WASHINGTON - Today, U.S. Sen. Mark R. Warner (D-VA) joined Sen. Patty Murray (D-WA), ranking member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, and 44 of their Democratic Senate colleagues in writing to Vice President Mike Pence, and Coronavirus Task Force Coordinator Dr. Deborah Birx, urging the Trump Administration to reverse recent changes requiring hospitals to report data to a new system set up by the Department of Health and Human Services instead of the National Healthcare Safety Network (NHSN) which is run by the Centers for Disease Control and Prevention (CDC) and has been in use for over a decade.  

WASHINGTON – Today, U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) joined Sen. Jon Tester (D-MT) and 44 Senate colleagues in introducing a resolution officially condemning the Trump Administration’s “reckless” effort to dismantle the Affordable Care Act (ACA), which provides coverage for millions of Americans. The Senate resolution also demands that the Department of Justice (DOJ) defend existing law in court and halt its efforts to repeal the health care protections for millions – including 133 million Americans with pre-existing conditions— in the middle of a public health emergency.

“The Trump Administration has made it clear that it will not stop its assault on our nation’s health care law until millions of Americans have lost the protections and coverage they desperately need,” said Sen. Warner. “This resolution affirms what we have said for years – that this Administration’s efforts to dismantle the Affordable Care Act are despicable and put too many vulnerable Virginians at risk. The Department of Justice must immediately put a stop to these efforts and fight to increase access to health care during the largest public health crisis in a generation.” 

“To rip health care away from millions of people during a pandemic would be like dousing a fire with gasoline,” said Kaine. “For the sake of the more than 431,000 Virginians benefiting from Medicaid expansion, more than 3 million Virginians with pre-existing conditions, and all else who rely on the ACA for affordable coverage and consumer protections, I oppose this administration’s latest display of inept cruelty.” 

Last week, the DOJ and a group of Republican Attorneys General submitted a brief to the U.S. Supreme Court urging it to invalidate the ACA and pull the rug out from underneath the millions of Americans with preexisting conditions who depend on the law for health care coverage. This move would take away health care coverage for more than 23 million Americans who receive health care coverage through the ACA marketplaces.

Additionally, if the Supreme Court agrees to overturn the ACA, it could sabotage protections for more than 3 million Virginians living with a preexisting condition such as COVID-19, diabetes, asthma, or cancer, potentially exposing them to annual or lifetime caps, medical underwriting for their insurance coverage, or denials for the care they need. Across the board, the Commonwealth could lose needed federal funds, causing significant job losses and jeopardizing the viability of Virginia’s rural hospitals in the midst of a global health crisis.

The resolution urges DOJ to reverse its position and instead protect the millions of people who rely on the ACA for health care coverage amid the COVID-19 pandemic that has infected more than 2.4 million Americans.

In addition to Sens. Warner, Kaine and Tester, the resolution is also backed by Sens. Jeanne Shaheen (D-NH), Joe Manchin (D-WV), Doug Jones (D-AL), Tina Smith (D-MN), Mazie Hirono (D-HI), Jack Reed (D-RI), Chris Van Hollen (D-MD), Catherine Cortez Masto (D-NV), Tammy Baldwin (D-WI), Sherrod Brown (D-OH), Michael Bennet (D-CO), Tom Carper (D-DE), Dick Blumenthal (D-CT), Ed Markey (D-MA), Dick Durbin (D-IL), Kamala Harris (D-CA), Ben Cardin (D-MD), Patty Murray (D-WA), Jacky Rosen (D-NV), Debbie Stabenow (D-MI), Chris Murphy (D-CT), Ron Wyden (D-OR), Maggie Hassan (D-NH), Gary Peters (D-MI), Amy Klobuchar (D-MN), Martin Heinrich (D-NM), Elizabeth Warren (D-MA), Kyrsten Sinema (D-AZ), Angus King (I-ME), Tom Udall (D-NM), Sheldon Whitehouse (D-RI), Bob Menendez (D-NJ), Dianne Feinstein (D-CA), Brian Schatz (D-HI), Chris Coons (D-DE), Patrick Leahy (D-VT), Bernie Sanders (I-VT), Cory Booker (D-NJ), Kirsten Gillibrand (D-NY), Jeff Merkley (D-OR), Maria Cantwell (D-WA), Bob Casey (D-PA), Tammy Duckworth (D-IL) and Chuck Schumer (D-NY).

In the Senate, Sens. Warner and Kaine have fought for expanded access to health care and have spoken out against the Trump Administration’s attempts to overturn the ACA. Last year, Sen. Warner led and Sen. Kaine joined a legislative maneuver to protect health coverage for Americans with preexisting conditions. The Senators have also demanded that the Trump Administration stop the health care sabotage that has undermined our preparedness and ability to respond to COVID-19. Recently, Sen. Warner penned an op-ed sounding the alarm of the devastating effects the health and economic crisis caused by COVID-19 has had on record high uninsured rates across the country.  

The full text of the resolution is available here.

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WASHINGTON, D.C. – U.S. Senators Mark R. Warner and Tim Kaine (both D-VA) joined Senators Brian Schatz (D-HI) and Roger Wicker (R-MS) in calling for the expansion of access to telehealth services during the COVID-19 pandemic to be made permanent. Provisions from the CONNECT for Health Act, legislation cosponsored by Senators Warner and Kaine, that have allowed Medicare beneficiaries in all areas of the country to utilize telehealth services from home, as well as more types of health care providers to provide telehealth, were included in previous COVID-19 legislation. However, without urgent congressional action to make these measures permanent, these telehealth services are at risk of expiring when the pandemic ends.  

“Americans have benefited significantly from this expansion of telehealth and have come to rely on its availability,” the Senators wrote in a letter to Senator Majority Leader Mitch McConnell (R-KY) and Senate Minority Leader Chuck Schumer (D-NY). “Congress should expand access to telehealth services on a permanent basis so that telehealth remains an option for all Medicare beneficiaries both now and after the pandemic. Doing so would assure patients that their care will not be interrupted when the pandemic ends. It would also provide certainty to health care providers that the costs to prepare for and use telehealth would be a sound long-term investment.” 

In their letter, the Senators highlight the growing use and benefits of telehealth during the ongoing coronavirus pandemic, as patients seek to avoid traveling to hospitals and other providers and instead receive care at home. New data shows that the number of Medicare beneficiaries using telehealth services increased by 11,718 percent in just a month and a half during the pandemic.

The full text of the letter is below and available here. 

Dear Majority Leader McConnell and Minority Leader Schumer:

As you continue your work on critical legislation to respond to the COVID-19 crisis, we write to ask that you make permanent the provisions from our bipartisan CONNECT for Health Act that were included in previous COVID-19 legislation.  These provisions have resulted in an important expansion of access to telehealth services for Medicare beneficiaries during the pandemic. 

We have long advocated for increasing access to telehealth because of its potential to expand access to health care, reduce costs, and improve health outcomes.  Telehealth has proven to be pivotal for many patients during the current pandemic, ensuring they receive the care they need while reducing the risk of infection and the further spread of COVID-19.  We have all heard from our constituents about how effective and convenient it is.  Expanded Medicare coverage of telehealth services on a permanent basis—where clinically appropriate and with appropriate guardrails and beneficiary protections in place—would ensure that telehealth continues to be an option for all Medicare beneficiaries after the pandemic ends.

