Is PRN or IPN Threatening Your Career?

Many licensed professionals are increasingly finding themselves at the mercy of non-governmental organizations that wield enormous power over the ability of health care and other licensed professionals to simply work and earn a livelihood. Known as the Impaired Professional Network (“IPN”) and the Professional Resource Network (“PRN”), these groups were created by the Florida Legislature (§ 456.076, Fla. Stat.) to assist professionals who may have substance abuse or alcohol problems that can affect their ability to safely render services to the public. While it sounds like a great concept, in practice, these statutes provide virtually no standards to be followed by IPN or PRN in deciding who may be subject to expensive and lengthy treatment programs to maintain their licenses.

The process will typically begin with a complaint investigation into allegations that a professional may have a substance abuse or alcohol problem. This might be triggered by an employer reporting concerns to the Board of Nursing, or by arrest for a DUI or possession of a controlled substance. Rather than face formal disciplinary sanctions, many professionals agree to enter into a “contract” with IPN or PRN for assessment and treatment. Once under “contract”, the professional is now at the mercy of IPN or PRN as to the requirements of a treatment program. For example, IPN or PRN may demand that the professional enter a 90-day inpatient treatment program costing as much as $40,000.00 – more than many professionals can reasonably afford – as a contract requirement. Failure to comply results in potential license suspension or revocation, and payment of fines. Another example would be failing to timely respond to a urine test request or testing positive for a controlled substance. In such cases IPN or PRN can impose a requirement to extend a lengthy multi-year “contract” for even longer periods of monitoring at the person’s own expense.

Worse, there are almost no due process rights to challenge an IPN or PRN decision. For example, a professional might be ordered by IPN or PRN to attend an exorbitantly expensive rehabilitation program on the basis that the person had a glass of wine at dinner, or smoked marijuana while not at work or on duty. Even though the professional could present overwhelming evidence that they do not have an alcohol or substance abuse problem, including testimony from employers of exemplary work performance and absolutely zero indication of any substance abuse problem, the professional can still have their license suspended or revoked simply because they did not comply with a decision of IPN or PRN to participate in the inpatient treatment program. The administrative hearing rights have been limited to simply deciding whether or not IPN or PRN ordered a treatment, and whether or not the individual complied. In short, due process has, for all practical purposes, been eliminated and IPN and PRN have no accountability for their decisions which can have a dramatic and even devastating impact on the professional’s career.

This process has been described as a “trap” and the full implications of the IPN/PRN trap are discussed here.

While nobody would suggest that an impaired physician, nurse, or other professional should be allowed to practice on patients, there also needs to accountability in the system that ensures protection to the professionals subject to these programs. Having a glass of wine or a beer at home, while off-duty and not on-call, should not be a career ending offense. Yet that is exactly the situation that many professionals encounter in agreeing to enter into an IPN or PRN program. Some professionals are now beginning to explore their legal options to challenge the IPN and PRN system. Whether through circuit court legal challenges, administrative litigation, or legislative change (or a combination of all three), professionals subject to IPN and PRN arbitrary actions may have legal avenues available to them to bring about reform in an unfair system.

If you believe IPN or PRN are threatening your ability to practice your profession, contact an attorney at Smith & Associates to discuss your rights and options.

Don’t Let CMS Add You to Its Lists

Have you received a letter from the Department of Health and Human Services (“DHS”) or the Centers for Medicare and Medicaid Services (“CMS”) informing you that they intend to exclude you from one or more federal payors (e.g., Medicare) or that they intend to add you to their preclusion list? If so, you need to act timely and appropriately to ensure you protect your rights. Being excluded or precluded from federal payor programs can have long-lasting consequences, both directly with the federal government and with the State of Florida.

What is Exclusion?

Exclusion applies to people and entities who participate in any federal payor programs, such as Medicare, Medicaid, Tricare, or other reimbursement programs funded by the federal government. Exclusions are governed by 42 U.S.C. § 1320a–7. This statute sets forth 21 reasons that DHS or CMS can use as a basis for exclusion from participation in federal payor programs. These reasons range from things like having a criminal conviction related to patient abuse or being a part of prohibited kickback scheme to failing to make adequate disclosures or defaulting on student loans.

Once an individual or entity is excluded, they will be added to the List of Excluded Individuals/Entities (“LEIE”) which is publicly available here. Exclusion also prohibits any other health care entity that is participating in a federal payor program from employing the excluded individual in any position involving management, administration, or patient care services. As a practical matter, most health care institutional providers such as hospitals, nursing homes, and other large companies will not employ individuals who are on the federal exclusion list.

The length of the exclusion will depend upon the reason for the exclusion, any aggravating factors, and any mitigating factors. For example, exclusion due to an individual’s criminal conviction related to patient abuse mandates a statutory five-year minimum exclusion (unless certain exceptions are met).

What is Preclusion?

Preclusion is similar to exclusion in that it bars an individual or entity from participating in the Medicare Advantage program. Thus, private insurers and managed care plans are precluded from paying individual practitioners on the preclusion list for services provided to their Medicare Advantage Plan enrollees. Further, unlike exclusion, preclusion extends its reach to include individual health care providers who may not even be enrolled in any federal payor programs. For example, a physician who is not enrolled in Medicaid or Medicare but has a contract with a private Medicare Advantage insurance plan may still be placed on the preclusion list, preventing payment for patients who have that insurer. The grounds for being added to the preclusion list are set forth in 42 C.F.R. § 422.2 and include reasons such as being excluded from Medicare and having a felony conviction in the past 10 years that CMS “deems detrimental to the best interests of the Medicare program.” Like exclusion, the length that an individual or entity can be placed on the preclusion list vary based on the details and the reason for being placed on the list. For example, a person placed on the preclusion list due to a felony conviction will be placed on the preclusion list for a “10-year period, beginning on the date of the felony conviction.” 42 CFR § 422.222(5).

Unlike exclusion, the preclusion list is not publicly available for viewing. However, CMS will notify private insurers informing them that an individual or entity was added to the preclusion list – which will almost inevitably lead to that individual or entity having those private insurance contracts cancelled.

The Importance of Timely and Fully Responding to a Notice

Preclusions and exclusions can have wide-reaching, long lasting consequences. In addition to the immediate effect – not being able to bill to the federal payor(s) at issue – being precluded or excluded can affect your ability to participate in Florida’s Medicaid program and can cause private insurers to cancel their contracts.

Beyond the payor issues, this can also affect your professional/facility license. See e.g., Florida Statute § 408.815(1) (providing for the revocation and/or denial of a renewal license for a health care facility that is “currently excluded, suspended, or terminated from participation in the state Medicaid program, the Medicaid program of any other state, or the Medicare program.”).

Due to these wide-reaching consequences, it is important that you timely and fully respond to any notice informing you or your facility that they may be excluded or precluded. Timely responding is a strict requirement. Failure to timely respond will almost always constitute a waiver of your right to challenge the preclusion or exclusion. Further, your response needs to include ALL of the information, defenses, and arguments you intend to make. Failure to raise an issue can constitute a waiver of that issue later in your appeal.

Conclusion

Being added to the LEIE or Preclusion List is a serious issue that can haunt you and your career for a long-time. If you have been informed that DHS or CMS seeks to add you to either of these lists, you should contact an attorney at Smith & Associates to discuss your rights and options.

