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UPDATED 4/28/20: OPWDD issues revised staff guidance for managing COVID-19

On  April 28, OPWDD released “Revised Staff Guidance for the Management of Coronavirus (COVID-19) in Facilities or Programs Operated and/or Certified by the Office for People with Developmental Disabilities.”

The guidance addresses the following topics (click to jump to section):

More information on the NYS Department of Health (DOH) and the Center for Disease Control and
Prevention (CDC) recommendations can be found at:

  • DOH: https://coronavirus.health.ny.gov/home
  • CDC: https://www.cdc.gov/coronavirus/2019-ncov/index.html

A. Visitation and Community Outings

All visitation remains suspended for all OPWDD settings, except when medically necessary (i.e. visitor is essential to the care of the individual or is providing support in imminent end-of-life situations), for family members of individuals in imminent end-of-life situations, or those providing Hospice care. Community outings should be minimized to only those that are medically necessary and as limited in number and duration as possible. Facilities must provide other methods to meet the social and emotional needs of individuals, such as video calls. Facilities shall post signage notifying the public of the suspension of visitation and proactively notify individuals’ family members.

B. Staffing Health Checks for All Settings

Health checks should be implemented for all direct support professionals and other facility staff at the
beginning of each shift, and every twelve hours thereafter. This includes all personnel entering the
facility, regardless of whether they are providing direct care to individuals. This monitoring must
include a COVID-related symptom screen and temperature check. The site should maintain a written
log of this data.

All facility staff with relevant symptoms or with a temperature greater than or equal to 100.4 F should
immediately be sent home and quarantined until test results, or presumptive diagnosis, is obtained.
All staff who have worked in close proximity with the presumed infected staff member, in addition to
all individuals living in the residential setting, should also be quarantined.

C. When there are Suspected or Confirmed Cases of COVID-19

The following steps must be taken when any individual living in a residential facility, certified or
operated by OPWDD, is identified as having a suspected or confirmed case of COVID-19:

  1. Notify the local health department and the OPWDD Incident Management Unit, in accordance
    with “OPWDD Guidelines for Implementation of Quarantine and/or Isolation Measures at StateOwned and Voluntary Providers in Congregate Settings,” issued March 11, 2020.
  2. All individuals in the residential setting should be placed in quarantine and all affected
    individuals should remain in their rooms. Cancel group activities and communal dining. Offer
    other activities for individuals in their rooms to the extent possible, such as video calls.
  3. All staff working at the facility, who have had contact with the individual, should maintain
    quarantine in accordance with the “COVID-19 Protocols for Direct Support Personnel to Return
    to Work”, issued March 28, 2020. Impacted staff members must, remain quarantined in their
    home when not at work.
  4. Do not float staff between units or between individuals, to the extent possible. Cohort
    individuals with suspected or confirmed COVID-19, with dedicated health care and direct care
    providers, to the extent possible. Minimize the number of staff entering individuals’ rooms.
  5. Staff must actively monitor all individuals in affected homes, once per shift. This monitoring
    must include a COVID-related symptom screen and temperature check. The site should
    maintain a written log of this data for later review. If the individual’s symptoms worsen, notify
    their healthcare provider that the individual has suspected or confirmed COVID-19. If the
    individual has a medical emergency and you need to call 911, notify the dispatch personnel
    that the individual has, or is being evaluated for, COVID-19.
  6. Other individuals living in the home should stay in another room, or be separated from the sick
    individual, as much as possible. Other individuals living in the home should use a separate
    bedroom and bathroom, if available.

Make sure that shared spaces in the home have good air flow, such as by an air conditioner or an
opened window, weather permitting.

D. Additional Staffing Practices with Suspected or Confirmed Cases of COVID-19

All settings certified or operated by OPWDD should continue to implement the following staffing
considerations, to the extent possible:

1) Maintain similar daily staff assignments into or out of sites that serve individuals with a
confirmed or suspected diagnosis of COVID-19.

2) Limit staff assignments into or out of sites that serve individuals who had contact with a person
with a confirmed or suspected diagnosis of COVID-19.

3) Assign staff to support asymptomatic individuals with a confirmed or suspected diagnosis of
COVID-19.
a. If the individual with a confirmed exposure begins to show signs and symptoms consistent with COVID-19, those exposed staff should not be reassigned to other sites.

4) Any staff member showing symptoms consistent with COVID-19 should be directed to stay
home, or if the symptoms emerge while at work, sent home immediately.

E. Hand Washing

Handwashing is the most effective strategy for reducing the spread of COVID-19. Proper handwashing saves lives at work and at home.

