibility. If there is a change in a covered entity’s eligibility status, the covered entity has a responsibility to immediately notify OPA and should stop purchasing drugs through the 340B Program. Learn more about the process here: Recertification.

How does COVID-19 impact my organization’s eligibility?

Many 340B stakeholders are concerned about the evolving impact of the COVID-19 pandemic. The circumstances surrounding this public health emergency may warrant additional flexibilities, especially to affected 340B covered entities. To the extent a 340B stakeholder has a specific circumstance where they believe their COVID-19 response may affect their compliance or eligibility in the 340B Program, the stakeholder should contact the 340B Prime Vendor at 1-888-340-2787 (Monday – Friday, 9 a.m. – 6 p.m. ET) or email apexusanswers@340bpvp.com. Additionally, plan on contacting this resource if your organization is currently seeing a surge in patients and need to expand services to another site, to learn if any special exemptions be made for covered entities or any changes will be made to the registration process. The 340B Prime Vendor will coordinate with HRSA technical assistance and evaluate each issue on a case-by-case basis.

Source: HRSA, AHA

Should Your Team Make Vaccinations Mandatory

Have you considered making COVID-19 vaccinations mandatory? If so, you’re not alone. Government workers have navigated uncertainty and unprecedented challenges since March 2020, even as most other sectors of the economy shut down completely or moved to remote employment. Just a week ago, public-facing government and other public employees, non-profit workers, and essential public-facing business service workers were deemed eligible for the vaccine in New York. This includes public works employees, social service and child service caseworkers, government inspectors, sanitation workers, DMV workers, County Clerks, building service workers, and election workers. Yet as the COVID-19 vaccine does gradually become more widely available, the scientific community did not foresee the next hurdle being vaccine resistance, but it’s the reality that’s setting in across the country. Polling data continues to show that a significant percentage of Americans prefer not to receive the COVID-19 vaccine – in fact, research from the Society for Human Resource Management (SHRM) found that 28% of U.S. workers are willing to lose their job rather than get vaccinated. The risk of unnecessary interruptions or delays in local municipality duties due to increased COVID-19 infection within offices is of great importance as it will directly impact communities. So, how do local governmental leaders navigate this latest bump on the road to economic recovery? Read on for the latest guidance.

Can an employer make COVID-19 vaccinations mandatory for workers?

ANSWER: In December, the federal agency focused on workplace discrimination, the Equal Employment Opportunity Commission, said because the vaccination itself is not a medical examination, employers could make COVID-19 shots mandatory for their workers. Keep in mind that if employees have medical or religious reasons that prevent them from taking a coronavirus vaccine, employers could be legally required to give the workers some reasonable alternative to continue to work. Also, for employers with a unionized workforce, the employer must consider bargaining requirements before implementing a mandatory vaccine policy.

Can an employer ask an employee if he or she has already received the vaccine or require proof of vaccination?

ANSWER: Generally, yes. However, that inquiry can only be made, according to the EEOC, if the question is “job-related and consistent with business necessity” as provided under the ADA. To meet this job-relatedness standard, the employer will need to establish that the worker’s failure to be vaccinated would pose a “direct threat” to the well-being of that employee or others with whom the employee would have contact as part of his or her job duties.

Can an employer fire an employee who refuses to be vaccinated?

ANSWER: Possibly, in limited circumstances. The EEOC guidance reminds employers that it will need to make reasonable accommodations to employees seeking an exemption due to disability-related reasons or religious objections and will need to follow the established reasonable accommodation process under either the ADA or Title VII before taking any adverse employment actions. The EEOC cautions employers that if it can establish that an employee who is not vaccinated poses a direct threat (that cannot be accommodated without undue hardship), the employer can exclude the employee from the worksite, but the employer cannot terminate the employee without further consideration of the employee’s legal protections or other possible accommodation, including whether the employee can perform his or her job remotely.

President Biden recently moved up the timeline for vaccine allocation by ordering all states, tribes, and territories to make every U.S. adult eligible for the COVID-19 vaccines by May 1. According to New York State’s COVID-19 Vaccine Tracker, 13% of the population is currently completely vaccinated.

It is important to remember that the EEOC guidance is only that—guidance—and not a law. Consequently, some employees may legally challenge mandatory vaccination programs and there is no guarantee that a court will react favorably to a particular legal challenge. There are also important legal limitations with a mandatory program even under the EEOC’s guidance. Therefore, employers mandating the vaccine should be prepared for some resistance from employees, and many may opt to strongly encourage vaccination without requiring it. A recent survey found that while most employers have no plan to create a mandatory vaccination process, many do plan to encourage employees to get the vaccine. Nearly 90% said they would provide information to employees (e.g., how to get vaccinated, the benefits of doing so) and nearly 40% said they would offer vaccine administration at their facility to increase convenience – even though this may be easier said than done. A third said they would offer paid time off for employees to receive the vaccine and/or recover from any side effects.

