DOH Posts DALs Clarifying, Lifting or Reiterating Various Emergency Regs, Waivers
The state Department of Health (DOH) has posted two Dear Administrator Letters (DALs) for home care and hospice agencies on the status of various emergency regulations.

Health Assessments and Immunizations  
DOH is lifting its suspension of the annual health assessment for all personnel. (The requirement was suspended on April 10.) All personnel are advised to obtain an annual health assessment by December 31, 2020, according to one of the latest DALs.
DOH stresses that pre-employment health assessments were not waived, and an annual reassessment is also required. The pre-employment health assessment may be completed by an RN.
Agencies should closely monitor the Health Commerce System (HCS) for a declaration by the Commissioner of Health regarding influenza prevalence and related personnel immunization requirements that go into effect for flu season.
Aide In-Service Requirements  
DOH also reports this week that it will exercise “enforcement discretion” when surveying providers for compliance with aide in-service requirements that have been waived by the federal government. See the DAL here for details.
HCA advises agencies to exercise caution in relying on enforcement discretion by individual surveyors and to document all efforts to meet the requirements, as well as document any barriers to compliance.
Orientation and Supervision  
Executive Order No. 202.5 permitted home care and hospice providers to conduct in-home aide supervision “as soon as practicable after the initial service visit,” or through indirect means (i.e., telephone or video communication).
A similar CMS waiver for hospices and CHHAs allows for postponement of annual onsite supervisory visits.
In one of the new DALs, DOH reminds providers that these must be completed no later than 60 days after the expiration of the public health emergency.
Use of Technology  
DOH also reiterates executive orders that permit home care cases to be opened using remote technology and other telehealth provisions previously reported to the membership. Please see the DAL for further details.
Agencies should closely monitor the HCS and the Department’s website for additional guidance.
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