ARCHIVES - Past guidance on COVID-19 Public Health Emergency that ended May 11, 2023

This  is an archive of past NYS guidance on the COVID-19 Public Health Emergency.  This information was previously part of the news article on COVID-19 and Medicaid in NYS.  For current guidance see that article here.  

Nursing Home Guidance and Data Reporting - archive

• March 2023 - Update: NYS Nursing Home Visitor Testing and Screening for COVID-19  -- nursing homes are no longer required to verify that visitors have a negative COVID-19 test before entry or conduct active COVID-19 screening.   Guidance says aligned with CMS visitation guidance, which was further updated in May 2023 --

  May 8, 2023 - CMS Updated Guidance on Nursing Home Visitation with FAQ, updated to align with the end of the Public Health Emergency May 11, 2023

  • "Facilities shall not restrict visitation without a reasonable clinical or safety cause, consistent with 42 CFR § 483.10(f)(4)(v). ... there are no longer scenarios related to COVID-19 where visitation should be limited, except for certain situations when the visit is limited to being conducted in the resident's room.  Therefore, a nursing home must facilitate in-person visitation consistent with the applicable CMS regulations, which can be done by applying the guidance stated above. Failure to facilitate visitation, without adequate reason related to clinical necessity or resident safety, would constitute a potential violation of 42 CFR § 483.10(f)(4), and the facility would be subject to citation and enforcement actions.

  • If a nursing home is not following the revised CMS/CDC guidance,  file a complaint with the NYS health department, making clear any harm or suffering that is resulting from the resident’s isolation. This includes emotional distress and psycho-social harm, which the health department is required to take seriously.  Seek help from your local Long Term Care Ombudsman office.  

• Mar. 25, 2021 - NYS DOH Issues Guidance Expanding Nursing Home Visitation -  

• Nov. 12, 2021 - CMS Issues Revised Guidance Expanding Nursing Home Visitation - The guidance  - QSO-20-39-NH REVISED  - and CMS  fact sheet.  

  • See Frequently Asked Questions: LTSS Visitation Rights & COVID-19  by the National Center on Law & Elder Rights (NCLER).  

  • Also see summary from  the Consumervoice.org - the new guidance allows indoor and outdoor visits for all residents, except in limited circumstances.  Infection prevention protocols are still in place and must be followed by all visitors.  Visitation is allowed regardless of vaccination status.
    
    Limitations on visitation may occur: for unvaccinated residents if the COVID-19 county positivity rate is greater than 10% and less than 70% of residents in the facility are fully vaccinated; for residents with COVID-19, regardless of vaccination status, until they have met criteria to discontinue precautions; or for residents in quarantine, regardless of vaccination status, until they have met criteria to be released from quarantine.
    
    Compassionate care visits should be allowed at all times, regardless of vaccination status, an outbreak in the facility, or the county's positivity rate.
    
    While CMS and CDC recommend that the core principles of infection prevention be followed at all times, including physical distancing, if a resident is fully vaccinated, they can choose to have close contact (including touch) with their visitor while wearing a well-fitting mask and performing hand hygiene.  

• Congregate Facility Visitation in Micro-Cluster Zones (suspends visitation in RED and ORANGE zones, with exceptions for "compassionate" or "medically necessary" care, accompanying a minor, etc. and superseding the 9/17/20 guidance in those zones described below), dated  Oct. 23, 2020 - Look up an address to see if falls into a Red, Orange, or Yellow Zone. 

• Health Advisory: Revised Skilled Nursing Facility Visitation   (NYS 9/17/20), revising guidance issued on 9/15/20 based on intervening CMS guidance issued on 9/17/20 -  Nursing Home Visitation - COVID-19 (CMS, 9/17/20).  State 9/17/20 guidance places many conditions on visitation - no new COVID positive tests in 14 days, weekly staff testing, many other requirements - see guidance. 

