State Updates
Governor Cuomo Indicates Further Plateauing of Cases, Discusses Large Scale Testing Efforts
Today (April 15th), Governor Cuomo held a press conference during which he announced further evidence of a plateau in the COVID-19 outbreak. Yesterday saw a decrease in the number of total ongoing hospitalizations as well as decreased average growth, while the number of new deaths remains steady. However, the Governor noted that there were 2,253 (gross) new COVID-19 hospitalizations yesterday, demonstrating that “reaching the plateau” still means new infections are occurring.
The Governor reiterated that until we have a vaccine or effective medical treatment, it will be necessary for New York State to have a gradual, phased “reopening” of the economy to avoid a second wave of infections. The “reopening” will require large-scale testing, including diagnostic and antibody testing administered via a saliva or finger-prick test, but the Governor stated that federal support would be needed to obtain adequate equipment, testing sites, and laboratories for this effort to be scaled. However, this week the State will begin administering 2,000 antibody tests per day via a finger-prick test developed by the Department of Health (DOH). The State has also asked the Federal Drug Administration (FDA) for expedited approval of an antibody finger-prick test that could test up to 100,000 people per day. Health care workers, first responders, and essential workers will be prioritized for antibody testing. The Governor noted that the State will also need to implement widespread contact tracing efforts.
Non-essential businesses are expected to be permitted to reopen based on factors such as how “essential” the business service or product is and the risk of workplace or customer infection associated with reopening that business. The Governor announced that he would be issuing an Executive Order requiring all New Yorkers to wear a mask or mouth/nose covering in situations in which individuals cannot maintain adequate social distancing.
Mother Cabrini 2020 Statewide and Coronavirus Emergency Support Grant Programs
Today, the Mother Cabrini Health Foundation announced that it has opened its online grant portal (available here) to accept Letters of Inquiry (LOI) from eligible not-for-profit 501(c)(3) organizations supporting needy New Yorkers. This year, two programs are available: (1) the existing Statewide Grants program and (2) the new Coronavirus Emergency Support Grant program. In either case, eligible applicants must be not-for-profit 501(c)(3) organizations. Funding will be prioritized for direct services and programs, but capital projects may be funded on a limited, case-by-case basis.
Statewide Grants
Last year, the Foundation awarded approximately $150 million in grants through its Statewide Grants Program to organizations serving vulnerable populations in New York State. In certain cases, the Foundation may consider awarding projects that were funded in 2019; however, the previously awarded organization will need to submit another LOI and complete the entire application process again. All organizations may submit multiple LOIs for distinct projects if they choose. The Foundation will generally consider funding grant proposals of $75,000 or greater.
Coronavirus Emergency Support Grants
The Cabrini Foundation will also award a total of $50 million in emergency grants to assist organizations dealing with COVID-19 through the Coronavirus Emergency Support Grants program. The first round of emergency grants were distributed by invitation, but organizations may be considered for the next round of funding by submitting an LOI through the online portal above. Organizations interested in receiving COVID-19 funding support should select “An initiative intended to help with COVID-19 issues or consequences” as the Project Status in the Narrative section of the LOI. The Coronavirus Emergency Support Grants will generally award funds in the range of $75,000 to $150,000.
Organizations may apply for both a Coronavirus Emergency Support Grant and a Statewide Grant, but a separate LOI will need to be submitted for each grant proposal. LOIs for the Coronavirus Emergency Support Grants are due on May 4th. LOIs for the Statewide Grants are due on June 3rd. After the LOIs are reviewed by the Foundation, selected organizations will be invited to submit full applications for consideration.
Additional information, including the Foundation’s 2020 Grantmaking Priorities and FAQs on both grant programs, is available here. Questions should be submitted to grantsupport@cabrinihealth.org.
Updated Guidance Documents
OMH Revised Disaster Emergency FAQ
The New York State Office of Mental Health (OMH) has released a revised Disaster Emergency FAQ (available here) that provides answers to new questions and guidance on issues related to the COVID-19 emergency, including questions on Medicaid coverage for dual-eligibles, hiring graduate student trainees, protocols for administering long-acting injectables, and the availability of mobile crisis services to support providers.
Some particularly notable items in the guidance include:
- Claims may be paid by Medicaid for dual enrollees for telephonic services not reimbursed by Medicare.
- Even if OMH outpatient programs are providing must services by telehealth, they should continue to have on-site capacity to address the needs of recipients who may require face-to-face contact using infection control guidelines. In particular, programs that provide long-acting injectable medications must make provisions for continuity of these services.
- If a client or staff member develops symptoms or tests positive for COVID-19, the program should inform all individuals who had close contact with that person and should advise potentially exposed clients to self-quarantine for 14 days. Potentially exposed staff members can report for work as long as they are asymptomatic, wear a mask, and check their temperature twice per day.