As you know, the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 and the Coronavirus Aid Relief and Economic Security Act included provisions from the CONNECT for Health Act to increase access to telehealth services for Medicare beneficiaries during the COVID-19 pandemic.  Specifically, these laws provide the Secretary of Health and Human Services the authority to waive telehealth requirements under Section 1834(m) of the Social Security Act, allow Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to provide distant site telehealth services, and allow for the use of telehealth to conduct the face-to-face visit required to recertify a patient’s eligibility for hospice care. 

Because of these new authorities provided by Congress, Medicare has expanded coverage of telehealth services for the duration of the pandemic to include all areas of the country—as well as allowing a patient’s home to serve as an originating site for telehealth.  In addition, more types of health care providers—including FQHCs and RHCs that provide primary care in rural and underserved areas—are able to furnish and bill Medicare for telehealth services.  These changes have already contributed to a dramatic increase in the use of telehealth services in Medicare.  Available data show that the number of Medicare beneficiaries using telehealth services during the pandemic increased 11,718 percent in just a month and a half.

Americans have benefited significantly from this expansion of telehealth and have come to rely on its availability.  Congress should expand access to telehealth services on a permanent basis so that telehealth remains an option for all Medicare beneficiaries both now and after the pandemic.  Doing so would assure patients that their care will not be interrupted when the pandemic ends.  It would also provide certainty to health care providers that the costs to prepare for and use telehealth would be a sound long-term investment. 

In addition, given the recent flexibilities provided by both Congress and the Centers for Medicare & Medicaid Services and the increased use of telehealth during the pandemic, we believe now is an important time to measure the impact of telehealth on Medicare.  Specifically, the federal government should collect and analyze data on the impact of telehealth on utilization, quality, health outcomes, and spending during the COVID-19 pandemic.  There is currently a scarcity of data available regarding the impact of telehealth on the Medicare program.  This data would assist Congress in crafting additional policies to improve health outcomes and use resources more effectively.

Thank you for your continued leadership during the present crisis.  We look forward to continuing to work together to increase access to telehealth.

Sincerely, 

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WASHINGTON - U.S. Sen. Mark R. Warner (VA) joined Sens. Debbie Stabenow (MI), Roger Wicker (MS), and 38 of their colleagues in urging Congress to support community health centers that provide Americans with critical health care, including testing and treatment of COVID-19. 

“We write to express our support for additional emergency funding for community health centers in the next COVID-19 relief package. Community health centers are vital to our response to the coronavirus pandemic and need appropriate funding to continue their front-line health care work,” wrote the Senators. “Community health centers provide affordable care to more than 29 million patients, including 385,000 veterans and 8.7 million children nationwide. These centers play a critical role in responding to the pandemic, offering coronavirus testing, primary care, dental care, behavioral health care, and other services to our nation’s most vulnerable patients.” 

In the letter, the Senators asked Senator Roy Blunt (MO) and Senator Patty Murray (WA), Chairman and Ranking Member of the Senate Appropriations Committee Subcommittee on Labor-HHS-Education, to support additional emergency funding for community health centers across the country. Over 2,000 centers have already had to close their doors, and many more remain concerned about how long they will be able to stay open. 

Full text of the letter can be found here and below:  

Dear Chairman Blunt and Ranking Member Murray: 

We write to express our support for additional emergency funding for community health centers in the next COVID-19 relief package. Community health centers are vital to our response to the coronavirus pandemic and need appropriate funding to continue their front-line health care work. 

 Community health centers provide affordable care to more than 29 million patients, including 385,000 veterans and 8.7 million children nationwide.  These centers play a critical role in responding to the pandemic, offering coronavirus testing, primary care, dental care, behavioral health care, and other services to our nation’s most vulnerable patients.  This care helps keep individuals out of emergency rooms, where beds are currently in particularly high need.  It also helps manage chronic conditions that may exacerbate the symptoms of COVID-19.

Over the next six months, community health centers will see 34 million fewer appointments as Americans cancel primary and preventive care appointments or delay non-essential care.  Health centers are anticipating $7.6 billion in lost revenue and 105,000 lost jobs.  Over 2,000 centers have already had to close their doors and many more remain concerned about how long they will be able to stay open. 

We appreciate the additional $2 billion in emergency funding provided to community health centers in recent COVID-19 response and relief packages, including $600 million dedicated to testing.  However, despite this funding, health centers are still worried about how to keep their doors open to serve their patients.  These valuable providers will continue to lose more revenue as the pandemic continues.  Additional funding is critical for these centers to continue providing quality, affordable health care and front-line response efforts.  

We look forward to working with you to reach a bipartisan agreement to enact legislation and ensure community health centers can continue to provide high quality and affordable care to those in need. 

Sincerely,

 

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WASHINGTON, D.C. – Today, U.S. Senators Mark R. Warner and Tim Kaine joined Senator Maggie Hassan and 14 of their colleagues in calling on the Centers for Disease Control and Prevention (CDC) to address the declining rate of routine child immunizations for measles and other dangerous viruses amid the COVID-19 pandemic.

“The administration of routine pediatric immunizations remains critical throughout the duration of this public health emergency,” wrote the Senators. “The decline in immunizations is largely attributable to efforts by families to adhere to social distancing guidelines to reduce both their exposure to, and the spread of COVID-19. But if this trend ofdecreased immunization rates among children continues, the United States could face yet another public health crisis: increased risk of outbreaks of vaccine-preventable diseases.”

The Senators continued, “Such outbreaks would put lives at risk, and place additional stress on our health care system and public health infrastructure at a time when these systems are struggling to respond to the COVID-19 pandemic.”

The Senators called for CDC to develop and execute a comprehensive plan to address the decline in immunization rates, including measures such as increased public outreach and education and best practices for parents and families to visit doctors while limiting their risk of contracting COVID-19. The Senators also asked for details on what CDC is doing to ensure sufficient supply of immunization doses and medical devices to administer them.

In addition to Senators Warner, Kaine, and Hassan, the letter was signed by Senators Patty Murray (D-WA), Bernie Sanders (I-VT), Jeff Merkley (D-OR), Tammy Baldwin (D-WI), Bob Casey (D-PA), Chris Van Hollen (D-MD), Mazie Hirono (D-HI), Richard Blumenthal (D-CT), Tina Smith (D-MN), Jacky Rosen (D-NV), Elizabeth Warren (D-MA), Amy Klobuchar (D-MN), Jack Reed (D-RI), and Doug Jones (D-AL).

Read the Senators’ full letter here or below. 

 

Dear Dr. Redfield,

We write to express significant concern regarding the recent decline in routine childhood immunization rates in the United States during the novel coronavirus (COVID-19) pandemic, and urge you to take immediate action to encourage and support routine pediatric immunizations through the duration of the COVID-19 pandemic.