• Visitation in Adult Care Facilities - rules for visitation in Phase 3 areas (July 10, 2020)

• Health Advisory: COVID-19 Cases in Nursing Homes and Adult Care Facilities  (Mar. 13, 2020, revised July 10, 2020)(limited visitation expanded to Long Term Care Ombudsprogram) 

• DAL 20-14: Required COVID-19 Testing for all Nursing Home and Adult Care Facility Personnel (requires weekly testing of all staff including private or Medicaid aides) (May 11, 2020)

• Advisory: Hospital Discharges and Admissions to Nursing Homes (Mar. 25, 2020)(Nursing homes must automatically re-admit residents who are temporarily hospitalized, even if they test positive for COVID-19)

• Guidance Regarding Adult  Care Facilities and CoronaVirus (Mar. 22, 2020)

• Recommendations to Protect Nursing Home Residents (Mar. 20, 2020)

• Health Advisory: Respiratory Illness in Nursing Homes and Adult Care Facilities in Areas
  of Sustained Community Transmission of COVID-19 (Mar. 21, 2020)

• Nursing Home Guidance Letter (March 11, 2020)

Adult Day Care - Archives

• Adult Day Health Care centers - closed  (March 13, 2020) (Medical Model programs only; DOH does not regulate social adult day care but they are apparently also closed) 

  • Medical Model ADHC programs may offer telehealth services --  COVID–19 Telephonic and Telehealth Services Available to Statewide Adult Day Health Care Program Services – (Web) – (PDF) 03.28.20.  COMMENT:  MLTC plans should continue to contract with ADHC for telehealth. 

  •  4/7/20 - Social Adult Day Care programs may offer telehealth services for MLTC plans - COVID-19 Guidance for Providing Adult Social Day Care (SDC) Services Telephonically. (Web) - (PDF) 

  • Questions and Answers Related to COVID-19 Guidance for Providing Adult Social Day Care (SDC) Services Telephonically, (May 16, 2020)(MLTC plans REQUIRED TO offer telephonic/telehealth  SDC services to members, and plan must reach out to members who received the SDC service before they closed down 3/18, and offer either telehealth or telephone services from SDC.  (NOTE that does not require MLTC to offer increased home care services in lieu of the day care services)  

    • SDC programs may offer home-delivered meals, and MLTC plan can contract with the SDC to provide them.  

Home Care and Telehealth Guidance - Archive

HOME CARE, WAIVER PROGRAMS, PRIVATE DUTY NURSING, DME

• DOH Medicaid Updates COVID-19 Special Editions

• Home Care Association of NYS - Covid-19 Resource Page

• July 23, 2021 - In-Service Requirements for Personal Care & Home Health Aides

• October 14, 2020, Dear Administrator Letter lifting  eerlier suspension of the annual health assessment for all personnel. All personnel are advised to obtain an annual health assessment by December 31, 2020.

• April 10, 2020  NYS DOH Dear Administrator Letter (see here) to CHHAs, LHCSAs, LTHHCPs, and Hospice programs, the state Department of Health has suspended or changed the following regulations.

   All CHHAs, LTHHCPs, AIDS home care programs and LHCSAs serving individuals affected by the COVID-19 public health emergency may conduct in-home and in-person supervision through indirect means, including by telephone or video communication, as soon as is practicable after the initial visit.

• COVID-19 Guidance for Home Health Care Agencies and Hospice Providers (March 22, 2020)(DHCBS DAL: 20-08 Updated  (replaces version issued 3/14/20)

• Interim Guidance for Home Care Services Regarding COVID-19 (Mar. 16, 2020)

• Nursing Home Transition & Diversion Waiver & TBI Waiver (Mar. 20, 2020)(must use telehealth for waiver services)

• Guidance on Medicaid Changes to Private Duty Nursing (PDN) Policy – (Web) – (PDF) – 3.28.2020

• Guidance on Medicaid Changes to Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Policy – (Web) – (PDF) – 3.28.2020

10.  NEWS UPDATES

• Oct. 16, 2021 - See Reports from Gothamist and NY Times on fallout from home care vaccine mandate. 

