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Jan. 11th 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 Jan. 10th, 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., Jan. 18th at 11 a.m. due to Martin Luther King Jr. Day, or would like the access information, please contact Jeff Diamond.

Cross-Sector Updates

Health Care Personnel Required to Receive COVID-19 Boosters Under New DOH Regulation

Most health care personnel (HCP) are required to receive a COVID-19 vaccine booster under emergency regulations approved on Jan. 11th by the State’s Public Health and Health Planning Council (PHHPC). The regulation directs “covered entities” to “continuously require personnel to be fully vaccinated against COVID-19 and to have received any booster or supplemental dose as recommended by the CDC.” In addition to the booster mandate, the PHHPC approved a related regulation that adds booster shots to existing requirements imposed on nursing homes and adult care facilities (ACFs) to provide staff and residents with access to COVID-19 vaccinations within a specified time period. The nursing home personal protective equipment (PPE) stockpile and Surge and Flex Health Care Coordination System regulations were also extended on Jan. 11th. Click here for more information.

Still Waiting for Supreme Court to Rule on CMS and OSHA ETS Vaccine Mandates

The U.S. Supreme Court heard arguments on Jan. 7th on the challenges to the Centers for Medicare and Medicaid Services (CMS) Interim Final Rule (IFR) and Occupational Safety and Health Administration (OSHA) Vaccination and Testing Emergency Temporary Standard (ETS). Click here for the latest on both cases.

Updated Vaccination Guidance Issued

The Department of Health (DOH) has issued updated vaccination guidance for provider vaccinators. New general vaccination guidance includes updated information allowing boosters for individuals aged 12 to 15. It also includes new recommendations from the Centers for Disease Control and Prevention (CDC) that allow a five-month interval between the primary series of vaccination and a booster shot for both the Pfizer and Moderna vaccines. CDC recommendations on the subject can be found here and here. This will come into play as providers determine staff eligibility for the booster per recent proposed emergency regulations requiring boosters for HCP.

New guidance has also been issued allowing for the expansion of vaccinations to individuals aged 5 to 11. Updated vaccination screening forms and checklists have been posted as well on the State’s vaccination provider website.

Clarifications on HERO Act and OSHA COVID-19 Healthcare ETS

There has been recent guidance issued regarding both the New York State HERO Act and the federal OSHA COVID-19 Healthcare ETS, both of which relate to workplace safety requirements for employers. To sum, the State has issued proposed regulations regarding the Workplace Safety Committees and other clarifications for the HERO Act, and the OSHA Healthcare ETS is withdrawn, and yet you should continue to comply. Confused? Read the linked articles for more information, and let us know what questions you have.

Provider Relief Reporting Webinars

Provider Relief Fund (PRF) Reporting Period 2 is now open. The PRF Reporting Portal opened on Jan. 1st, and providers have until March 31st to submit their reports. Click here for more information, including registration details for two upcoming webinars on the Portal for new and returning reporters.

Nursing Home Updates

No Further Guidance on Nursing Home Visitor Testing Requirement

LeadingAge NY has not received any further guidance from DOH concerning Governor Hochul’s announcement at a news conference last week that, as of tomorrow (Wed., Jan. 12th), visitors to nursing homes would be required to present a negative test result from within 24 hours prior to the visit. We have submitted over a dozen questions about this reported requirement to DOH but have not received a response. Without official direction from DOH, we believe that implementing the announced visitor testing requirement would place facilities at risk of violating the CMS guidance prohibiting the imposition of a testing requirement.

As background, the CMS visitation QSO states:

“While not required, we encourage facilities in counties with substantial or high levels of community transmission to offer testing to visitors, if feasible. If facilities do not offer testing, they should encourage visitors to be tested on their own before coming to the facility (e.g., within 2–3 days). Visitor testing and vaccination can help prevent the spread of COVID-19 and facilities may ask about a visitors’ vaccination status, however, visitors are not required to be tested or vaccinated (or show proof of such) as a condition of visitation.”

