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ADHCC Update - March 21, 2023

ADHCC Update - March 21, 2023

The following issues were addressed in the combined Regional Meeting last week.  Thank you for the participation. 

State Budget Advocacy - The Senate and Assembly have introduced their one-house bills. They have included a 10% Medicaid increase for nursing homes (which include ADHC.)  The Governor proposed 5%. We lobbied to include a Method 1 rate increase in the budget and all versions of the budget do not include such an increase. 

In their Ambulette Rate Study, the State Department of Health recognizes the need for ADHC transportation rate increases, but they only plan to increase Method 2 rates.  This is good for Method 2, but we want to ensure both methods are funded.  Please see our memo attached.  And see the DOH report attached also. 

ADHCC is continuing with lobbying, geofencing ads around the capital on ADHC closures and the need for Medicaid rate increases. Please continue to send action alerts on these issues - here and here.

Masking guidance  - The current masking guidance is linked below.  Our DOH guidance refers to CDC guidance and requires health care providers to adhere at least to the CDC standards.  ADHC programs, like their nursing homes, should check the community transmission rates.  If those rates are high, then HCP should mask. If community transmission rates are high but community levels are not, HCP may unmask in patient restricted areas.  See community levels here (they are different and usually lower than the transmission rates.)  

If the community transmission rates are not high - but substantial, moderate or low- than HCP may unmask.  

Masking Guidance is here: https://www.leadingageny.org/topics/coronavirus/guidance/home-and-community-based-services/doh-guidance/new-masking-requirements-what-they-mean-for-hcbs-providers/
 

HCBS Settings Rule - Not much to report. March 17th is the official deadline for compliance with this Rule. Many of our ADHC programs were found to be partially compliant with a new compliance deadline of July 2024. 

I will find out where programs go from here on complying with the Rule if they were deemed partially compliant.  I know many are frustrated with the program status listed in the evidence package on DOH's site. 

Virtual ADHC Reopening and Rebuilding Education Series - Coming SOON in the last week of April, first week of May.  This is for both open programs and those that are in the process of reopening. We will have sessions on the upcoming eFMAP funding for ADHCs, current COVID guidance, and the nuts and bolts of how to reopen a program. Other sessions will address HCBS care planning and community integration, workforce strategies and referral sources and marketing. 

Capital component rates - Nursing homes are receiving their new capital rates based on 2019.  The ADHC capital component is included.  Nothing is publicly posted on this. 

Nurses Across New York (NANY) - ADHC programs should be aware of the Nurses Across New York tuition reimbursement program for those serving in high need areas.  ADHC and nursing homes qualify as high need.  This program may help current and future staff who are in the process of studying nursing. Applications are due April 12th: 

https://www.leadingageny.org/topics/workforce-issues-and-regulations/tools-and-resources/nurses-across-ny-loan-repayment-soi-available/

Increasing Training Capacity for Statewide HC Facilities:  On March 3, 2023, the Department of Health announced the availability of $22,500,000 in funding through a Solicitation of Interest (SOI) for Increasing Training Capacity in Statewide Healthcare Facilities. The anticipated term of these awards is Oct. 1, 2023 to Sept. 30, 2025. The deadline for applications is April 19, 2023 at 4 p.m.; late applications will not be accepted. Many nursing homes will likely apply for this funding.  We urge ADHCs to approach your sponsoring nursing home for inclusion in this training if it is applying for funding: 

https://www.leadingageny.org/providers/nursing-homes/best-practices-and-resources/ideas-and-resources-for-increasing-training-capacity-in-statewide-healthcare-facilities/

COVID Test Kits Still Available For Aging Services Providers – Will Continue After May 11 End of PHE. Since February, LeadingAge providers across the continuum of care have been ordering free COVID-19 test kits from LeadingAge, through an arrangement with the U.S. Department of Health and Human Services. More information and the easy order form are located here. LeadingAge Members have asked if tests will still be available after the end of the Public Health Emergency on May 11. The answer is YES. HHS and White House officials have clearly stated that arrangements related to tests, vaccines, and treatments are separate from the timing of the end of the PHE. 

Meetings with DOH - I recently met with Adam Herbst, Assistant Commissioner for the Office of Aging and Long term Care, and Deputy Commissioner Val Deetz and DOH Dep Director Carol Rodat to voice our concerns about the many ADHC programs that are still closed, our need for an increased Medicaid rate, concerns with Medicaid transportation and the need for increased eFMAP funding for ADHC compared to SADCs. I think the meeting went well. They understand the urgency and expressed their willingness to work with us to move things forward.  I also brought up the proposed Part 425 regulsations and telehealth and asked for ongoing communication to also work on those issues.   

NYS Department of Health issued a Medicaid Update to address Telehealth past the Pubic Health emergency.  I think some of our issues will be tied up in specific guidance for ADHC providers.  I will include this in my follow up email with the Department. 

https://www.leadingageny.org/providers/nursing-homes/reimbursement1/new-post-phe-telehealth-guidance-for-medicaid-providers-released/

Complaint Lines/Emails - We had significant discussion on MAS concerns, MLTC transportation concerns as well as MLTC denials and downgrading to SADC.   Thank you for this input and please, if you haven't communicated issues like this to me, please do so.  In the meantime, every program should document these concerns and report them to complaint hotlines, as well as communicate with me.

MAS: https://www.medanswering.com/comments-or-concerns/

MLTC complaints: 1-866-712-7197 or email the Managed Long Term Care Technical Assistance Center  mltctac@health.ny.gov.

COVID Cases in ADHC: Regarding COVID-19 cases in programs, please be reminded of the following: 

Return to Work Guidance: Infections are rising, so I wanted to reiterate the current policy on nursing home and ADHC staff Return to Work guidance issued by DOH on November 28th.  

For staff who've had high risk exposures: masking is required and testing should take place at 24 hours after exposure (not before) and then day 3 and 5, but no work exclusion is required.  

For infected staff: workers are required to stay out 7 days with a test 48 hours before their return. This is for staff in the NH, ADHC and other HCP settings. 

Please feel free to reach out to me with question or concerns. 

Meg Everett, meverett@leadingageny.org, 518 867-8871.