COVID-19 Update
April 11, 2020

Media Coverage of COVID-I9 Impact
Print and broadcast news outlets are covering the unique challenges and impact of COVID-19 on people with intellectual and developmental disabilities and the service system in New York. We continue to work with New York Disability Advocates (NYDA) to tell our stories, and will share ongoing coverage. Recent stories can be found below. 
OPWDD Webinars
On April 9,  The Office for People With Developmental Disabilities (OPWDD) presented updates on the day service retainer methodology as part of a webinar sponsored by the Managed Care Community of Practice (MCCOP).  OPWDD will be following up to that webinar with a presentation on the billing and service documentation requirements for the program. The webinar will be held  Thursday at 2 p.m.  Another webinar on Telehealth during the COVID-19 emergency is being conducted by OPWDD Friday at 2 p.m.  The recording and slides from the April 9 presentation and registration for the two upcoming webinars can be found here

Retainer Day Billing Questions (ICFs and In-home and Remote Delivery)
We received several questions pertaining to billing for day habilitation services to individuals residing in Intermediate Care Facilities (ICFs). We reached out to OPWDD who confirmed  that for the first 30 days of the COVID019 crisis, providers may bill for ICF individuals attending Day Habilitation programs. OPWDD continues to explore the methodology for services delivered post 4/15/20. 

Additionally, there has been some confusion surrounding day and prevocational habilitation services delivered in-home or remotely to people living with family. Providers are allowed to deliver these services and bill for half or full units. We provided clarification via email  on Friday.
OPWDD Operational Instructions for Agency Contact Tracing
OPWDD ha s has published "Operational Instructions for Agency Contact Tracing." The instructions formalize the three-part process for contact tracing, which is conducted by the Local Health Department or the Chapter. Notably, there is no record retention requirement established for the information documented in part one, aside from some information being entered into OPWDD's Incident Report and Management Application (IRMA). 

An April 8 New York State Department of Health (NYSDOH) Health Advisory that directed LHDs to conduct contact investigations (i.e., contact tracing), the instructions follow up to this advisory with new recommendations based on increasing concern over pre-symptomatic and asymptomatic transmission of COVID-19. S ection 3 of the instructions are the newest addition to the process, requiring that record of contacts be uploaded to the "other" folder in IRMA.  Please share this with all staff responsible for notifying the LHDs and IRMA entry. We have scheduled a call with OPWDD next week to discuss several incident management related topics. Please let us know if you have any questions or comments for further discussion. 
OPWDD Performing Nursing Services and Duties Remotely
For the past few weeks, we have been continuously advocating with OPWDD for guidance on nursing services during the COVID-19 public health crisis. In response, OPWDD has published the guidance document, " Performing Nursing Services and Duties Remotely." Providers are encouraged to use technology to assist in the completion of nursing duties. Many routine duties can be completed remotely, such as chart reviews and training/instruction of staff. Some nursing assessments may also be performed remotely. There remain some specific delegated tasks that cannot be performed remotely.  Chapters should review this guidance closely and provide to all nursing staff.
OPWDD Guidance for Resident and Family Communication
OPWDD adopted the previously issued NYSDOH " Guidance for Resident and Family Communication in Adult Care Facilities (ACFs) and Nursing Homes (NHs)" for all operated, certified and funded residences. The guidance answers several questions about sharing of information when a provider experiences a suspected or confirmed case of COVID-19. As a reminder, we have developed a template notification letter, which can be found here and on  The Arc New York COVID-19 Resource Page.
OPWDD Revised Telehealth Guidance
OPWDD published " Revised Interim Guidance Regarding the Delivery of Services Through Telehealth Modalities." Several changes have been made to the guidance. We have reviewed the document and highlighted the revisions for your reference.
The most significant revisions include the addition of language specifically allowing respite services to be conducted via telehealth. However, respite services must be delivered via two-way audio-visual technology. Telephonic transmission is not permissible. Claims for respite services delivered via telehealth may also be submitted to Medicaid for reimbursement.  The revisions also clarify that Life Plans do not need to be amended at this time to reflect the delivery of services via telehealth.
Updated Hospital Visitation Guidance
The NYSDOH has updated guidance initially issued on March 18 regarding hospital visitation. Effective immediately, an exception to the suspension of hospital visitation has been made for "patients for whom a support person has been determined to be essential to the care of the patient (medically necessary) including patients with intellectual and/or developmental disabilities, and patients with cognitive impairments including dementia."  There is additional detail in the document specific to supporting patients with I/DD and handling end-of-life situations for all patients. The full guidance document is here

Workers' Compensation Claims
Chapters have noted that there is an increase in the number of Workers' Compensation claims due to COVID. Whether these injuries are caused by a work accident remains a question for the Workers' Compensation Bureau (WCB) - and the facts of each case are likely to dictate their decision. For example, if a co-worker or individual supported tests positive, and another staff member in close proximity tests positive later as well, the WCB may find this to be work-related. The WCB has no guidance available yet on this topic, but the Attorney General's Office has posted a broad statement, as follows:  "Employees that contract COVID-19 at their place of work may be entitled to workers' compensation insurance during any treatment or recovery . . . Employees should apply for benefits with the Workers' Compensation Board."  We will continue to monitor this and report to Chapters as additional guidance becomes available. 
The Affordable Care Act Look-Back Measurement Method and COVID-19
Under the Affordable Care Act (ACA) employers can use one of two methods - the monthly measurement method or the look-back method - to determine how many full time employees they have and, therefore, must provide with minimum value health coverage. The look-back method considers average hours of service during a prior period of greater than a month to determine the number of full-time employees.

There has been some confusion and uncertainty regarding the application of the look-back measurement method during periods of layoff, furlough, and COVID-19-related paid and unpaid leave. There is no federal guidance yet regarding the application of this method during the ongoing public health crisis, so the general rules continue to apply. Under the look-back measurement method, full-time status continues to be based on hours of service during the applicable period, regardless of whether the employee experiences a level of absence or reduced hours of service.  All periods of paid leave must be taken into account. Special rules apply for certain types of unpaid leave - including FMLA - and for rehired employees. We will continue to monitor for any federal guidance specific to COVID-19.

Recovery Rebate Update: SSI Beneficiaries and Stimulus Payments
The Internal Revenue Service (IRS) released a new electronic portal to assist Supplemental Security Income (SSI) beneficiaries and other non-tax-filers in receiving their stimulus payments. Individuals can go to the IRS  portal and enter their personal information, which will be used to send their a stimulus payment. 

We understand this presents an additional burden on people with disabilities, their families, and service providers. Therefore, we are continuing our advocacy with the IRS, Social Security Administration (SSA), and Congress to ensure that people on SSI will receive their stimulus payments automatically. Current Social Security beneficiaries and those receiving Social Security Disability Insurance (SSDI) should receive their stimulus payment without additional steps. The recovery rebate check is available through December 2020, so there is time to wait as we  see if this extra step can be abolished. An  updated fact sheet on coronavirus stimulus payments can be found  here

Upgrades to Department of Labor's Technology Systems
The New York State Department of Labor announced  upgrades to their online and telephone-based unemployment insurance applications. The updated online system can be found 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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