Germs can spread from other people or surfaces when you:

  • Touch your eyes, nose, and mouth with unwashed hands;
  • Prepare or eat food and drinks with unwashed hands;
  • Touch a contaminated surface or objects; or
  • Blow your nose, cough, or sneeze into your hands and then touch other people’s hands or
    common objects.

When to Wash Hands: Direct support professionals and other facility staff should perform hand
hygiene before and after all individual contact, contact with potentially infectious material, and before
donning (putting on) and after doffing (removing) PPE, including gloves. Hand hygiene after doffing
PPE is particularly important, to get rid of any germs that might have been transferred to bare hands
during the removal process.

You can help yourself and your loved ones stay healthy by washing your hands often, especially
during these key times when you are likely to get and spread germs:

  1. When starting work;
  2. Before handling medications;
  3. Before assisting individuals with personal hygiene (toileting, bathing, shaving, menstrual care,
    wound care, etc.);
  4. After assisting with personal hygiene tasks;
  5. Before, during, and after preparing food;
  6. After using the bathroom;
  7. After coughing, sneezing, or smoking;
  8. Before donning disposable gloves;
  9. After doffing disposable gloves;
  10. After touching garbage;
  11. After touching an animal, animal feed, or animal waste;
  12. After handling pet food or pet treats; and
  13. Before leaving work.

During the COVID-19 public health emergency, you should also clean hands:

1) After you have been in a public place and touched an item or surface that may be frequently
touched by other people, such as door handles, tables, gas pumps, shopping carts, or
electronic cashier registers/screens, etc.

2) Before touching your eyes, nose, or mouth.

How to Wash Hands: Follow Five Steps to Wash Your Hands the Right Way: Washing your
hands is easy, and it’s one of the most effective ways to prevent the spread of germs. Clean hands
can stop germs from spreading from one person to another and throughout an entire community—
from your home and workplace to childcare facilities and hospitals.

Follow these five steps every time.

1. Wet your hands with clean, running water (warm or cold), and apply soap.

2. Lather your hands by rubbing them together with the soap. Lather the backs of your hands,between your fingers, and under your nails.

3. Scrub your hands for at least 20 seconds.

4. Rinse your hands well under clean, running water.

5. Dry your hands using a clean towel or air dry them.

All facilities should ensure that hand hygiene supplies are readily available to all personnel in
every care location.
Every staff member, whether they are involved in direct support tasks or not, is encouraged to watch
the CDC training videos on handwashing, available at https://www.cdc.gov/handwashing/index.html.

F. Use of Hand Sanitizer

Washing hands with soap and water is the best way to get rid of germs. However, if soap and water
are not readily available, you can use an alcohol-based hand sanitizer that contains at least 60%
alcohol. You can tell if the sanitizer contains at least 60% alcohol by looking at the product label.
Staff should perform hand hygiene by using hand sanitizer containing at least 60% alcohol or washing
hands with soap and water for at least 20 seconds. If hands are visibly soiled, use soap and water.
Sanitizers can quickly reduce the number of germs on hands in many situations. However,
• Sanitizers do not get rid of all types of germs.
• Hand sanitizers may not be as effective when hands are visibly dirty or greasy.
• Hand sanitizers might not remove harmful chemicals from hands like pesticides and heavy
metals.
How to use hand sanitizer
• Apply the gel product to the palm of one hand (read the label to learn the correct amount).
• Rub your hands together.
• Rub the gel over all the surfaces of your hands and fingers until your hands are dry. This
should take around 20 seconds
Access to Hand Sanitizer
Hand sanitizer should be readily available throughout the residential setting. At a minimum, there
should be a hand sanitizer station near the front door of the facility, in the kitchen/dining room, and in
the living room/common room, if one exists. Hand sanitizer should be present at the bedroom door of
each individual. If staff are not wearing gloves, staff should use hand sanitizer whenever they enter or
exit an individual’s bedroom. To the extent that individuals in the home are at risk of ingesting the
hand sanitizer, or engaging in other unsafe behaviors with it, the location of hand sanitizer throughout
the residential facility may need to be modified, or staff may need to carry refillable pocket size hand
sanitizers on their person.