On a Nov. 23rd CMS National Nursing Home Stakeholder call, Evan Shulman, director of the CMS Division of Nursing Homes, reinforced that “a facility cannot require a visitor to be vaccinated or tested. Safe visitation can occur, even when a visitor is not vaccinated” (27:35).

Accordingly, we recommend that, until we receive written guidance from DOH directing nursing homes to make testing a prerequisite for visitation, nursing homes should encourage, but not require testing, and provide rapid test kits to visitors if you have them. The visitors may test themselves in their car, at home, or in designated facility space and present the test strip or cartridge or a photo of it.

Refresher on CDC Infection Prevention Guidance for Nursing Homes

Nursing home members are reminded that on Sept. 10th, the CDC issued recommendations designed to prevent the spread of SARS-CoV-2 in long term care facilities. The recommendations address the following:

  • Updated outbreak response guidance to promote use of contact tracing approach. Alternative broad-based approaches to outbreak response at facility-wide or unit level also described;
  • Updated expanded screening testing recommendations for HCP;
  • Updated recommendations for quarantine of fully vaccinated residents;
  • Updated visitation guidance.

Click here for more information.

Reminder on EO for Staffing Flexibilities

Nursing home members should be aware that the below provision in Executive Order (EO) 4 allows for licensed nurses from outside of New York State to practice in New York State without a license throughout the duration of the EO. As mentioned on LeadingAge NY’s Jan. 10th COVID-19 update webinar, it is recommended that any nurses being used from other states apply for reciprocity in case the EO is ended while out-of-state nurses are still employed in your facility.

  • Section 6502 of the Education Law and 8 NYCRR 59.8, to the extent necessary to allow physician’s assistants, registered professional nurses, licensed practical nurses, and nurse practitioners licensed and in current good standing in New York State but not registered in New York State to practice in New York State without civil or criminal penalty related to lack of registration, and to allow specialist assistants, respiratory therapists, respiratory therapist technicians, pharmacists, clinical nurse specialists, dentists, dental hygienists, registered dental assistants, midwives, perfusionists, clinical laboratory technologists, cytotechnologists, certified clinical laboratory technicians, certified histological technicians, licensed clinical social workers, licensed master social workers, podiatrists, physical therapists, physical therapist assistants, mental health counselors, marriage and family therapists, creative arts therapists, psychoanalysts and psychologists who have an unencumbered license and are currently in good standing in New York State but not registered in New York State to practice in New York State without civil or criminal penalty related to lack of registration;

Home and Community-Based Services (HCBS) Updates

Reminder: Telehealth Flexibilities Are Available for Home Care and Hospice Providers

As COVID-19 cases rise and home care and hospice agencies experience staffing shortages, agencies are reminded that they may utilize the telehealth flexibilities outlined here.

Program of All-Inclusive Care for the Elderly (PACE)/Managed Long Term Care (MLTC) Updates

DOH Updates Medicaid Managed Care Guidance to Include January Assessments

On Jan. 5th, DOH updated the guidance document titled Rescission of Updated COVID-19 Guidance for the Authorization of Community Based Long Term Services and Supports Covered by Medicaid to include instructions for plans on reassessments. While the original transition guidance was issued in July 2021 to provide details on what steps were to be taken to return to pre-emergency status for various topic areas, the only change this update makes is to specify that for the month of January 2022, plans should conduct periodic reassessments and home visits for members who would have been scheduled for reassessment during September 2020. Click here for more information.

DFS Suspends Certain Utilization Review Requirements

In response to rising demand for inpatient hospital care due to an increase in COVID-19 Omicron variant cases combined with staffing shortages, the Department of Financial Services (DFS) is suspending existing preauthorization requirements for certain services to facilitate hospitals to rapidly transfer or discharge patients. Click here for more information.