According to recent data published by the Centers for Disease Control and Prevention (CDC), a decline in provider orders for non-influenza childhood vaccines, and measles-containing vaccines including the measles-mumps-rubella (MMR) vaccine, began one week after President Trump declared a national emergency on March 13, 2020 due to the COVID-19 pandemic. ^[1] In May, the Michigan Care Improvement Registry found a drastic decrease in vaccination rates among children across nearly every age group. The percentage of children five months and younger who remain up-to-date on recommended vaccines declined from 67.9 percent in 2019, to 49.7 percent in May 2020.^[2] The New York City health department reported a 63 percent drop in the number of vaccine doses administered to children between March 23 and May 9, including a 91 percent drop for children ages 2 and above.^[3]

The administration of routine pediatric immunizations remains critical throughout the duration of this public health emergency. The decline in immunizations is largely attributable to efforts by families to adhere to social distancing guidelines to reduce both their exposure to, and the spread of COVID-19. But if this trend of decreased immunization rates among children continues, the United States could face yet another public health crisis: increased risk of outbreaks of vaccine-preventable diseases. Such outbreaks would put lives at risk, and place additional stress on our health care system and public health infrastructure at a time when these systems are struggling to respond to the COVID-19 pandemic.

To avoid this potential crisis, we urge the CDC to immediately develop an action plan that incorporates targeted public outreach and education efforts on addressing vaccine hesitancy and emphasizing the importance of pediatric immunizations; resources for communities that have seen reductions in their immunization rates since the start of the COVID-19 pandemic; and guidance for parents and families on how to safely access pediatric immunizations during the COVID-19 pandemic, including best practices regarding personal protective equipment (PPE) use and other precautions to limit the risk of exposure to COVID-19 in health care settings; and necessary efforts to ensure rapid catch-up for children who are not up to date on critical pediatric vaccines.

In addition to developing the plans described above, we request that you respond to the following questions no later than July 1, 2020 to help us better understand how the federal government is working to address the alarming drop in pediatric immunization rates:

1. What specific steps is CDC taking to reverse the dramatic drop in vaccinations since mid-March?

1. How does CDC plan to capture accurate real-time data on pediatric immunization rates and identify potential solutions, particularly in vulnerable communities?

2. What outreach and education efforts are underway at CDC to address fears among parents and families related to bringing children into health care settings during the COVID-19 crisis? 

1. Is CDC planning a public information campaign to address vaccine hesitancy, and if so, how will CDC ensure that the necessary communication on the importance of routine immunizations is reaching parents and families?

2. How will CDC ensure that families receive guidance on safe access to care for children during the COVID-19 pandemic, including the appropriate use of PPE?

3. How will CDC communicate with health care workers, and provide the necessary tools to inform communities about the importance of receiving pediatric immunizations during the COVID-19 pandemic? 

4. What guidance is CDC providing to pediatricians and other health care workers on procedures to ensure that they can safely provide and promote routine pediatric immunizations?

5. Given the significant increase in unemployment due to COVID-19, many families are finding themselves uninsured. How will CDC raise awareness of the Vaccines for Children (VFC) program to ensure that families know their children can still access routine immunizations, and how does CDC plan to support participating VFC providers as they work to catch up VFC-eligible children on missed vaccinations, while also preparing for the upcoming flu season?

3. How will CDC monitor the ongoing availability and ordering of pediatric immunizations, including doses and other essential medical devices, PPE, and other supplies needed to store, transport and administer vaccines, and what plans are in place to address any supply chain disruptions?

1. Is CDC taking steps now to ensure that the availability of pediatric immunizations, and necessary medical devices and supplies, is not impacted when production and domestic distribution of a COVID-19 vaccine is underway?

4. Has CDC developed or reviewed modeling or projections that predict the potential impact on future vaccine-preventable outbreaks if the current pediatric immunization rate continues throughout the duration of the COVID-19 pandemic? 

5. Does CDC require additional resources from Congress in order to support efforts to reverse the decline in pediatric immunizations? If so, what level of funding would be sufficient?

We appreciate your timely response and look forward to working with you on this critical issue.

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WASHINGTON — U.S. Sen. Mark R. Warner (D-Va.) joined Sens. Chris Coons (D-Del.), Susan Collins (R-Maine) and nine of their colleagues on a bipartisan letter to Senate Leadership encouraging additional support for first responders in the next COVID-19 relief package. 

In addition to Sens. Warner, Coons and Collins, the letter was joined by Senators Tom Carper (D-Del.), Dick Durbin (D-Ill.), Richard Blumenthal (D-Conn.), Angus King (I-Maine), Jon Tester (D-Mont.), Chris Van Hollen (D-Md.), Ron Wyden (D-Ore.), Bob Casey (D-Pa.), and Amy Klobuchar (D-Minn.). 

The lawmakers detailed the following priorities for first responders:

• Bolster Assistance to Firefighter Grant, Staffing for Adequate Fire and Emergency Response (SAFER), and Department of Justice grant funding, including for the Community Oriented Policing Services program, so that state and local police, fire, and EMS departments can access resources to purchase and be reimbursed for PPE and other COVID-19 related expenses, recruit and retain employees and volunteers, and cover overtime, backfill costs, authorized hazard pay, and COVID-19-related paid sick leave during the crisis.
• Require that the Secretary of the Department of Homeland Security waive the cost share and maintenance of expenditure requirements for Assistance to Firefighter Grants for reimbursement of COVID-19-related expenses through FY21. 
• Require that the Secretary of the Department of Homeland Security grant waivers to SAFER grant recipients for employee retention to aid staffing shortages through FY21.  In addition, any legislation should retroactively require that the Secretary grant such waivers for FY19 and FY20 SAFER funds. 
• Waive the prohibition on hazard pay for federal firefighters under 5 U.S.C. §?5545b(d)(1) for purposes of COVID-19 response, provide funding to federal agencies sufficient to cover hazard pay to frontline federal firefighters and law enforcement officers when appropriate, extend overtime pay to U.S. Probation Officers, and waive the federal firefighter and law enforcement officer overtime cap under 5 U.S.C. §?5547.
• Address the gap in paid sick leave coverage for first responders by requiring that the employing agency, not the employee, provide up to 80 hours of paid sick leave should these departments order the employee to self-quarantine in accordance with Centers for Disease Control and Prevention guidelines due to potential COVID-19 exposure.
• Create a presumption in the Public Safety Officers’ Benefits Program that a public safety officer’s infection of COVID-19 resulted from their employment to clearly establish eligibility for benefits due to the pandemic.
• Prevent the taxation of state and local incentives for volunteer firefighters and EMS personnel beyond 2020 in order to help departments continue to recruit and retain volunteer personnel.

The lawmakers’ effort is supported by the Fraternal Order of Police, the National Association of Police Organizations, the Federal Law Enforcement Officers Association, the International Association of Fire Fighters, the National Volunteer Fire Council, and the Congressional Fire Services Institute.

The full text of the letter is available here and below. 

 

Dear Leader McConnell and Leader Schumer: 

We appreciate your work to provide support for our nation’s police officers, firefighters, and emergency medical services (EMS) personnel in the Coronavirus Aid, Relief, and Economic Security Act.  However, additional assistance is needed during this crisis.  As Congress considers further legislation in response to the COVID-19 pandemic, we urge you to include additional support for our nation’s first responders who work in some of the highest risk occupations for COVID-19 exposure.^[i]  First responders are routinely in physical contact with potentially infected persons and are facing unprecedented volumes of dispatch calls in severely impacted areas.^[ii]

A short supply of personal protective equipment (PPE) for first responders to guard against disease exposure has left many police officers, firefighters, and EMS personnel exposed to the dangers of this crisis.  This has resulted in too many first responders across our nation contracting COVID-19 and being forced to self-quarantine, which has led to staffing shortages.^[iii]  As of April 1, more than 1,400 New York City Police Department employees have contracted COVID-19, with 6,100 in total in quarantine, and 282 New York City Fire Department employees have contracted COVID-19, with 950 in total in quarantine.^[iv]  While New York City is the current epicenter of the U.S. outbreak, many other cities and states with developing outbreaks such as New Jersey, Florida, Detroit, Seattle, Washington D.C., and several additional states and cities across the nation^[v] have reported a significant number of first responders contracting COVID-19 or requiring self-quarantine.