The Importance of Policing Your Trademark

Building a brand is difficult, especially one that sets you apart from your competitors and instills confidence and association with your product from consumers. But building a brand isn’t the end, it is only the beginning. Maintaining and policing your mark is just as important, if not more important. Once your brand starts accumulating client goodwill, competitors and knockoffs will invariably want to “steal” some of that goodwill for themselves. These competitors will seek to confuse your clients and potential clients – using the goodwill you have worked so hard to build up for their own gain.

Taking steps to police your brand and the marks associated with it requires affirmative actions to seek out these copycats and to then stop them. Not only is this a good business practice, it is legally required if you wish to keep the legal rights to your mark.

The courts have held that a “trademark owner has an affirmative duty to police his trademark.” Wisconsin Cheese Group, Inc. v. V & V Supremo Foods, Inc., 537 F. Supp. 2d 994, 1001 (W.D. Wis. 2008). If a trademark owner allows an infringing mark to continue in commerce for too long, the owner may lose any rights to prevent the continued infringement in the future. Id.

Importantly, courts have held that trademark owners cannot just hide theirs heads in the sand and be willfully ignorant of potential infringing uses. Trademark owners must affirmatively take actions to seek out infringing uses and take affirmative steps to prevent them. See Wisconsin Cheese Group, supra (“lack of actual knowledge of infringement does not automatically excuse a trademark owner from unreasonable delay”) and Chattanoga Mfg., Inc. v. Nike, Inc., 301 F.3d 789, 793 (7th Cir. 2002) (“a trademark owner is ‘chargeable with information it might have received had due inquiry been made.’”).

Because of this, if you have a trademark or servicemark that you wish to keep, you need to take affirmative steps to ensure that no one else is infringing on it. Otherwise, all your hard work and customer goodwill may have been for nothing.

What Steps Can Trademark Owners Take to Protect Their Marks?

One of the most important things a mark owner can do is to be knowledgeable of their industry and the players in that industry. To do this a trademark owner should:

Know who your competitors are and who the new entries into the market are (industry groups and trade associations are great for helping with this);
Perform internet searches for your mark to know who is using it and in what context; and
Importantly, know who is filing federal registrations with marks that are confusingly similar to your mark.

For the last entry, it involves periodically checking the United States Patent and Trademark Office’s (“USPTO”) trademark database to see the new filings and what goods or services they identify and, from there, determining if any new filings have a likelihood of consumer confusion with your mark.

How Can Smith & Associates Help You?

While anyone can search the USPTO’s trademark database, understanding their impact is a whole other issue. In fact, there are numerous companies that will search the USPTO database for you and send you their results periodically each year. Unfortunately, a listing of registration results does not help a trademark owner know if this is something that requires action.

This is where we can help. Smith & Associates offers very affordable, flat-fee pricing to monitor your marks against the USPTO database. Our service doesn’t just give you a listing of search results, it gives you actionable advice based on the search so that you will know a) if anyone is potentially infringing on your mark and b) what actions you should take to prevent this moving forward. More importantly, if you have questions about the results, you will have an experienced trademark attorney to discuss your results and your options.

If you would like to have us monitor your marks against the USPTO database, contact an experienced attorney at Smith & Associates for a free consultation to discuss your options.

The IPN/PRN Trap

The stresses put on medical professionals, especially licensed physicians and nurses, can be extreme. Long hours, emergency responses, and dealing with patients’ severe medical issues – some who will not survive – can take an emotional toll on even the strongest doctor or nurse. However, when a medical professional turns to alcohol or drugs to help cope with these issues, the outcomes can be disastrous for both the patients and the professional.

Acknowledging the stresses that medical professionals face, the Florida Legislature authorized the creation of the Professional Resource Network and the Intervention Project for Nurses to help medical professionals (and other licensed professionals) with alcohol and drug abuse problems.

While the programs have lofty and laudable goals, the reality is that, for many professionals who enter these programs, PRN and IPN can become an inescapable nightmare.

How the Trap is Set

The problem starts when a doctor or nurse does something wrong. It can be directly related to patient care, such as showing up to work hungover or impaired, or it can be unconnected to work, such as being charged with Driving Under the Influence (“DUI”). In any case, the Department of Health (“DOH”), which oversees both the Board of Medicine and the Board of Nursing, is notified.

Once DOH is notified, they will evaluate the claim. If DOH believes that the infraction impacts patient care (and DOH almost always believes that the infraction will affect patient care), they will issue an administrative complaint against the doctor or nurse seeking any number of potential remedies, including the imposing of fines and the revocation of the medical or nursing license.

However, once the administrative complaint is served, DOH will typically offer what seems like a very reasonable resolution, especially when the potential alternative is having the license revoked. That resolution involves the doctor or nurse agreeing to sign up for PRN or IPN and have their license suspended until they complete the program. DOH will also usually require that the investigative costs be paid as well.

The doctor or nurse, faced with the choice of either accepting this settlement or being forced to hire an attorney to fight these claims and potentially lose their license, believes that this is a reasonable solution and agrees to the settlement.

Once the agreement is signed and incorporated into a Final Order, the doctor or nurse must sign an agreement with PRN or IPN, agreeing to follow all its terms and agreeing to follow whatever medical treatment the program believes is appropriate, otherwise the doctor or nurse will be terminated from the program. Now the trap is set.

The Trap Gets Sprung

What many doctors and nurses who enter PRN or IPN do not realize is that, while it is an independent, non-governmental entity, if it cancels the contract with the doctor or nurse, that is an independent reason for DOH to revoke the doctor or nurse’s license. Fla. Stat. § 456.072(1)(hh). Thus, when PRN or IPN “recommend” a course of treatment – no matter how extreme or expensive – it must be followed, or the contract will be terminated. If the contract is terminated – DOH will almost certainly seek to revoke the license.

What happens to many people involved in these programs is that, regardless of what brought them there, they are “prescribed” an intensive program that involves no alcohol and bears significant costs, such as Intensive Outpatient Program Treatment. There is no opportunity for the doctor or nurse to appeal this decision – they must comply.

This is where the trap gets sprung. The doctor or nurse is already out of work due to the license suspension and now they are spending any accumulated savings on the initial program. Further, despite whether the person believes they have an alcohol problem or not, they are forbidden from having any alcohol. If that doctor or nurse has a urine test positive for alcohol (or voluntarily admits to using alcohol), even if it was a single, social drink – the trap is sprung.

Once there is any non-compliance, no matter how small, the provider will then “prescribe” an even more extreme program such as inpatient treatment. These programs can cost over $40,000 and must be attended or the contract will be cancelled. People who have already had their license suspended, who are out of work, and who have already spent any savings they had on the prior treatment, cannot afford this treatment. Regardless, if they do not attend, the contract will be cancelled and DOH will then seek to revoke the license. The practitioner is now trapped – pay money they don’t have for treatment they don’t need or lose their license.

“Good Cause” Defenses

The statute at issue allows DOH to revoke the license for:

Being terminated from an impaired practitioner program that is overseen by a consultant as described in s. 456.076, for failure to comply, without good cause, with the terms of the monitoring or participant contract entered into by the licensee, or for not successfully completing any drug treatment or alcohol treatment program.

Fla. Stat. § 456.072(1)(hh) (emphasis added).

