SB 104-05: Direct COVID-19 Vaccination Distribution Act (Passed)
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  SB 104-05: Direct COVID-19 Vaccination Distribution Act (Passed)
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Author Topic: SB 104-05: Direct COVID-19 Vaccination Distribution Act (Passed)  (Read 1433 times)
The world will shine with light in our nightmare
Just Passion Through
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« on: July 11, 2021, 04:54:23 PM »
« edited: July 22, 2021, 11:34:41 AM by Senator Scott, PPT »

Quote
AN ACT
To promote COVID-19 vaccination efforts by recruiting volunteers for house visits


Be it enacted by the Senate of the Republic of Atlasia assembled


Quote
Section 1. Title

This legislation may be cited as the Direct COVID-19 Vaccination Distribution Act.

Section 2. At-home vaccinations for COVID-19

1. The Atlasian Department of Health and Human Services shall be tasked with collaborating with regional, state, and local governments in recruiting volunteers to administer at-home vaccinations for COVID-19.

2. Regional, state, and local governments shall be in charge of collaborating with hospitals, pharmacies, academic institutions, and non-governmental organizations in recruiting volunteers to administer COVID-19 vaccines.

3. All volunteer applicants must either be a Certified Nursing Assistant (CNA) or higher in order to volunteer, or a student in the nursing field under the supervision of a teacher or mentor.
Sponsor: Scott

The gentleman from Wyoming is recognized.
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The world will shine with light in our nightmare
Just Passion Through
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« Reply #1 on: July 11, 2021, 05:08:28 PM »
« Edited: July 11, 2021, 08:57:58 PM by Senator Scott, PPT »

Moving this to the top of the queue given the subject matter of the legislation.

In a nutshell, this bill directs the DHS to coordinate with states and regions in establishing a network to enable qualified volunteers to make house visits for administering the COVID-19 vaccines.

Absent a CG, I am not sure if I should include a cost estimate but given that this is a volunteer program that will draw recruits, presumably, from existing charitable organizations and NGOs, it should have a very low price tag.

Also, the brevity of the text gives the DHS a lot of flexibility over requirements not pertaining to education or training necessary. And I trust that the states and regions will know how to direct resources best. At this point in the pandemic, I would assume the majority of people who are not vaccinated but would like to be to be either disabled, in poverty, or in a remote area with limited access to pharmacies. In which case, it is our most vulnerable who stand to benefit most from this legislation, and I hope it enjoys broad support from each party.
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OBD
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« Reply #2 on: July 11, 2021, 08:21:39 PM »

This is an excellent bill that I will be proud to support. Especially in the face of the new Delta variant, we need to get Atlasia vaccinated, and fast.
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AGA
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« Reply #3 on: July 11, 2021, 10:38:55 PM »

Are we sure that this will actually get more people vaccinated? It seems that people who aren't vaccinated don't want to get vaccinated.
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SevenEleven
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« Reply #4 on: July 11, 2021, 10:42:45 PM »

It seems unlikely that CNAs would be willing to do this on a voluntary basis.
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The world will shine with light in our nightmare
Just Passion Through
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« Reply #5 on: July 11, 2021, 11:10:41 PM »
« Edited: July 11, 2021, 11:29:33 PM by Senator Scott, PPT »

Okay, taking what the President has said into account, AtlasCare can continue assuming payment:

Quote from: Amendment
AN ACT
To promote COVID-19 vaccination efforts by recruiting volunteers for house visits


Be it enacted by the Senate of the Republic of Atlasia assembled


Quote
Section 1. Title

This legislation may be cited as the Direct COVID-19 Vaccination Distribution Act.

Section 2. At-home vaccinations for COVID-19

1. The Atlasian Department of Health and Human Services shall be tasked with collaborating with regional, state, and local governments in recruiting volunteers nurses to administer at-home vaccinations for COVID-19.

2. Regional, state, and local governments shall be in charge of collaborating with hospitals, pharmacies, academic institutions, and non-governmental organizations in recruiting volunteers nurses to administer COVID-19 vaccines.

