Oct. 5th COVID-19 Update

New COVID-19-related updates for providers of long-term/post-acute care (LTPAC) and senior services continue to be shared on a regular basis by both state and federal authorities. The latest developments are described 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 Oct. 4^th, is available here, and a list of the items shared by LeadingAge NY staff in the webinar chat can be accessed here. If you have questions for next week’s update, which will be held on Tues., Oct. 12^th at 1 p.m. due to Columbus Day, or would like the access information, please contact Jeff Diamond.

Cross-Sector Updates

Oct. 7^th Vaccine Mandate Deadline and HERDS Survey Updates

As the Oct. 7^th deadline for COVID-19 vaccinations for adult care facilities (ACFs), home care, and hospice looms, we are acutely aware of the challenges members are facing and have been communicating them to the Department of Health (DOH) and the Governor’s Office. If you remain understandably confused about the status of religious exemptions to the mandate and the legal challenges, click here for more information. DOH has directed nursing homes, ACFs, home care, hospice, and other DOH-regulated providers to contact the DOH Surge and Flex Operations Center at 917-909-2676 anytime there is concern about health care personnel (HCP) staffing, patient care capacity, or other triage concerns. The Surge and Flex Operations Center is available 24 hours a day, 7 days a week. While we are uncertain of the response or resource you will receive as a result, we recommend that you report through this avenue if you are in that circumstance at this time. At a minimum, it is critical that DOH have a full understanding of the scope of the issue. Please also let us know.

The Department has been amending the various Health Emergency Response Data System (HERDS) surveys as well, with a daily survey for licensed home care services agencies (LHCSAs) this week. DOH has made it clear that LHCSAs that serve only Assisted Living Programs (ALPs) do not need to complete the survey. LHCSAs that serve both the ALP and the greater community should complete the survey but not include the ALP services in that reporting. Please let us know if you have any difficulty with this. We worked to ensure that ALP members were not subject to duplicative reporting.

Several questions have been added to the nursing home and ACF surveys to incorporate many of the elements of the recent supplemental surveys and the staffing situation. Meanwhile, DOH will be removing the personal protective equipment (PPE) questions from the daily HERDS surveys. We understand that this daily reporting is excessive and burdensome and will continue to work to get you some relief.

Vaccination Update

The latest vaccination information, including updates on new State vaccination guidance and consent forms and a newly released Booster Toolkit from LeadingAge National, is summarized here.

Commissioner's Designation Keeps HERO Act in Effect

Members may recall that on Sept. 6^th, Governor Hochul announced the designation of COVID-19 as a highly contagious communicable disease that presents a serious risk of harm to the public health under New York State’s HERO Act, triggering implementation of certain requirements of the law. The HERO Act covers all non-governmental industries across New York and worksites, with the exception of any employee or employer within the coverage of a temporary or permanent Occupational Safety and Health Administration (OSHA) standard on COVID-19 or airborne infectious diseases generally. On Sept. 30^th, the Commissioner of Health extended the declaration that triggers this requirement through Oct. 31^st.

In addition, members are reminded that all employers with 10 or more employees must permit workers to establish and administer a joint labor-management workplace safety committee by Nov. 1^st. This requirement applies regardless of whether the employer is held to the OSHA standard. Click here for more information.

HHS Accepting PRF Applications

The Health Resources and Services Administration (HRSA), the division of the Department of Health and Human Services (HHS) that administers the Provider Relief Fund (PRF), began accepting applications for the next round of PRF funding on Sept. 29^th. The application portal will remain open for four weeks. Providers must submit their completed application by the final deadline of Oct. 26^th at 11:59 p.m. ET. Click here for more information.

Nursing Home Updates

State Creates Monoclonal Antibody Therapy Webpage

Members should note that the State now has a new webpage that provides information about ordering and administering monoclonal antibody (mAb) therapy. The site includes a link to the Health Commerce System (HCS) for providers to order supply. Currently, only providers registered with AmerisourceBergen may order. LeadingAge NY will let members know when this opens up to all interested providers.