A reasonable person may think that not having the money to comply with the treatment plan would constitute “good cause” or that being prescribed a treatment plan that doesn’t align with the problems the person is facing would constitute “good cause,” but the administrative law judges (“ALJ”) and the Department of Health would disagree.

While “good cause” is not defined in the statute, ALJs have limited its application to situations that make it almost superfluous for the Legislature to have included. As one ALJ wrote, “[s]ome examples of good cause for failing to comply with the terms of an impaired practitioner monitoring contract, as found in one DOAH case, include serious and unavoidable events in the life of a practitioner; such as the return to active military duty, the acute appearance of a disabling medical condition, or death of the practitioner.” Department of Health v. Grace Mary Guastella, M.D., DOAH Case Number 2013-12197 (DOAH 2017). Thus, according to these ALJs, unless you are active duty military, so disabled as to not be able to practice, or dead, you don’t have good cause to violate the treatment plan.

Once a practitioner is trapped in PRN or IPN, even if it only started out as “drinking alcoholic beverages, if only socially on rare occasion,” whatever the recommended course of treatment is, no matter how intense or expensive, it must be followed or the contract will be terminated and DOH will seek to revoke the license. Department of Health v. Grace Mary Guastella, M.D., DOAH Case Number 17-2923PL (DOAH 2018).

At least as the law stands, as interpreted by DOH and ALJs, good cause is rare and doesn’t provide the protection that a reasonable person reading the statute would believe it would provide.

Potential Challenges

One potential challenge that a practitioner caught in this trap could make is that the “good cause” exception has been read too narrowly and should encompass the ability to pay for the treatment and the medical necessity of the treatment. To date, no successful challenges to the existing “good cause” factors has been made. However, with passage of Amendment 6 to Florida’s Constitution in 2018, judges no longer need to defer to an administrative agency’s (like DOH) interpretation of a statute. See http://smithlawtlh.com/agencies-longer-afforded-deference-interpretation-rules-statutes/

In almost any other context, before a court can impose a penalty due to a person’s failure to pay some fine or court ordered payment (e.g., restitution, court fines, and child support), the Court must first determine if the person has the ability to pay. If the person does not have the ability to pay, then the Court cannot punish the person for not paying. See Del Valle v. State, 80 So. 3d 999, 1002 (Fla. 2011) (“an automatic revocation of probation without evidence presented as to ability to pay to support the trial court’s finding of willfulness violates due process.”); Vincent v. State, 699 So. 2d 806, 807 (Fla. 1st DCA 1997) (“In order to revoke a defendant’s probation based on a failure to pay restitution, a trial court must find that the defendant had the ability to pay the restitution not only before ordering restitution [but also] before revoking probation for failure to pay restitution imposed as a condition thereof.”); and Pompey v. Cochran, 685 So. 2d 1007, 1009 (Fla. 4th DCA 1997) (“finding that Pompey’s incarceration was unlawful because there was no evidence at all to support the trial court’s affirmative finding that the petitioner had the ability to pay a [back child support].”).

A strong argument could be made that the ALJ’s limited interpretation of the “good cause” exception and the imposition of sanctions without determining the practitioner’s ability to pay violates the statute and the practitioner’s due process rights.

There is also a potential challenge to the entire PRN/IPN setup as a violation of the Florida Constitution. Article II, Section 3 of the Florida Constitution provides:

The powers of the state government shall be divided into legislative, executive and judicial branches. No person belonging to one branch shall exercise any powers appertaining to either of the other branches unless expressly provided herein.

Interpreting this, the Court has held that, while power can be delegated to other branches, the Legislature must define clear guidelines and limitations in the statute. Specifically, the Court has held, that “statutes granting power to the executive branch must clearly announce adequate standards to guide … in the execution of the powers delegated. The statute must so clearly define the power delegated that the [executive] is precluded from acting through whim, showing favoritism, or exercising unbridled discretion.” Florida Dept. of State, Div. of Elections v. Martin, 916 So. 2d 763, 770 (Fla. 2005).

Here, the Legislature establishes the Impaired Practitioner Programs in Florida Statute § 456.076. That statute provides no limits or guidance as to what can be contained in the participant contract, the limits on the treatments these programs can require, or any way for a participant to appeal or seek a second opinion. Further, as described above, Florida Statute § 456.072(1)(hh) allows DOH to revoke a participant’s license if they are terminated from a program, but provides no direction or guidance as to what grounds constitute good cause for a program to terminate a participant. In short, the Legislature has improperly delegated its authority to a third-party.

Based on the foregoing, there is a strong argument to be made that both PRN and IPN are unconstitutional and, without additional guidance from the Legislature, they should not be permitted at all or, at the very least, DOH cannot take action against a practitioner for not complying with the terms of a PRN or IPN contract or course of treatment.

Conclusion

If you are being offered IPN or PRN as a term of settlement or if you have already agreed to PRN or IPN and are having trouble meeting their requirements, you should contact an experienced health care attorney to discuss your rights.

Medical Marijuana and the IRS

Marijuana holds a unique place in the legal system. On one hand, many states, including Florida, have legalized marijuana for medical use. Some states have even legalized marijuana for recreational use. Despite this, marijuana remains a federally controlled substance and is illegal under federal law. Through a series of federal legislation and executive orders, however, people and businesses complying with their state’s marijuana laws have little to fear from the federal government when it comes to the possession, use, and sale of marijuana.

One notable exception to this rule is taxes, as the Tenth Circuit Court of Appeals recently made clear. In 2017, the IRS began auditing Standing Akimbo, a Colorado medical marijuana dispensary. During this audit, Standing Akimbo refused to produce certain documents, which led to a lawsuit filed by the IRS. While the majority of the case revolves around Colorado record laws and the Fourth Amendment, there was one key holding every dispensary across the County should be aware of. In its opinion, the Court made clear that marijuana was still an illegal, controlled substance pursuant to federal law and, as such, deducting business expenses related to the sale of marijuana is an “unlawful activity.” The Court explained that “despite legally operating under Colorado law, the Taxpayers are subject to greater federal tax liability because of their federally unlawful activities, and any remedy [for this] must come from Congressional change to § 280E or 21 U.S.C. § 812(c) (Schedule I) rather than from the courts.” Standing Akimbo, LLC v. United States, 19-1049, 2020 WL 1684056, at *7 (10th Cir. Apr. 7, 2020).

As the “legal” use and sale of marijuana in Florida continues to grow, dispensaries need to clearly understand their rights and how federal and state laws intersect. If you operate a medical marijuana dispensary in Florida and have questions about your rights, you should contact an attorney at Smith & Associates for a free initial consultation.

Hemp Cultivation Licenses in Florida: The End is in Sight

Barring any unforeseen events, by the end of April 2020, the U.S. Department of Agriculture should have approved Florida’s proposed hemp cultivation rules (located at 5B-57.014, F.A.C.). Once this occurs, any person interested in growing/cultivating hemp can apply for a license from the State and, once approved, begin growing hemp.

Licensing and Cultivation Rules

To be eligible for a license under the proposed rules, you must first fill out an application and provide the following information:

A description of the property you intend to use for the cultivation of hemp, including address, legal description, tax parcel number, and GPS coordinates.
A receipt showing that each person who has “control” and “responsibility” for the operation has received Livescan Fingerprinting and background checks; and
An environmental containment plan showing containment systems to prevent hemp from spreading from the licensed land, a plan for cleaning equipment before it is removed from the land, and a transportation plan to ensure all hemp is contained during any off-site movement.