As this outbreak continues, many more first responders will undoubtedly contract COVID-19 or be forced to self-quarantine.  To support our nation’s police officers, firefighters, and EMS personnel serving on the front lines of this pandemic, we urge action on the below items.  

• Bolster Assistance to Firefighter Grant, Staffing for Adequate Fire and Emergency Response (SAFER), and Department of Justice grant funding, including for the Community Oriented Policing Services program, so that state and local police, fire, and EMS departments can access resources to purchase and be reimbursed for PPE and other COVID-19 related expenses, recruit and retain employees and volunteers, and cover overtime, backfill costs, authorized hazard pay, and COVID-19-related paid sick leave during the crisis.
• Require that the Secretary of the Department of Homeland Security waive the cost share and maintenance of expenditure requirements for Assistance to Firefighter Grants for reimbursement of COVID-19-related expenses through FY21. 
• Require that the Secretary of the Department of Homeland Security grant waivers to SAFER grant recipients for employee retention to aid staffing shortages through FY21.  In addition, any legislation should retroactively require that the Secretary grant such waivers for FY19 and FY20 SAFER funds. 
• Waive the prohibition on hazard pay for federal firefighters under 5 U.S.C. §?5545b(d)(1) for purposes of COVID-19 response, provide funding to federal agencies sufficient to cover hazard pay to frontline federal firefighters and law enforcement officers when appropriate, extend overtime pay to U.S. Probation Officers, and waive the federal firefighter and law enforcement officer overtime cap under 5 U.S.C. §?5547.
• Address the gap in paid sick leave coverage for first responders by requiring that the employing agency, not the employee, provide up to 80 hours of paid sick leave should these departments order the employee to self-quarantine in accordance with Centers for Disease Control and Prevention guidelines due to potential COVID-19 exposure.
• Create a presumption in the Public Safety Officers’ Benefits Program that a public safety officer’s infection of COVID-19 resulted from their employment to clearly establish eligibility for benefits due to the pandemic.
• Prevent the taxation of state and local incentives for volunteer firefighters and EMS personnel beyond 2020 in order to help departments continue to recruit and retain volunteer personnel. 

During a time of crisis, communities rely on local first responders as the first line of defense for protection and emergency response.  As you continue to develop further legislation in response to the COVID-19 pandemic, we urge you to include the above items so that our nation’s first responders can operate at full capacity as we fight the COVID-19 pandemic. 

Sincerely, 

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) joined Sen. Chris Van Hollen (D-MD) and seven of their Senate colleagues in urging the President to expand his use of Title III of the Defense Production Act (DPA) in order to dramatically increase domestic production capacity for personal protective equipment (PPE) and COVID-19 testing supplies. 

“An analysis by Harvard University researchers found that the United States must, at minimum and under the best-case scenario, double the number of tests being conducted each week,” wrote the Senators. “In many cases, even when state and local governments are able to get some supplies into the hands of their frontline medical personnel, they go unused because of shortages in other key supplies.” 

They continued, “Congress appropriated $57.6 billion to address critical needs such as these, including $16 billion to purchase medical supplies for distribution through the Strategic National Stockpile and at least $11 billion to support efforts to expand testing by states, localities, and tribes. But it is clear that these widespread shortages will not be fully resolved until the nation’s production capacity can be dramatically scaled up, and despite unprecedented global demand, private sector companies have been reticent to expand production capacity without support and direction from the federal government. For that reason, is imperative that the federal government fully use its authority to support and expand production of PPE and testing supplies.”

Section 301 and 302 of Title III authorize the President to reduce current or projected shortfalls of industrial resources, critical technology items, or essential materials needed for national defense purposes. Meanwhile, Section 303 gives the President the authority to create, maintain, protect, expand, or restore domestic industrial base capacity, which includes purchasing or making purchase commitments of industrial resources or critical technology items, making subsidy payments for domestically produced materials, and installing and purchasing equipment for government and privately-owned industrial facilities to expand their production capacity.

In their letter, the Senators note that Title III has only been used twice by the government to respond to this health crisis and urge the President to immediately expand production and deliveries of PPE and testing supplies by using Title III of the Defense Production Act and any other appropriate authority.

Sen. Warner has long called for an increase in testing and PPE production in the Commonwealth. In March, he joined his colleagues in introducing the Free COVID-19 Testing Act, legislation that would expand free tests to confirm coronavirus (COVID-19) infections. He has also introduced legislation to require the president to utilize all available authorities under the Defense Production Act to mobilize a federal response to the pandemic through an equitable and transparent process. Additionally, he has pressed the Administration to outline how it plans to use Defense Production Act powers to increase production of testing supplies and equipment needed for the pandemic response. 

Joining Sens. Warner and Van Hollen on the letter are Sens. Angus King (I-ME), Gary Peters (D-MI), Kamala Harris (D-CA), Mazie Hirono (D-HI, Patrick Leahy (D-VT), Debbie Stabenow (D-MI), and Jack Reed (D-RI).

The full text of the letter is available here and below.

 

Dear President Trump: 

We write in response to the release of your administration’s blueprint for State testing plans and rapid response programs to urge you to broaden your use of Title III of the Defense Production Act (DPA) and other appropriate authorities to expand domestic production capacity for personal protective equipment (PPE) and COVID-19 testing supplies.

On April 27, you announced that your administration had “successfully scaled a robust testing regime that is able to meet the massive needs of a nationwide pandemic.” On the same day, an analysis by Harvard University researchers found that the United States must, at minimum and under the best-case scenario, double the number of tests being conducted each week. Nationwide shortages continue to prevent the United States from conducting enough tests to safely reopen.

In many cases, even when state and local governments are able to get some supplies into the hands of their frontline medical personnel, they go unused because of shortages in other key supplies. In Maryland, for example, the state has secured a large number of testing kits, but the kits cannot be used without the necessary swabs and viral transport media—both of which have been in short supply.

Similarly, the nation continues to face critical shortages of PPE. This has led to dangerous rationing and efforts by medical providers to disinfect, reuse, or fashion their own equipment. Reports from across the country paint a bleak picture: staff at the Henry Ford Health System in Michigan made their own face shields using plastic sheets, elastic bands, and tongue depressors. Providence Health in Washington did the same using supplies from Home Depot. Elsewhere, medical staff are soliciting donations of homemade cloth masks and constructing makeshift decontamination systems to reuse their PPE.

Before any state in the country can reopen responsibly, PPE and testing needs must be met. Congress appropriated $57.6 billion to address critical needs such as these, including $16 billion to purchase medical supplies for distribution through the Strategic National Stockpile and at least $11 billion to support efforts to expand testing by states, localities, and tribes. But it is clear that these widespread shortages will not be fully resolved until the nation’s production capacity can be dramatically scaled up, and despite unprecedented global demand, private sector companies have been reticent to expand production capacity without support and direction from the federal government. For that reason, is imperative that the federal government fully use its authority to support and expand production of PPE and testing supplies.

