COVID-19 Updates

Important UOTA and AOTA Updates Regarding Telehealth and COVID-19

September 20, 2021:

Based on President Biden’s recent news conference, the Department of Labor’s Occupational Safety and Health Administration (OSHA) is developing a rule that will require all employers with 100 or more employees to ensure their workforce is fully vaccinated or require any workers who remain unvaccinated to produce a negative test result on at least a weekly basis before coming to work. OSHA will issue an Emergency Temporary Standard (ETS) to implement this requirement. This requirement will impact over 80 million workers in private sector businesses with 100+ employees.

The Centers for Medicare & Medicaid Services (CMS) is taking action to require COVID-19 vaccinations for workers in most health care settings that receive Medicare or Medicaid reimbursement, including but not limited to hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies. This action builds on the vaccination requirement for nursing facilities recently announced by CMS and will apply to nursing home staff as well as staff in hospitals and other CMS-regulated settings, including clinical staff, individuals providing services under arrangements, volunteers, and staff who are not involved in direct patient, resident, or client care. These requirements will apply to approximately 50,000 providers and cover a majority of health care workers across the country. Some facilities and states have begun to adopt hospital staff or health care sector vaccination mandates. This action will create a consistent standard across the country, while giving patients assurance of the vaccination status of those delivering care.

Summaries of Utah legislation as related to higher education and our faculty/student members of UOTA:

House Bill 1007—institutions of higher education cannot mandate use of face coverings after spring 2021.
House Bill 107—75% of the higher education coursework which was face-to-face instruction in 2019-2020 must return face-to-face in 2021-2022.
House Bill 308—Vaccinations cannot be required in institutions of higher education.
House Bill 231—Higher education institutions must allow medical, religious, and personal exemptions for students regarding COVID-19 vaccinations.

AOTA, APTA, and ASHA Joint Statement and Call for Professional Action on COVID-19 Vaccination and Education:

The American Occupational Therapy Association (AOTA), the American Physical Therapy Association (APTA), and the American Speech-Language-Hearing Association (ASHA) have come together to call for our members and professionals to lead the way in adhering to public health practices and guidance on vaccinations and masking, to mitigate the recent surge in COVID-19 infections.

AOTA, APTA, and ASHA strongly encourage, recommend, and support all health care professionals to obtain full vaccination status and to educate our peers, patients, and the public on the need for vaccinations to address the public health challenges associated with COVID-19. We also support masking and other mitigation strategies in all public indoor settings. Our Associations believe it is a professional responsibility to promote standards that are critical to protecting the health, safety, and welfare of patients, peers, practitioners, and the general public. Individually and collectively, we are committed to addressing this public health crisis with the best information, evidence, and resources.

AOTA, APTA, and ASHA are the leading professional organizations representing occupational therapy, physical therapy, and audiology and speech-language pathology, respectively. Our members and professionals serve individuals across the lifespan and in all health care settings and facilities. In addition, our professionals practice in their communities as part of our school systems and are frontline providers in homes and workplaces.

American Occupational Therapy Association (AOTA)
Information Pertaining to Occupational Therapy in the Era of Coronavirus (COVID-19)
American Physical Therapy Association (APTA) 
Coronavirus (COVID-19) Resources for the Physical Therapy Profession | APTA
American Speech-Language-Hearing Association (ASHA) 
Coronavirus/COVID-19 Updates (

On July 30, 2021, AOTA was added to the list of signatories on this Joint Statement in Support of COVID-19 Vaccine Mandates for All Workers in Health and Long-Term Care.

Compliments from our partner organization the Homecare & Hospice Association of Utah from their newsletter 20Sep2021:

$25.5 Billion in New COVID-19 Provider Funding Available

The U.S. Department of Health and Human Services (HHS), through the (HRSA) is making $25.5 billion in new funding available for health care providers affected by the COVID-19 pandemic.

Providers, defined as any provider or supplier of health care, services, and support in a medical setting, at home, or in the community, will apply for both programs in a single application. HRSA will use existing Medicaid, CHIP and Medicare claims data in calculating payments. The application portal will open on September 29, 2021.

PRF Phase 4

75% of the Phase 4 payments will be based on lost revenues and expenditures between July 1, 2020, and March 31, 2021. The remaining 25% of payments will be utilized for bonus payments for providers who serve Medicaid, CHIP, and/or Medicare patients.