We hope this summary provides some helpful information for your team to consider as you navigate this complex issue. Pursuing a mandatory vaccination program ultimately requires management, together with legal and HR teams, to engage in significant planning and develop a program detailing how the process will work from beginning to end. If you would like to talk to our dedicated team, please contact us today. Additionally, if you have HR questions, please reach out to our wholly-owned subsidiary Visions HR, and connect with Janet Giannetta.

Sources: PBS, AARP, NY.Gov, SHRM

Remote Learning Trends

2020-2021

The Hyde Park Central School District is making changes to its contact tracing protocols that could result in more days in which all of its students are remote learning.

The district says the change will be for the better.

While the more precise contact tracing system is expected to increase the burden on staff and perhaps take longer to complete, resulting in more days in which the schools are closed, it’s also expected to lower the number of students who will have extended periods of mandatory quarantine.

It’s a system other districts around Dutchess County are also considering, as schools continue looking for ways to maximize the number of days students can have in-person learning.

The plan, approved by the Dutchess County Department of Behavioral and Community Health and to be implemented after spring break, calls for quarantining students only when one of them comes within a six-foot radius of an individual who tested positive, rather than everyone in a given room or building, according to local school officials.

Dutchess BOCES Superintendent Richard Hooley said there have been discussions among district leaders across the county about making similar changes.

“A lot of schools were saying, ‘Really? You want to quarantine my entire lunchroom?’ If you have a lunchroom that is six feet apart, you would only quarantine the kids that are closer than six feet,” Hooley said. He noted that every district is different, but contact tracing has been a time-consuming task for many of them.

Kafka and Hooley agree that fewer children required to quarantine is a positive.

“This may cause us to go full-remote more often while we contact trace, as a more usual occurrence, but the good news is … less students would have to miss school activities,” Kafka said. “We have been quarantining a whole bus, or a whole classroom, and we wouldn’t have to do that anymore.”

The new contact tracing plan in Hyde Park would go into effect after students return from break April 6. The district is holding off until then to allow for time to inform the school community of the changes and get feedback from families.

 

It would also “allow us some time for seating charts for classrooms and for buses,” Kafka added. “It will take longer to do contract tracing this way because we will have to look at the classroom, and where they were sitting.”

Hooley said while contact tracing can be an arduous task, it’s a key component to keeping schools safe.

“The contact tracing is always tough … I breathe a sigh of relief at the end of each day that we don’t have a positive case,” Hooley said. “Yes it is a burden, but it is necessary, and something we are well equipped to do.”

 

The American Educator Panels (AEP) consists of the three nationally representative samples of educators who provide their feedback on important issues of educational policy and practice. The three panels are the American Teacher Panel, the American School Leader Panel, and the American School District Panel

12% of teachers reported covering—via distance learning—the full curriculum they would have if schools hadn’t closed due to COVID-19

42% of teachers reported the civic education and social studies materials provided by their school or district are not engaging for students

87% of middle and high school social studies teachers said students made unfounded claims based on unreliable media sources in the past month

66% of teachers reported that students lacked devices or reliable internet to acquire digital instructional materials from home

 

A fall 2020 survey of 375 school districts nationwide found

  • About two in ten districts have already adopted, plan to adopt, or are considering adopting virtual school as part of their district portfolio after the end of the COVID-19 pandemic. District leaders cited reasons related to student and parent demand for continuing various forms of online instruction in future years.
  • Among a wide variety of school instructional and staffing matters, three widely shared concerns rose to the top for district leaders for the 2020–2021 school year: disparities in students’ opportunities to learn during the COVID-19 pandemic, students’ social and emotional learning needs, and insufficient funding to cover staff.
  • School district leaders reported that the U.S. Department of Education had the second-least amount of influence on their COVID-19 plans; state and local health departments had the most.
  • School district leaders diverged in terms of the degree to which they emphasized certain needs for the 2020–2021 school year. More leaders from focus districts than from nonfocus districts rated fundamentals (such as internet and technology access) as a greatest need. In contrast, more nonfocus district leaders rated student mental health and high-quality instructional resources as greatest needs.

 

Pandemic pods. Our data also permit us to gauge the extent of the most widely discussed adaptation to the pandemic on the part of American households: The formation of pods through which families band together in small groups to share responsibility for childcare, instruction, or both. Some commentators hail this development as an example of Americans’ resilience and ingenuity, while others fret about its implications for equal opportunity. But just how common are pandemic pods at the midpoint of the 2020–21 school year?

According to parent reports, 72% of students are participating in remote or hybrid instruction, leaving them in need of supervision and potentially academic support during the school day. Of these students, the parents of 20% report that their child regularly participates in additional instruction with someone who is neither affiliated with the child’s school nor a family member living in the home. The parents of 40% of students who participate in this form of tutoring report doing so in a group with other children. In other words, the parents of fewer than 6% of American students report participating in a pandemic pod. Even so, this represents more than three million students nationwide.