Other resources for members interested in proving mAb treatment include:

NHSN Reporting

The Centers for Disease Control and Prevention (CDC) has implemented changes to the way that nursing homes report COVID-19 vaccination status data for staff and residents on the National Healthcare Safety Network (NHSN). The CDC presented a webinar on Sept. 23^rd that highlighted the changes. The slides used during the webinar are available here.

While much of the presentation reviews the reporting that nursing homes have been doing for a number of months, there are some changes that may increase the stakes and add to the burden of reporting. For example, the categories of staff have been reorganized, requiring reporting facilities to become familiar with the new categories and report accordingly. Changes in reporting requirements are indicated by green stars in the presentation. The changes, which are related only to the COVID-19 module, were effective as of Oct. 1^st. Long term care weekly COVID-19 resident vaccination reporting instructions are available here, and HCP instructions are here.

Although the need to complete a monthly reporting plan (MRP) was initially required along with other Oct. 1^st changes, the CDC has since communicated that no action is currently required. Providers do not need to complete the MRP to report COVID-19 vaccination data for residents and HCP for reporting weeks ending Oct. 3, 2021 through March 27, 2022. For now, NHSN will auto-populate the MRP for the vaccination coverage module. When required, the MRP will consist of simply checking off boxes indicating that the facility intends to report weekly data for the given month. Instructions for completing the MRP are available here. Note that accessing the MRP functionality requires Level 3 Secure Access Management Services (SAMS) access, and weekly data (after March 27, 2022) cannot be submitted until the MRP is complete.

To initiate the process of upgrading data security from Level 1 (general NHSN user) to Level 3, NHSN users should email nhsn@cdc.gov with “Enhancing SAMS Data Security” in the subject line, then follow the instructions here.

The Point-of-Care (POC) Test Reporting Tool is a reporting option for long term care providers to report testing results through NHSN. The reporting of POC test result data in this tool does not take the place of answering POC-related questions. Those who have been submitting test data directly to state and local health departments can continue to do so.

Members may want to review the updated data collection forms and instructions posted under the heading Data Collection Forms and Instructions on the NHSN page here, which also contains a number of reporting resources. A beneficial vaccination tracking tool is available on the Agency for Healthcare Research and Quality (AHRQ) website here.

Home and Community-Based Services (HCBS) and Program of All-Inclusive Care for the Elderly (PACE)/Managed Long Term Care (MLTC) Updates

New HERDS Survey for LHCSAs

DOH is requiring a new HERDS survey for LHCSAs that seeks to understand how the Oct. 7^th vaccine mandate is impacting staffing and the capacity to serve home care patients. The survey started Mon., Oct. 4^th and will be repeated daily for the remainder of the week. It will then be collected every Monday, Wednesday, and Friday until further notice starting Mon., Oct. 11^th. Click here for more information.

DOH Updates Guidance on Community Health Assessments

DOH has updated and replaced the guidance document entitled “Rescission of Updated COVID-19 Guidance for the Authorization of Community Based Long Term Services and Supports Covered by Medicaid” issued on July 26^th. The new and updated guidance is available here.

The new guidance provides for the following:

Extends the due date for Consumer Directed Personal Assistance Program (CDPAP) personal assistants to obtain an annual health assessment from Sept. 30, 2021 to Dec. 31, 2021; and
Allows telehealth Uniform Assessment System for New York (UAS-NY) Community Health Assessments (CHAs) to resume as an option for all assessments, in addition to in-person mode.

Click here for more information.

Affordable Housing/Independent Living Updates

HUD Staff Join LeadingAge National Call to Answer Fourth Round CSP Questions

During a special edition of LeadingAge National’s regular Housing Advisory Group call on Oct. 4^th, Department of Housing and Urban Development (HUD) staff reviewed key details of COVID-19 Supplemental Payments (CSPs), which provide a mechanism for housing providers to receive reimbursement for COVID-19-related expenses. As a reminder, requests for these funds are due to HUD by Nov. 19^th for COVID-19 costs incurred prior to Oct. 31^st by Multifamily Housing providers (Project-Based Section 8, Section 202, and Section 811). Click here for more information.