• TELEHEALTH NURSE ASSESSMENTS REINSTATED - On Sept. 30, 2021, NYS DOH reinstated Telehealth assessments for MLTC and other home care assessments, modifying  July 26, 2021 - NYS Dept. of Health RESCINDS Some Home Care Rules - Requiring UAS In-Person, Requiring M11q/Physician Orders to be in Writing (not called in), and other changes

• VACCINE MANDATE - On Jan. 25, 2022, DOH  updated FAQ's about the emergency regulation passed on  Aug. 26, 2021 mandating COVID-19 vaccinations for licensed home services agencies (LHCSAs) and certified home care agencies (CHHAs), among other providers. Workers at those agencies must  have their first shots by Oct. 7.  The FAQ No. 3 states that this mandate does not apply to CDPAP personal assistants.  This expands the vaccination mandate announced on August 16th requiring all staff of nursing homes, other congregate care setings, and hospitals to have first shots by Sept. 27th.   The DOH  FAQ's exempted CDPAP PA's but in NYC it is possible that they are  required to be vaccinated under a Dec. 2021 NYC  Executive Order.  The exact meaning of this order for CDPAP is unclear. 

• August 5, 2021 - NYLAG and other advocates send letter to CMS with concerns about the NYS plan for spending billions of enhanced federal Medicaid dollars available under the American Rescue Plan Act of 2021 (ARPA) that must be used for enhancing access to Home & Community Based Services (HCBS).    See more consumer advocacy here.

• Vaccination Rates and COVID cases and deaths  in Nursing Homes - NYS is no longer be posting COVID deaths by nursing facility, but CMS is posting them here.   Click here for more info. 

• Automatic Medicaid extensions for one year for authorizations ending March 2020 through May 2023 Medicaid Program Modifications COVID-19 Emergency  (January 25, 2023) - see more here

• July 8, 2021 - NYS DEPT OF HEALTH relaxes rules on visitation in Nursing Homes, Adult Homes, and Assisted Living. 

NEWS UPDATES re VACCINES for OLDER NEW YORKERS  -

• NYS Point of Contact in Every County for Homebound Vaccines - click to download here

• NYC Form for HomeBound  Persons to Request Vaccine

• Community Services Society Fact Sheet about Vaccines 

• Feb. 26, 2021 -  New  NYS guidelines for nursing home visitation take effect  Visitations are contingent on a county’s COVID-19 risk level, as well as the nursing home facility being free of COVID-19 cases for 14 days, and have a COVID-19 testing requirement if the county positivity rate is 5% or higher. Visitations are not permitted if the county positivity rate is 10% or higher, however, compassionate care visits are permitted regardless of positivity rate.  Advocates are asking CMS to open up visitation more broadly.  

• New June 12, 2020 - DOH posts Guidance for Nursing Home and Adult Home Administrators that residents are entitled to keep the stimulus payment.   See more here. 

• May 20, 2020 NYS DOH POSTS FACT SHEETS FOR CONSUMERS on DOH website and  NYSofHealth websites
• MAY 28, 2020 - NYC HRA issues an ALERT that it mistakenly notified 32,052 individuals that Medicaid or MSP would be discontinued because of not sending renewals due  in May 2020.  See info here. 

• Medicaid Coverage through Your Local Dept. of Social Services (LDSS) during the Coronavirus Emergency: English - (PDF)  (Discussed further below  - Medicaid Applications and Keeping Medicaid)

• Medicaid Telehealth Services During the Coronavirus Emergency - May 2020 - English -(PDF)

• NYSofHealth:  Fast Facts on NYS of Health Insurance Options During COVID Emergency - English (PDF)

• NYSofHealth:  Q&A on Grace Period & Special Enrollment Period for COVID-19  (PDF)

•  May 18, 2020 -NYLAG Know Your Rights Fact Sheet for MLTC Members about April 23, 2020 DOH Guidance on Voluntary Service Plan Changes in MLTC, FFS Home Care  -

  • What are members' rights  to "pause" home care during the emergency?

