COVID-19 Update: CMS Survey Guidance for Home Care and Hospice, Face Masks, Emergency Regs

The Home Care Association of New York State awaits an official state guidance on COVID-19 for home and community-based service providers The federal government has issued specific infection-control guidance for home care and hospice, components of which would also be a factor in any forthcoming state guidance, in addition to questions or concerns raised by HCA and others from the field.

In the meantime, what follows is a series of updates on this dynamic and fast-changing situation. (All relevant resource links will continue to be posted on HCA’s emergency preparedness website under the menu item COVID-19.)

CMS Guidance on COVID-19 Infection Control for Home Health and Hospice

In the past two days, the U.S. Centers for Medicare and Medicaid Services (CMS) has issued COVID-19 guidance for infection control and prevention in home health and hospice. While the guidance is for state survey agencies, the information is very helpful for home care and hospice agencies as they continue to provide services during the COVID-19 outbreak. The home health guidance is hereThe hospice guidance is here. (Both are posted to the resources page of HCA’s home care emergency preparedness website.)

The home health guidance links to many resources, including one that HCA highly recommends you review (directly available here): Interim Guidance for Public Health Personnel Evaluating Persons Under Investigation (PUIs) and Asymptomatic Close Contacts of Confirmed Cases at Their Home or Non-Home Residential Settings.

The information includes answers to many questions asked by providers and we urge you to review it closely.

Face Mask Guidance

In addition, CMS has issued guidance for state survey agency directors on the use of certain face masks by health care personnel when respirators are not available in situations involving COVID-19. That guidance is here.

PHHPC Approves Emergency Regulations

On March 9, the Public Health and Health Planning Council (PHHPC) approved an emergency regulation that would “update, clarify and strengthen the Department’s authority as well as that of local health departments to take specific actions to control the spread of disease, including actions related to investigation and response to a disease outbreak, as well as the issuance of isolation and quarantine orders.” The regulation is here. Among other provisions, it:

  • Lists actions that local health departments must take to investigate a case, suspected case, outbreak, or unusual disease.
  • Requires individuals and entities subject to a public health investigation to cooperate with the state Department of Health (DOH) and local health departments.
  • Clarifies authority for the DOH Commissioner to lead investigation activities.
  • Includes several provisions on isolation or quarantine orders, including where they may be appropriate, requirements and procedures, and an explicit statement that violation of an order constitutes grounds for civil and/or criminal penalties.
  • Requires the DOH Commissioner to designate those communicable diseases that require prompt action and to publish that list.
  • Mandates hospital reporting of surveillance data and permits the DOH Commissioner to direct hospitals to take patients.

Medicaid Update Stresses Telehealth Use Where Practical and Allowable

DOH has issued a special March edition of its Medicaid Update newsletter, which stresses that “services that are covered under a comprehensive health insurance policy or contract cannot be excluded when the service is delivered via telehealth. To the extent it is practical, the Department encourages the use of telehealth to provide COVID-19 related services to Medicaid members.”

OSHA guidance

The Occupational Safety and Health Administration (OSHA) has also posted Guidance on Preparing Workplaces for COVID-19 (see here) that agencies should review.

HCA continues to reach out to DOH about further guidance for home and community-based providers and will let members know when it is available.

As information is changing more often than daily, HCA advises members to check the DOH, CDC, and NYC Department of Health and Mental Hygiene websites regularly for updates, all linked to our COVID-19 page.

HCA is planning to hold a program on issues faced by home care and hospice providers in providing services to COVID-19 patients and will announce that soon.

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