Medium and small providers will receive a base payment plus a supplement, with smaller providers receiving the highest supplement. Large providers will receive a minimum payment amount based on a percentage of lost revenues and COVID-related expenses. HHS will determine the exact amount of the base payments and supplements after analyzing data from all the applications received to ensure available funds are distributed equitably.


HRSA will make $8.5B in rural payments to providers who serve patients who receive Medicaid, CHIP, and/or Medicare services in a rural area as defined by the HHS Federal Office of Rural Health Policy. Search the Rural Health Grants Eligibility Analyzer  to see what areas qualify as "rural" for the rural payments.

Phase 3 Reconsiderations
Providers who believe their Phase 3 payment was not calculated correctly according to this methodology will now have an opportunity to request a reconsideration. Further details on this Phase 3 reconsideration process are forthcoming.

Grace Period for Reporting Period 1

In order to help providers come into compliance with PRF Reporting requirements if they miss the September 30, 2021 deadline for the first PRF Reporting Time Period, HHS announced a final 60-day grace period for those who received a PRF payment between April 10, 2020 and June 30, 2020.

It’s important to note that the deadlines to use funds and the Reporting Time Period are not changing. However, HHS will not enforce actions for noncompliant providers during the grace period. More information on reporting is available on the HRSA website.

Additional Information:

Visit the HRSA website for more information about eligibility requirements, documents, and information providers will need to complete their application.

Division of Occupational and Professional Licensing COVID-19 announcements regarding resumption of fingerprinting services and the lifting of the temporary suspension of “live” CE requirements as of June 1, 2021 (virtual or online CE will continue to be accepted by DOPL through December 31, 2021).

Emergency rule authorizes a Medicaid enrolled provider to deliver covered services via a synchronous or asynchronous telehealth platform as clinically appropriate. (See page 111-113 of linked pdf). This rule (see pages 51-53 here for text) has been permanently adopted, only authorizing synchronous telehealth services, and went into effect on September 22, 2020.

August 25, 2021:

Division of Occupational and Professional Licensing COVID-19 announcements regarding resumption of fingerprinting services and the lifting of the temporary suspension of “live” CE requirements as of June 1, 2021 (virtual or online CE will continue to be accepted by DOPL through December 31, 2021).

Emergency rule authorizes a Medicaid enrolled provider to deliver covered services via a synchronous or asynchronous telehealth platform as clinically appropriate. (See page 111-113 of linked pdf). This rule (see pages 51-53 here for text) has been permanently adopted, only authorizing synchronous telehealth services, and went into effect on September 22, 2020.

January 2021:
COVID Vaccine Scheduling for Healthcare Professions – Salt Lake County Health Department

Registration Code: Mav1stDose

AOTA’s Position on Vaccination of the Occupational Therapy Workforce


It is the position of AOTA that occupational therapists and occupational therapy assistants working as essential personnel in settings with the potential for COVID-19 exposure should be included in the first round of vaccinations. Furthermore, because the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention’s definition of health care personnel includes “unpaid persons,” students providing services during fieldwork should be included if their fieldwork is in settings with exposure risk.

AOTA’s Position on Vaccination of the Occupational Therapy Workforce 

The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) issued recommendations on December 1 as to who should receive Phase 1 COVID-19 vaccinations. The recommendations included health care personnel, defined as “paid and unpaid persons serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials.” The recommendations go on to state that if there are limitations to the number of vaccine doses available, “jurisdictions might consider first offering vaccination to residents and health care personnel in skilled nursing facilities because of high medical acuity and COVID-19–associated mortality among residents in these settings.”

In its Guidance on the Essential Critical Infrastructure Workforce: Ensuring Community and National Resilience in COVID-19 Response, the Cybersecurity & Infrastructure Security Agency (CISA) recognizes occupational therapists and assistants as essential critical infrastructure workers. Based on the ACIP recommendations, this position supports that occupational therapists and occupational therapy assistants who work in settings with potential for exposure should be included in the first round of vaccinations.

At this time, the situation is fluid and continues to evolve. AOTA will update this article as we receive additional information.

59 Mental Health Resource for Health Care Providers

For home health agencies and OT practitioners working in home health:

Medicaid 1915(c) Appendix K waiver allowing flexibilities in the home and community based services (HCBS) waiver.

