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June 16th 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 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 June 15th, 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

$15 Billion CARES Act Funding for Medicaid Providers

Click here for information on the Department of Health and Human Services’ (HHS) distribution of $15 billion of Provider Relief Funding under the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) to Medicaid and Children’s Health Insurance Program (CHIP) providers including assisted living, home care agencies, and hospices.

Provider Relief Funding Attestations Required Starting Next Month

HHS is reminding providers that received Provider Relief Funds under the CARES Act that they are required to submit attestations indicating they agree with the Terms and Conditions. Attestations are to be submitted through the HHS attestation portal beginning as early as July 10, 2020.

Each Provider Relief Fund recipient must sign an attestation confirming receipt of the funds and agreeing to the Terms and Conditions of the funding within 90 days of Automated Clearing House (ACH) payment or 90 days of check payment issuance. The first round of $30 billion in General Distribution payments was made beginning April 10th, hence the July 10th initial deadline.

Those providers that retain payments for more than 90 days are deemed to have accepted the Terms and Conditions. By accepting funds, the recipient consents to HHS publicly disclosing the payments that the recipient has received from the Provider Relief Fund.

If a provider elects to reject the funds, it must also complete the attestation to indicate this. If a provider affirmatively attests to a General Distribution payment already received and later wishes to reject those funds and retract its attestation, it may do so by calling the provider support line at 866-569-3522; for TTY, dial 711.

LeadingAge NY Updates Guide on COVID-19 Funding Opportunities

LeadingAge NY has updated its guide, COVID-19 Grants, Loans & Advance Funding Opportunities for Not-for-Profit Providers, as of June 16th to provide important updates to several assistance programs including CARES Act Provider Relief Funding, the Federal Emergency Management Agency (FEMA) Public Assistance Program, the Paycheck Protection Program (PPP), the Economic Injury Disaster Loan (EIDL) and Emergency Advance program, and the Main Street Lending Program.

The CARES Act Provider Relief Funding section was updated to include information on the new Medicaid/CHIP Targeted Distribution, for which applications are due July 20th. The FEMA Public Assistance Program section was updated to reflect new training opportunities, a new resource on COVID-19 testing, and an updated FEMA Public Assistance Handbook. The PPP section update reflects new guidance on loan forgiveness and use of funds resulting from the PPP Flexibility Act. EIDL applications are being accepted once again from qualifying small businesses as of June 16th. Changes have also been made to the Main Street Lending Program, and an announcement on opportunities for not-for-profits to apply is expected soon.

The LeadingAge NY guide provides consolidated information on various grants, loans, tax benefits, and advance funding opportunities for not-for-profit providers impacted by the COVID-19 pandemic in a single document. Along with a brief description of each program, the document provides links to further information and will be updated as revisions are made and additional opportunities become available. The guide includes a separate section on opportunities for affordable housing providers.

We urge members to review the programs that may be helpful to them, to let us know if they have questions, and to share their experiences when accessing these programs. Please note that COVID-19 resources are available on the dedicated section of our website here.

NYC DOHMH Holds Webinar on Preservation and Purchasing of PPE

With its planned slowdown of personal protective equipment (PPE) distributions to New York City (NYC) health care providers, the NYC Department of Health and Mental Hygiene (DOHMH) held a webinar on PPE Purchasing and Capacity Building on June 10th. The webinar provided a refresher on the use of PPE; informed agencies and providers how to calculate a burn rate; shared considerations and best practices for purchasing PPE, including a contact for reporting price gouging; and offered a list of medical suppliers. Its intended audience included agencies and providers with limited experience purchasing PPE and health care workers on staff who require PPE for interactions with clients, patients, or residents.

Presenters included Mary Foote, MD, MPH, Senior Health Security Specialist, Bureau of Healthcare System Readiness, NYC DOHMH; David Starr, Assistant Commissioner, Emergency Field Operations, NYC DOHMH; Jay Gormley, Chief Strategy Officer, MJHS Health System; and Jennie Sutcliffe, Senior Healthcare Policy Analyst, Bureau of Equitable Health Systems, NYC DOHMH.

Member can access the webinar recording here and the slides here.

