COVID-19 Update: DOH Webinar for Providers at 1 p.m., Emergency Declaration, Waiver Requests, New Resources

The state Department of Health (DOH) has announced a webinar today that is open to all health care providers on COVID-19. HCA members are invited to participate in this webinar and Q&A from 1 to 2 p.m. for critical updates. The audio line is at (844) 512-2950 and the web link is here.

HCA will be participating in the webinar, too, and providing key updates for any members unable to join the presentation.

State of Emergency

As COVID-19 continues to spread, with confirmed cases in a rising list of New York counties, Governor Cuomo has announced limits on mass gatherings to fewer than 500 persons (including new occupancy levels also applying); efforts to ramp up screenings; and other measures.

New York City Mayor Bill de Blasio, meanwhile, has also called a state of emergency allowing for the mayor to take certain measures like curfews, transit restrictions, or other actions not yet implemented at the time of this report.

In a press briefing this morning, the Governor announced the state’s first COVID-19 mobile drive-through testing center in New Rochelle. He is also asking former health care workers to reconnect with their employers for possible on-call service to mitigate shortages.

State Regulations and Assistance Sought for HCA Members

HCA is actively working with state health officials on measures to support home care, hospice and Managed Long Term Care (MLTC), including the flow of critical information and updates.

In a message to managed care plans and follow-up communications with associations over the past 24 hours, state Department of Health (DOH) officials indicated they are currently reviewing several requests related to Medicaid regulatory relief.

With continuous input from the HCA Board and members, HCA has provided extensive input to state officials on relief for plans, providers and practitioners alike. This includes dozens of items related to: financial assistance and priority access for equipment; telehealth monitoring allowances and reimbursement as appropriate; workforce and transportation issues or concerns; flexibility on service area provision; procedural clarifications; regulatory waivers related to supervision, assessment time-frames, in-service training and other requirements; and more.

A March 7 Executive Order by Governor Cuomo, declaring the state of emergency, has already temporarily suspended certain regulations that may be applicable to home care.

One of these, consistent with HCA’s recommendations, is a waiver of nursing supervision regulations that “permit nursing supervision visits for personal care services provided to individuals affected by the disaster emergency be made as soon as practicable” (emphasis added) in place of requirements for such visits to be made “at least every 90 days.”

Guidance that All Providers Should Read

The state has also issued an important Interim Guidance for Procedures When Identifying an Employee with Concerns for COVID-19 Exposures (see here). It includes criteria for “required mandatory quarantine”; “required mandatory isolation”; and “required precautionary quarantine.”

As noted in our prior alert to the membership, on Wednesday, state surveyors were issued guidance from the U.S. Centers for Medicare and Medicaid Services (CMS) for home care and hospice COVID-19 control and prevention.

While directed at state surveyors overseeing home care and hospice, the guidelines also inform what agencies should be doing in terms of admitting and treating patients with known or suspected infection; monitoring or restricting home visits; transfer of patients to the hospital; implications of Medicare discharge-planning regulations; when confirmed cases are safe to be treated at home; and a range of other items. You can find both the home care and hospice guidance on our Home Care Prepare website here.

Federal Regulations and Assistance Sought

On the federal level, HCA and our colleagues at the National Association for Home Care and Hospice (NAHC) have also urged critical assistance on supplies and testing as well as federal regulatory waivers, including: flexibility on the Medicare “homebound” requirement; reimbursement allowances and regulatory flexibility on the use of telehealth; allowing nurse practitioners and physician assistants to order and certify home care; waivers on the frequency and length of OASIS assessments; and a number of other provisions to help agencies operate more nimbly amid a surge in demand and an overstretched workforce. See NAHC’s letter to CMS Administrator Seema Verma with further details. HCA will immediately report back on any further CMS response to these critical requests.

Check our COVID-19 Page for Resources Including Several New Education Programs Offered by Partners, Members

HCA continues to add resources to the COVID-19 page of our emergency preparedness website. Among the newest items are several free educational programs being offered from a range of HCA partner or member organizations, including some happening today which we encourage you to share with your staffPlease see these offerings here and stay alert for further updates from HCA and other officials.

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