For new incoming OT practitioners to Utah who are seeking licensure:

The Division of Professional Licensing has announced temporary suspension of fingerprinting services. Because of the temporary suspension of FBI fingerprint background checks, DOPL is issuing temporary licenses based on Utah-only background checks. At this time, applicants will be required to obtain the FBI fingerprint check within 180 days of receiving their temporary license. If an applicant's later fingerprint check does not reveal any concerning information, their license application will be considered complete. If concerning information is revealed, DOPL may investigate and take action against the license. Applicants who fail to obtain the required fingerprint check may face disciplinary action.

National insurers, Governor Herbert, and DOPL have been making modifications to existing regulations that previously limited patient utilization of telehealth OT/OTA services. Governor Herbert’s response can be found in the following two documents:

Telehealth Executive Order
Live CE Temporary Suspension DOPL

Coverage updates for Utah private insurances are listed here.
AOTA is regularly posting updates regarding telehealth services on their website here. They have also produced a chart summarizing the current status of telehealth services state-by-state which can be reviewed here. AOTA has organized regular webinars for updated COVID trainings and CE which can be found here. AOTA also offers a support forum for COVID through CommuneOT.
Finally, in Salt Lake, there is a community of volunteers called Mutual Aid SLC providing vital services in the valley. There may also be volunteer groups popping up in other Utah communities.

Please do not hesitate to contact the UOTA for more information or help through our contact page listed here. Stay safe and healthy during this challenging time.

AOTA resources to support Telehealth Services during COVID-19 to occupational therapists practicing in Utah:


AOTA Telehealth decision guide
Starting Monday, AOTA members can view a webinar regarding providing OT services via Telehealth here.

COVID-19 Mutual Aid SLC

This support group has been working from the beginning of this crisis to provide essential services such as grocery delivery to households who must self-isolate or who are otherwise in need.  People can call or go to this website to request services or volunteer:

AOTA is hosting a series of FREE virtual CE programs to equip occupational therapy practitioners, educators, and students to navigate through the evolving coronavirus pandemic. This series is free for AOTA members and non-members. Earn from 1 to 1.5 contact hours per session. Browse and join here: Free AOTA Webinar CE Series

The Role of Occupational Therapy: Providing Care in a Pandemic

This is an unprecedented time in health care that is evolving every day. Due to the outbreak of COVID-19, many organizations and occupational therapy practitioners are struggling with the question, “what is the appropriate role of occupational therapy during a pandemic?” Guidance from federal agencies is continually shared as the status of the pandemic within the United States is evolving on a daily basis. AOTA urges occupational therapy practitioners to continue to check guidance from the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS) for the most up-to-date information.

On March 19, the Department of Homeland Security released a Memorandum to further respond to a March 16 statement from President Trump stating that:

 “If you work in a critical infrastructure industry, as defined by the Department of Homeland Security, such as healthcare services and pharmaceutical and food supply, you have a special responsibility to maintain your normal work schedule.”

The Memorandum identifies workers who conduct a range of operations and services that are essential to continued national critical infrastructure viability. The list includes occupational therapists as critical workers within health care in the following category:

Caregivers (e.g., physicians, dentists, psychologists, mid-level practitioners, nurses and assistants, infection control and quality assurance personnel, pharmacists, physical and occupational therapists and assistants, social workers, speech pathologists and diagnostic and therapeutic technicians and technologists).

At the same time, the CDC now recommends that “Healthcare facilities and clinicians should prioritize urgent and emergency visits and procedures now and for the coming several weeks.” This includes delaying all elective ambulatory visits. The CDC recommendations are regularly updated to reflect the best available information and the environment.

This is an extremely difficult time, but it does not minimize the value of occupational therapy. Clients and practitioners should be aware of the risks associated with both providing care and delaying care in order to make an informed decision regarding next steps. This is where your clinical judgement and leadership skills in navigating your unique setting to engage in decision making with your care teams is of vital importance to the health of the community and country at large.

AOTA considers occupational therapy services as essential because they are a key part of client care plans and may often be the reason a client is receiving care in a certain setting. Delays in rehabilitation have been associated with worsening symptoms and adverse events for children, adolescents, and adults.

Consider the role of occupational therapy in:

  • Reducing the likelihood of hospitalization or readmission;
  • Decreasing the likelihood of contractures and joint deformities;
  • Improving resistance to infection via movement and activities proven to enhance immunity;
  • Combatting disruptions to mood as a result of social isolation;
  • Addressing clients’ occupational deprivation and establishing habits, roles, and routines;
  • Promoting participation in education, play, and learning in the home or school; and
  • Increasing independence in occupations, thereby reducing the need for caregivers to be in close proximity to clients.

