July 13th Newsletter - Sachs Policy Group

State Updates

Governor Cuomo Discusses Steady COVID-19 Status and Enforcement of Travel Advisory

Today (July 13^th), Governor Cuomo held a press conference during which he announced that COVID-19 hospitalizations, infections, and deaths remain steady. Yesterday there were 792 hospitalizations, the lowest since March 18^th, and 10 deaths related to COVID-19. There were 51,687 tests conducted yesterday, of which 557 (1.08 percent) came back positive. The infection rate in New York City also remains steady at around 1 percent.

Despite this progress, the Governor reiterated that COVID-19 remains a serious threat, including the risk of spread from other states with high infection rates. To address this, the State will be issuing an emergency order requiring travelers coming from states designated by the travel advisory to provide local authorities with contact information upon entering New York to help enforce quarantine. Travelers who fail to provide information will receive a summons with a $2,000 fine and may be ordered to complete a mandatory quarantine.

The Governor also addressed the school reopening process for fall 2020. New York plans to allow the reopening of schools located in Phase 4 regions that have a daily infection rate of 5 percent or lower, based on a 14-day average. This determination will be made in the first week of August. Afterwards, schools will close again (or not be reopened) if the 7-day average regional infection rate reaches 9 percent or higher. While the specifics of reopening will be left up to the school districts, schools will be required to follow guidelines from the New York State Department of Health (DOH) and New York State Education Department (NYSED).

Governor Cuomo Issues Executive Order 202.50

On July 10^th, Governor Cuomo signed Executive Order 202.50 (available here), which extends the directives contained in Executive Order 202.30 (available here) and the amendments to those directives contained in Executive Order 202.40 (available here). These Orders implemented the requirement for all nursing homes and adult care facilities to test or make arrangements for the testing of all personnel for COVID-19 once per week. This testing requirement is now extended through August 8^th.

DOH Announces Resumption of Limited Visitation in Nursing Homes, Adult Care Facilities, and Pediatric Skilled Nursing Facilities

On July 10^th, DOH announced that nursing homes and long-term care facilities will be allowed to resume limited visitations as long as they have not had a COVID-19 case for at least 28 days, in accordance with CDC guidelines. Residents of nursing homes and pediatric skilled nursing facilities will be permitted to have two visitors at a time. All visitors must undergo temperature checks, wear face coverings, and maintain social distance for the duration of the visit. For each nursing facility, only 10 percent of the residents are permitted to have visitors at any given time. Nursing homes and pediatric skilled nursing facilities accepting visitors will be required to send their visitation plan to DOH and attest that they are following the DOH guidance. At adult care facilities, the total number of visitors may not exceed 10 percent of the in-house resident census at any given time. Visitors will be screened for signs and symptoms of COVID-19 and must wear face coverings at all times.

All three types of facilities must provide visitors with a face covering if they do not have one. If any facility fails to comply with these requirements and other provisions in the guidance documents below, they must immediately halt visitation and inform the appropriate DOH regional office.

The DOH press release is available here. Guidance documents specific to each facility are listed below.

Pediatric Skilled Nursing Facility Visitation (7.10.20)
Visitation in Adult Care Facilities (7.10.20)
Skilled Nursing Facility Visitation (7.10.20)
COVID-19 Cases in Nursing Homes and Adult Care Facilities (7.10.20)

OPWDD Guidance on the Resumption of Services

On July 10^th, the New York State Office for People with Developmental Disabilities (OPWDD) released guidance on the resumption of home visits, community outings, day services, and return to residences after extended home visits. The guidelines are effective on July 15^th for regions that have entered Phase 4 of the State’s reopening plan (currently all regions except New York City).

The interim guidance regarding the reopening of day services (available here) applies to Day Habilitation, Prevocational Services, Sheltered Workshops, Day Treatment, and Respite. The guidance includes requirements related to screening, signage, isolation/quarantine, social distancing, transportation, personal protective equipment (PPE), and hygiene/cleaning, among others. The guidance indicates that initially, day program capacity should be prioritized for individuals who are best served on-site due to their specific clinical needs. Providers should allow high-risk individuals who prefer to remain at home to participate in less intensive in-home supports of a shorter duration. Providers should also encourage the continued use of telehealth to supplement service delivery. All programs must develop a safety plan for reopening that addresses the requirements contained in this document and send the plan to quality@opwdd.ny.gov.

For individuals residing in OPWDD certified residential facilities, home visits are permitted to resume in accordance with the guidance here. Following extended stays with family, OPWDD residential facilities should follow the guidance here for individuals returning to their residence. Facilities should observe returning residents for signs and symptoms of illness for 14 days after return to the residential facility. Additionally, depending on where the resident traveled for the extended stay, they may be required to quarantine upon return as per the State’s travel advisory. Community outings for individuals residing in OPWDD residential facilities may also resume in accordance with the guidance here.

Updated Guidance Documents

Recently released New York State and City guidance documents are listed below:

Federal Updates

HHS Announces Additional $4 Billion of Provider Relief for Safety Net and Rural Hospitals

On July 10^th, HHS announced a new distribution from the CARES Act Provider Relief Fund for additional safety net and rural hospitals. Approximately $3 billion will be disbursed across 215 hospitals which were excluded from the original Safety Net Hospital distribution in June, but that meet revised criteria for a sufficiently low operating margin. Also, about $1 billion will be provided to 479 hospitals that were excluded from the original Rural Provider distribution in May, but who also serve a significantly rural population. These include some urban hospitals with certain rural Medicare designations and some suburban hospitals in small metropolitan areas. These new distributions bring the total amount allocated from the $175 billion Provider Relief Fund to almost $117 billion, although according to news reports, providers have only attested to $60 billion so far.

HHS has published the allocations of the new distributions by state. The breakdown of the additional safety net distribution is available here. The breakdown of the additional rural distribution is available here.

HHS Updates Provider Relief Fund FAQ

HHS also continues to update the FAQ document for the Provider Relief Fund. Recent notable updates include:

Providers may now contact the Provider Support for assistance with the status of their Provider Relief Fund payment or application at (866) 569-3522. When calling, providers should have ready the last four digits of the recipient’s or applicant’s Tax Identification Number (TIN), the name of the recipient or applicant as it appears on the most recent tax filing, the mailing address for the recipient or applicant as it appears on the most recent tax filing, and the application number (which begins with either “DS” or “CR”) if they have submitted an application in the Provider Relief Fund Payment Portal.
Provider Relief Fund payments are not qualified disaster relief payments under Section 139 of the Internal Revenue Code and should not be excluded from gross income.
Not-for-profit or other tax-exempt organizations will not be subject to taxes on payments received from the Provider Relief Fund. However, they may be subject to tax under section 511 of the Code if the payment reimburses the provider for expenses or lost revenue attributable to an unrelated trade or business as defined in section 513.

CMS Directs Additional Resources to Nursing Homes in COVID-19 Hotspot Areas

On July 10^th, the Centers for Medicare and Medicaid Services (CMS) announced that the agency will be providing additional resources to nursing homes by deploying Quality Improvement Organizations (QIOs) in COVID-19 hotspot areas identified by the White House Coronavirus Task Force. The QIOs will work with healthcare providers to help them improve the quality of healthcare they provide to Medicare beneficiaries. Additionally, CMS is implementing a survey process tailored to the needs of each hotspot area.

More information about the QIO program is available here.