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March 9th 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 March 8th, 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

CDC and State Revise Guidance for Fully Vaccinated Individuals

The Centers for Disease Control and Prevention (CDC) and New York State have indicated that greater flexibility in private gatherings and travel may be available for individuals who have been fully vaccinated. Click here for more information.

Latest Vaccination Updates

The latest vaccination updates – including details on newly issued prioritization guidance, eligibility for staff of senior housing and independent living, New York City Department of Health and Mental Hygiene (NYC DOHMH) efforts to vaccinate home care workers, and NYC utilization of the Johnson & Johnson vaccine – are summarized here.

Next DHSES Applicant Briefing on FEMA COVID-19 Funding Set for April 7th

The Office of Disaster Recovery at the New York State Division of Homeland Security and Emergency Services (DHSES) is continuing to hold virtual Applicant Briefings to discuss funding from the Federal Emergency Management Agency (FEMA) that may be available under the major disaster declaration for COVID-19. Registration for the next briefing, to be held on Wed., April 7th at 1 p.m., can be accessed here.

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

Updates for Nursing Homes on Post-Federal Program Vaccination Plan

LeadingAge NY met with representatives from the Department of Health (DOH) and the Governor’s Office last week and participated in the call for nursing homes on March 8th with Dr. Zucker, the Commissioner of Health, regarding vaccinations for nursing home residents and staff now that the federal vaccination program has concluded. It was noted that similar discussions are being held for ACFs, and plans will be unveiled shortly. Click here for more details about the nursing home vaccination plans from those discussions.

DOH Issues Q&As on New Nursing Home Visitation Guidance

On March 9th, DOH issued a ‘questions and answers’ (Q&A) document to clarify certain aspects of its Feb. 23rd nursing home visitation guidance. Notably, the document clarifies that the 14-day COVID-free requirement applies to new “facility-onset” COVID-19 cases as defined by the Centers for Medicare and Medicaid Services (CMS). Click here for more information.

Updated NHSN Reporting Forms and Templates

Nursing homes should be aware of the updates in reporting forms and new CSV file templates from the CDC’s National Healthcare Safety Network (NHSN) Long-Term Care Facility COVID-19 Reporting Module. The updated forms and templates are available here.

A New Pathway to Request Staff Support for Monoclonal Antibody Infusions

LeadingAge National is part of a new opportunity that connects providers looking to use COVID-19 monoclonal antibody infusions with interested and qualified Medical Reserve Corps (MRC) volunteers to provide staff support for administering the infusions in nursing homes. The Long-Term Care Infusion Support Activity (LISA) is a collaborative initiative of six national associations, including LeadingAge, that have created the Coalition to Advance Community-Based Solutions for COVID-19. Click here for more information from LeadingAge National.

Revised ACF Visitation Guidance

Last week, DOH issued updated visitation guidance for ACFs. While the guidance does not change the standard of having to go 14 days without a new COVID-positive resident or staff to open visitation, there are some notable changes. Click here for more information.

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. While we continue to advocate for policies that take into consideration the fact that most nursing home residents and staff are now vaccinated, nursing homes across the state are still required to test staff twice per week. Updated visitation guidance dated Feb. 23rd requires nursing homes to consult the federal positivity rates to guide their approach to requiring visitors to be tested as follows:

  • Homes in counties where the positivity rate is below 5 percent are encouraged, but not required, to offer a rapid test to visitors or request that visitors present a negative test.
  • Homes in counties where positivity rates are between 5 and 10 percent are required to have visitors present a negative COVID-19 test taken within 72 hours or can offer visitors a rapid test on site. Alternatively, visitors in such counties may provide proof of having completed the COVID-19 vaccination series no less than 14 days prior to the date of the visit but also within 90 days of the last vaccination (although testing is still recommended, and facilities may choose to require testing for all visitors).
  • For homes located in counties where positivity rates exceed 10 percent, visitation is limited to compassionate care.

Note that the ACF visitation guidance issued March 3rd, while different from the nursing home guidance, also refers ACF providers to the CMS county positivity rates. The guidance recommends that facilities accommodate and support indoor visitation, including visits for reasons beyond compassionate care situations, when the COVID-19 countywide positivity rate as provided by CMS is less than 10 percent.

The county positivity data posted by CMS are lagged by a week and are updated each Tuesday (e.g., data for the two-week period ending March 2nd are posted on March 9th). They are available for download in raw format here. LeadingAge NY extracts the CMS-calculated rates for New York State counties and posts them here, along with positivity rates calculated on state data covering the same two-week period. Members should note that although state data are more current and comprehensive (e.g., they include both PCR and antigen tests, where CMS positivity rates are calculated exclusively on PCR tests), the visitation guidance specifies that providers use CMS positivity rates to guide their approach to visitation.

Current daily county-level data for New York State are here, 7- and 14-day regional data are here, and ZIP code-level data for NYC 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.

Home and Community-Based Services (HCBS) Updates

Federal Stimulus Bill Includes 10 Percent FMAP Increase for HCBS Providers 

The $1.9 trillion federal stimulus package passed by the U.S. Senate last weekend includes a 10 percent Federal Medical Assistance Percentage (FMAP) boost for HCBS providers. The original bill included a proposed FMAP increase of 7.35 percent. The final version includes a 10 percent increase for a total of $12.67 billion for HCBS providers across the country. The additional funding applies to services provided from April 1, 2021 through March 31, 2022.

New York State will have to decide whether it wants to receive the FMAP funding, and DOH will likely submit a State Plan Amendment to receive it. The funding has the potential to increase reimbursement rates and/or offset COVID-19 expenses or fund other initiatives such as technology, child care, hazard pay, and recruitment.

This increase will support all HCBS providers, including Program of All-Inclusive Care for the Elderly (PACE) centers, social and adult day health care, home care, waiver services, and other providers. The boost is welcome but requires cautionary spending, as it will conclude in a year's time. The bill is headed to the House for passage and then to President Biden for signature this week. LeadingAge NY will keep members informed of New York's utilization of this potential payment increase.