5B-57.014(4), F.A.C.

Once the application is approved and the license issued, it will need to be renewed annually. To actually grow hemp, cultivators must comply with the cultivation requirements set forth by rule. These include the following:

Complying with the environmental containment plan;
Complying with the Hemp Waste Disposal Manual;
Maintaining documents describing the varieties of hemp cultivated for three years after harvest;
Maintaining the certification, label, and receipts for all Certified hemp seed or Certified hemp cultivars for three years after harvest.
Use only Certified hemp seed or Certified hemp cultivars or nursery stock from a Florida licensed hemp nursery;
Only cultivate hemp on lands that are only used for a bona fide agricultural purpose or are zoned agricultural or industrial;
Follow signage requirements; and
Identify each hemp cultivation lot with a unique numerical identification number.

5B-57.014(6), F.A.C.

Finally, prior to harvest, a representative sample of the crop must be tested to ensure it is not “hot” (i.e., containing more THC than is allowed by law.) 5B-57.014(8), F.A.C.

Potential Issues

Currently, there are only two sources of “certified” seeds for potential hemp growers to obtain their seeds from: 1) seeds that have been certified by the Association of Official Seed Analysts (“AOSA”) or 2) “pilot project hemp seeds” from an approved Florida college or university. 5E-4.016, F.A.C.

This provides a conundrum for growers trying to determine which seeds to invest in. Currently, no AOSA certified seeds are from Florida. They are from other states with very different climates than Florida (e.g., Colorado, California, Washington, etc.). This poses a real concern as to how these seeds will tolerate the Flroida weather, if these seeds will end up producing “hot” hemp when grown in the different climate, or if they will produce the proper germination rate.

Meanwhile, the “pilot project” seeds have only gone through one or two growth cycles – cycles that were done under scientific, university settings. How these seeds will react when grown in the “wild” is still unknown.

This means that cultivators should carefully scrutinize their seed purchasing contracts and negotiate with seed suppliers to ensure that if the hemp ends up “hot” or with improper germination rates, the cultivator can receive refunds or new seeds.

Additionally, some labs are offering discounts on additional testing. While Florida only requires one test right before harvest, labs like Kaycha Labs are offering discounts on testing when four tests are ordered per growth cycle. This early and often testing allows for remediation and potentially salvaging the crop.

In short, until Florida has tried and true seeds of its own, how these seeds will grow is a big uncertainty that cultivators should be prepared for and should take steps to mitigate against.

Conclusion

Hemp cultivation in Florida is right around the corner. If you are considering cultivating hemp, now is the time to begin the process. If you have any questions about obtaining the license, complying with the applicable laws, or dealing with the business and contracting end of cultivation, you should contact an attorney at Smith & Associates to discuss your rights and options.

COVID-19 UPDATE: STATE AND FEDERAL ASSISTANCE FOR INDIVIDUALS AND SMALL BUSINESS OWNERS

Responding to the ongoing global Coronavirus pandemic, government, at all levels, has been taking drastic measures to help combat the spread of COVID-19 and to provide economic assistance to the individuals and businesses that have been impacted. This article highlights some of the key actions taken by state and federal government

Economic Assistance

In an effort to slow the spread of COVID-19, President Trump issued the national guidelines “15 Days to Slow the Spread” and, after briefly suggesting that businesses and people could potentially return to normal by Easter, extended the National Guidelines for at least another 30 days. Florida Governor Ron DeSantis initially resisted calls for a state-wide lockdown but has now issued an Executive Order providing for “Safer at Home” measures including the closure of all non-essential businesses, and directing that citizens remain at home except for essential services and functions. The economic fallout has been dramatic as the economy grinds to a halt. Global economic recession is now a reality, with the only question being how long will the recession last and when can the country get back to work.

While all sectors of the economy have been dramatically impacted, small businesses and individual employees have been especially hard hit. With the need to continue social distancing guidelines and business closures, the Federal Government and the State of Florida have implemented economic packages to provide emergency relief and economic stimulus for the affected businesses and the people who were employed by them.

The CARES Act: On Friday, March 27, 2020, the Coronavirus Aid, Relief and Economic Security Act (“CARES Act”) was signed into law. This law provides an estimated $2 trillion in relief to individuals and businesses suffering due to COVID-19.

Individuals: Under the CARES Act:
- Individuals will receive a check of up to $1,200 per person and $500 per child based upon the individuals income;
- If you are on unemployment, the amount of time you can be on unemployment has increased by 13 weeks and the federal government will add an additional $600 per week to the unemployment pay for up to four months;
- All federal held student loan payments, including interest, are deferred through September 30, 2020 without penalty to the borrower;
- A Pandemic Unemployment Assistance program for gig workers and freelancers is established;
- The time to file 2019 tax returns is extended until July 15, 2020; and
- All health insurance plans are mandated to cover COVID-19 testing, vaccination and treatment,
Small Businesses: The CARES Act defines a small business as one with 500 or fewer employees. For these small businesses, the CARES Act:
- Provides $10 billion for grants of up to $10,000 to provide emergency funds for small businesses to cover immediate operating costs;
- Allows for the Small Business Administration to provide loans of up to $10 million per business. Any funds from that loan that are used to maintain payroll, keep workers on the books or pay for rent, mortgage and existing debt could be forgiven, provided that workers stay employed through the end of June of 2020; and
- For businesses with existing SBA loans, $17 billion has been allocated to help pay for up to six months of payments.
- With regards to whether a business has fewer than 500 employees, the SBA will be applying its “affiliation” rules to determine if a business is actually “controlled” by another business. If so, those businesses will be treated as a single business for the purposes of determining the number of employees. SBA’s guide on “affiliations” can be found here.
Larger Businesses and Targeted Businesses: In addition to small businesses, the CARES Act provides some relief to larger businesses and also to specific types of businesses. These include:
- The “Main Street Business Lending” program which will be administered by the Department of the Treasury and Federal Reserve. This program provides:
  - $25 billion in loans or loan guarantees for passenger air carriers, aviation repair stations, and airline ticket agents;
  - $4 billion in loans or loan guarantees for cargo air carriers;
  - $17 billion in loans or loan guarantees for businesses critical to maintaining national security;
  - $454 billion (plus any unused amounts from the programs above) for loans, loan guarantees and other investments in support of the Federal Reserve’s lending facilities that support eligible businesses, states and municipalities.
- Tax credits for businesses that keep employees on the payroll;
- For hospitals, the CARES Act:
  - Sets up a $100 billion emergency fund to keep hospitals and employees afloat;
  - Give hospitals that treat Medicare COVID-19 patients a 20% payment increase for all services provided; and
  - Lifts the planned 2% Medicare sequestration payments cuts to providers until the end of this year.
  - Providing $1.32 billion in immediate additional funding for community health centers; and
  - Significantly expanding the availability and use of telehealth.