Section 301 and 302 of Title III authorize you to issue loan guarantees and direct loans to reduce current or projected shortfalls of industrial resources, critical technology items, or essential materials needed for national defense purposes. Section 303 grants you a range of authorities to create, maintain, protect, expand, or restore domestic industrial base capacity. These include purchasing or making purchase commitments of industrial resources or critical technology items, making subsidy payments for domestically produced materials, and installing and purchasing equipment for government and privately owned industrial facilities to expand their production capacity. In short, these authorities allow you to provide a company the financing and equipment they need to expand their production capacity and guarantee a buyer for their products once that capacity comes online. 

As part of the CARES Act, Congress appropriated $1 billion for the primary purpose of expanding domestic production of medical supplies to respond to COVID-19. We appreciated your executive order on March 27, 2020 to delegate authority to the Secretaries of Health and Human Services and Homeland Security, allowing each to make use of DPA Title III to expand production capacity. However, to date, Title III has been used just twice as part of the government’s response to the COVID-19 pandemic. On April 11, 2020, the Department of Defense announced that it would use Title III to secure a $133 million investment resulting in the production of 39 million additional N95 masks. On April 29, DOD announced a Title III award to expand the production of swabs by Puritan Medical Supplies in Maine.

These measures are totally inadequate to meeting the challenge we face. This crisis requires faster, more coordinated action to limit loss of life in the near term and over the next year. We urge you to act immediately to expand production and deliveries of PPE and testing supplies using Title III of the Defense Production Act and any other appropriate authority.

Sincerely,

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WASHINGTON – Today, U.S. Sens. Mark R. Warner (D-VA), Tim Kaine (D-VA), Michael Bennet (D-CO), Sherrod Brown (D-OH), and Jack Reed (D-RI) sent a letter to the U.S. Department of Veterans Affairs (VA) pushing for more information regarding the personal protective equipment (PPE) available to its employees at hospitals, clinics and other facilities during the COVID-19 health crisis, as well as whether the Centers for Disease Control (CDC) guidelines are sufficient enough to protect its employees. The Senators are raising the alarm following reporting that indicates a serious shortage of PPE at VA facilities across the country, directly contradicting VA leadership’s claim that they have enough PPE at their facilities. In addition, the Senators have heard directly from their constituents who are VA facility employees concerned for their well-being while on-the-job.

“We write to request information about the use of personal protective equipment (PPE) by Department of Veterans Affairs (VA) employees at hospitals, clinics, and other facilities, and whether the VA’s guidance to its employees, based on guidelines from the Centers for Disease Control and Prevention (CDC), is sufficiently robust in safeguarding staff. With more than 1,600 positive COVID-19 cases among VA staff nationwide, and more than a dozen employee deaths, the Department must take every possible action to protect staff and veterans,” the Senators wrote in a letter to VA Secretary Robert Wilkie.

According to the VA, they have instructed their employees to adhere to the CDC guidelines, which allows for the reuse of single-use masks for multiple days, as well as the ability to disinfect and reuse those masks. However, some VA staff who are not interacting directly with COVID-19 patients are working without PPE.

“The Wall Street Journal reports that VA internal memos caution that a ‘serious shortage’ of PPE masks exists and rationing may be reduced to one mask per day for providers. Additional Wall Street Journal reporting suggests that the Department has only a two-week PPE supply and workers must use the same mask as they move from patient to patient. We have also heard from a number of our constituents who are employees at VA facilities, who think they are not being provided adequate PPE in their jobs and fear for their personal health and safety. Employees report being asked to use one N95 mask for up to a week, which manufacturers recommend be changed each shift at a minimum. These employees report that they are being asked to store surgical or procedural masks in paper bags, and that some masks begin disintegrating after too many days of use,” they continued.

In their letter, the Senators underscored the need for VA medical facility staff, as well as clinical and administrative employees, to have the appropriate PPE to protect their health and the health of the veterans they serve during the current health crisis. Following recent reporting that some VA employees are being penalized for following guidance from public health authorities, the Senators are also calling on the VA to allow flexibility for their employees by providing administrative leave if required to self-quarantine.

Additionally, the Senators requested answers to the following questions:

• Are VA healthcare providers using the same PPE for multiple encounters with patients, even though these devices are not approved by the Food and Drug Administration for reuse?
• How many medical facilities have instituted PPE rationing processes that require providers to use single-use PPE for multiple patients?
• How often are employees being provided new PPE, including masks, at these facilities?
• Are VA facilities relying on CDC guidance regarding the extended use of PPE to modify standards, ration equipment, or determine that adequate PPE supplies exist?
• If single-use masks are used for multiple patients, what procedures are in place to protect both provider and patient health?
• What is the maximum number of patients that providers are permitted to care for while using the same single-use PPE?
• If sufficient essential supplies are present, do providers need to reuse single-use PPE or use PPE for extended periods?
• If single-use PPE must be reused, what methods for decontamination and reuse are being followed?
• Of the $14.4 billion included in the CARES Act for PPE, please provide us with a breakdown of how much has VA spent on  PPE supplies and equipment. And if additional funding is required, has Congress been explicitly notified of this need?
• Have multiple-use face masks or other alternatives designed for routine decontamination been considered instead of single-use PPE?

• If PPE levels are not sufficient, what is the VA’s plan to ensure large-scale national-level PPE purchases and distribution to facilities in-need?

A copy of the letter can be found here and below.

 

The Honorable Robert Wilkie

Secretary of Veterans Affairs

U.S. Department of Veterans Affairs

810 Vermont Avenue NW

Washington, D.C. 20420

Dear Secretary Wilkie: 

We write to request information about the use of personal protective equipment (PPE) by Department of Veterans Affairs (VA) employees at hospitals, clinics, and other facilities, and whether the VA’s guidance to its employees, based on guidelines from the Centers for Disease Control and Prevention (CDC), is sufficiently robust in safeguarding staff. With more than 1,600 positive COVID-19 cases among VA staff nationwide, and more than a dozen employee deaths, the Department must take every possible action to protect staff and veterans. 

We understand from media reports, as well as discussions with VA employees and leadership, that the VA is adhering to CDC guidelines, which allows for the reuse of single-use masks for multiple days, disinfecting and reusing masks, and no masks for some staff who are not interacting directly with COVID-19 patients. VA leadership has asserted that they have enough PPE at their facilities and that their employees have access to the necessary PPE, given these guidelines. We are concerned that this guidance may be driven not by best practices for VA staff and patients, but by PPE shortages throughout the system. 

The Wall Street Journal reports that VA internal memos caution that a “serious shortage” of PPE masks exists and rationing may be reduced to one mask per day for providers. Additional Wall Street Journal reporting suggests that the Department has only a two-week PPE supply and workers must use the same mask as they move from patient to patient. We have also heard from a number of our constituents who are employees at VA facilities, who think they are not being provided adequate PPE in their jobs and fear for their personal health and safety. Employees report being asked to use one N95 mask for up to a week, which manufacturers recommend be changed each shift at a minimum. These employees report that they are being asked to store surgical or procedural masks in paper bags, and that some masks begin disintegrating after too many days of use.

