November 17th Newsletter

SPG COVID-19 Vaccination Strategy Federal-State Crosswalk

SPG has created a new Vaccination Strategy Crosswalk which compares policy and guidance elements of the federal and New York State COVID-19 vaccination playbook and strategy documents released so far. We will update this document when more information is published, and we continue to update our other COVID-19 Resources on an ongoing basis.

State Updates

Governor Cuomo Issues Executive Order 202.75

On November 13th, Governor Cuomo signed Executive Order 202.75 (available here), which extends the following provisions through December 13th:

  • Authorizes the Commissioner of Health to suspend or revoke the operating certificate of any skilled nursing facility or adult care facility if that facility has not complied with regulations or directives from DOH.
  • Authorizes licensed pharmacists to order tests to detect SARS-CoV-2 or its antibodies, and to administer COVID-19 tests after completion of appropriate DOH training.
  • Permits licensed pharmacists to be designated as a qualified health care professional for the purpose of directing a clinical service laboratory to test patients for COVID-19 or its antibodies.
  • Allows physicians to order COVID-19 tests for self-collection, without otherwise having an initial physician-patient relationship with the patient.
  • Allows clinical laboratories to accept and examine specimens for COVID-19 testing from personnel of nursing homes and adult care facilities without a prescription or order from an authorized ordering source, and to report the results of such tests to the appropriate operators and administrators of the nursing home or adult care facility.

The Order also extends a provision stipulating that an employee may not be entitled to legally required paid benefits if they voluntarily travel to a state or country with significant community spread of COVID-19.

OMH Updated Infection Control Manual for Public Mental Health System Programs

On November 12th, the New York State Office of Mental Health (OMH) released an updated Infection Control Manual (available here) for Public Mental Health System Programs. OMH released a memo (available here) outlining the updates to the manual, which include the following: 

  • Adds new section starting on page 5 that explains to agencies when programs should take enhanced precautions.
  • Incorporates guidance from the NY Cluster Action Initiative, including new orders regarding visitation at hospitals and residential programs.
  • Incorporates updated New York State Travel Advisory Guidance.
  • In the section for outpatient programs, starting on page 6, clarifies how programs should determine which clients should be seen virtually and which clients should be seen in person. Assertive Community Treatment (ACT), Mobile Crisis Teams, and Forensic Linkage Teams should prioritize in-person encounters given the hard-to-engage nature of each client population.
  • In sections for outpatient and residential programs on pages 6-18, clarifies regulations for Personal Protective Equipment (PPE). All staff should always wear a mask around clients and always maintain 6 feet of distance. When physical distancing is not possible or if staff is caring for an individual with known or suspected COVID-19-Like Illness, then staff should also wear additional PPE such as eye protection and gloves. It is critically important to understand that both physical distancing and a face covering is required, not one or the other.
  • Explains that indoor, in-person groups are only permitted when programs are in standard precautions. There can be no more than ten individuals, last no more than one hour, and all participants must wear a face covering and maintain physical distancing.
  • Clarifies visitation rules for residential programs, including new rules for programs in red and orange zones.
  • Indicates that organized outings from residential programs are only permitted if precautions can be taken and if the program is observing standard precautions.

Guidance on discontinuation of isolation and return to work has not changed in this version. Agencies should use this updated information to update their Policy and Procedures manuals.

Updated Guidance Documents

The Office for People with Developmental Disabilities (OPWDD) has updated the below Return to Work guidance document for staff to include additional details on the State’s travel advisory:

Federal Updates

CMS Accepting Extreme and Uncontrollable Circumstances Exception Applications

On November 16th, the Centers for Medicare and Medicaid Services (CMS) announced that the agency will be using the Extreme and Uncontrollable Circumstances policy to allow Merit-based Incentive Payment System (MIPS) eligible clinicians, groups, and virtual groups to submit an application requesting reweighting of one or more MIPS performance categories to zero due to the COVID-19 public health emergency. Applicants may qualify for the re-weighting if they:

  • Are a small practice; 
  • Have decertified EHR technology; 
  • Have insufficient Internet connectivity; 
  • Face extreme and uncontrollable circumstances such as disaster, practice closure, severe financial distress, or vendor issues; or
  • Lack control over the availability of Certified EHR Technology.

CMS intends to allow Alternative Payment Model Entities to receive the re-weighted MIPS performance categories but will not be able to make final determinations on applications until a relevant provision in the 2021 Medicare Physician Fee Schedule Notice of Proposed Rulemaking is finalized.

Applications are due by December 31st at 8pm and can be submitted here.

HHS Partners with Pharmacy Networks to Increase Access to Future COVID-19 Vaccines

On November 12th, the Department of Health and Human Services (HHS) announced that it has signed up approximately 60 percent of pharmacies nationally through its chain pharmacy and pharmacy network program to receive direct allocations of future COVID-19 vaccines. Vaccines provided through this initiative will be administered at pharmacy locations, including those in retail and grocery stores, with no cost to patients.

The announcement, with a list of participating networks, is available here.