Access to personal protective equipment (PPE) may be limited during this emergency, but it is an important part of following CDC Recommendations for infection control. AOTA is advocating for immediate solutions to the shortage of PPE. While the CDC guidance on extending the life of PPE is necessary during this crisis, it is not sufficient. For example, at this time, many clients want to stay in their home or return home to minimize their risk of exposure to COVID-19. Occupational therapy practitioners have a critical role in treating patients in home health and are also competent in infection control procedures across settings. Occupational therapy practitioners also need access to PPE for the safety of their clients and themselves to avoid further spread of the virus.

Regardless of the setting, there may be long-term negative physical, cognitive, and psychosocial effects for clients who do not receive the therapy they need. But in this unprecedented time, there are many factors that will affect care delivery, such as population, geographic location, staff availability (due to possible exposure requiring self-isolation), etc. Some therapy may need to be suspended or modified based on the client. Therapy practitioners may be advised not go to multiple buildings in one day. In addition, therapy practitioners in some facilities may be asked to provide additional public health support activities in order to meet other clients’ basic needs such as taking vitals or completing screening questions.

Each individual facility must determine who is an essential health care worker in accordance with their own policies and procedures. In addition, they must comply with the CDC, their state governor, and state health departments. Additional CDC Guidance includes this Q&A:

Q: Should any diagnostic or therapeutic interventions be withheld due to concerns about transmission of COVID-19?

A: Patients should receive any interventions they would normally receive as standard of care. Patients with suspected or confirmed COVID-19 should be asked to wear a surgical mask as soon as they are identified and be evaluated in a private room with the door closed. Healthcare personnel entering the room should use Standard and Transmission-based Precautions.

If there are interruptions to service that delay continued access to care, CMS provides the following guidance to assist providers:

  • Review clients’ plan of care and consider making any updates or modifications that may be necessary to account for client access issues related to COVID-19;
  • Communicate with clients and their families/caregivers as appropriate to help them understand the situation and assure them that you are doing all that you can to provide (or resume) services; and
  • Ensure that all members of the care team are documenting in the medical record their efforts to adhere to the client’s plan of care, including all refused attempts to see clients in person and all alternative methods used to perform client visits (e.g., phone calls and virtual visits).

Occupational therapy practitioners work in a variety of settings and treat populations that each present unique challenges. Practitioners should consider the AOTA Code of Ethics as they collaborate with clients to determine the best way to meet occupational therapy needs in a way that is as safe as possible for both clients and practitioners.

While telehealth seems like a practical option, the current reality is that each state determines whether telehealth is allowed. Therapy practitioners must follow their state and local laws, regulations, and policies. AOTA is tirelessly advocating for coverage of telehealth services provided by therapy practitioners at the state and federal levels. State telehealth policies are evolving every day as a safe option to provide patient care. Please check our website for updates.

We are working hard to provide accurate guidance to our members, and we encourage occupational therapy practitioners to make every reasonable effort to meet client needs and avoid interruptions and delays in care while keeping clients and themselves safe and healthy. Please continue to watch our website for updates.

Additional Resources

Memorandum on Identification of Essential Critical Infrastructure Workers during COVID-19 response. U.S. Department of Homeland SecurityCybersecurity & Infrastructure Security Agency, Office of the Director (March 19, 2020).

American Occupational Therapy Association (AOTA) Occupational Therapy Code of Ethics (2015).

American Health Care Association (AHCA) guidance The Role of Physical and Occupational Therapy and Speech-Language Pathology Personnel in LTC Facilities During the COVID-19 Pandemic

AHCA Coronavirus Resources

National Association for Home Care & Hospice (NAHC) Coronavirus Resources

Occupational Therapy’s Role in Home Health (AOTA Fact Sheet)

Skilled Nursing News article

DC Information on COVID-19 for Pregnant Women and Children

Trump Administration Releases COVID-19 Checklists and Tools to Accelerate Relief for State Medicaid & CHIP Programs
New tools to help speed states’ access to emergency flexibilities and resources

Today, the Trump Administration released new tools to strip away regulatory red tape and unleash new resources to support state Medicaid and Children’s Health Insurance Programs (CHIP) during the 2019 Novel Coronavirus (COVID-19) outbreak. Because of the President’s bold action in declaring COVID-19 a national emergency, CMS now has a full suite of tools available to maximize responsiveness to state needs. The agency has created four checklists that together will make up a comprehensive Medicaid COVID-19 federal authority checklist to make it easier for states to receive federal waivers and implement flexibilities in their program. 

