COVID-19 Update
April 20, 2020

Revised Staffing Guidance For Management of COVID-19 April 20
OPWDD has published a second revision to their "Staffing Guidance for the Management of COVID-19."  Revisions to the document are underlined.  The update expands the requirement to conduct health checks on individuals in ICFs to all residential facilities. 
Following the last revision, we shared concerns with OPWDD regarding face covers not being included as an option for staff when caring for individuals who are not infected or presumed to be infected with COVID-19. Notably, OPWDD has since expanded their instructions to include the option of cloth or other masks. 

As a reminder,  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 revised guidance still includes language that "all staff wearing N95 respirators should undergo medical clearance and fit testing." However, OPWDD has not provided any specific guidance on what constitutes medical clearance and fit testing. The Occupational Safety and Health Administration (OSHA) is exercising enforcement discretion concerning the annual fit testing requirements. Initial fit testing remains a requirement. OSHA is allowing healthcare employers to  change the method of fit testing from a destructive method (i.e., quantitative) to a non-destructive method (i.e., qualitative). Information on completing a qualitative fit test can be viewed in OSHA's instructional video here. Instruction on qualitative fit tests starts at 3 minutes and 15 seconds. Chapters should make their best effort to comply with the fit testing requirements. Where it is not possible, a seal test should be implemented by the user at minimum. Seal tests are  discussed at the 2 minute and 55 second mark.
We are still seeking additional clarification on a few other areas of the guidance and will provide further updates as they become available.
Hydroxychloroquine/Chloroquine Use Now Approved for Community Settings
Following our morning call yesterday, The Arc New York advocated with OPWDD for the ability to use various drug regimens that have demonstrated preliminary and anecdotal efficacy in combating COVID-19. Previously, the drugs were not authorized to be prescribed in community-based settings. We are pleased to report that, based upon the Food and Drug Administration's (FDA) emergency use authorization (EUA), the New York State Department of Health (NYSDOH) ruled that hydroxychloroquine and chloroquine can be used to treat patients with confirmed COVID-19, despite the treatment not yet being approved by the FDA for this purpose. Emergency use authorization provided by the FDA and authorized by  Executive Order 202.11 allows health care practitioners to prescribe hydroxychloroquine for the treatment of most confirmed COVID-19 patients  weighing 50 kilograms or more, and permits pharmacists to fulfill such prescriptions in retail or other non-hospital pharmacies and inpatient settings.  NYSDOH issued a   memo describing the policy change. 
While this is a welcome change in policy, and affords flexibility in treatment, it still remains to be seen whether the supply for these medications will meet the new demands. Due to the limited clinical trials, we urge extreme prudence when considering the appropriateness of these medications for the people we serve.   
Guidance for the Management of IV Therapy in OPWDD Residences
The Office for People With Developmental Disabilities (OPWDD) has published " Guidance for the Management of Intravenous Therapy in OPWDD Residential Residence s." The guidance clarifies the locations in which a Licensed Practical Nurse (LPN) may provide Intravenous (IV) Therapy, provides alternative measures for training on IV therapy, and outlines responsibilities for documentation.  More information on LPN Scope of Practice and IV therapy can be found here .
Executive Orders
This weekend Governor Cuomo issued Executive Order 202.19, EO 202.20, and EO 202.21. These EOs do not contain substantive language that would significantly impact Chapter operations. 202.19 addresses statewide coordinated testing and notification to families regarding COVID-19 by select facilities. 202.20 addresses expiration of marriage licenses, as well as the conditions under which marriage ceremonies may be performed utilizing audio-video technology. 202.21 modifies language in 202.20 to include select parties as authorized to perform the marriage ceremony.
Employee Retention Credit
The Arc New York qualifies for the Employee Retention Credit ("ERC") under the CARES act, because our business operations have been partially suspended by governmental order due to COVID-19. For employers with over 100 employees, such as The Arc New York, qualifying wages for the ERC are wages paid to employees who are retained but unable to work due to suspension of the business by governmental order. The question of whether an employee meets the "unable to work" standard becomes more complicated with Chapters reallocating employees who previously provided day program services or other non-residential programs to support residential operations. Below are some common scenarios that can be used as guidance to determine whether the ERC can be claimed for a particular employee:
  1. Employee is retained and provides no services for residential operations, but continues to receive salary and/or benefits. All compensation paid to these employees will be "qualified wages" for purposes of the ERC. Can claim a credit up to the maximum $5,000 credit per employee.
  2. Employee is retained and provides services for residential operations full time. The wages will not qualify, because the employee is being compensated on the same basis in exchange for providing services. The employees are not "unable to work" within the meaning of the ERC, rather they are working in a different role. Cannot claim a credit.
  3. Employee is retained and provides services for residential operations, but not the same amount or level of services they were previously providing. It is less clear whether wages paid to the employee in these cases are qualified wages. The language provided by the IRS in its preliminary FAQ supports the position that any pay for time not providing services is qualified wages, even if the employee is also paid for some working time. If an employee is performing services on a reduced schedule, wages paid to the employee are only treated as qualified wages if they exceed what the employee would have otherwise been paid for the services performed. Can claim a credit for the difference between the total wages paid to the employee and the amount that would have been paid for the reduced hours or services actually provided by the employee.
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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