In addition, Government Executive recently reported that some VA medical facility staff are not permitted to wear masks. A medical support assistant was placed on absent without leave status when she stayed home with symptoms consistent with COVID-19 while waiting several weeks for test results. Upon being able to return to work she was prohibited from wearing a mask until the VA later provided one mask per week.

Ensuring that VA medical facility staff, as well as clinical and administrative employees, have the appropriate PPE to protect their health and the health of the veterans they serve is essential to countering the pandemic. Additionally, when staff take the appropriate steps to self-quarantine, VA should provide them with administrative leave and not require them to deplete their own sick leave bank.

To ensure VA staff are protected and that transparent information is available about PPE supplies, we ask that you provide a response to the following questions:

• Are VA healthcare providers using the same PPE for multiple encounters with patients, even though these devices are not approved by the Food and Drug Administration for reuse?
• How many medical facilities have instituted PPE rationing processes that require providers to use single-use PPE for multiple patients?
• How often are employees being provided new PPE, including masks, at these facilities?
• Are VA facilities relying on CDC guidance regarding the extended use of PPE to modify standards, ration equipment, or determine that adequate PPE supplies exist?
• If single-use masks are used for multiple patients, what procedures are in place to protect both provider and patient health?
• What is the maximum number of patients that providers are permitted to care for while using the same single-use PPE?
• If sufficient essential supplies are present, do providers need to reuse single-use PPE or use PPE for extended periods?
• If single-use PPE must be reused, what methods for decontamination and reuse are being followed?
• Of the $14.4 billion included in the CARES Act for PPE, please provide us with a breakdown of how much has VA spent on  PPE supplies and equipment. And if additional funding is required, has Congress been explicitly notified of this need?
• Have multiple-use face masks or other alternatives designed for routine decontamination been considered instead of single-use PPE?

• If PPE levels are not sufficient, what is the VA’s plan to ensure large-scale national-level PPE purchases and distribution to facilities in-need?

We ask that you take all necessary steps to ensure that VA employees have the resources and guidance required for their safety and the safety of our veterans. We stand ready to help and appreciate your candor and consideration.   

Sincerely,

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WASHINGTON – U.S. Sen. Mark R. Warner (D-VA) joined Sen. Dick Durbin (D-IL) and 16 Senators in a letter to Senate Majority Leader Mitch McConnell (R-KY) and Senate Democratic Leader Chuck Schumer (D-NY) to ensure that any forthcoming COVID-19 legislation includes robust federal subsidies so that individuals who lose their job as a result of this pandemic can maintain their employer-sponsored health coverage. 

One option for Americans who lose their jobs, or drop below the hours necessary to be eligible for employer-sponsored health coverage, is COBRA. COBRA allows people to keep the employer-sponsored coverage that they selected for up to 18 months.  However, instead of having employers contribute to the premium costs, individuals are responsible for having to pay the full insurance premium themselves—an average of $1,700 a month for a family plan—which is often unaffordable for those newly unemployed.  In today’s letter, the Senators called on Congress to craft a bill that provides a robust federal COBRA premium subsidy for individuals who would otherwise lose their employer-sponsored coverage as a result of the COVID-19 pandemic.

“Allowing families to maintain the coverage they previously selected will help ensure continuity of care and limit disruption for both families and employers as our economy gets back on track,” the Senators wrote.  “We stand ready and eager to work with you to ensure that the next COVID-19 relief package includes this important policy, which will ensure that millions of people losing their jobs as a result of this pandemic will not also suddenly become uninsured and at risk for catastrophic health care costs.” 

In the U.S., over half of Americans receive their health coverage through their employer.  Depending on the extent of unemployment as a result of the coronavirus pandemic, between 23 to 35 million workers could end up losing their employer-based health care coverage. 

Along with Durbin, today’s letter is also signed by Senators Amy Klobuchar (D-MN), Tom Carper (D-DE), Jeanne Shaheen (D-NH), Sherrod Brown (D-OH), Jacky Rosen (D-NV), Catherine Cortez Masto (D-NV), Bob Menendez (D-NJ), Jack Reed (D-RI), Doug Jones (D-AL), Jeff Merkley (D-OR), Dianne Feinstein (D-CA), Michael Bennet (D-CO), Tammy Duckworth (D-IL), Debbie Stabenow (D-MI), Richard Blumenthal (D-CT), and Brian Schatz (D-HI). 

Full text of the letter is available here and below:

 

Thank you for your efforts to date to ensure swift passage of multiple bipartisan pieces of legislation vital to helping our nation’s families, health care providers, and small businesses cope with the ongoing COVID-19 pandemic. Looking forward, we recognize that additional legislation will be necessary to improve the public health and America’s ailing economy. To that end, we strongly urge you to ensure that any forthcoming COVID-19 package include robust federal subsidies so that individuals can maintain on their employer-sponsored health coverage when they lose their jobs.

Over the last three weeks, approximately seventeen million people have filed unemployment claims in their state. However, this unprecedented number of filings only reflects claims filed through April 4. Many more Americans are likely out of work, or soon will be, because of the COVID-19 pandemic. Forecasters predict that as many as 20 million people could lose their jobs by the end of April. Compounding this problem is the fact that unemployment for these individuals and their families will also mean they will lose their existing employer-sponsored health insurance. 

In the U.S., over half of Americans receive their health coverage through their employer. Of the seventeen million Americans who have recently lost their jobs due to COVID-19, it is estimated that more than six million of these individuals have also lost their employer-sponsored health care. Depending on the extent of unemployment, between 23 to 35 million workers could lose their coverage.  

One option for Americans who lose their jobs, or drop below the hours necessary to be eligible for employer-sponsored health coverage, is COBRA. COBRA allows people to keep the employer-sponsored coverage that they selected for up to 18 months. However, people have to pay the full insurance premium—an average of $1,700 a month for a family plan—which is often unaffordable for those newly unemployed. Congress must step in and assist these individuals and families.

Following the 2008 financial crisis, the American Recovery and Reinvestment Act of 2009 (ARRA) was signed into law, which made COBRA continuation coverage more affordable and accessible to those who unexpectedly became unemployed. The law offered a 65 percent COBRA premium subsidy to individuals from September 1, 2008 to May 31, 2010. While well-intentioned and helpful to some, many individuals were unable to participate in the program because the remaining 35 percent insurance costs were still too expensive for them to cover.

We have heard from our constituents, as we know you have too. They are in dire economic circumstances. Despite government relief—in the form of extending monthly bill deadlines and increasing unemployment insurance—it will not be enough for most Americans to continue affording the health insurance policy they and their families elected through their employer’s plan. Allowing families to maintain the coverage they previously selected will help ensure continuity of care and limit disruption for both families and employers as our economy gets back on track. In order to provide our constituents adequate relief and to improve upon ARRA’s COBRA provision, we believe Congress must craft a bill that provides a robust federal COBRA premium subsidy for individuals who would otherwise lose their employer-sponsored coverage as a result of the COVID-19 pandemic.

We stand ready and eager to work with you to ensure that the next COVID-19 relief package includes this important policy, which will ensure that millions of people losing their jobs as a result of this pandemic will not also suddenly become uninsured and at risk for catastrophic health care costs. 