The Florida Small Business Emergency Bridge Loan Program: The Florida Department of Economic Opportunity administers this Program in partnership with the Florida SBDC Network and Florida First Capital Finance Corporation to provide cash flow to businesses economically impacted by COVID-19. These short-term, interest-free loans help bridge the gap between the time the economic impact occurred and when a business secures other financial resources, including payment of insurance claims or longer-term Small Business Administration (SBA) loans. Up to $50 million has been allocated for the Program. The application period for this short-term interest-free loan opened on March 17, 2020 and will continue at least through May 8, 2020. The highlights of the program are:

Short-term interest-free loans in an amount up to $50,000 for business owners.
Loans to be repaid without interest within one year.
Interest rates after one year go to 12%.
Purpose of the Program is to provide short-term liquidity to small business owners to remain open despite economic impacts of the Coronavirus pandemic.

“Families First Coronavirus Response Act” (H.R. 6201): The key features place new responsibilities on employers to assist employees who are affected when the employee or a family member is affected by Coronavirus. The Bill includes the following:

Applies to businesses with fewer than 500 employees.
Paid Family and Medical Leave for 12 weeks (the first 14 days are to be paid under sick leave provisions).
This leave benefit covers employees who have been working for at least 30 calendar days.
Among other uses, employees may use the leave to respond to quarantine requirements or recommendations, to care for family members who are responding to quarantine requirements or recommendations, and to care for a child whose school has been closed as a result of the COVID-19 pandemic.
After the first 14 days, employers must compensate employees in an amount that is not less than two-thirds of the employee’s regular rate of pay. These pay requirements apply to only the COVID-19-related leave reasons listed above.
The provisions will go into effect 15 days after the date of enactment and expire on December 31, 2020.
Paid Sick Leave provisions of the Bill also require employers with fewer than 500 employees to provide full-time employees two weeks (80 hours) of paid sick leave for specific circumstances related to COVID-19 (e.g., self-isolating, doctors’ visits, etc.).
Part-time employees are also covered and entitled to paid sick leave for the number of hours equal to the number of hours they work, on average, over a two-week period.
Employers must compensate employees for any paid sick time they take at their regular rates of pay.
Employers will be required to post a notice informing employees of their rights to leave.
As currently drafted, the Bill expressly provides that it does not preempt existing state or local paid sick leave entitlements.
Employers will be provided with tax credits to offset their costs in meeting the new paid leave mandates.
The provisions will go into effect 15 days after the date of enactment and expire on December 31, 2020.
The Bill provides $1 billion in emergency unemployment insurance (UI) relief to the states: $500 million for costs associated with increased administration of each state’s UI program and $500 million held in reserve to assist states with a 10 percent increase in unemployment. Besides the necessary increase in unemployment, in order to receive a portion of this grant money, states must temporarily relax certain UI eligibility requirements, such as waiting periods and work search requirements.

Florida Department of Emergency Management – Emergency Requisition Requests: For healthcare facilities unable to get necessary supplies, including personal protective equipment, N95 Masks, and COVID-19 tests, the Florida Department of Emergency Management has created a COVID_19 Emergency Requisition Request system that allows the facilities to request necessary equipment when it is unable to obtain it anywhere else. The form for this can be found here.

Actions Taken to Slow/Stop the Spread of COVID-19

The Executive Office of the Governor: As of the date of this article, the Governor has issued numerous Executive Orders aimed at slowing or stopping the spread of COVID-19. These orders include:

EO #2020-51 establishing a coronavirus response protocol and directing a public health emergency;
EO #2020-52 declaring a state of emergency;
EO #2020-68 suspending bars, pubs, and nightclubs and limiting capacity at restaurants, and limiting the size of groups at public beaches;
EO #2020-69 allowing local government meeting to occur electronically;
EO #2020-70 restricting restaurants to take out food service only and suspending movie theatres, concert houses, auditoriums, playhouses, bowling alleys, arcades, gymnasiums, fitness studios and beaches in Broward and Palm Beach counties;
EO #2020-71 restricting on-site alcoholic sales, but allowing restaurants to sell packaged alcohol to-go and closing gyms and fitness centers;
EO #2020-72 prohibiting any non-emergency or elective emergency procedure or surgery;
EO #2020-80 requiring the screening and isolation of anyone arriving in Florida from New York, New Jersey, or Connecticut by airplane;
EO #2020-82 requiring the screening and isolation of anyone arriving in Florida from New York, New Jersey, or Connecticut regardless of how they arrive;
EO #2020-83 advising people over the age of 65 or with other health issues to stay at home and advising against any gathering, including work, where 10 or more people are together.
EO #2020-91 and 92, commonly referred to as the “Safer at Home” order, closing all non-essential businesses, and directing that citizens remain at home except for essential services and functions.

Florida State Agencies: In addition to the actions taken by the Governor, state agencies are also taking action.

All agencies have suspended licensing, and renewal requirements for existing licensed professionals for at least 30 days.
Florida Department of Emergency Management: FDEM has activated Level 1, which is a full scale Activation of State Emergency Response Teams and has mobilized the national guard. Additionally, FDEM has:
- Established a grant program to assist Florida Counties;
- Worked with the federal government to provide needed medical supplies, including mobile intensive care units, ventilators, hospital beds, personal Protective equipment,. N95 face masks, and other necessary medical supplies.
- As discussed above, FDEM has established a process to allow healthcare facilities to request these needed items.
- FDEM, in conjunction with the Agency for Healthcare Administration, have implemented emergency rules restricting who can visit nursing homes and assisted living facilities.
Florida Department of Highway Safety and Motor Vehicles: Driver license renewal requirements have been suspended for at least 30 days.
Florida Department of State: The Florida Department of State has extended the annual report filing deadline for businesses until June 30, 2020.

Centers for Medicare and Medicaid Services (“CMS”): CMS, in conjunction with Florida Medicaid, has also taken steps to stop the spread of COVID-19 and provide additional access to care to patients that have or may have COVID-19. These steps include:

Confirmation that Florida Medicaid will cover all medically necessary services related to testing and treatment of COVID-19;
Waiving prior authorization for medically necessary services and supplies for Florida Medicaid patients;
Removing limits on prescription refills and allowing for 90-day supplies of medications for Florida Medicaid patients;
Waiving co-pays for all services for Florida Medicaid patients; and
Waiving Medicare Telehealth Reimbursement Restrictions.

Schools and Universities: School districts and universities across the state are making significant changes to ensure the safety of their students, staff, and the community at large. These include:

Extending spring break until March 30, 2020 (with the exception of Collier, Duval, Sumter, and Union counties);
Implementing distance learning for all K-12 students from March 30 through at least April 15th;
Cancelling required student assessments and adjusting graduation and grade promotion requirements accordingly;
Cancelling school grades;
Establishing programs to provide technology and internet access to low-income K-12 students to access distance learning;
Colleges and universities are directed to use virtual or remote learning for the remainder of the spring semester and all other activities and gatherings have been cancelled or postponed; and
Colleges and universities have cancelled May 2020 commencement ceremonies and are considering extending the spring semester through June of 2020.

County and other Local Government Actions: Counties and other local governments are also taking action to stem the tide of COVID-19. These actions include:

Orange and Osceola County have ordered all theme parks to close and imposed curfews;
Miami-Dade County has ordered parks and public beaches to close;
Many other counties have also closed or limited beach access;
Lake County has issued emergency orders requesting that residents over 65 shelter in place and requesting that employers with residents over the age of 65 to allow working from home.
The Florida Keys have closed to visitors; and
Some counties and cities have also closed boat ramps and restricted access to boating and boat gatherings.

