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Jan. 5th 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 Jan. 4th, 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

PPP Session This Friday!

The COVID-19 stimulus bill signed into law near the end of 2020 provides additional opportunities for organizations to access forgivable Paycheck Protection Program (PPP) loans and makes some changes to existing COVID-19 relief programs. To ensure that members have sufficient information to make the most of these changes, LeadingAge NY is partnering with The Bonadio Group to offer an educational session this Fri., Jan. 8th, at 1 p.m. The session description is copied below. Please note that while the session is free, registration is required and can be accessed here.

The federal Paycheck Protection Program (PPP) has provided critical assistance to many LeadingAge NY members facing financial stress due to COVID. What’s better than a PPP forgivable loan? A second one!!! Congress has not only refreshed the program with the PPP second draw loan but also made beneficial retroactive changes to the original program and expanded eligibility for other programs. The COVID Relief bill adds another $325 billion to small business programs that many long term care providers will be able to access. We invite members to learn about new PPP forgivable loan provisions and the Employer Retention Credit programs that are included in the coronavirus stimulus/government spending bill (Consolidated Appropriations Act, 2021) signed into law on Dec. 27th. Join us on Friday, Jan. 8th at 1 p.m. as Rob Nasso, CPA, Partner with The Bonadio Group, reviews the opportunity that the new provisions offer for providers meeting the established criteria, including those who may have received a PPP loan previously. Rob will also discuss the overlap between the PPP, the Employee Retention Credit, and Phase 3 & 4 of Provider Relief Funding. Don’t miss the chance to learn the latest about these provisions from an expert who has been guiding members through the process since the CARES Act was first unveiled.

New HCP Populations Added to State's COVID-19 Vaccine Priority List

The Department of Health (DOH) recently issued more weekly vaccine guidance prioritizing new populations for COVID-19 vaccination. Initially, the Department was going to initiate vaccination of these populations on Jan. 11th, but that date has now been moved up to Jan. 4th.

According to the new guidance, issued on Jan. 5th, the State will start vaccinating the following populations:

  • Home care 
  • Hospice 
  • Personal assistants under the Consumer Directed Personal Assistance Program (CDPAP)
  • Nursing home staff not yet vaccinated through the federal Pharmacy Partnership for Long Term Care program
  • Adult care facility (ACF) staff not yet vaccinated through the federal Pharmacy Partnership for Long Term Care program

Click here for more information.

Reporting Requirement for Administration of COVID-19 Vaccine and Influenza Vaccine

Members should be aware of provisions in Executive Order (EO) 202.82, issued on Dec. 13th, which require providers to report COVID-19 vaccinations into the New York State Immunization Information System (NYSIIS) once providers start administering them on their own (outside of the federal Pharmacy Partnership for Long Term Care). They also require providers to input administration of influenza vaccines into NYSIIS as well.

The relevant section:

Section 2168 of the Public Health Law and section 66-1.2 of Title 10 of the NYCRR, to the extent necessary to: (1) suspend the requirement that persons 19 years of age or older must consent to have their immunization information reported to the New York State Immunization Information Registry (NYSIIS) or the City Immunization Registry (CIR), so that for the purposes of this Executive Order, the New York State Commissioner of Health or the New York City Commissioner or Health may include adult immunization information in NYSIIS or the CIR, as applicable, without the consent of the vaccine, and subject to guidance issued by the New York State Department of Health; and (2) require all influenza and COVID-19 vaccinations for any individual (child or adult) to be reported to the NYSIIS or CIR, as applicable, within 24 hours of administration of such vaccine. Nothing in this provision shall be read to permit the vaccination of any person without their consent, or the consent of another person legally authorized to provide such consent on their behalf such as a parent or guardian;

Nursing Home and ACF/Assisted Living (AL) Updates

Providers Receive MOU to Participate in State Vaccination Program

Late last week, DOH distributed a memorandum of understanding (MOU) to certain providers that have enrolled in the State’s COVID-19 vaccine administration program. The execution of the MOU is a prerequisite to participating as a vaccine provider in the State program. It is unrelated to the federal Pharmacy Partnership for Long Term Care vaccination program currently under way in nursing homes and ACFs. Click here for more information.

