The New York State Budget, Health and Mental Hygiene Bill (the “HMH Bill”), has been published (read it here). There are several important highlights for home care providers.

CDPAP RFO

As we had indicated in our alerts last week, the Gottfried bill has been defeated and, instead, there is significantly narrower language in the final budget that will provide the Commissioner of Health with discretion to select additional fiscal intermediaries to be added to the list of awardees. As discussed in our alert (see here), the Commissioner will canvas the current RFO applicants for certain information and, based on the responses received from such applicants, may select qualifying intermediaries (but is not required to select any). The HMH Bill authorizes the Commissioner to select:

1. “one or two additional applicants” that are located (with their primary address) in a county that has more than 250,000 residents but less than 500,000.
2. “one or two additional applicants” that are located (with their primary address) in a county that has more than 500,000 residents.
3. “at least two additional applicants” that are nonprofits, who have been performing fiscal intermediary services since January 1, 2012, and that are licensed to provide waiver services to individuals with intellectual and developmental disabilities
4. “at least two additional applicants” that are nonprofits, who have been performing fiscal intermediary services since January 1, 2012, and that “serve racial and ethnic minority residents, religious minority residents, or new Americans in those consumers’ primary language.”
5. “at least two additional applicants” that are certified by New York State as a minority or woman-owned business enterprise.

FAIR PAY FOR HOME CARE

The Fair Pay for Home Care is not included in the HMH Bill and, thus, it appears that this measure was defeated. As we had discussed, the Fair Pay for Home Care was a proposal to raise home care workers’ wages to almost $40,000/year. It also included an increase in wage parity benefit rates. 

LHCSA RFO

The HMH Bill also does not repeal the LHCSA RFO. In the days leading up to the publication of the HMH Bill, there were a number of efforts calling on the Legislature to repeal the LHCSA RFO language from the law, but it appears these efforts were not successful. Thus, providers will be faced with the LHCSA RFO at some point in the future, once the Department of Health is ready and able to publish the request for proposals.

Please let us know if you have any questions regarding the implications of the Budget bill.

New York Department of Health has released updated Return to Work Guidance for Personnel in Healthcare Settings after COVID-19 Exposure (see it here).

Asymptomatic healthcare personnel (“HCP”) who have had exposure to, or been in contact with, a confirmed or suspected case of COVID-19 (e.g. had prolonged close contact in a healthcare setting with a patient, visitor, or HCP with confirmed or suspected COVID-19 while not wearing recommended personal protective equipment per CDC guidelines; had close community contact within 6 feet of a confirmed or suspected case for 10 minutes or more; or was deemed to have had an exposure [including proximate contact] by a local health department), may return to work after completing a 10 day quarantine without testing if no symptoms have been reported during the quarantine period, providing the following conditions are met:

1. HCP must continue daily symptom monitoring through Day 14;
2. HCP must be counseled to continue strict adherence to all recommended nonpharmaceutical interventions, including hand hygiene, the use of face masks or other appropriate respiratory protection face coverings, and the use of eye protection;
3. HCP must be advised that if any symptoms develop, they should immediately self-isolate and contact the local public health authority and/or their supervisor to report this change in clinical status and determine if they should seek testing.
4. HCP exposed to COVID-19 who are working in nursing homes or adult care facilities certified as Enhanced Assisted Living Residences (EALR) or licensed as Assisted Living Programs (ALP) who complete the 10 day quarantine cannot return to their workplace (must furlough) through the 14th day after exposure unless they meet the vaccination or recent SARS-CoV-2 recovery criteria below.

Importantly, exceptions to the above requirements apply to HCP who are fully vaccinated who meet criteria outlined below and HCP who have recovered from recent SARS-CoV-2 infection within the past 3 months who meet the criteria outlined below.

Asymptomatic HCP who have been fully vaccinated against COVID-19 do not need to quarantine or furlough after exposure to COVID-19. Fully vaccinated is defined as being 2 weeks or more after either receipt of the second dose in a 2-dose series or receipt of one dose of a single-dose vaccine.

The guidance states that “all healthcare facilities” are expected to know which of their staff have been vaccinated. Any vaccinated staff who did not receive the vaccine through their workplace must inform the facility of their vaccination status through the same process the facility uses to maintain information on annual influenza immunizations and tuberculosis tests. These requirements seem to apply only to HCP who work in an actual facility, not the traditional home care setting.

With respect to exposed HCP who are asymptomatic and who have recovered from SARS-CoV-2, the DOH will follow February 14, 2021 guidance and will not require such HCPs to undergo repeat testing or quarantine if exposed to COVID within 3 months after the date of symptom onset from the initial infection or date of first positive diagnostic test if asymptomatic during the illness.

The guidance also discusses travel for HCP who are arriving back to NYS from other U.S. States and territories. Such HCP s are not required to test or quarantine. However, quarantine, consistent with the CDC recommendations for international travel, is still recommended unless the HCP is fully vaccinated or has recovered from laboratory confirmed COVID-19 within the previous 3 months.

Asymptomatic HCP returning from domestic travel may return to work accordingly. Asymptomatic HCP returning from travel to another country must follow CDC’s international travel requirements including showing proof of negative diagnostic test result no more than 3 days before flight departure or documentation of recovery from COVID-19 prior to boarding, and must either quarantine for 7 days with a test 3-5 days after travel or quarantine for 10 days with no test. HCP can return to work upon completion of the CDC quarantine requirements except for HCP working in nursing homes, EALRs, or ALPs. These HCP cannot return to their workplace (must furlough) through the 14th day after return from international travel unless they are fully vaccinated or have recovered from laboratory confirmed SARS-CoV-2 infection within the previous 3 months.

The guidance also reinforces prior guidance regarding the process to follow if putting employees on COVID paid sick leave will result in staffing shortages and jeopardize essential patient services. 

If you have any questions about this topic, please do not hesitate to reach out to us.

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