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July 28th 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 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 July 27th, 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 Issues Updated Return to Work Guidance for ACFs, Home Care, Hospice, and Other Non-Nursing Home Providers

Over the weekend, the Department of Health (DOH) issued new guidance entitled Revised Protocols for Personnel in Healthcare and Other Direct Care Settings to Return to Work Following COVID-19 Exposure or Infection. Please note that this does NOT apply to nursing homes. While the directive references an update to the April 1st guidance, it appears to update subsequent guidance that was issued on July 3rd (which had updated the April 1st guidance).

The change evident in the July 24th guidance is the elimination of a condition as it relates to health care personnel (HCP) to work under certain conditions if they have traveled to a state with a significant degree of community spread of COVID-19. Specifically, the following requirement is omitted in the July 24th guidance: “Furloughing such HCP would result in staff shortages that would adversely impact operation of the healthcare entity, and all other staffing options have been exhausted.”

DHSES Officials Describe Process for Seeking FEMA Public Assistance Reimbursement

On July 23rd, officials with the New York State Division of Homeland Security and Emergency Services (DHSES) presented a webinar to LeadingAge NY members on the Federal Emergency Management Agency (FEMA) Public Assistance Program, which offers reimbursement of eligible emergency response expenses to nursing homes and other senior services providers. Click here for more information.

CARES Act Funding for Medicaid Providers

As a reminder, the Department of Health and Human Services (HHS) has extended the deadline to apply for a distribution under the $15 billion Coronavirus Aid, Relief, and Economic Security Act (CARES Act) Provider Relief Funding allocation for Medicaid and Children’s Health Insurance Program (CHIP) providers. This program is aimed at Medicaid providers that did not receive a payment from the $50 billion Provider Relief General Distribution. HHS has extended the deadline for eligible providers to apply for this funding until Aug. 3rd.

Assisted living programs (ALPs), home and community-based services (HCBS) providers, nursing facilities, clinics, and hospices can apply if they meet certain criteria. Each successful applicant will receive a grant of at least 2 percent of its reported gross revenue from patient care. Applications are being processed on a rolling basis, so it makes sense to apply as soon as possible before the deadline.

Materials, a recorded webinar, updated Frequently Asked Questions (FAQs), and access to the application portal are posted on HHS’s CARES Act Provider Relief Fund webpage. The LeadingAge NY COVID-19 Financial Assistance Opportunities for Not-for-Profit Providers guide provides the most updated information on this program and other financial assistance for members.

National Public Health Emergency Extended

The HHS Secretary has renewed the COVID-19 public health emergency declaration that was set to expire on July 25th for an additional 90 days. The declaration was originally effective in January of this year and renewed in April. The extension means that waivers whose expiration is tied to the expiration of the emergency declaration will continue into October unless specifically rescinded.

New York Adds Three States, Puerto Rico, and DC to Travel Advisory

LeadingAge NY has been tracking the COVID-19 Travel Advisory requiring people to quarantine if traveling to New York from certain states, with certain conditional exceptions for essential workers. On July 28th, the Governor announced that three new states have been added to the list: Illinois, Kentucky, and Minnesota. Puerto Rico and Washington, DC have also been added. Click here for more information and an archived list of states as they have been added or removed.

Nursing Home Updates 

Extension of Application Deadline for Civil Money Reinvestment Funds

DOH has extended the deadline for nursing homes to apply for Civil Monetary Penalty (CMP) Reinvestment funds for the purchase of communication devices to facilitate communication between residents and families to no later than 3 p.m. on Fri., July 31st. Click here for more information.

CARES Act Funding for Nursing Homes

Last week, the Centers for Medicare and Medicaid Services (CMS) announced that an additional $5 billion in Provider Relief Funding authorized by the CARES Act will be allocated to nursing homes. While the timing and distribution methodology have not been revealed, indications are that the funding will target all nursing homes. The CMS announcement states that appropriate use of the funding will include hiring additional staff, implementing infection control “mentorship” programs, increasing testing, and providing additional services such as technology so residents can connect with their families if they are not able to visit.

One of the eligibility criteria will be a requirement that the nursing home participate in a COVID-19 training program focused on infection control and best practices, a joint CMS/Centers for Disease Control and Prevention (CDC) initiative that will feature 23 online, self-paced modules. The CMS announcement is available here.

Federal Testing Kit Distribution

HHS has begun distributing antigen diagnostic test kits to nursing homes. All homes in the nation are slated to receive the tests eventually, although the initial distribution, which began last week, targets COVID-19 hot spots. Nursing homes in California, Texas, Florida, and Arizona account for 75 percent of the initial distribution aimed at 635 homes. While homes will receive a testing instrument along with a stock of supplies to test all staff and residents at least once, providers will be responsible for procuring subsequent test supplies directly. While HHS indicates that most shipments will occur within four weeks, some homes may not receive the supplies for 14 weeks. To receive the supply, a home must have a Clinical Laboratory Improvement Amendment (CLIA) Certificate of Waiver and should add these tests to their existing laboratory registration. More information on that process is available here. A set of FAQs on the testing supply distribution is available here.

Adult Care Facility (ACF)/Assisted Living (AL) Updates

LeadingAge NY Discusses ACF and AL Concerns with DOH

On July 24th, LeadingAge NY met with DOH to discuss a variety of issues of interest to ACF and AL members, including visitation, the daily and weekly surveys, resident testing, staff testing, and infection control. A few non-COVID-19 issues were discussed as well. Members can access a summary of the issues discussed here.

LeadingAge Needs Data From Assisted Living Members ASAP for Possible Funding

According to our colleagues at LeadingAge National, relief funds for private-pay assisted living providers are under consideration by HHS. HHS has requested our assistance in gathering specific information, which will be needed by July 31st. Click here for more information.

HCBS Updates

LeadingAge NY Proposes Recommendations for Virtual Training of HHAs and PCAs

On July 28th, LeadingAge NY, the Home Care Association of New York State (HCA), and the New York State Association of Health Care Providers (HCP) jointly presented DOH with recommendations to institute virtual training programs for home health aides (HHAs) and personal care aides (PCAs). The proposal allows for HHA and PCA initial training to be accomplished through a hybrid approach of virtual instruction supplemented with in-person instruction with appropriate verification and in-person evaluation of skills. Click here for more information.

HHS and HUD to Host Telehealth Webinar on July 29th

The HHS Office of the Assistant Secretary for Preparedness and Response, the HHS Administration for Community Living, and the Department of Housing and Urban Development (HUD) will host a webinar entitled “Telehealth for Community-Based Organizations: Services, Payment, and Partners” on Wed., July 29th from 2 to 3 p.m. ET. The webinar will include an overview of telehealth basics and opportunities related to COVID-19, information on telehealth payment flexibilities and toolkits, resources for community-based organizations serving older adults, and lessons from the field on use of telehealth during the COVID-19 emergency. Click here for registration and additional information from LeadingAge National.

Affordable Housing Updates

HUD Releases COVID-19 Supplemental Payment Guidance

On July 23rd, HUD published guidance for accessing COVID-19 Supplemental Payments (CSP) for Project-Based Section 8, Section 202, and Section 811 communities. These one-time supplemental payments from the CARES Act are intended to help offset expenses for COVID-19 preparedness and response. Click here for more information.