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March 30th COVID-19 Update

New updates pertaining to the COVID-19 emergency continue to be announced by both the state and federal government on a regular basis. The latest developments for providers of long-term/post-acute care (LTPAC) and senior services are reviewed below.

As a reminder, LeadingAge NY continues to convene weekly webinars on Mondays at 11 a.m. to address emerging questions on COVID-19. A recording of our most recent webinar, held on March 29th, is available here. If you have questions for next week’s update, please send them to Ami Schnauber, and be sure to check your email for the access information, or contact Jeff Diamond.

Cross-Sector Updates

Medicare Accelerated and Advance Payments

Providers who received Medicare accelerated or advance payments in April 2020 will begin seeing recoupments of these payments in April 2021. Originally, providers would have experienced recoupments offsetting entire Medicare payments beginning 120 days after receipt of the advance payment. The Continuing Appropriations Act, 2021 and Other Extensions Act amended the repayment terms for the COVID-19 accelerated/advance payments so that automatic recoupments would not start until one year after the date the payment was issued. In addition, once recoupments do begin, for the first 11 months, the recoupment rate will be 25 percent of a provider’s Medicare payment. At the end of the 11-month period, the recoupment rate will increase from 25 percent to 50 percent. No interest will be applied for 29 months. The fact sheet issued in October is available here, and Frequently Asked Questions (FAQs) are here.

New Populations Eligible for COVID-19 Vaccine

This week, the State announced and issued updated guidance per the State Vaccine Provider Program that permits individuals age 30 to 50 to receive the COVID-19 vaccine starting March 30th. Current vaccine guidance is available here. Individuals age 16 and up will be eligible for scheduling and receiving vaccination beginning April 6th.

State Launches Excelsior Pass

Last week, the State announced the launch of Excelsior Pass, a free, voluntary platform developed in partnership with IBM that utilizes secure technology to confirm an individual’s recent negative PCR or antigen test result or proof of vaccination. This will help fast-track the reopening of businesses and event venues around the state. Similar to a mobile airline boarding pass, individuals will be able to either print out their pass or store it on their smartphones using the Excelsior Pass Wallet app. Each Pass will have a secure QR code, which participating businesses and venues can scan using a companion app to verify proof of a negative test result or proof of vaccination. An individual’s data will be kept secure and confidential at all times. If successful, this may encourage uptake of the vaccine. More details on the program are available here.

Infection Control and Visitation Resources

As the State begins to loosen restrictions and more people are vaccinated, the public may not realize the importance of ongoing infection control practices, particularly in member congregate settings. The Centers for Disease Control and Prevention (CDC) has a wealth of resources on their webpage, including printable resources, which can be found here. This site may be useful in accessing materials to provide signage reminding visitors of the required protocols.

LeadingAge National has also developed some tools that may be useful, particularly to nursing homes and adult care facilities (ACFs), regarding visitation:

Nursing Home and ACF/Assisted Living Updates

New DOH Nursing Home Visitation Guidance Aligns with CMS Requirements

The Department of Health (DOH) issued new nursing home visitation guidance last week that aligns State requirements with guidance issued by the Centers for Medicare and Medicaid Services (CMS). Click here for more information about the guidance, including key highlights.

DOH Issues Revised ACF Visitation Guidance

On March 25th, DOH issued revised visitation guidance for ACFs, which significantly reopens visitation, given certain practices and protocols are in place. LeadingAge NY’s counsel, Hinman Straub, has provided this summary of the changes, as well as considerations in how to implement the changes. Members are encouraged to review the summary carefully. LeadingAge NY has submitted multiple questions to DOH regarding the guidance and will share any answers we receive with members.

Local Positivity Rates

A document showing the most recent 14-day test positivity rates for each county in New York State based on both federal and state figures is available here. Nursing homes across the state are still required to test staff twice per week. The county positivity data posted by CMS are lagged by a week and are updated each Monday or Tuesday (e.g., data for the two-week period ending March 16th are posted on March 23rd). They are available for download in raw format here. LeadingAge NY extracts the CMS-calculated rates for New York State counties and posts them here, along with positivity rates calculated on state data covering the same two-week period.

Current daily county-level data for New York State are here, 7- and 14-day regional data are here, and ZIP code-level data for New York City showing infection rates during the most recent four weeks are available here. Metrics related to the State’s micro-cluster initiative are available here, and links to updated cluster maps and the address look-up tool are here.

Home and Community-Based Services (HCBS) Updates

CHHA HERDS Reporting Clarification

DOH has provided clarification on the certified home health agency (CHHA) Health Emergency Response Data System (HERDS) survey regarding reporting of caseload numbers. Currently, it is finding some agencies reporting information inaccurately. Please note that for the question relating to “today’s caseloads by Level 1, Level 2, Level 3,” answers should not pertain to only new cases on the day of survey, but should include the total census reported by level on the reporting day. DOH has confirmed that CHHAs should not include patients from the licensed home care services agency (LHCSA) unless the patients are on their CHHA caseload as well. CHHAs should not be reporting LHCSA caseloads.

Affordable Housing/Independent Living Updates

CDC Issues Extension to Eviction Moratorium

On March 29th, the CDC issued an extension to the eviction moratorium that was scheduled to expire on March 31, 2021. It has been extended through June 30, 2021. In a statement, CDC Director Dr. Rochelle Walensky stated that the “COVID-19 pandemic has presented a historic threat to the nation’s public health. Keeping people in their homes and out of crowded or congregate settings — like homeless shelters — by preventing evictions is a key step in helping to stop the spread of COVID-19.”

The Department of Housing and Urban Development (HUD) Office of Multifamily Housing will be issuing revised guidance on the extension in its forthcoming COVID-19 Questions and Answers (Q&A). The most recent Q&A document and additional COVID-19 resources may be found here.