Discussions have escalated in the last 24 hours on long-sought state COVID-19 guidance and assistance for home care and hospice. Throughout the weekend, HCA has again discussed with state officials a list of pressing requests for regulatory relief waivers, priority access to supplies, procedural guidance, and financial support to help providers amid the pandemic.
A just-released Dear Administrator Letter for Certified Home Health Agencies and Licensed Home Care Services Agencies (see here) provides some information on screening of patients and staff, as well as on the responsibilities of personnel in observing patients at home. It followed another guidance, sent earlier today (see here), with regulatory guidance for 1915(c) waiver programs (addressed to providers serving children and youth under the Children’s Waiver).
Yet many other critical areas of support, procedural guidance and regulatory waiver are needed across all home and community-based programs and providers.To help better define this request, HCA asks that all home care and hospice providers immediately complete a brief survey here. The aggregate results will be shared with the Department. Please complete the survey as soon as possible and no later than Tuesday, March 17, at noon. The earlier we begin collecting responses, the sooner we can convey specific needs to the Department of Health.
Late last week, Congress passed an $8.3 billion aid package that includes some waivers allowing for telehealth, but these are mostly applicable to other settings (not home health and hospice), and HCA is seeking waiver authority more broadly for use of telehealth in place of in-person and supervisory home visits where appropriate. This is necessary to reduce exposure but also to cope with staffing shortages, as is the rationale for all of our many regulatory waiver requests so far requested at both the state and federal levels.
A CMS fact sheet on the national emergency declaration does reference the availability of relief on the timeframe for OASIS transmission yet without detail on what those relaxed timeframes are. (HCA is tracking down further information.)President Trump, in declaring a national emergency on Friday, announced yet another $50 billion in anticipated aid to assist states and localities to address the crisis.
The U.S. House of Representatives has passed a relief package and the President has expressed support. The Senate is expected to act in the coming week.The House package reportedly includes $6.7 billion in federal Medicaid assistance percentage dollars for New York, a large portion of which would go to the state, as well as allocations to New York City and counties.Meanwhile, there are continuing reports that the State Legislature is working to finish the state budget this coming week, well ahead of schedule, especially after word that two members of the State Assembly are among the over 700 confirmed COVID-19 cases in New York State.
It is unknown what this may mean for health care and Medicaid, as the state’s Medicaid Redesign Team (MRT) has been considering a package of $2.5 billion in cost reductions. It remains to be seen whether the MRT process is suspended in favor of a more expedited or stripped-down budget for Medicaid, including whether (and to what extent) a federal aid package may be a determining factor in the budget outlook.
HCA will continue to keep the membership apprised of all relevant updates. Most importantly, please complete our survey so we can report your needs directly to the Department.Please also look for the latest info on our home care emergency preparedness site including our COVID-19 resources page here.