Stay Up To Date

Additionally, both the state and federal governments are providing numerous online resources to keep people informed of COVID-19 and how to protect themselves. These sites include:

The Centers for Disease Control and Prevention: https://www.cdc.gov/coronavirus/2019-ncov/index.html
The Florida Department of Health: https://floridahealthcovid19.gov/
Florida Division of Emergency Management: https://floridadisaster.org/covid19/
Florida Department of Education: http://www.fldoe.org/em-response/index.stml

Conclusion

COVID-19 is an unprecedented challenge for everyone. If you have concerns as to how to access the resources described in this article, please consider contacting an attorney at Smith & Associates to discuss your rights under these new laws and regulation.

COVID-19 – Economic Stimulus Packages for Employers

During the ongoing national economic and health care crisis caused by the global coronavirus pandemic, Smith & Associates, will remain open and available to assist our clients with their legal needs. We have received numerous inquiries about the recently enacted state and federal programs that are now available to address the economic dislocation caused by the pandemic. The good news is that there are federal and state programs that can provide immediate financial assistance in these stressful times. Since there is always much confusion when dealing with applications and the required supplemental documents that need to be gathered, we are here to assist you by explaining the programs available and the best options for you. Below is a brief description of some of the available financial assistance program.

Paycheck Protection Program (PPP) Loans

The Paycheck Protection Program is part of the federal economic stimulus bill known as the CARES Act. This program is intended to provide eligible small businesses with eight weeks of cash-flow assistance through a 100% federally guaranteed loan from the U.S. Small Business Administration. Provided the funds are used to maintain employee payroll and other business expenses as detailed below, the loan amount will be forgiven for those expenses incurred in the eight weeks following the approval of the loan. In other words, a small business owner who meets the requirements will receive a cash infusion with no required repayment if they meet the conditions set forth in the Act.

Who is eligible?

Small businesses with 500 employees or fewer and other eligible entities (includes corporations, partnerships, sole proprietors, independent contractors, self-employed individuals, 501(c)(3) and 501(c)(19) organizations) will be able to apply for funding in the form of an SBA loan to offset harm to the business caused by the coronavirus crisis between February 15, 2020 and June 30, 2020. This program would be retroactive to February 15, 2020, in order to help bring workers who may have already been laid off back onto payrolls.

How much may I borrow?

Up to 2.5 times your monthly payroll costs as reflected in your most recent tax return (up to a maximum amount of $10 Million), which includes salaries, wages, tips, payments for sick and medical leave, insurance premiums, and state and local taxes assessed on the compensation of employees. Eligible payroll costs do not include compensation of individual employees for amounts exceeding $100,000 annually (this would be pro-rated for the relevant period). Any loan payments will be deferred for periods of six months and in some cases a maximum deferral of up to a year. No collateral or personal guarantees are required for loans. You do not have to provide financial qualifications for the loan. Neither the government nor lenders will charge small businesses any fees.

What can I use the loan for?

Payroll costs; mortgage, rent and utility costs; interest on debt obligations incurred prior to February 15, 2020.

Can my loan be forgiven?

You will not be required to pay back the portion of the loan used for the above expenses paid within the eight-week period after the loan closing date. HOWEVER, if the business does not retain or re-hire employees at the same level as the previous 12-month period, the loan amount forgiven will be reduced in proportion to any reduction in employees and/or reduction in pay of any employee beyond 25%. Businesses that rehire workers previously laid off by June 30, 2020 will not be penalized for having reduced payroll at the beginning of the period.

Forgiven expenses include:

Up to eight weeks of payroll expenses in the form of wages, salaries, commissions, tips, health insurance costs, and retirement benefits.
Mortgage payments on the business property.
Rent payments for the business property.
Utility payments.

What happens after the forgiveness period?

Any loan amounts not forgiven are carried forward as an ongoing loan with max terms of 10 years, at a maximum interest rate of 4% (the amount will be determined by the SBA lender at the time of the loan). Principal and interest will continue to be deferred for a total of six months with the potential to defer for up to a year after disbursement of the loan. The clock does not start again. (Be on the lookout for the Main Street Business Lending Program soon to be announced by the Federal Reserve as a complement to the PPP.)

SBA Economic Injury Disaster Loans & Emergency Economic Injury Grants

These grants provide an emergency advance of up to $10,000 to small businesses and private non-profits harmed by COVID-19 within three days of applying for an SBA Economic Injury Disaster Loan (EIDL). To access the advance, you first apply for an EIDL and then request the advance. The advance does not need to be repaid under any circumstance, even if you are not approved for the loan, and may be used to keep employees on payroll, to pay for sick leave, meet increased production costs due to supply chain disruptions, or pay business obligations, including debts, and rent or mortgage payments.

Who is eligible?

Small businesses with 500 or fewer employees including sole proprietorships, with or without employees; independent contractors; cooperatives and employee owned businesses; and tribal small businesses. Small business concerns and small agricultural cooperatives that meet the applicable size standard for SBA are also eligible, as well as most private non-profits of any size.

What are the loan terms if I’m approved?

A maximum low interest loan of $2 Million, determined by SBA; up to a 30-year term and amortization (determined by the SBA on a case-by-case basis) and no payments for the first 6-12 months. Within 72 hours of submitting a complete application, you can receive a grant of $10,000 if you have been in business since January 31, 2020. This does not have to be paid back, even if the loan is not approved. The deadline to apply is December 18, 2020.

If I get an EIDL and/or an Emergency Economic Injury Grant, can I get a PPP loan?

Whether you’ve already received an EIDL unrelated to COVID-19 or you receive a COVID-19 related EIDL and/or Emergency Grant between January 31, 2020 and June 30, 2020, you may also apply for a PPP loan. If you ultimately receive a PPP loan or refinance an EIDL into a PPP loan, any advance amount received under the Emergency Economic Injury Grant Program would be subtracted from the amount forgiven in the PPP. However, you cannot use your EIDL for the same purpose as your PPP loan. For example, if you use your EIDL to cover payroll for certain workers in April, you cannot use PPP for payroll for those same workers in April, although you could use it for payroll in March or for different workers in April.

Florida Small Business Emergency Bridge Loan Program

These short-term, interest-free working capital loans are intended to “bridge the gap” between the time a major catastrophe hits and when a business has secured longer term recovery resources, such as sufficient profits from a revived business, receipt of payments on insurance claims or federal disaster assistance.

Who is eligible?
Applications will be accepted by qualified for-profit, privately held small businesses that maintain a place of business in the state of Florida. All qualified applicants must have been established prior to March 9, 2020 and suffered economic injury as a result of the designated disaster. Qualified small business applicants must be an employer business with 2 to 100 employees.

How much may I borrow?

Up to $50,000 per eligible small business. Loans of up to $100,000 may be made in special cases as warranted by the need of the eligible small business.

What are the loan terms?
One year and loans will be interest-free for the loan term (one year). The Interest rate will be 12% per annum on the unpaid balance thereafter, until the loan balance is repaid in full.

When should I apply?

Applications will be accepted by qualified Florida small businesses under this program through May 8, 2020, contingent on the availability of funds.

Families First Coronavirus Response Act (FFCRA)

This Act imposes new requirements on small business employers to provide employees with paid sick leave for COVID-19 related illnesses and expanded family and medical leave with 2/3 pay for specified reasons related to COVID-19.

Who is a covered employer?

Covered Employers include certain public employers, and private employers with fewer than 500 employees.