  • What are member's rights if plan tells member hours must be reduced because of Covid-19?

7.  Federal Authorities Allowing States Flexibility in Disasters - and New York Application to CMS 

• CMS Disaster Response Toolkit

• CMS Covid-19 Resource Page

• New COVID-19 FAQs for State Medicaid and CHIP Agencies (PDF)  (FAQs contained in this document are available in the COVID-19 FAQs for State Medicaid and CHIP Agencies (PDF)  (Posted 5/5/2020)

• COVID-19 FAQs on implementation of Section 6008 of the Families First Coronavirus Response Act (Section 6008 is the Maintenance of effort provision which prohibits a state from receiving the enhanced Federal match (FMAP) if they make standards, methodologies or procedures more restrictive than those in effect on Jan. 1, 2020) (April 13, 2020)

• NYS Medicaid 1135 Waiver Request to CMS - (March 23, 2020) NYS DOH seeks waiver of certain requirements for Medicaid eligibility and services, under the 1135 waiver applicable to disasters 

  • CMS waiver approval for NYS  March. 26, 2020 Section 1135 Waiver Flexibilities - New York Coronavirus Disease 2019

  • See other states here

• NHELP Fact Sheet on the Federal Covid-19 laws - CARES ACT and Families First Coronavirus Response Act

• NYS Medicaid Redesign Team (MRT) Waiver COVID-19 1115-a Demonstration Request:
  • Letter (Web) - Application (PDF) - 5.11.2020

9. Web resources - compilations of policies - Medicaid, Medicare, etc.

• WNYLC - Links to State Government Policies re Covid-19 for Legal Services Advocates and Clients  - compiles links for numerous state agencies and for New York City concerning housing, benefits, court access, health care, employment, etc.

• United Hospital Fund - Grim Times &  Health Insurance - Maintaining Coverage in NYS in the Pandemic

• Center for Medicare Advocacy Resources on Covid-19

• Justice in Aging Resources for Advocates Working with Older Adults 

• National Health Law program https://healthlaw.org/coronavirus-resources/ 

• NYS Coalition for the Homeless COVID-19 Resources

4.   ARCHIVES -CONSUMER ADVOCACY - by NYLAG and OTHER CONSUMER ORGANIZATIONS 

NURSING HOMES -

• Policy plan sent to  Gov. Cuomo and other New York State leadership to reorient state’s long-term care system  from Nursing Homes to home and community-based care (Jan. 2021)

• New York Post -- NY lawmakers appeal to Biden for COVID-19 death data in nursing homes  (Jan. 21, 2021) - criticizes posted Deaths in Nursing Homes from COVID - data by NH for omitting deaths of nursing home residents who were  transferred to and died in hospitals 

• April 13, 2020 - NYLAG, MFJ, & NYAIL, joined by 14 other organizations, wrote to the NYS Dept. of Health requesting  a directive to Nursing Home & Adult Home operators to ensure that the stimulus payments are protected for residents.  

HOME CARE

•  Letter to CMS August 5, 2021 from NYLAG and other advocates   with concerns about the NYS plan for spending billions of enhanced federal Medicaid dollars available under the American Rescue Plan Act of 2021 (ARPA).  the letter points out how NYS's plan will not be sufficiently used to enhance access to Home & Community Based Services (HCBS),   See Kaiser article about this funding.  NYS Plan posted here.

• May 18, 2020 -NYLAG Know Your Rights Fact Sheet for MLTC Members about April 23, 2020 DOH Guidance on Voluntary Service Plan Changes  

• Letter to DOH 3/13/20 supplemented 3/16/20 - from NYLAG, Legal Aid Society, Empire Justice Center  and other organizations 

• Letter to DOH 4/1/20 requesting protections for MLTC members and other long term care recipients from NYLAG, Empire Justice Center & Bronx Legal Services

For current guidance  related to the UNWINDING OF THE Public Health Emergency see that article here.