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April 6th 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 discussed 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 April 5th, 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

DOH Releases New RTW Guidance for Exposed Staff and Travelers

New guidance from the Department of Health (DOH) expands exemptions from work exclusion for staff who are exposed to COVID-19 and are fully vaccinated or recently recovered. In addition, the new guidance modifies furlough and testing requirements for staff who travel to other states or foreign countries. The guidance applies to personnel in all health care settings, but includes special provisions for staff in nursing homes, enhanced assisted living residences (EALRs), and assisted living programs (ALPs). Click here for more information.

New Travel Advisory for the General Public Eliminates Requirements for Domestic Travel

On April 1st, DOH issued guidance for the general public lifting quarantine and testing requirements for domestic travelers arriving in New York State. Health care providers and travelers working in health care settings are reminded to consult with the Revised Protocols for Personnel in Healthcare and Other Direct Care Settings to Return to Work Following COVID-19 Exposure for relevant requirements. Click here for more information.

Vaccination Update

The latest vaccination information – including updates on vaccine supply from local health departments, paid leave for vaccinations, monoclonal antibody treatments, and grant funding to facilitate vaccination access – is summarized here.

Recoupment of Accelerated Payments Begins

We remind members who received Medicare accelerated or advance payments in April 2020 that they 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.

FEMA COVID-19 Funeral Assistance Program Launches April 12th

This week, the Federal Emergency Management Agency (FEMA) released guidance on the delivery of the COVID-19 funeral assistance program authorized by the Coronavirus Response and Relief Supplemental Appropriations Act, 2021. Applications will be accepted beginning April 12th. Click here for more information from LeadingAge National.

Nursing Home and Adult Care Facility (ACF)/Assisted Living Updates

Note on ACF Visitation

There is some debate regarding the interpretation of the new ACF visitation guidance as it relates to the implications of a COVID-positive resident or staff member. Members are reminded to alert your local (county or New York City (NYC)) health department, your regional office, and the covidadultcareinfo@health.ny.gov email when a positive occurs and follow their direction regarding visitation, communal activities, and communal dining. Be sure to document the direction you receive.

Guidance Issued Regarding Hospital Vaccination of Discharges to LTC Facilities

On April 4th, DOH issued guidance to hospitals regarding vaccinating long term care (LTC) patients before discharge to a LTC facility. Click here for more information.

FCC to Provide Second Round of COVID-19 Telehealth Program

On March 30th, the Federal Communications Commission (FCC) voted to formally adopt a Report and Order that establishes a second round of the COVID-19 Telehealth Program. The program allows eligible health care providers to be reimbursed for providing telecommunications services, information services, and connected devices necessary to enable telehealth during the pandemic. The Consolidated Appropriations Act, 2021, enacted in December 2020, allocated $249 million for the program on top of the initial $200 million that was established as part of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act).

The new application window is expected to open within 30 days, and the FCC will provide advance notice. Eligible health care providers include sites that treat patients, whether located in rural or non-rural areas or U.S. territories, and the program is limited to non-profit and public eligible providers that fall within the following categories: post-secondary educational institutions offering health care instruction, teaching hospitals, and medical schools; community health centers or health centers providing health care to migrants; local health departments or agencies; community mental health centers; not-for-profit hospitals; rural health clinics; skilled nursing facilities (SNFs); or consortia of health care providers consisting of one or more entities falling into the first seven categories.

More information about the COVID-19 Telehealth Program can be accessed here and here.

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. The number of counties with test positivity rates above 5 percent based on federal data has increased since last week, and the rate in Orange County exceeds 10 percent. The requirement for nursing homes across the state to test staff twice weekly remains in effect. The county positivity data posted by the Centers for Medicare and Medicaid Services (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 NYC showing infection rates during the most recent four weeks are available here. Effective March 22nd, the final remaining yellow zone clusters in New York State have been lifted. The State’s regional COVID-19 Early Warning Monitoring Dashboard showing new infections, severity of infections, and hospitalization data is available here.

Adult Day Health Care (ADHC)/Home and Community-Based Services (HCBS) Updates

CDC Issues Recommendations for Adult Day Care Operations During COVID-19

The Centers for Disease Control and Prevention (CDC) has issued guidance providing recommendations regarding operation of adult day programs during COVID-19. The documents are appropriate for participants and providers and address issues such as promotion of behaviors that reduce the spread of COVID-19, infection control practices, maintenance of healthy operations, signage throughout programs, health screenings, isolation and transport of staff and participants who have symptoms while at program, modified program layout, activities, transportation, maintenance of healthy environments regarding ventilation, restrooms, shared areas, and more. They also provide mental health resources.

The documents will be helpful for both social adult day and ADHC program operation. As members know, DOH recently issued guidance reopening ADHC programs across the state. The reopening process will likely take several weeks to months.

Affordable Housing/Independent Living Updates

HUD Issues Memo, Q&A on Extended Eviction Moratorium

Last week, the Department of Housing and Urban Development (HUD) Office of Multifamily Housing issued an updated memo to housing providers and a set of questions and answers (Q&A) related to the CDC order to temporarily halt residential evictions, including its extension until June 30, 2021. Click here for more information from LeadingAge National.

New Q&A Discusses Vaccine Access, Property Expenses at HUD Communities

In its first update since the Biden administration took office, the HUD Office of Multifamily Housing released an updated COVID-19 Q&A on April 2nd. The updated document discusses testing and vaccine clinics at HUD-assisted communities as well as use of operating funds for preparedness activities on site. It also covers allowable medical expenses for residents, treatment in income calculations of the latest round of stimulus checks, tenant income recertifications, and electronic file transmission. Click here for more information from LeadingAge National.