3. All volunteer applicants must either be a Certified Nursing Assistant (CNA) or higher in order to volunteer be listed., or a student in the nursing field under the supervision of a teacher or mentor.

4. AtlasCare shall assume compensation for all approved nurses.

Senators have 24 hours to object.
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Joseph Cao
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« Reply #6 on: July 12, 2021, 01:05:20 AM »

How much does this overlap with our current vaccination efforts – the Thumb bill, the CEC&R omnibus from last year, and so forth? We did just cover something similar six months ago that is presumably still in operation.
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The world will shine with light in our nightmare
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« Reply #7 on: July 12, 2021, 01:16:06 AM »

How much does this overlap with our current vaccination efforts – the Thumb bill, the CEC&R omnibus from last year, and so forth? We did just cover something similar six months ago that is presumably still in operation.

Did either of those bills include at-home vaccinations? The stimulus bills we passed last year couldn't have instructed home deliveries for a vaccine that didn't exist.
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wxtransit
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« Reply #8 on: July 12, 2021, 09:55:57 PM »

Concerning the at-home nature of vaccine distribution, I assume that such residents who wish to be vaccinated at-home would need to register with their region's or state's health department first? If so, I offer the following amendment:

Quote from: Amendment
AN ACT
To promote COVID-19 vaccination efforts by recruiting volunteers for house visits


Be it enacted by the Senate of the Republic of Atlasia assembled


Quote
Section 1. Title

This legislation may be cited as the Direct COVID-19 Vaccination Distribution Act.

Section 2. At-home vaccinations for COVID-19

1. The Atlasian Department of Health and Human Services shall be tasked with collaborating with regional, state, and local governments in recruiting volunteers nurses to administer at-home vaccinations for COVID-19.

2. Regional, state, and local governments shall be in charge of collaborating with hospitals, pharmacies, academic institutions, and non-governmental organizations in recruiting volunteers nurses to administer COVID-19 vaccines.

3. All volunteer applicants must either be a Certified Nursing Assistant (CNA) or higher in order to volunteer be listed., or a student in the nursing field under the supervision of a teacher or mentor.

4. AtlasCare shall assume compensation for all approved nurses.

5. Regional, state, and local governments shall be in charge of creating online portals where residents can sign up to request at-home vaccinations.

6. In addition, the DHS shall collaborate with regional, state, and local health departments in promoting at-home vaccinations by recruiting volunteers to distribute flyers promoting at-home vaccinations in low-income areas.

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« Reply #9 on: July 12, 2021, 10:31:20 PM »

The amendment is friendly.

Senators have 24 hours to object.
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Joseph Cao
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« Reply #10 on: July 13, 2021, 01:04:39 AM »

We might also be able to use the DefeatCoronavirus app to promote at-home vaccinations if it comes to that. Depending on what the sponsor and the rest of the Senate think, I may write up an amendment for it once Transit's amendment is acted on.
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wxtransit
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« Reply #11 on: July 13, 2021, 01:16:31 AM »

We might also be able to use the DefeatCoronavirus app to promote at-home vaccinations if it comes to that. Depending on what the sponsor and the rest of the Senate think, I may write up an amendment for it once Transit's amendment is acted on.

I would support such an amendment as well, giving the people more ways to get vaccinated is a net positive to me. Additionally building functionality in an existing app leads to less costs and manpower, so it should not be too hard to add to this overall effort.
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Spark
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« Reply #12 on: July 13, 2021, 07:57:48 AM »

We might also be able to use the DefeatCoronavirus app to promote at-home vaccinations if it comes to that. Depending on what the sponsor and the rest of the Senate think, I may write up an amendment for it once Transit's amendment is acted on.

I support this to raise awareness and help with the mobilization effort.
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Joseph Cao
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« Reply #13 on: July 14, 2021, 12:43:16 AM »

Assume this amendment introduced once Transit's amendment is adopted.