Sincerely,

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WASHINGTON - U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) joined Sen. Elizabeth Warren to introduce the bicameral Equitable Data Collection and Disclosure on COVID-19 Act. The bill would require the Department of Health and Human Services (HHS) to collect and report racial and other demographic data on COVID-19 testing, treatment, and fatality rates, and provide a summary of the final statistics and a report to Congress within 60 days after the end of the public health emergency. It would require HHS to use all available surveillance systems to post daily updates on the CDC website showing data on testing, treatment, and fatalities, disaggregated by race, ethnicity, sex, age, socioeconomic status, disability status, county, and other demographic information. 

The legislation comes as reports across the United States point to stark racial disparities in COVID-19 cases and fatalities. In Michigan, Black residents account for 33% of confirmed COVID cases and 40% of fatalities, despite making up only 14% of the state’s population.  In Louisiana, 70% of those who have died from COVID-19 so far are Black, compared with 32% of the state’s population. Initial data from Boston shows that among people whose race was reported, more than 40% of people infected were Black, compared with only 25% of the population.

“It’s deeply troubling that the coronavirus is disproportionately impacting communities of color. It’s imperative that we get data to help us understand the scope of this crisis and take action to reduce racial disparities,” the Senators said.

Specifically, the Equitable Data Collection and Disclosure on COVID-19 Act would require the reporting of the following data disaggregated by race, ethnicity, sex, age, socioeconomic status, disability status, county, and other demographic information:

• Data related to COVID-19 testing, including the number of individuals tested and the number of tests that were positive.
• Data related to treatment for COVID-19, including hospitalizations and intensive care unit admissions and duration;
• Data related to COVID-19 outcomes, including fatalities.

The legislation would also authorize $50 million in funding for the CDC, state public health agencies, the Indian Health Service, and other agencies to improve their data collection infrastructure and create an inter-agency commission to make recommendations on improving data collection and transparency and responding equitably to this crisis. 

The Equitable Data Collection and Disclosure on COVID-19 Act is endorsed by the National Urban League, Lawyer’s Committee on Civil Rights, Asian & Pacific Islander American Health Forum and National Action Network. In the House, the legislation is being introduced by Representative Ayanna Pressley (D-MA-07), Chair of the Congressional Black Caucus Health Braintrust Representative Robin Kelly (D-IL-02), Chair of the Congressional Black Caucus Representative Karen Bass (D-CA-37), Representative Barbara Lee (D- CA-13), and is co-sponsored by 80 of their colleagues. 

Warner and Kaine also joined their colleagues in sending a letter to Vice President Pence regarding the racial health disparities among COVID-19 patients. The letter highlights racial disparities in the mortality rate of the virus, calls for disaggregated racial data in COVID-19 case reporting, asks the Administration for more information on its outreach to minority communities, and requests that COVID-19 vaccine and drug trials include diverse participants. 

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA), a member of the Senate Finance Committee, joined his Senate Democratic colleagues in pressing the U.S. Department of Labor (DOL) to ensure workers Congress intended to be covered by the Pandemic Unemployment Assistance Program receive the benefits they deserve. The program, which was established in the CARES Act, is intended to make sure that individuals who would normally not qualify for unemployment benefits under state law, but are currently unemployed, unable, or unavailable to work as a direct result of the COVID-19 health crisis, are eligible to receive unemployment compensation.

“[P]arts of the guidance appear narrow or ambiguous, which could make states think they need to exclude workers who Congress clearly intended to receive unemployment compensation through the Pandemic Unemployment Assistance (PUA) program,” wrote the Senators in their letter to Secretary of Labor Eugene Scalia.

In the letter, the Senators are requesting the Department of Labor clarify its guidance pertaining to workers who have been diagnosed with COVID-19 without receiving a test, workers with COVID-19 who take time off of work, workers without child care options in summer months, workers unable to get to work due to stay-at-home orders, workers with underlying health conditions like asthma, and self-employed workers like gig workers who are unable to work due to plummeting demand for their services.

Earlier this month, Sen. Warner sent a letter to Secretary Scalia calling on the federal agency to streamline the Pandemic Unemployment Assistance (PUA) process by issuing additional, more comprehensive guidance to states so they can quickly implement the unemployment provisions in the CARES Act and ensure that gig workers are able to access unemployment benefits in the midst of the growing economic emergency. Among other recommendations, the letter called on the Department of Labor to take the lead with innovative technological solutions for administration of the PUA that states could use in order to facilitate the process and limit the need to stand up new state-level solutions.

In addition to Sen. Warner, today’s letter was led by Sen. Ron Wyden (D-OR), Minority Leader Chuck Schumer (D-NY) and co-signed by Sens. Patrick Leahy (D-VT), Sherrod Brown (D-OH), Patty Murray (D-WA), Chris Van Hollen (D-MD), Michael Bennet (D-CO), Ed Markey (D-MA), Doug Jones (D-AL), Sheldon Whitehouse (D-RI), Angus King (D-VT), Bob Menendez (D-NJ), Cory Booker (D-NJ), Ben Cardin (D-MD), Kirsten Gillibrand (D-NY), Mazie Hirono (D-HI), Amy Klobuchar (D-MN), Tom Carper (D-DE), Richard Blumenthal (D-CT), Debbie Stabenow (D-MI), Tina Smith (D-MN), Tammy Duckworth (D-IL), Bob Casey (D-PA), Elizabeth Warren (D-MA), Bernie Sanders (I-VT), Dianne Feinstein (D-CA), Dick Durbin (D-IL), Jeff Merkley (D-OR), Jack Reed (D-RI), Catherine Cortez Masto (D-NV), Jacky Rosen (D-NV), Maria Cantwell (D-WA), and Tom Udall (D-NM). 

A copy of the letter can be found here and below. A list of Sen. Warner’s work to protect Americans amid the COVID-19 outbreak is available here.

 

The Honorable Eugene Scalia

Secretary of Labor

U.S. Department of Labor

200 Constitution Ave. NW

Washington, DC 20210

Dear Secretary Scalia: 

Thank you for entering into agreements with states and territories and issuing some of the key guidance needed to implement new federal unemployment compensation programs on April 4 and April 5, 2020 (Unemployment Insurance Program Letter [UIPL] Numbers 15-20 and 16-20). This guidance is essential to start getting more unemployment benefits to workers across the country, including self-employed and other workers who are not covered by the traditional Unemployment Insurance (UI) program. 

We understand that the examples of covered workers provided in the guidance are not intended to be exhaustive. However, parts of the guidance appear narrow or ambiguous, which could make states think they need to exclude workers who Congress clearly intended to receive unemployment compensation through the Pandemic Unemployment Assistance (PUA) program.

We request that the Department of Labor (the Department) issue additional guidance on the issues described below no later than Friday, April 17. Understanding that you are still working diligently to release guidance for several CARES Act programs, if you are unable to issue clarifying guidance by Friday, April 17, we request a written response to this letter providing a timeline for issuing clarifying guidance and detailing how you intend to address these issues.

