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Oct. 20th 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 Oct. 19th, 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 Releases Guidance on Use of COVID-19 Antigen Tests

Guidance issued by the Department of Health (DOH) on Oct. 19th clarifies the recommended uses of antigen tests for COVID-19 and the circumstances in which confirmatory PCR testing must be conducted. The guidance documents, which include an Interim Recommendations memorandum, Frequently Asked Questions (FAQs), and a confirmatory testing algorithm, indicate that antigen tests may be used to test individuals when there is an outbreak in a public setting or environment and to test residents and employees in nursing homes, adult care facilities (ACFs), and other congregate facilities regardless of outbreak status. The FAQs confirm that, notwithstanding a requirement in prior guidance that nursing homes have an arrangement with a lab to conduct testing with a specified sensitivity, antigen tests may be used to satisfy staff testing requirements in nursing homes. In addition, the FAQs state that antigen tests may be used to satisfy the visitor test result requirement in nursing homes. Click here for more information.

Provider Relief Fund Applications Due by Nov. 6th

The Department of Health and Human Services (HHS) is accepting applications for a Phase 3 General Distribution of Coronavirus Aid, Relief, and Economic Security Act (CARES Act) Provider Relief Funding (PRF) until Nov. 6th. This $20 billion distribution will target providers that have not yet received PRF funding equal to 2 percent of their annual patient revenue, behavioral health providers, and new providers that opened in January through March 2020. Any remaining funding will be distributed to applicants with COVID-19-related losses not otherwise reimbursed. Any provider that has received PRF funding or was eligible to apply for funding is eligible to apply, although whether and how much funding a provider can expect based on COVID-19 losses will not be known until all applications are considered.

The announcement is available here, and the application portal is here. Application instructions are available under the heading “How to Apply for Phase 3 General Distribution” on the PRF Provider page here, and a number of questions in the PRF FAQ compilation address this distribution. An archived, hour-long webcast that details eligibility and the application process can be accessed here.

New Main Street NFP Lending Program Summary and Webinar Available

The Main Street Lending Program recently posted a short, shareable overview for potential not-for-profit (NFP) borrowers, explaining the core terms of the program and the eligibility criteria. This tool complements the previously posted general program overview and video overview. In addition, a Main Street Lending Program Info Session is being presented by the Federal Reserve Bank of Boston via webinar on Wed., Oct. 21st at 2 p.m. The webinar is intended to help prospective borrowers learn about the Main Street Lending Program and provide an opportunity for borrowers to get answers to specific questions on the Program and its operations from Federal Reserve officials.

The Main Street Lending Program is now fully operational and accepting submissions of eligible loans to NFP organizations through the lender portal by registered eligible lenders. It is designed to support small and medium-sized for-profit businesses and NFP organizations that were unable to access the Payroll Protection Program (PPP) or that require additional financial support after receiving a PPP loan. Main Street loans are not forgivable, and the underwriting requirements are somewhat restrictive. All Main Street Lending Programs are available through at least Dec. 31, 2020.

The two available NFP programs are the Nonprofit Organization New Loan Facility (NONLF) and the Nonprofit Organization Expanded Loan Facility (NOELF). The Federal Reserve System webpage and the Federal Reserve Bank of Boston’s Information for Nonprofit Borrowers webpage provide updated information on the program, including term sheets and forms/agreements for the lending options, an updated FAQ document, and a recorded webinar on the program. A total of 13 banks and credit unions in New York State are participating lenders in these NFP programs.

Travel Advisory States

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. The list is growing; on Oct. 20th, it was announced that there are 43 states and territories on the list. Arizona and Maryland were added this week, and no states were removed. According to a press release from the Governor’s Office, Connecticut, New Jersey, and Pennsylvania also meet the criteria for the Travel Advisory, but a quarantine on those states is not practical given the interconnectedness of the region. Non-essential travel to and from those states is discouraged, however. Click here for more information and an archived list of states as they have been added or removed.

County Positivity Rates

The most recent listing of 14-day testing positivity rates for each county in New York State from the Centers for Medicare and Medicaid Services (CMS) is available here. 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.

New Guidance on New York State Paid Sick Leave Law

On Sept. 30, 2020, employers in New York State were required to begin allowing covered employees to accrue sick hours at a rate of one hour for every 30 hours worked. On Jan. 1, 2021, employees may start using accrued leave in accordance with the new state Paid Sick Leave Law.

Members are encouraged to review a new Department of Labor (DOL) guidance document and Frequently Asked Questions (FAQs) regarding implementation of the new law, which can be accessed here and here. Additional information is also provided in an April 2020 memo from LeadingAge NY counsel Hinman Straub.

For additional information or questions, please contact Ellen Quinn at equinn@leadingageny.org.

Nursing Home and ACF/Assisted Living Updates

New York and Feds Announce COVID-19 Vaccination Plans

Health care workers and high-risk populations are prioritized for COVID-19 vaccine distribution under both New York State and federal vaccine distribution plans. The Centers for Disease Control and Prevention (CDC) has announced that it is partnering with CVS and Walgreens to offer on-site COVID-19 vaccination services for residents and staff of nursing homes and assisted living facilities. New York State has released a draft plan for vaccination administration that would offer long-term care facility workers and residents vaccines in the first phase of distribution. Click here for more information.

Nursing Home Infection Control Incentive Payments

LeadingAge National staff have learned some additional information regarding the nursing home infection control incentive payments in their discussions with HHS. While the exact calculations are not yet known, HHS did change their original plan of distributing 80 percent of the funding based on infection rates and 20 percent on mortality rates. In the new approach, each facility will receive an infection control distribution which may be increased or decreased by up to 20 percent based on mortality rates, if applicable. The initial $400 million distribution will be based on rates reported from Aug. 31st through Sept. 27th and is expected to be made before the end of October. Homes with infection rates lower than that of their county and with mortality rates lower than 10 percent will be eligible. Note that the county infection rates used by HHS are not publicly available at this time and that mortality rates will be risk-adjusted based on resident age, gender, and whether they are in a long- or short-term stay. More information is available here.

Affordable Housing Updates

CDC Issues Eviction Ban FAQs

On Oct. 9th, the CDC issued FAQs for the eviction moratorium in place from Sept. 4th through Dec. 30th. The FAQs were issued jointly by the CDC, the Department of Housing and Urban Development (HUD), HHS, and the Department of Justice (DOJ) to clarify outstanding questions related to the declaration used by tenants to certify eligibility for the eviction protections, as well as timing for housing providers initiating evictions. Click here for more information from LeadingAge National.

HUD Multifamily Issues Updated FAQs

On Oct. 14th, HUD issued updated COVID-19 FAQs for Multifamily Housing providers, including HUD Section 202 and Section 8 providers. The agency had last issued an update on July 31st. The new FAQs include updated guidance on the CDC’s order to halt evictions, on-site flu shots and COVID-19 testing, and Real Estate Assessment Center (REAC) inspections and Management and Occupancy Reviews (MORs). Click here for more information from LeadingAge National.