COVID-19 Update
April 16, 2020

Extension of New York on PAUSE and Blueprint to Un-PAUSE NY
Today the Governor issued Executive Order 202.18, extending all New York State on PAUSE orders issued on March 22 from April 29 through May 16. Schools will remain closed until that time, and essential business teleworking rules will remain in place. 
While at the same time the PAUSE order is extended, the Governor announced the beginnings of a detailed plan to un-PAUSE New York in a careful way. This plan is being done in concert with many surrounding states and includes a variety of elements, including increasing stock of personal protective equipment (PPE), increased testing and contact tracing, and evaluating returning to work certain industries based on risk and essential nature. More information can be found here.

Flexibilities for Delivering and Documenting Day Services
Today, The Office for People with Developmental Disabilities (OPWDD) presented a webinar on "Flexibilities for Delivering and Documenting Day Services." Some key concepts regarding service delivery and payment included:
  • OPWDD intends to publish an attestation form that providers will need to complete and submit by the end of April in order to participate in the retainer program.
  • Day Habilitation (DH), Community Habilitation (CH) and Prevocational (PV) services provided in a supervised residence cannot be billed to Medicaid if the residential agency is also receiving an enhanced residential rate for the person (i.e., the individual participated in these services from another agency).
  • Individuals within Supportive IRAs, Family Care, and living with family or independently may receive DH, CH, or PV within those locations.
  • CH may temporarily be delivered during weekday, daytime hours to students who are authorized to receive the service.
  • Current Life Plans (LP) and Staff Action Plans (SAP) remain in place. OPWDD will publish documentation expectations in the near future.
  • Retainer claims may be submitted to eMedNY beginning 5/1/20 and payment will cover the periods of 4/16/20 through the first half value of May.
  • OPWDD will posting additional information on the claim submission process.
We will share a recording of the webinar and slide deck in a future COVID-19 Update as soon as they are published.

Revised Staff Guidance for OPWDD Programs 
The Office for People with Developmental Disabilities published " Revised Staffing Guidance For Management of COVID-19." This is an update to the guidance of the same name issued March 25. There are several revisions to the document, primarily incorporating other previously released guidance from the New York State Department of Health (NYSDOH) or Centers for Disease Prevention and Control (CDC). To assist Chapters, we have highlighted the substantive changes to the new guidance document. In summary, the most significant changes that Chapters should be aware of are as follows:
  • This staffing guidance now applies to all settings as opposed to just Intermediate Care Facilities (ICFs).
  • Where there is a suspected or confirmed case of COVID-19, a health check must be completed at the beginning of each shift and every twelve hours.
  • The revision removes the heart and respiratory rates as part of the staff health checks. We raised concern on this matter to OPWDD a few weeks ago, and this appears to be the resolution. (Page 1, Section B)
  • A written log of the symptom and temperature check is now required. (Page 1, Section B)
  • The guidance states, "all facility staff with relevant symptoms or with a temperature greater than or equal to 100.4 F should immediately be sent home and quarantined until test results, or presumptive diagnosis, is obtained. All staff who have worked in close proximity with the presumed infected staff member, in addition to all individuals living in the residential setting, should also be quarantined." There is no mention that providers should contact their Local Health Department (LHD) and follow their instruction. As a reminder, providers cannot direct quarantine and instead should be contacting the LHD and following instruction. (Page 1, Section B)
  • Consistent with current practice, Chapter staff are now required to wear facemasks (not face coverings) at all times while at work. (Page 6, Section I). This is intended to reduce COVID-19 transmission from potentially infected staff, who may be asymptomatic. While at work, the facemask will be standard PPE.
  • "All staff wearing N95 respirators should undergo medical clearance and fit testing." There is no clarity provided on what constitutes "medical clearance" or appropriate fit testing. We will be reaching out to OPWDD for clarification on these requirements. (Page 6, Section I)
Health Advisory: Local Health Department Response Activities
The New York State Department of Health (NYSDOH) issued guidance to Local Health Departments (LHDs) on prioritizing response activities. This guidance provides insight into how LHDs will approach reports of COVID-19 within communities. Response is dependent on the level of community transmission. The guidance also includes updated criteria for isolation and quarantine directives. The updates incorporate the return-to-work conditions set by the NYSDOH. 

The Arc Voices Support for DSPs through Federal "Heroes Fund"
As part of the next COVID-19 stimulus package, New York's Senator Schumer has proposed the creation of a " Heroes Fund" which would provide direct hazard pay to Direct Support Professionals (DSP). Recognizing the important and essential work of DSPs and their impact on the people we serve and support, this proposal has two main components:
  1. A $25,000 pandemic premium pay increase for essential frontline workers, equivalent to a raise of an additional $13 per hour from the start of the public health emergency until December 31, 2020.
  2. A $15,000 recruitment incentive for health and home care workers and first responders to attract and secure the workforce needed to fight the public health crisis.
The Arc US, along with The Consortium for Citizens with Disabilities (CCD), is actively voicing their support to congressional leaders, along with other vital items specific to our workforce and support framework.  Opportunities for individual advocacy on the next stimulus package will be forthcoming in the coming days and weeks.

OCR Resolves Civil Rights Complaint Against Pennsylvania Triaging Policies 
Today, the Office for Civil Rights (OCR) at the U.S Department of Health and Human Services (HHS) announced that it has resolved a complaint filed against the Pennsylvania Department of Health (PDH) after PDH revised its Interim Pennsylvania Crisis Standards of Care for Pandemic Guidelines (CSC Guidelines) to ensure that persons will not be discriminated against based on disability if providers in the state were to begin triaging life-saving health care services. This is the second enforcement action OCR has taken since OCR issued a Bulletin reminding covered entities of the continued applicability of civil rights laws during the COVID-19 public health emergency.

Research Brief on Fatality Rate of COVID-19 in the I/DD Population 
A recent research brief from the Learner Center for Public Health Promotion suggests people with intellectual and developmental disabilities are dying from COVID-19 at higher rates than the general population and calls for better reporting. The Arc New York continues to collect weekly data on the impact of COVID-19 within our organization to inform our advocacy and operational response. 

Delay Reason Code 15 (Natural Disaster)
In response to the current State of Emergency, eMedNY has authorized the use of Delay Reason Code 15 to allow the electronic processing of claims in excess of the timely filing limits. Additional information on the use of Delay Reason Code 15 can be found here and here.

This and all related updates will be cataloged on  The Arc New York COVID-19 Resource Page   for future reference. Please contact us if you have questions regarding any of this information.

Josh Christiana , Associate Executive Director for Quality, Compliance & Chapter Relations

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