New HERDS Vaccination Questions for ACFs

As ACF/AL members are aware, new questions have been added to the daily Health Emergency Response Data System (HERDS) survey regarding vaccination. Members are encouraged to read the questions carefully. We will let members know when the recording of the DOH webinar regarding the questions becomes available.

LeadingAge NY is pleased to hear that some members have had their vaccination clinics scheduled for the upcoming weeks. We are aware that some members have not yet received a clinic date, and we anticipate you will hear soon. If members receive first clinic dates for February, please let us know so that we can advocate on your behalf for accessing vaccines earlier. DOH and the Governor’s Office have expressed a commitment to ensuring that the ACF/AL population be vaccinated as quickly as possible as a member of the 1a priority population.

CVS Vaccine Clinic Q&A Forums

CVS has announced plans to hold two optional open office-hours forums to address vaccine clinic-related questions on Jan. 6th and 7th from 1 to 2 p.m. Registration for both sessions 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 federal figures is available here. The rates exceed 10 percent in 21 counties for the 14-day period ending Dec. 30th.

We remind nursing home members that under the federal Centers for Medicare and Medicaid Services (CMS) nursing home testing guidance, when a county reaches a test positivity rate in excess of 10 percent and is designated a red zone by CMS, nursing homes must test staff twice weekly. However, CMS Frequently Asked Questions (FAQs) allow facilities to use state positivity data, instead of the federal data, to determine whether the twice-weekly testing requirement has been triggered, provided that the state data are available at the same frequency and use a similar methodology to the Centers for Disease Control and Prevention (CDC). The State uses a similar, but not identical, positivity rate calculation methodology to the CDC.

Until recently, New York State only posted daily test positivity rates, which providers could use to calculate 14-day rates if they chose to use state data in place of federal data to determine whether the federal threshold for twice-weekly staff testing had been triggered. The State recently rolled out COVID-19 dashboards that provide state-calculated 7- and 14-day test positivity rates on a county level and are available here. Nursing home providers opting to use state data should use their best judgment whether to use 7- or 14-day rates. We believe that using state-calculated 14-day rates issued on the same day as the CMS data are updated (i.e., each Tuesday) meets the requirement that state data be “based on a similar methodology used by the CDC and the rates are posted on the same or more frequent basis as CMS.”

Providers who opt to use the state rates should document the source, date, and rate used to determine the frequency of staff testing based on CMS guidance. Homes should also continue to use the same source for determining staff testing frequency (i.e., do not switch sources from week to week). If the positivity rate in your county reaches a level in excess of 10 percent (based on the data source you selected), the twice-weekly CMS staff testing requirement is effective “as soon as the criteria are met.” It continues until the county positivity rate has remained at the lower activity level for at least two weeks.

Under the state micro-cluster guidance, nursing homes are also required to test twice weekly if the facility is in a red, orange, or yellow micro-cluster zone, even if the federal requirement is not triggered. Unlike the CMS zones, the micro-cluster zones are not county-wide – they may be ZIP codes or census tracts.

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 cluster maps and the address look-up tool are here.

Affordable Housing/Independent Living Updates

Toolkit for HUD Section 202 Providers in the CDC Pharmacy Partnership for Long Term Care Program

On Dec. 30th, LeadingAge National published a toolkit for Housing and Urban Development (HUD) Section 202 providers participating in the federal Pharmacy Partnership based on the CDC’s vaccine toolkit for long term care communities. The toolkit provides sample communications to residents about vaccine clinics, including a sample resident letter and survey, communication tips, and posters and stickers. Click here to access the toolkit.