What are qualified reasons for leave?

There are six qualifying reasons for an employee to take leave:

The employee is subject to a Federal, State, or local quarantine or isolation order related to COVID-19;
The employee has been advised by a health care provider to self-quarantine related to COVID-19;
The employee is experiencing COVID-19 symptoms and is seeking a medical diagnosis;
The employee is caring for an individual subject to an order described in section 1 or self-quarantine as described in section 2;
The employee is caring for his or her child whose school or place of care is closed or unavailable due to COVID -19-related reasons; and
The employee is experiencing any other substantially similar condition specified by the U.S. Department of Health and Human Services.

What is the duration of leave and the rate of pay?
An employer must provide up to two weeks of paid sick leave to qualified employees, paid at:

100% of their regular rate of pay (up to $511 per day and $5,110 total) if the leave is for any of reasons 1 through 3 above; or
2/3 of their regular rate of pay (up to $200 daily and $2,000 total) if the leave is for reasons 2 or 6 above.

Additionally, if the employee is taking leave due to reason 5, they are entitled to up to 12 weeks of paid leave at 2/3 their hourly rate (up to $200 daily and $12,000 total). If the employee has been employed for at least 30 days, the employee may be entitled to an additional 10 weeks of 2/3 pay if it is being taken for reason 5.
For part-time employees, the regular rate of pay is calculated based on the normal hours that the employee would have been expected to work during that weekly time period.

For example, workers can take time off if they’re isolated because of “a broad range of governmental orders,” including stay-at-home orders or mandates that “otherwise restrict” their mobility. However, they’ll only qualify if the order is what prevents them from working. A worker can’t take leave if they can telework or if they wouldn’t have work even without the isolation order, such as if they work for a coffee shop that has shuttered because of low business. Additionally, workers can use leave intermittently by agreement with employers and that employers can make workers take accrued vacation days or other paid time off at the same time they take leave to care for a child.

What Employees qualify for Family Medical Leave due to COVID-19 related reasons?

In general, employees of private sector employers with fewer than 500 employees, and certain public sector employers.

What if my business cannot afford to make these payments?

The long-term leave portion of the law includes a provision exempting businesses with fewer than 50 workers for whom granting leave would jeopardize business viability.

The regulation lays out three circumstances that qualify an employer for this exemption. Under the rule, these small business employers will not have to provide leave if doing so would raise expenses above revenue such that the employer would “cease operating at a minimal capacity”; the absence would “pose a substantial risk” to the employer’s financial health or operations because of the requesting worker’s skills, knowledge or duties; or the employer can’t find enough workers to perform the work of the employee requesting an absence. Such employers are not exempt from the two-week sick time requirement unless the worker is requesting time off to care for a child whose school has closed, however.

Are there any benefits for the employer?

While the FFCRA imposes significant financial obligations on small businesses as described above, it also ensures that those financial obligations are 100% refundable. Employers who provide the leave and pay described above are entitled to 100% reimbursement. This reimbursement includes the employer’s share of the Medicare tax imposed on those wages and its cost of maintaining health insurance coverage for the employee during the leave period. To ensure that businesses already struggling due to the COVID-19 pandemic receive this reimbursement quickly, the IRS has set up a two-pronged process for reimbursement.

The first prong allows employers to deduct from their Federal payroll taxes the amounts they spent complying with the employee sick leave portion of the FFCRA. Thus, employers will immediately receive reimbursement up to the amount of their payroll taxes. The second prong allows the employer to submit forms for reimbursement of costs above the amounts covered by the payroll tax withholding, and even allows for advanced reimbursement for anticipated overages. The IRS is promising a fast turn-around time on these refunds (two weeks), to help ensure that employers are getting these refunds quickly.
Can I require that the employee provide documentation of the COVID related illness such as a doctor’s order?
Yes, and in order for the employer to get the credit discussed above, they must maintain sufficient documentation to show the employee’s leave was for one of the qualifying reasons.

Conclusion

In conclusion, there are programs available to help you during this unprecedented time. We are here to assist in finding the right program for you. Call or email us, we will help!

Employer’s Guide to the new FFCRA Paid Sick Leave Requirements

Updated April 2, 2020 with information from the Department of Labor’s new rule.

With the flurry of new legislation in response to the COVID-19 pandemic, many companies are concerned about what benefits they have to provide their employees regarding paid sick leave, especially related to COVID-19, and what, if any, programs are available to help them bear the costs of these new employee benefits.

In short, while employers are obligated to grant employees paid sick time in accordance with these new laws, the employer will receive immediate reimbursement in the form of a credit against any Federal withholding tax amounts due to the IRS and an additional cash refund if the credit is insufficient to offset the paid leave granted to employees.

Employee Rights and Benefits

The Families First Coronavirus Response Act (“FFCRA”) granted broad, new paid sick leave rights to employees of qualified employers – namely any private business with fewer than 500 employees. These new provisions, at least currently, are limited in time and only apply from April 1, 2020 through December 31, 2020.

Importantly, the FFCRA established six qualifying reasons for an employee to take leave. These reasons are:

The employee is subject to a Federal, State, or local quarantine or isolation order related to COVID-19;
The employee has been advised by a health care provide to self-quarantine related to COVID-19;
The employee is experiencing COVID-19 symptoms and is seeking a medical diagnosis;
The employee is caring for an individual subject to an order described in section 1 or self-quarantine as described in section 2;
The employee is caring for his or her child whose school or place of care is closed or unavailable due to COVID -19-related reasons; and
The employee is experiencing any other substantially similar condition specified by the U.S. Department of Health and Human Services.

Further, the FFCRA provides that an employer must provide up to two weeks of paid sick leave to qualified employees, paid at:

100% of their regular rate of pay (up to $511 per day and $5,110 total) if the leave is for any of reasons 1 through 3 above; or
2/3 of their regular rate of pay (up to $200 daily and $2,000 total) if the leave is for reasons 2 or 6 above.

For part-time employees, the regular rate of pay is calculated based on the normal hours that the employee would have been expected to work during that weekly time period.

As with the FMLA, the employee must provide notice and that notice must only be given within a reasonable time given the circumstances. However, given the reasons for leave, reasonable notice could very well be shortly before or even shortly after the leave begins.

Additionally, documentation as to the reason for the leave is required. This documentation must include a signed statement by the employee containing the following information: (1) the employee’s name; (2) the date(s) for which leave is requested; (3) the COVID-19 qualifying reason for leave; and (4) a statement representing that the employee is unable to work or telework because of the COVID-19 qualifying reason. Additionally, this documentation must include whatever additional information is necessary to show that the employee is lacking leave for a qualified reason. For example, if the employee is taking leave due to a government quarantine, the name of the government entity that ordered the quarantine is required in the documentation. An employee requesting paid sick leave due to a doctor-imposed quarantine must provide the name of the health care provider who advised him or her to self-quarantine for COVID-19 related reasons. An employee requesting paid sick leave to care for an individual must provide either (1) the government entity that issued the quarantine or isolation order to which the individual is subject or (2) the name of the health care provider who advised the individual to self-quarantine, depending on the precise reason for the request. An employee requesting to take paid sick leave or expanded family and medical leave to care for his or her child must provide the following information: (1) the name of the child being cared for; (2) the name of the school, place of care, or child care provider that closed or became unavailable due to COVID-19 reasons; and (3) a statement representing that no other suitable person is available to care for the child during the period of requested leave.