Quote from: Amendment Offered
AN ACT
To promote COVID-19 vaccination efforts by recruiting volunteers for house visits


Be it enacted by the Senate of the Republic of Atlasia assembled


Quote
Section 1. Title

This legislation may be cited as the Direct COVID-19 Vaccination Distribution Act.

Section 2. At-home vaccinations for COVID-19

1. The Atlasian Department of Health and Human Services shall be tasked with collaborating with regional, state, and local governments in recruiting nurses to administer at-home vaccinations for COVID-19.

2. Regional, state, and local governments shall be in charge of collaborating with hospitals, pharmacies, academic institutions, and non-governmental organizations in recruiting nurses to administer COVID-19 vaccines.

3. All applicants must be a Certified Nursing Assistant (CNA) or higher in order to be listed.

4. AtlasCare shall assume compensation for all approved nurses.

5. Regional, state, and local governments shall be in charge of creating online portals where residents can sign up to request at-home vaccinations. The DefeatCoronavirus mobile app shall provide promotional information about at-home vaccinations and links to these online portals in addition to its present capabilities.

6. In addition, the DHS shall collaborate with regional, state, and local health departments in promoting at-home vaccinations by recruiting volunteers to distribute flyers promoting at-home vaccinations in low-income areas.

Got to say that I'm still relatively unsure how well this wording works and whether the app actually is capable of doing this given its past usage, so feedback is welcomed.
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« Reply #14 on: July 14, 2021, 12:45:04 AM »

Hearing no objection, the amendment is adopted.

If someone feels the need to amend the bill to add a clause for the DefeatCoronavirus app, I'm not opposed, but it's also something I'd think the government would handle automatically.
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Joseph Cao
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« Reply #15 on: July 14, 2021, 12:47:31 AM »

I would normally agree, though past GM feedback on the DefeatCoronavirus app seems to imply that it performs better when we players actually take executive or legislative action on it. No harm in spelling it out in any case.
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Southern Senator North Carolina Yankee
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« Reply #16 on: July 15, 2021, 08:08:41 PM »

I realize that this should have been emphasized on a number of bills previously, but Atlascare (or officially the AtlasCare Office or ACO for short) generally only has direct appropriations for his own administration. The Gov't through various agencies pays Atlascare to handle or cover various things. Most of the money is generally in the hands of the "Healthcare Subsidy Office (HSO)", agencies within the DoD, HHS, or some other other sub-Department etc.

At the end of the day, it all funnels back to the treasury anyway, but just something to consider when assigning costs related to health care in terms of agencies etc.
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Joseph Cao
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« Reply #17 on: July 16, 2021, 11:43:15 PM »

Did we ever get specific sponsor feedback on this amendment? Along the lines of "friendly" or "unfriendly" or something. Tongue
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« Reply #18 on: July 16, 2021, 11:45:21 PM »

Sorry, I was a bit on the fence with this one. Friendly.
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« Reply #19 on: July 18, 2021, 07:40:08 AM »

Hearing no objection, the amendment is adopted.

Should we clarify the language on funding, or are we ready to take this to a vote?
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wxtransit
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« Reply #20 on: July 18, 2021, 11:39:00 PM »

Hearing no objection, the amendment is adopted.

Should we clarify the language on funding, or are we ready to take this to a vote?

From my perspective, the bill seems ready, but Yankee may have something more to say about funding? I assume the funding question arises with respect to hiring nurses.
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Southern Senator North Carolina Yankee
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« Reply #21 on: July 19, 2021, 12:39:20 AM »

Hearing no objection, the amendment is adopted.

Should we clarify the language on funding, or are we ready to take this to a vote?

From my perspective, the bill seems ready, but Yankee may have something more to say about funding? I assume the funding question arises with respect to hiring nurses.


So I wrote up eight paragraphs at one in the morning responding to this (six of which can be viewed below) to only to reread clause 2 and realize it was not as big of an issue as I first thought, though it was more so on previous bills.

