March 27th Newsletter - Sachs Policy Group

Governor Cuomo Announces Executive Order 202.11

Today (March 27^th), Governor Cuomo signed Executive Order 202.11 (available here), containing new directives intended to address the COVID-19 emergency. The Order states that any guidance issued by the New York State Department of Health (DOH) related to prevention and infection control of COVID-19 will supersede any prior conflicting DOH guidance and any guidance issued by any local government unit or agency. The Executive Order will also:

Suspend or modify regulations related to operating certificates for providers of individuals with intellectual and/or developmental disabilities (I/DD) that limit the provision of certain services in certified settings (with OPWDD approval).
Allow for abbreviated training and/or extension of recertification deadlines for direct support professionals providing services to individuals with I/DD that are experiencing staff shortages;
Suspend or modify regulations that limit the duration and amount of reimbursement for residential programs that serve victims of domestic violence;
Temporarily permit registered resident pharmacies and registered resident outsourcing facilities to compound certain alcohol-based hand sanitizer products;
Permit pharmacy technicians and pharmacists to practice at an alternative location, including their home, as long as there is adequate security to protect Personal Health Information;
Permit graduates of registered professional nurse and licensed practical nurse licensure qualifying education programs to be employed to practice nursing under the supervision of a registered professional nurse and with the endorsement of the employing hospital or nursing home for 180 days immediately following graduation;
Allow midwives licensed and in current good standing in any state, or in any province or territory of Canada, to practice in New York State without penalty;
Amend previous restrictions on dispensing the drugs under investigation or treatment of COVID-19 (hydroxychloroquine or chloroquine) for prophylactic purposes; and
Ensure that physicians assisting in the State’s response to COVID-19 in a facility owned or leased by SUNY and operated by SUNY will be provided with defense from the State in an instance of civil action or proceeding.

The Executive Order also authorizes police to remove individuals who are in violation of rules on public gatherings or other space usage.

Governor Cuomo Announces Additional Hospital Capacity, Predicts Significant Budget Shortfall

During today’s COVID-19 press conference (available here), Governor Cuomo announced the completion of the first 1,000-bed hospital at the Jacob Javits Center in Manhattan. The State will seek federal approval to develop four additional temporary hospital sites in New York City, which would increase current capacity by 4,000 beds, resulting in a temporary 1,000-bed hospital in each borough if approved. The proposed sites include:

Brooklyn Cruise Terminal
College of Staten Island (CUNY)
New York Expo Center in the Bronx
Aqueduct Racetrack in Queens

The Governor also announced that New York schools will continue to be closed through April 15^th, at which point the State will reassess based on the status of the COVID-19 outbreak.

In the Governor’s March 26^th press conference (available here), a major topic of discussion was the economic implications of the COVID-19 outbreak, and in particular, the effects on the upcoming State FY 2021 budget. The Governor again stated his disappointment in the $2 trillion stimulus package passed by the Senate last night, which will provide approximately $5 billion to New York State for COVID-19 expenses but does not help state or local governments address lost revenue. New York State anticipates a loss of revenue between $10 billion and $15 billion. The Governor announced that the State still expects to pass the budget by April 1^st, but, given the significant uncertainty of forecasts about revenue loss and how or when the economy will rebound, the budget will include both (a) immediate decreases in expenditures based on the revenue, and (b) ongoing expenditure adjustments which will be made periodically throughout the year (e.g., quarterly) based on the State’s actual tax receipts.

DFS Provides Temporary Relief for Insurance Producer Licensing Requirements

On March 25^th, the New York State Department of Financial Services (DFS) issued a letter (available here) to insurance producers temporarily suspending the expiration of individual licenses for 60 days and waiving any resulting late fees during the suspension period. DFS will also suspend the requirement that a monitor be present to complete producer continuing education and pre-licensing course exams during the suspension period. If at the end of the suspension period a license would have been expired, it will automatically expire unless the producer has submitted a license renewal application, including completion of all necessary continuing education requirements before that date. DFS notes that although in-person continuing education courses may be temporarily suspended, numerous providers offer courses online or as webinars.

CMS Approves Further 1135 Medicaid Waiver Requests

CMS has now approved a total of 34 requests by states, including New York, for 1135 Medicaid emergency waivers either in full or in part. Although states have requested a variety of provisions, the approved components so far have been limited to the following:

Suspending Medicaid FFS prior authorization requirements;
Rolling over existing prior authorizations;
Suspending PASRR (nursing home) assessments for 30 days;
Extending timeframes for Medicaid fair hearings;
Waiving certain requirements for non-enrolled out-of-state providers to serve a State’s Medicaid enrollees;
Allowing facilities (nursing homes, ICFs, etc.) to be reimbursed if residents are relocated from the facility in an emergency; and
Offering increased flexibility around submitting SPAs, such as waiver of public notice and timeframes.

All Section 1135 approval letters are available here.

RFP for Human Services Organizations Impacted by COVID-19

The New York Community Trust, in collaboration with several charitable organizations, has launched the NYC COVID-19 Response & Impact Fund, a $75 million pool that will support NYC-based social services and arts and cultural organizations that have been affected by the COVID-19 pandemic. As part of this pool, New York Community Trust released a Request for Proposals (RFP) for human services not-for-profit 501(c)(3) organizations with an operating budget of less than $20 million (excluding government payments). Eligible organizations must receive NYC or New York State government funding and demonstrate a track record of robust programming and services for NYC residents. Priority will be given to direct service providers, particularly those supporting essential health care, food delivery, and education services. Grants are expected to be between $10,000 and $250,000, depending on the organization’s total operating budget, and will cover a twelve-week period. Organizations may request funding for equipment, personnel, or other new emergency needs related to COVID-19, such as remote educational programming or protocols to keep housing-insecure New Yorkers sheltered while reducing the spread of the virus. Grants will not cover expenses that will be reimbursed by government contracts or awards.

The full RFP is available here. Proposals must be submitted by May 30^th.

New York State Postpones the Transition of Foster Care Children and Services into Managed Care

On March 27^th, DOH announced that it would postpone the transition of foster care children and services into managed care (previously scheduled for July 1^st) due to the ongoing COVID-19 pandemic. This includes postponement of plan readiness review, plan selection, and enrollment preparatory work. The State recognizes that plans, providers, and local districts have diverted all efforts to address the outbreak and ensure continued patient access to care and critical services. The State will reevaluate the implementation timeline after the State of Emergency, but will continue to work on implementation efforts including developing policy guidance and training materials and procuring necessary federal approvals.

Questions may be submitted to BH.Transition@health.ny.gov.

New York State Guidance Documents

Over the last week, New York State agencies have released more specific guidance documents. A compilation of documents we have not previously reported is below: