COVID-19 Update
April 6, 2020

New York State on PAUSE Directives Extended 
Today Governor Cuomo announced that all current New York State on PAUSE directives will be extended through April. All non-essential workers must continue to work from home, and schools will be closed through April 29. We continue to advocate for solutions to sustain providers throughout the duration of this crisis and ensure the long-term viability of our system and the critical services it delivers. 

Personal Protective Equipment Guidance
On April 2, The New York State Department of Health (NYSDOH) published the Health Advisory " Options when Personal Protective Equipment (PPE) is in Short Supply or Not Available ."  The guidance in the health alert assumes that conventional capacity strategies are no longer possible, and that Chapters must use crisis strategies to ensure the protection of employees and individuals supported.
Please note that since this health advisory was published, the Centers for Disease Control and Prevention (CDC) has published recommendations for the use of cloth face covers. This includes guidance on when and how to wear, clean, remove, and make cloth face coverings.  The CDC also maintains an FAQ on this topic.  The use of cloth face coverings is only recommended by the CDC for public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies). Chapter employees should continue to use standard PPE when working with individuals supported within their programs and facilities.
We've received several questions from Chapters on the use of PPE. We are currently working with the Managed Care Community of Practice (MCCOP) to provide comprehensive guidance in this area. In the meantime, here are some great resources for Chapters on the appropriate use of PPE.  
DQI Agency PPE Review
On Friday, many Chapters received requests from the Office for People with Developmental Disabilities (OPWDD) Division of Quality Improvement (DQI) for information on their PPE supplies, including phone calls and an email. On Saturday, we discussed our concerns regarding this request with OPWDD's Executive Deputy Commissioner. We indicated that we would be directing Chapters not to respond individually to these requests at this time, and would work with OPWDD collectively to communicate supply needs for The Arc New York. This position was also expressed in a formal letter to OPWDD.
OPWDD IRMA Entry Training and Advocacy
On April 1, OPWDD conducted their "Entry into the Incident Report and Management Application (IRMA)" training. This process replaces OPWDD's Contact Tracking Form, the use of which included several follow-up calls from OPWDD's DQI staff. The PowerPoint can be viewed hereThe revised process eliminates the use of the Contact Tracking Form and several program questions (e.g., requests for Life Plans, floor plans, cleaning schedules, staffing schedules). However, we continue to have concerns about duplicative reporting. The Arc New York reached out to OPWDD's Deputy Commissioner of DQI to request a discussion on the revised process. We will provide additional updates when we have more information.
IPSIDD and Retainer Day Billing
We have received several questions about billing Individual Practitioner Services for Individuals with Developmental Disabilities (IPSIDD) during a period where a day service retainer day is claimed. Per OPWDD correspondence, providers may continue to bill for IPSIDD services during the time that a day service retainer day is also claimed. 
Quarantine and Isolation Directives
We have received several questions about the authority to direct quarantine and isolation --- specifically, what professionals are authorized to direct this.  NYCRR Title 10, Section 2.13 provides this authority to the State Commissioner of Health, the local health authority, or the attending physician. W hile many of our employees have experience and knowledge of medical care and treatment, the authority to direct quarantine or isolation is limited to these three parties, per regulation. 
Economic Recovery Rebates Under the CARES Act
Individuals who receive SSI, SSDI, VA disability and VA pension benefits will be eligible for a Recovery Rebate under the CARE act. Rebates will be issued based on 2018 or 2019 income taxes returns, or, if the individual has not filed taxes in either year, their Form SSA-1099 or Form RRB-1099. However, there is concern that individuals who receive these benefits will not automatically be issued a rebate, because they do not have any of these tax filings. The Arc New York has signed on to a letter by the Consortium for Citizens with Disabilities urging the Federal government to address this oversight so the people who receive SSI, SSDI and other benefits can receive their Recovery Rebate. On a positive note, the Social Security Administration confirmed in a press release dated April 3, 2020 that Recovery Rebates will not be counted as income for SSI recipients, and the payments will be excluded from resource calculations for a period of 12 months. 

GIS Regarding Medicaid Eligibility Protocol During the COVID-19 Emergency
The  Office of Health Insurance Programs issued  GIS 20 MA/04, which includes several changes regarding Medicaid eligibility and enrollment that are effective immediately and will remain in effect for the duration of the public health emergency. Notably, any individuals who would normally have to recertify their Medicaid eligibility in March, April, May or June will automatically have their coverage extended for 12 months. 

Residential Live-In Model 
Some Chapters are implementing a residential live-in model during a period of quarantine on a voluntary basis. An example could be an employee working two shifts in a 24-hour period (with an 8-hour designated sleep period) being compensated with overtime along with an additional stipend. Sample guidelines for implementing this model can be found here

Barclay Damon Webinar - Updated Recording Link and Slides
Last week, Barclay Damon provided The Arc New York with a personalized webinar for our Chapters covering the Federal CARES Act and updates on New York state's financial, regulatory and legal initiatives related to COVID-19. A corrected link for the recorded presentation can be found  here, and the slides can be found  here.

Tax-Free Payments to Employees Under Internal Revenue Code Section 139-NA
The federal government has declared New York a major disaster area due to COVID-19. This opens the door to billions of dollars in federal aid to help the state fight the virus. Part of this aid package includes tax-free qualified disaster payments under Internal Revenue Code Section 139 for New York residents. Section 139 permits employers to make tax-free payments for reasonable and necessary medical, personal, family, living or funeral expenses incurred as a result of the declared disaster.

This disaster declaration allows for Chapters to use foundation assets to make tax-free reimbursements to provide relief to staff. Whether or not the foundation is controlled, this provision could apply (even though the foundation is not the employer in these circumstances). Please keep this in mind as an option to support your work force. For example, the ARC Foundation of Clinton County is providing grants to staff to help defray the cost of childcare. Copies of a sample day care reimbursement form and letter to staff are attached.  The IRS may issue guidance on this topic to provide additional clarity. More information is available here .
OCR Alert: Individual Posing as OCR Investigator
The Department of  Health and Human Services  Office for Civil Rights (OCR) has published an alert warning of an individual contacting HIPAA covered entities requesting protected health information (PHI). Please review this alert and share with all staff for their awareness.
Westchester Learning Resources for the Community
The Arc Westchester added a new section to their website titled, " Learning Resources for Our Community." This section of the site is intended to assist Chapters with ideas for supplementing activities that may have been lost due to the temporary closure of day services and limitations on community activities. The site offers some great ideas for remote learning.

Social Distancing Activities for Employees
The State Office EAP, shared an excellent resource to share with your employees and their families about ways to stay engaged and busy while observing social distancing. 

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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