1. The Department’s guidance for sections 2102(a)(3)(A)(ii)(I)(aa), (bb), and (ff) reference circumstances under which an individual testing positive for COVID-19 is a possible qualification for a person receiving PUA. In the CARES Act, Congress deliberately used language referring to a “diagnosis” rather than “tested positive”, knowing testing shortages, delays in test results, and guidance instructing people to stay home rather than travel to medical facilities could make testing-based criteria difficult to meet. Furthermore, if someone suspects they have COVID-19 but can care for themselves at home, the Centers for Disease Control and Prevention (CDC) recommends they recover at home to avoid infecting others.  

We are pleased that the language in the Department’s guidance says that someone may qualify for PUA if they have tested positive or received a diagnosis, but we request that the Department make crystal clear that while a positive test would be sufficient to qualify for PUA under these provisions, a qualifying diagnosis never requires a positive test. Any diagnosis from a health care provider, including one made via phone or telehealth, is also sufficient for a person to qualify for PUA.  

2. The two examples provided in UIPL 16-20 Attachment I (C)(1)(a) of the guidance for an individual who might qualify for unemployment benefits under section 2102(a)(3)(A)(ii)(I)(aa) of the CARES Act based on their own illness both involve an individual who must quit a job. This provision of the CARES Act also covers any individual who is forced to take unpaid time off work for the reasons described, regardless of whether their employment relationship is formally severed. The guidance should be clarified to ensure that such individuals are covered. 

3. Section 2102(a)(3)(A)(ii)(I)(dd) of the CARES Act says an individual may qualify for PUA if “a child or other person in the household for which the individual has primary caregiving responsibility is unable to attend school or another facility that is closed as a direct result of the COVID–19 public health emergency and such school or facility care is required for the individual to work.” The guidance in UIPL 16-20 Attachment I (C)(1)(d) provides accurate examples of situations in which a caregiver could qualify for PUA under this provision.

However, the guidance later states that “a school is not closed as a direct result of the COVID-19 public health emergency, for purposes of section 2102(a)(3)(A)(ii)(I)(dd), after the date the school year was originally scheduled to end.” Many families rely on child care, summer camp, or other facilities (including school facilities) to care for their children in the summer and those facilities may remain closed as a result of COVID-19. The guidance should be clarified to confirm that individuals may qualify under section 2102(a)(3)(A)(ii)(I)(dd) during the summer months, for families that rely on any of those facilities.

4. Section 2102(a)(3)(A)(ii)(I)(ee) of the CARES Act says that an individual who is “unable to reach the place of employment because of a quarantine imposed as a direct result of the COVID–19 public health emergency” may qualify for PUA. The example of a quarantine provided in UIPL 16-20 Attachment I (C)(1)(e) of the Department’s guidance describes “a state or municipal order restricting travel” preventing an individual from getting to work. We are concerned that using the language of “restricting travel” may be too narrow to capture all of types of quarantine orders that are covered under this provision of the CARES Act. The guidance should clarify that such an order includes any stay-at-home, shelter-in-place, social distancing, or other order that requires individuals to stay home in quarantine to reduce the spread of COVID-19.

Similarly, UIPL 16-20 Attachment I (C)(1)(g) references a “state or municipal order restricting travel” with respect to section 2102(a)(3)(A)(ii)(I)(gg) of the CARES Act. This should also be clarified as described above.

5. Section 2102(a)(3)(A)(ii)(I)(ff) of the CARES Act says that an individual who is “unable to reach the place of employment because the individual has been advised by a health care provider to self-quarantine due to concerns related to COVID–19” may qualify for PUA. The examples specified in the Department’s guidance describe a person who suspects they are infected with COVID-19 and a person who is immune-compromised because of a serious health condition.  

The reference to a person “whose immune system is compromised by virtue of a serious health condition” in the guidance does not cover the wide range of reasons a health care provider may advise self-quarantine. For example, while the CDC considers older Americans more at risk of serious complications from COVID-19, states may not think they are covered under Department’s guidance. Furthermore, workers with certain health conditions (such as a respiratory condition) may not technically have a compromised immune system but would be at increased risk from COVID-19 and may need to self-quarantine. As we learn more about COVID-19, we may discover that there are other populations at risk too.

The Department needs to clarify that anyone advised by a health care provider to self-quarantine due to increased risk of COVID-19 should be covered by PUA, regardless of the underlying reason for their increased risk.

6. We are pleased that the Secretary established additional criteria under section 2102(a)(3)(A)(ii)(I)(kk) of the CARES Act to clarify that self-employed individuals such as independent contractors who may not have one specific place of employment are covered by PUA, in keeping with the intent of the legislation. While we believe that such workers are covered by the text of the law, we appreciate the Department’s action to eliminate ambiguity and ensure these workers receive benefits.

However, to avoid any confusion about who should qualify under UIPL 16-20 Attachment I (C)(1)(k), the Department must clarify that an independent contractor who is unable to work and forced to suspend work activities because there is reduced demand for their services also qualifies for PUA benefits. Many independent contractors have seen demand for their services dry up as a direct result of COVID-19. In the example of a ride share driver, a driver should be able to claim PUA when they are forced to suspend their work because there are too few customers seeking rides. For an independent contractor, losing many or all of their customers overnight is analogous to an employee being laid off by an employer, or, as the Department’s guidance notes, their “place of employment” being closed. Congress created the PUA program with the intent to cover workers like independent contractors and gig workers who may not have traditional employment relationships, but who have suddenly lost their livelihoods during this time of crisis. We believe that that the CARES Act definitively covers such workers, and the Department should clarify its guidance to reflect this.

7. The Department’s guidance says that “States should bear in mind that many of the qualifying circumstances described in section 2102(a)(3)(A)(ii)(I) are likely to be of short term duration.” Although we agree that some individuals may qualify for PUA for only a short period, many applicants will rely on PUA for longer periods, especially if this public health crisis persists. Furthermore, the way an individual qualifies for PUA may vary from week to week. For example, someone could first qualify if they get sick with COVID-19, then their child’s school may close as they recover, and they would qualify based on the new circumstance.

The Department’s guidance should encourage states to consider this as they create PUA application systems. It would be inefficient for both the claimant and the state workforce agency if individuals have to file a new initial application each time their qualifying circumstance changes. Individuals continue to qualify for benefits as long as they continue to meet at least one of the qualifying circumstances described in section 2102(a)(3)(A)(ii)(I), even if the precise provision under which they qualify changes.

8. We have heard conflicting reports of whether the Department’s guidance allows for the addition of the $600 federal supplement to PUA benefits in U.S. territories that do not have UI programs. The guidance the Department has issued for Federal Pandemic Unemployment Compensation and PUA is ambiguous on this matter.

Section 2102(d) of the CARES Act says that for an individual who lives in these territories, “the assistance authorized under subsection (b) for a week of unemployment shall be calculated in accordance with section 625.6 of title 20, Code of Federal Regulations, or any successor thereto, and shall be increased by the amount of Federal Pandemic Unemployment Compensation under section 2104.” This language makes clear that the “amount of Federal Pandemic Unemployment Compensation” ($600) should be included in the PUA benefit amount for anyone qualifying for PUA in any of the territories. We would appreciate if the Department would clarify this matter to facilitate the administration and payment of benefits in these territories.

In addition to the concerns we have raised above, we know that states will have additional questions as they continue to implement PUA and other CARES Act programs. We urge the Department to respond to questions from states as quickly as possible to avoid causing any delay in the processing of benefits.

Thank you for your attention to this important matter.

Sincerely,

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