The Department of Labor (“DOL”), in a temporary rule issued April 1, 2020, has also clarified that employers are not required to pay this sick leave if there is no work for the employee. The DOL provided the following example:

For example, if a coffee shop closes temporarily or indefinitely due to a downturn in business related to COVID-19, it would no longer have any work for its employees. A cashier previously employed at the coffee shop who is subject to a stay-at-home order would not be able to work even if he were not required to stay at home. As such, he may not take paid sick leave because his inability to work is not due to his need to comply with the stay-at-home order, but rather due to the closure of his place of employment.

Additionally, the temporary rule provides that if an employee subject to an isolation order is able to telework, that employee is not eligible for the paid sick leave benefits of the FFCRA.

Finally, the employer must post in a conspicuous place notice of these FFCRA requirements. The Department of Labor poster containing these rights is available here.

Employer Benefits, and Potential Exemptions

While the FFCRA imposes significant financial obligations on small businesses as described above, it also ensures that those financial obligations are 100% refundable. Following the passage of the FFCRA, the IRS issued guidance to businesses as to how to obtain refunds. This guidance was adopted into law with the passage of the CARES Act.

Importantly, the FFCRA provides that employers who provide the leave and pay described above are entitled to 100% reimbursement. This reimbursement includes the employer’s share of the Medicare tax imposed on those wages and its cost of maintaining health insurance coverage for the employee during the leave period. To ensure that businesses already struggling due to the COVID-19 pandemic receive this reimbursement quickly, the IRS has set up a two-pronged process for reimbursement.

To the extent the reimbursement exceeds the payroll taxes, the IRS has created a second prong that allows the employer to submit forms for reimbursement of costs above the amounts covered by the payroll tax withholding, and even allows for advanced reimbursement for anticipated overages. The IRS is working on drafts of these forms and they are expected to be final in the very near future. Further, the IRS is promising a fast turn-around time on these refunds (two weeks), to help ensure that employers are getting these refunds quickly.

As mentioned above, the IRS is requiring that employers who claim this credit maintain sufficient documentation to show that the employee’s leave was for one of the qualifying reasons.

Finally, if the company has less than 50 employees, it may be eligible for an exemption to the requirement that the employer cover leave for reason number 5. To qualify, the employer must believe that providing said leave would “jeopardize the viability of the business as an ongoing concern.” The DOL’s temporary rule sets forth the criteria for determining if a business qualifies for this exemption:

Such leave would cause the small business employer’s expenses and financial obligations to exceed available business revenue and cause the small business employer to cease operating at a minimal capacity;
The absence of the employee or employees requesting such leave would pose a substantial risk to the financial health or operational capacity of the small business employer because of their specialized skills, knowledge of the business, or responsibilities; or
The small business employer cannot find enough other workers who are able, willing, and qualified, and who will be available at the time and place needed, to perform the labor or services the employee or employees requesting leave provide, and these labor or services are needed for the small business employer to operate at a minimal capacity.

If a company believes it qualifies for this exemption, it must keep documentation and records that support its reasoning. However, that documentation should not be submitted to DOL.

Conclusion

If you need any assistance in implementing the new FFCRA sick leave provisions, obtaining the refund, or determining if you qualify for the exemption, you should contact an attorney at Smith & Associates to discuss your rights and options.

New Law Allows Pharmacists to Diagnose and Treat Certain Medical Conditions

On March 11, 2020, Governor Ron DeSantis signed HB 389 into law. This law allows qualified pharmacists the ability to treat chronic illnesses and to test, diagnose, and treat certain minor, non-chronic illnesses.

Treatment of Chronic Illnesses

This new law creates Florida Statute § 465.1865 entitled “Collaborative Pharmacy Practice for Chronic Health Conditions.” This section sets forth the requirements for a pharmacist to treat certain chronic health conditions. Importantly, these chronic health conditions are limited to:

Arthritis;
Asthma;
Chronic obstructive pulmonary diseases;
Type 2 Diabetes;
Human immunodeficiency virus or acquired immune deficiency syndrome;
Obesity; and
Other chronic conditions that the Board of Pharmacy may allow by future rule making.

Fla. Stat. § 465.1865(1).

To be able to treat these chronic conditions, a pharmacist must enter into a “Collaborative Pharmacy Practice Agreement” with the patient’s licensed physician. This agreement must include:

The name of the patient(s) for whom a pharmacist may provide services;
The chronic health condition(s) to be managed;
The specific drugs to be managed;
The circumstances under which the pharmacist may order and evaluate laboratory or clinical tests;
The conditions upon which the pharmacist must notify the physician;
The beginning and end dates of the treatment; and
A statement that the agreement can be terminated at any time by either the pharmacist or the physician.

Fla. Stat. § 465.1865(3)(a).

Additionally, before a pharmacist can treat these chronic conditions, the pharmacists must be certified by the Board of Pharmacy. To obtain this certification, the pharmacists must:

Have an active pharmacy license;
Have a Doctor of Pharmacy or have completed five years as a licensed pharmacist;
Complete a 20-hour course on Collaborative Treatment of Chronic Health Conditions that is approved by the Board of Pharmacy;
Maintain at least $250,000 of professional liability insurance; and
Have an established system for keeping patient records.

Fla. Stat. § 465.1865(2).

As this law was recently passed, rulemaking has not yet begun. However, as the Board of Pharmacy promulgates rules on collaborative treatment of chronic illnesses, we will provide update with any new developments.

Treatment of Non-Chronic Health Conditions

Additionally, the new law created Florida Statute § 465.1895, which allows for the testing and treatment of minor, non-chronic health conditions by a pharmacist. Minor, non-chronic health conditions include:

Influenza;
Streptococcus;
Lice;
Certain skin conditions; and
Minor, uncomplicated infections.

Fla. Stat. § 465.1895(1)(a).

Much like the treatment of chronic conditions, a pharmacist who wishes to treat non-chronic, minor illnesses must do so under the supervision of a physician and pursuant to written protocol between the pharmacist and the physician. This protocol must contain:

The categories of patients the pharmacist s authorized to treat;
The physician’s instruction for obtaining relevant patient medical history;
The physician’s instructions for the treatment of the condition based on the patients age, symptoms, and test results; and
A process and schedule for the physician to review the pharmacist’s actions and for the pharmacist to notify the physician of his or her actions.

Fla. Stat. § 465.1895(5).

As rule making progresses, new requirements may be added to this list.

Finally, any pharmacist who wishes to treat minor, non-chronic health conditions must be certified by the Board of Pharmacy to do so. To obtain this certification, the pharmacist must, among other things:

Hold an active license to practice pharmacy in Florida;
Take a 20-hour board approved education course on assessing and treating minor, non-chronic health conditions;
Maintain at least $250,000 of liability coverage;
Upon request, furnish patient health care records to a health care practitioner designated by the patient; and
Maintain patient records for five years.

Fla. Stat. § 465.1895(2).

Conclusion

This new law takes effect on July 1, 2020. Right now, the Board of Pharmacy is in the beginning stages of developing rules to implement this new law. As these rules progress, we will provide any important updates.

If you are a pharmacist who would like to take advantage of this new law and have questions about how to obtain licensing, you should contact an attorney at Smith & Associates to discuss your options.