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Feb. 2nd 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 Feb. 1st, is available here. In addition to updates from LeadingAge NY staff, this week’s webinar includes a discussion on staff COVID-19 vaccine education efforts with Adriene Rosell, vice president of operations at Elizabeth Seton Children’s Center. 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

CDC Allows First Vaccine Doses for Staff at Third Clinics

Many members have been inquiring about the possibility of staff acquiring first doses of the COVID-19 vaccine at their third clinics delivered through the federal Pharmacy Partnership for Long Term Care program. LeadingAge National has indicated that the Centers for Disease Control and Prevention (CDC) is directing Walgreens and CVS to allow for first dose vaccination of staff at third clinics. This pertains only to staff, as they will be able to follow up with their second doses at community vaccination sites. 

This is good news for many members with staff who are no longer hesitant to receive the vaccine. Please reach out to your pharmacy match to discuss this new development.

CMS Updates Vaccine Toolkit

The Centers for Medicare and Medicaid Services (CMS) has issued an update to its Toolkit on COVID-19 Vaccine: Health Insurance Issuers and Medicare Advantage Plans. Click here to access the toolkit.

DOH Issues Guidance on Who Can Administer COVID-19 Vaccinations

On Jan. 25th, the Department of Health (DOH) issued guidance on who can administer COVID-19 vaccinations, along with training requirements. The guidance distinguishes between Group 1 (current and modified vaccinators who can serve at any number of vaccine site types) and Group 2 (new vaccinators who are only allowed to practice at Points of Dispensing (PODs)). Provider types include registered nurses (RNs), licensed practical nurses (LPNs) (under the supervision of an RN), LPNs without RN supervision at a POD site, emergency medical services (EMS) providers, and others.

DOH Offers Staff Support Training Video

The DOH Office of Health Emergency Preparedness (OHEP) has shared an announcement for a training entitled Disaster Mental Health: How Long Has Your “Check Engine” Light Been On? Enhancing Your Understanding of Yourself and Stress During COVID-19.

As noted in the training announcement, understanding our own early warning signs of emotional trouble (like the check engine light in your car), our personal responses to adversity, and the current state of our overall wellbeing are essential components of being able to help others cope and heal. However, compounded stressors related to the pandemic such as social distancing, facility surges, and limited resources have created challenges for recognizing these early signs of stress and have led to an increase in complex behavioral health risks, including compassion fatigue, caution fatigue, moral injury, and complex grief.

The original training was offered on Dec. 17th by the Office of Mental Health (OMH), but this week the recorded session was released. To register, click the link in the training announcement. OHEP has also shared the slide presentation.

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

Payment for Nursing Home and ACF Staff Testing

On Feb. 1st, DOH issued advisories to nursing homes and ACFs reminding them that while “facilities may submit claims to insurers for the cost of medically necessary COVID-19 testing, if payment is not available for the staff members’ routine testing, facilities must pay for the testing.” The advisories also remind providers that they are required to test or arrange for the testing of all personnel, including employees, per diem staff, contract staff, medical staff, operators, administrators, and volunteers. Nursing homes statewide are required to test personnel twice weekly, while ACFs are required to do so once per week. The nursing home advisory is here, and the ACF document is here. While most insurers clarified early on that routine testing for employment purposes was not covered, a number of members experienced large, surprise bills months later. We continue to advocate for funding to help defray these costs and hope that distributions of point-of-care antigen tests to some providers can decrease the significant expenses associated with staff testing.

Expiration Date for Abbott BinaxNOW Tests

It has been brought to our attention that the Abbott BinaxNOW COVID-19 tests have an expiration date. These tests should not be used beyond their expiration date, so be sure to examine the tests and make use of them before they expire.

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. Although nursing homes across the state are required to test staff twice per week, we encourage members to be aware of their local positivity rates. Nursing home members should also keep in mind the federal requirement that for homes located in counties where positivity rates exceed 10 percent, visitation is limited to compassionate care.

Current daily county-level data for New York State 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.

HHS Updates Provider Relief Fund FAQs

New Frequently Asked Questions (FAQs) added by the Department of Health and Human Services (HHS) to the Provider Relief Fund (PRF) FAQ compendium clarify that HHS intends to issue all of the PRF dollars dedicated for Nursing Home Infection Control in four payments. Previously, HHS had signaled that along with four monthly performance period payments, there would be a fifth payment calculated on aggregate performance for the entire four-month timeframe. This does not reduce overall funding, but rather consolidates it into four rather than five payments. We are still waiting for HHS to release the list of homes that received November funding along with key county-level data governing the eligibility calculation. While not issuing a deadline for PRF recipients to file the required reports, HHS did update several FAQs that address reporting issues. Among them is clarification that lost revenue comparisons need to be calculated on an annual, not quarterly, basis. The FAQs are available here, and the link to the reporting portal (which only allows registration at this point) is here.

Focused Infection Control Considerations Following the Care Compare Refresh

Focused Infection Control (FIC) survey activity requirements were revised in CMS memo QSO 20-31-All-REVISED, issued on Jan. 4th, including revised criteria for triggering a FIC survey. Click here for more information.

LeadingAge NY Hosts Respiratory Protection Program Webinar

On Jan. 27th, LeadingAge NY sponsored a webinar entitled Respiratory Protection: OSHA Compliance for Long-Term Care Facilities. The webinar provided excellent information on the process of setting up an approved Respiratory Protection Program (RPP) within your facility and can be viewed here. The presentation referenced an Occupational Safety and Health Administration (OSHA)-approved template that can be utilized while setting up your program. In October 2009, during the H1N1 health emergency, DOH issued a Dear Administrator Letter (DAL) addressing respiratory protection, and it remains pertinent when addressing COVID-19 today.

Affordable Housing/Independent Living Updates

CDC Officially Extends Eviction Moratorium

On Jan. 29th, the CDC ordered an extension to the temporary halt in residential evictions until March 31st. The eviction moratorium began in September and shields renters from eviction due to non-payment of rent. The CDC order comes after an Executive Order by President Biden instructing the CDC to extend the moratorium until at least the end of March. Click here for more information from LeadingAge National.