DOH Updates Guidance on Elective Surgeries

Post-acute care providers should be aware that as of June 8, 2020, with the resumption of elective surgeries in NYC, hospitals, ambulatory surgery centers (ASCs), office-based surgery (OBS) practices, and diagnostic and treatment centers (D&TCs) in all counties may resume non-essential elective surgery and non-urgent procedures. The Department of Health (DOH) has noted, however, that eligibility requirements may be adjusted based on the prevalence of COVID-19 in a region or a county, and these surgeries and procedures may be suspended if there is a significant increase in community spread and/or hospitalization rates.

Nursing Home and Adult Care Facility (ACF) Updates

TOMORROW at 10 A.M.: DOH to Host Webinar Regarding Weekly Nursing Home and ACF Staff Testing Survey

Tomorrow, June 17th, at 10 a.m., DOH will host a 45-minute webinar for nursing homes and ACFs regarding the weekly staff testing survey. Members may register for the webinar here and submit their questions to covidadultcareinfo@health.ny.gov or covidnursinghomeinfo@health.ny.gov.

During the webinar, DOH will review minor updates to the staff testing survey to reflect the changes in Executive Order (EO) 202.40, issued on June 9th. On an associations call held on June 16th, DOH clarified that if nursing homes and ACFs in regions that have transitioned to once-weekly testing choose to change their testing date, they will not be deemed out of compliance if they are acting in good faith to meet the testing requirement and are not repeatedly changing the day to extend the period between testing. The Department is also working to address the delays that were reported in receiving test results from certain labs.

Nursing Home and ACF Visitation Update

During his June 16th press conference, Governor Cuomo announced that he is allowing visitation in hospitals and group homes at the providers’ discretion. Visitation in nursing home and ACFs is still not permitted at this time; however, LeadingAge NY anticipates more guidance on this issue this week. We have been in regular discussions with DOH and the Governor’s Office about this issue.

Other ACF Updates

Assisted living program (ALP) members are encouraged to review our Intelligence article pertaining to the distribution of $15 billion of Provider Relief Funding under the CARES Act to Medicaid and CHIP providers.

This week, DOH issued guidance regarding Economic Impact Payments (EIPs) for ACF residents. DOH is also reaching out to ACFs across the state to test residents of ACFs, free of charge. The testing is not mandatory but is recommended to help infection control. You will likely be asked to have a staff person available to assist on the day of testing. Residents have the right to refuse to be tested. LeadingAge NY has heard from members in the Western Region that this outreach is already beginning.

DOH is continuing to conduct Infection Control surveys in ACFs. Click here for a checklist issued by DOH to guide you in your infection control efforts.

Free Nursing Home Training Series Offered by CMS and QIO

The Centers for Medicare and Medicaid Services (CMS) and the Quality Improvement Organization (QIO) Program, a national network of Quality Innovation Network (QIN)-QIOs, will be offering a one-hour live webinar every Thursday through July 2020. The webinars will feature experts on different aspects of infection prevention in nursing home settings. The planned sessions are as follows:

  • Clinical Care: Managing COVID-Positive Residents – Thurs., June 18, 2020, 4 p.m. EDT
  • PPE Strategies for COVID Care – Thurs., June 25, 2020, 4 p.m. EDT
  • Transparency: Resident and Family Notification – Thurs., July 2, 2020, 4 p.m. EDT
  • Managing Staffing Challenges – Thurs., July 9, 2020, 4 p.m. EDT
  • Reopening Considerations – Thurs., July 16, 2020, 4 p.m. EDT

Registration is required in advance.

Home and Community-Based Services (HCBS) Updates

CHHA and Hospice HERDS Survey Update

Beginning tomorrow, June 17th, DOH will be reducing the number of times that certified home health agencies (CHHAs) and hospices need to complete the Health Emergency Response Data System (HERDS) COVID-19 survey to three times a week. They have communicated that if they see continued reduction in the number of suspected and confirmed COVID-19-positive patients and stability in PPE access, they will halt the surveys. If and when this occurs, DOH will provide a method for CHHAs and hospices to communicate severe PPE shortages.

DOH Updates COVID-19 Guidance on 1915(c) Children’s Waiver

On June 10th, DOH issued an update to its March 13th guidance on the 1915(c) Children’s Waiver providing further flexibility regarding billing of services, telehealth, and telephonic visits in lieu of face-to-face, as well as screening procedures when face-to-face visits are carried out. The guidance can be accessed here.