We see similar increases in the frequency with which students receive assignments and feedback on their work. The parents of 75% of students reported in November that their child’s school or teachers assign required work on a daily basis, up from 45% in May. At that time, the parents of only 21% of students said their child received daily feedback on completed assignments, with parents of another 27% reporting their child got feedback several times a week. For students who are fully remote in the 2020–21 school year, those shares have increased to 42% and 30%, respectively.

In sum, according to parents’ survey responses, the measures taken by schools to prevent spread of the virus are having the least negative impact on academic knowledge and skills and on emotional well-being. They are having a greater effect on children’s social relationships and physical fitness. Across all five domains of students’ well-being, the least negative impacts are reported for those children attending school in the traditional in-person manner. The hybrid model seems to offer little, if any, advantage over fully remote instruction.

 

https://www.air.org/project/national-survey-public-education-s-response-covid-19

https://nces.ed.gov/surveys/

https://www.poughkeepsiejournal.com/story/news/education/2021/03/15/covid-contact-tracing-hyde-park-aims-limit-student-quarantines/4663552001/

Sources: RAND, AEP, Education Next,

Should Your Company Make Vaccinations Mandatory

Have you considered making COVID-19 vaccinations mandatory? If so, you’re not alone. Manufacturing workers have navigated uncertainty and unprecedented challenges since March 2020, even as most other sectors of the economy shut down completely or moved to remote employment. Although manufacturers cannot work from home, they are not currently included in the recently expanded list of eligible New York vaccination groups, prompting a growing number of industry leaders to create a petition to include essential manufacturing workers in the next group. Yet as the COVID-19 vaccine does gradually become more widely available, the scientific community did not foresee the next hurdle being vaccine resistance, but it’s the reality that’s setting in across the country. Polling data continues to show that a significant percentage of Americans prefer not to receive the COVID-19 vaccine – in fact, research from the Society for Human Resource Management (SHRM) found that 28% of U.S. workers are willing to lose their job rather than get vaccinated. The risk of unnecessary interruptions or delays in manufacturing due to increased COVID-19 infection in facilities is of great importance as it will directly impact not only New York state but the country. So, how do manufacturing industry leaders navigate this latest bump on the road to economic recovery? Read on for the latest guidance.

Can an employer make COVID-19 vaccinations mandatory for workers?

ANSWER: In December, the federal agency focused on workplace discrimination, the Equal Employment Opportunity Commission, said because the vaccination itself is not a medical examination, employers could make COVID-19 shots mandatory for their workers. Keep in mind that if employees have medical or religious reasons that prevent them from taking a coronavirus vaccine, employers could be legally required to give the workers some reasonable alternative to continue to work. Also, for employers with a unionized workforce, the employer must consider bargaining requirements before implementing a mandatory vaccine policy.

Can an employer ask an employee if he or she has already received the vaccine or require proof of vaccination?

ANSWER: Generally, yes. However, that inquiry can only be made, according to the EEOC, if the question is “job-related and consistent with business necessity” as provided under the ADA. To meet this job-relatedness standard, the employer will need to establish that the worker’s failure to be vaccinated would pose a “direct threat” to the well-being of that employee or others with whom the employee would have contact as part of his or her job duties.

Can an employer fire an employee who refuses to be vaccinated?

ANSWER: Possibly, in limited circumstances. The EEOC guidance reminds employers that it will need to make reasonable accommodations to employees seeking an exemption due to disability-related reasons or religious objections and will need to follow the established reasonable accommodation process under either the ADA or Title VII before taking any adverse employment actions. The EEOC cautions employers that if it can establish that an employee who is not vaccinated poses a direct threat (that cannot be accommodated without undue hardship), the employer can exclude the employee from the worksite, but the employer cannot terminate the employee without further consideration of the employee’s legal protections or other possible accommodation, including whether the employee can perform his or her job remotely.

President Biden recently moved up the timeline for vaccine allocation by ordering all states, tribes, and territories to make every U.S. adult eligible for the COVID-19 vaccines by May 1. According to New York State’s COVID-19 Vaccine Tracker, 13% of the population is currently completely vaccinated.

It is important to remember that the EEOC guidance is only that—guidance—and not a law. Consequently, some employees may legally challenge mandatory vaccination programs and there is no guarantee that a court will react favorably to a particular legal challenge. There are also important legal limitations with a mandatory program even under the EEOC’s guidance. Therefore, employers mandating the vaccine should be prepared for some resistance from employees, and many may opt to strongly encourage vaccination without requiring it. A recent survey found that while most employers have no plan to create a mandatory vaccination process, many do plan to encourage employees to get the vaccine. Nearly 90% said they would provide information to employees (e.g., how to get vaccinated, the benefits of doing so) and nearly 40% said they would offer vaccine administration at their facility to increase convenience – even though this may be easier said than done. A third said they would offer paid time off for employees to receive the vaccine and/or recover from any side effects.