“The Trump Administration is marshaling all its support behind states battling the Coronavirus,” said Administrator Seema Verma. “CMS is making it easier and faster for state Medicaid agencies to get the regulatory relief and additional support they need to respond as rapidly and effectively as possible to protect their most vulnerable residents from this disease.”

The four tools CMS is announcing today will permit states to access emergency administrative relief, make temporary modifications to Medicaid eligibility and benefit requirements, relax rules to ensure that individuals with disabilities and the elderly can be effectively served in their homes, and modify payment rules to support health care providers impacted by the outbreak. President Trump has also called on states to allow Medicaid beneficiaries to receive services through telehealth. While this doesn’t require federal approval in many cases, these tools can also help states quickly remove state-specific restrictions on telehealth.

All of the options that CMS is providing to states are aimed at helping states by reducing burdensome red tape and making it possible for states to provide the best care to their residents during this outbreak. We are providing states the option to request these waivers and other authorities be made effective retroactively, to at least March 1, 2020, the effective date of the national emergency declared by the President. These options include:

1115 Waiver Opportunity and Application Checklist

CMS is releasing a State Medicaid Director Letter (SMDL) #20-002, which outlines a new section 1115 demonstration opportunity to aid states with addressing the public health emergency.  States will be able to waive federal rules to streamline enrollment into long-term care programs and home and community-based services, as well as access broad authorities to vary and target services based on population needs.

The SMDL includes a waiver checklist to streamline state application requirements. Due to the extraordinary circumstances of this emergency, CMS has determined that an exception to the normal state and federal public notice procedures is warranted.

1135 Waiver Checklist 

CMCS has pre-packaged relevant and commonly requested 1135 authorities into a checklist template to share with states. This will expedite their ability to apply for and receive approval for these waivers that are now available under the President’s national emergency declaration. Examples of flexibilities include the ability to temporarily suspend prior authorization requirements, provide beneficiaries more time for appeals and fair hearings, relax rules to more quickly enroll providers, and allow providers from out of state to bill for services delivered to Medicaid beneficiaries.

 1915(c) Appendix K Template

 CMS developed the Appendix K to help states accelerate changes to their 1915(c) home and community-based services waiver operations or to request emergency amendments. To support the specific types of flexibilities that states are asking for during the COVID-19 outbreak, CMS has designed an Appendix K template addendum that has been pre-populated with commonly requested and relevant program changes. Examples of the types of flexibilities that states can access through this process include adding an electronic method of service delivery for certain services allowing continuity of service without face to face interaction, adding services to address additional needs of waiver recipients during the time of emergency, and adjustments to process requirements to decrease state burden during this time.

Medicaid Disaster State Plan Amendment Template

The Medicaid state plan is the document that describes the state’s rules related to eligibility, benefits, and payments. States have wide discretion within a broad federal framework to design their programs, and changes are processed through state plan amendments. Sometimes, states might wish to make changes that are only temporary during a disaster or emergency situation. To streamline and support this process, CMS has developed a Disaster State Plan Amendment (SPA) template that would allow a state to submit one combined request for temporary changes that we expect states may wish to make in their programs. This includes expanding temporary coverage to optional eligibility groups, adding specialized benefits, expanding telehealth coverage, and temporarily increasing provider reimbursement, among other temporary changes.

The tools released today further CMS’s commitment to providing our state partners the resources they need at this time.  Additionally, the agency recently approved its first section 1135 public health emergency waivers for the state of Florida on March 16, and the first 1915(c) Home and Community-Based Services waiver Appendix K approval on March 18th for the state of Pennsylvania in response to the COVID-19 outbreak. These approvals have granted these states a wide range of Medicaid and CHIP flexibilities, and we encourage other states to apply for the additional flexibilities they need in this situation. All state requests will be reviewed on a case-by-case basis to ensure they may be approved under applicable law.

These tools, and earlier CMS actions in response to the COVID-19 emergency, are all part of ongoing White House Coronavirus Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, please visit For a complete and updated list of CMS actions, guidance, and other information in response to COVID-19, please visit the, please visit the Current Emergencies Website.