For some reason I thought that the gov't was hiring these nurses and then paying them through Atlascare, which would be rather roundabout way of doing it obviously. However, as structured it is workable as a coverage mandate.

Quote
It is not my desire to long delay this bill over this matter above as it is a mistake made in numerous bills up to this point, of basically applying costs to the wrong federal agencies.

Theoretically Atlascare could be authorized to cover in home assistance for certain groups maybe the elderly, but they aren't paying and recruiting the nurses. A health care provider or office or network of providers/offices would and then they would bill Atlascare, which is how I think it works with Medicare IRL but I am not 100% sure on that. Maybe Scott would know more about that aspect.

The say I see it and the way the law is structured, various gov't agencies pay Atlascare to cover healthcare expenses, which they then turn around and use their vast size to leverage lower prices for said expenses (Think Medicare negotiating drug prices, but across the board). Its administration is an agency within HHS, but Atlascare itself functions more as a GSE (Government Sponsored Entity) allowing it to compete on the individual market place as a public option and once again obtain more leverage to reduce costs, while also being able to function as a successor to most all previous gov't health care programs.

On the exchanges, it competes for the general population as well as the same people that would have been in either Obamacare or Medicaid or lets be frank completely on their own or dying in the street, but are now covered by the Healthcare Subsidy. If these people are in Atlascare as most of these people are, the Healthcare Subsidy Office (HSO) pays Atlascare in accordance with the formula to cover these people (I know its 100% of all out of pocket costs and premiums for former Medicaid recipients or equivalent income levels and is so above those income levels for a good bit then tapers off, the slope is bit steeper than I would have liked around the mid five digit incomes but hey, "math's hard yall").

It also absorbs the coverage aspects of Medicare, CHIP, Tricare and the VA, but it is paid to do these things via a relevant agency in the government (For ex. DoD would pay Atlascare to cover active duty military or veterans health care costs), and do so in accordance with the expectations or mandates of the previous program.

Atlascare does cover preventative care and vaccinations and has for quite a while. There were improvements made in this regards early this year (or maybe last year) as well as beefing up some of the laws on the exchanges.



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The world will shine with light in our nightmare
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« Reply #22 on: July 19, 2021, 02:21:41 PM »

Thanks, Yankee. Yes, that is how both Medicare and Medicaid work IRL: you are assigned to a plan and they pay for health services through those.

If no one has any further comments, questions, or amendments, I'll open a vote in 24 hours.
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The world will shine with light in our nightmare
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« Reply #23 on: July 20, 2021, 03:31:05 PM »

Hearing no objection, an opening vote is now open. Senators, please vote Aye, Nay, or Abstain.

Quote from: Final Senate Text
AN ACT
To promote COVID-19 vaccination efforts by recruiting volunteers for house visits


Be it enacted by the Senate of the Republic of Atlasia assembled


Quote
Section 1. Title

This legislation may be cited as the Direct COVID-19 Vaccination Distribution Act.

Section 2. At-home vaccinations for COVID-19

1. The Atlasian Department of Health and Human Services shall be tasked with collaborating with regional, state, and local governments in recruiting nurses to administer at-home vaccinations for COVID-19.

2. Regional, state, and local governments shall be in charge of collaborating with hospitals, pharmacies, academic institutions, and non-governmental organizations in recruiting nurses to administer COVID-19 vaccines.

3. All applicants must be a Certified Nursing Assistant (CNA) or higher in order to be listed.

4. AtlasCare shall assume compensation for all approved nurses.

5. Regional, state, and local governments shall be in charge of creating online portals where residents can sign up to request at-home vaccinations. The DefeatCoronavirus mobile app shall provide promotional information about at-home vaccinations and links to these online portals in addition to its present capabilities.

6. In addition, the DHS shall collaborate with regional, state, and local health departments in promoting at-home vaccinations by recruiting volunteers to distribute flyers promoting at-home vaccinations in low-income areas.
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Dr. MB
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« Reply #24 on: July 20, 2021, 03:32:04 PM »

Aye
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