We hope this summary provides some helpful information for your company to consider as you navigate this complex issue. Pursuing a mandatory vaccination program ultimately requires a company’s management, together with its legal and HR teams, to engage in significant planning and develop a program detailing how the process will work from beginning to end. If your manufacturing company would like to talk to our dedicated team, please contact us today. Additionally, if you have HR questions, please reach out to our wholly-owned subsidiary Visions HR, and connect with Janet Giannetta.

Sources: PBS, AARP, NY.Gov, SHRM

Should Your Company Make Vaccinations Mandatory

Have you considered making COVID-19 vaccinations mandatory? If so, you’re not alone. As the COVID-19 vaccine becomes more widely available, the scientific community did not foresee the next challenge being vaccine resistance, but it’s the reality that’s setting in across the country. Polling data continues to show that a significant percentage of Americans prefer not to receive the COVID-19 vaccine. Essential construction workers are less likely than the average U.S. employee to take the COVID-19 vaccine when it’s available to them. A series of surveys on employee acceptance of the vaccine found just 53% of workers in the construction industry said they would take the COVID-19 vaccine. There’s no doubt that publicizing team member vaccination is one effective way to assure customers of increased job site safety, and would mean less disruption on project completion time. So, how do construction industry leaders navigate this latest bump on the road to economic recovery? Read on for the latest guidance.

Can an employer make COVID-19 vaccinations mandatory for workers?

ANSWER: In December, the federal agency focused on workplace discrimination, the Equal Employment Opportunity Commission, said because the vaccination itself is not a medical examination, employers could make COVID-19 shots mandatory for their workers. Keep in mind that if employees have medical or religious reasons that prevent them from taking a coronavirus vaccine, employers could be legally required to give the workers some reasonable alternative to continue to work. Also, for employers with a unionized workforce, the employer must consider bargaining requirements before implementing a mandatory vaccine policy.

Can an employer ask an employee if he or she has already received the vaccine or require proof of vaccination?

ANSWER: Generally, yes. However, that inquiry can only be made, according to the EEOC, if the question is “job-related and consistent with business necessity” as provided under the ADA. To meet this job-relatedness standard, the employer will need to establish that the worker’s failure to be vaccinated would pose a “direct threat” to the well-being of that employee or others with whom the employee would have contact as part of his or her job duties.

Can an employer fire an employee who refuses to be vaccinated?

ANSWER: Possibly, in limited circumstances. The EEOC guidance reminds employers that it will need to make reasonable accommodations to employees seeking an exemption due to disability-related reasons or religious objections and will need to follow the established reasonable accommodation process under either the ADA or Title VII before taking any adverse employment actions. The EEOC cautions employers that if it can establish that an employee who is not vaccinated poses a direct threat (that cannot be accommodated without undue hardship), the employer can exclude the employee from the worksite, but the employer cannot terminate the employee without further consideration of the employee’s legal protections or other possible accommodation, including whether the employee can perform his or her job remotely.

President Biden recently moved up the timeline for vaccine allocation by ordering all states, tribes, and territories to make every U.S. adult eligible for the COVID-19 vaccines by May 1. According to New York State’s COVID-19 Vaccine Tracker, 13% of the population is currently completely vaccinated.

It is important to remember that the EEOC guidance is only that—guidance—and not a law. Consequently, some employees may legally challenge mandatory vaccination programs and there is no guarantee that a court will react favorably to a particular legal challenge. There are also important legal limitations with a mandatory program even under the EEOC’s guidance. Therefore, employers mandating the vaccine should be prepared for some resistance from employees, and many may opt to strongly encourage vaccination without requiring it. A recent survey found that while most employers have no plan to create a mandatory vaccination process, many do plan to encourage employees to get the vaccine. Nearly 90% said they would provide information to employees (e.g., how to get vaccinated, the benefits of doing so) and nearly 40% said they would offer vaccine administration at their facility to increase convenience – even though this may be easier said than done. A third said they would offer paid time off for employees to receive the vaccine and/or recover from any side effects.

We hope this summary provides some helpful information for your business to consider as you navigate this complex issue. Pursuing a mandatory vaccination program ultimately requires a company’s management, together with its legal and HR teams, to engage in significant planning and develop a program detailing how the process will work from beginning to end. If your construction company would like to talk to our dedicated team, please contact us today. Additionally, if you have HR questions, please reach out to our wholly-owned subsidiary Visions HR, and connect with Janet Giannetta.

Sources: ForConstructionPros, PBS, AARP, NY.Gov