- Providers of telemental health services may obtain consent for PSYCKES verbally so long as the consent is informed and recorded in the patient’s treatment record.
- OMH explicitly permits admissions procedures, new client intakes, initial evaluations, documentation, and treatment plans to be completed or managed remotely via telemental health services.
OMH Infection Control Guidance
OMH also revised their COVID-19 Infection Control Guidance for OMH Residential and Site-Based Programs (available here). The revised guidance applies to the following additional programs:
- Crisis Residences Serving Children and Youth
- Community Residences for Children and Youth
- Residential Treatment Facilities (RTFs)
- Community Residence for Eating Disorder Integrated Treatment Programs
The guidance provides updates on appropriate infection control procedures, including guidance on physical distancing and accepting new clients. The revised guidance also provides a new section providing guidance on home-time leaves for children and youth serving programs during the COVID-19 emergency.
OPWDD Background Check Guidance
The New York State Office for People with Developmental Disabilities (OPWDD) has released interim guidance (available here) regarding modified background check requirements for existing and new staff members during the COVID-19 emergency. The guidance, which differs slightly from the OMH guidance released last week on this subject, applies to all facilities and programs certified, approved, or funded by OPWDD, and is in effect on a time-limited basis. The guidance does not preclude any provider from requiring all regularly required pre-employment checks of any prospective staff members.
For prospective employees who do not currently hold a position with an OPWDD provider or with a provider approved or certified by another State agency, the hiring provider must submit the Criminal Background Check (CBC), Staff Exclusion List (SEL) check, State Central Register (SCR) check, and Mental Hygiene Law 16.34 (MHL 16.34) check for that employee. An appointment for fingerprinting must be completed within three days after the employee’s first day of work. An employee may be hired while pre-employment checks are pending as long as they are not on the SEL. Once the CBC is completed, the employee may work unsupervised while awaiting the results of the SCR and 16.34 checks, but unsupervised work should be limited to the extent possible until these checks are complete.
For prospective employees currently employed by an OPWDD provider or with a provider approved or certified by another State agency, the hiring provider should complete the CBC Request Form (available here) and submit the form to OPWDD.sm.IMU.Project@opwdd.ny.gov. The Justice Center will approve the request or ask for more information within one business day. If approved, the hiring provider may hire the prospective employee without the need for any additional pre-employment checks. An employee who has not previously submitted an SCR check due to the nature of the service provided by their current employer, will not be required to undergo an SCR check for purposes of this temporary directive.
Federal Updates
CMS Provides Transfer/Discharge Information for SNFs and LTCFs
On April 13th, CMS announced supplemental information for transferring or discharging residents between skilled nursing facilities (SNFs) and/or long-term care facilities (LTCFs) based on COVID-19 status: positive, negative, or unknown/under observation. CMS is waiving approval requirements when two or more certified LTCFs want to transfer or discharge residents between themselves for the purposes of cohorting by COVID-19 status. LTCFs can also transfer or discharge residents to a non-certified location for cohorting so long as it is approved by the state.
A copy of the guidance and a graphic explaining the various scenarios is available here.
CMS to Increase Payments for High-Throughput Diagnostic Tests
On April 15th, CMS announced that it will make higher Medicare payments of $100 for COVID-19 clinical diagnostic lab tests that make use of high-throughput technologies that process more than two hundred specimens a day. In a CMS Ruling, the agency cited the higher training and resource costs for high-throughput technologies such as the Roche cobas 6800 System, Roche cobas 8800 System, Abbott m2000 System, Hologic Panther Fusion System, GeneXpert Infinity System, and NeuMoDx 288 Molecular. The increased payments are effective as of April 14th through the duration of the COVID-19 national emergency.
The CMS Ruling is available here.
NIH Study Validates N95 Decontamination Methods
On April 15th, the National Institutes of Health (NIH) announced the results of a study investigating decontamination methods that would allow for re-use of N95 respirators. They found that vaporized hydrogen peroxide (VHP), 70-degree Celsius dry heat, ultraviolet light, and 70% ethanol spray were effective in eliminating detectable viable viruses from N95 fabric test samples. The researchers then tested the integrity of the masks and found that masks treated with the first three methods, VHP, heat, and ultraviolet light, could potentially be re-used twice. Finally, the researchers found that VHP was the most effective decontamination method, as it eliminated all detectable viruses after only a 10-minute treatment.
A preprint copy of the study is available here.
CMS COVID-19 Call with Nurses
Tomorrow (April 16th), from 3pm to 3:30pm, CMS will hold a “CMS COVID-19 Call with Nurses,” which will provide updates on the agency’s latest nursing guidance and feature best practices from leaders in the field. To access the event, attendees can call 833-614-0820 and use the Conference ID 5058949. Alternatively, attendees can access the audio webcast link here.