G. Environmental Hygiene

The transmission of the COVID-19 virus can be reduced by maintaining a germ-free environment.
The following measures should be taken at all facilities:
• Clean all “high-touch” surfaces, such as counters, tabletops, doorknobs, bathroom fixtures,
toilets, phones, keyboards, tablets, and bedside tables, every shift. Bedroom and bathroom
doorknobs are prime locations for germ transmission.
• Clean any surfaces that may have blood, stool, or body fluids on them. Use a household
cleaning spray according to the label instructions. Labels contain instructions for safe and
effective use of the cleaning product, including precautions you should take when applying the
product, such as wearing gloves and making sure you have good ventilation during use of the
product.
• If the residence requires the use of a shared bathroom, bathroom surfaces must be cleaned
after every use.
• Avoid sharing household items with the individual. Individuals should not share dishes, drinking
glasses, cups, eating utensils, towels, bedding, or other items. After the individual uses these
items, wash them thoroughly.
• Wash laundry thoroughly. Immediately remove and wash clothes or bedding that have blood,
stool, or body fluids on them.
• Staff should wear disposable gloves while handling soiled items and keep soiled items away
from the body. Staff should clean their hands with soap and water or an alcohol-based hand
sanitizer immediately after removing gloves.
• Read and follow directions on labels of laundry or clothing items and detergent. In general, use
a normal laundry detergent according to washing machine instructions and dry thoroughly
using the warmest temperatures recommended on the clothing label.
• Place all used disposable gloves, facemasks, and other contaminated items in a lined
container before disposing of them with other household waste. Staff should clean their hands
with soap and water or an alcohol-based hand sanitizer immediately after handling these
items. Soap and water should be used if hands are visibly dirty.
• Staff should discuss any additional questions with their supervisor or assigned nursing staff or
contact the state or local health department or healthcare provider, as needed. Check
available hours when contacting the local health department.

H. Individual Placement

Maximal effort should be made to separate individuals who are either infected or presumed to be
infected with COVID-19, from those who are thought not to be infected. When hospitalization is not
medically necessary, care in the home must be provided as safely as possible and should consider
the following:
• If possible, move an individual with COVID-19 to a separate cohorted setting, potentially in a
different location or home.
• Whenever possible, place an individual with known or suspected COVID-19 in a single-person
room with the door closed. If possible, the individual should have a dedicated bathroom.
• As a measure to limit staff exposure and conserve PPE, agencies could consider designating
entire programs within the agency, with dedicated staff, to care only for individuals with known
or suspected COVID-19.
• Determine how staffing needs will be met as the number of individuals with known or
suspected COVID-19 increases and staff become ill and are excluded from work.
Please note that it might not be possible to distinguish individuals who have COVID-19 from
individuals with other respiratory viruses. As such, individuals with different respiratory viruses will
likely be housed together.

I. Personal Protective Equipment

PPE is used by healthcare personnel, including direct support staff and clinicians, to protect themselves, individuals, and others, when providing care. PPE helps protect staff from potentially infectious individuals and materials, toxic medications, and other potentially dangerous substances used in healthcare delivery. However, PPE is only effective as one component of a comprehensive program aimed at preventing the transmission of COVID-19. Facilities and programs should consult the Centers for Disease Control and Prevention (CDC) guidance to optimize the supply of PPE and equipment through conventional, contingency, and crisis strategies at
https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html.

When Caring for Individuals who are NOT Infected with or Presumed to be Infected with COVID-19:
Consistent with current practice, all staff are instructed to wear a facemask, at all times, while at work.
This is intended to reduce COVID-19 transmission from potentially infected staff, who may be
asymptomatic. While at work, the facemask will be standard PPE.
When Caring for Individuals who are Infected with or Presumed to be Infected with COVID-19:
Individuals confirmed or suspected of having COVID-19 should wear a facemask when around other
people, unless they are not able to tolerate wearing one (for example, because it causes trouble
breathing). Staff should always wear a mask when in the same room as that individual.
Staff should perform hand hygiene before and after all individual contact, contact with potentially
infectious material, and before donning and doffing PPE, including gloves. Hand hygiene after
removing PPE is particularly important to get rid of any germs that might have been transferred to
bare hands during the removal process.
The PPE protocol recommended when caring for an individual with known or suspected COVID-19
includes:
• Facemasks
o Put on facemask upon entry into the group home, and wear at all times while in the
work setting.
o As needed, implement extended use of facemasks. Wear the same facemask for
multiple individuals with confirmed COVID-19 without removing between individuals.
Change only when soiled, wet, or damaged. Do not touch the facemask.
o If necessary, use expired facemasks.
o Prioritize facemasks for staff rather than as source control for individuals. Have
individuals use tissues or similar barriers to cover their mouth and nose. Assist
individuals with this as needed.
o If necessary, implement limited re-use of facemasks. Do not touch outer surface of
facemask. After removal, fold so that outer surface in inward and store in breathable
container, such as a paper bag, between uses. This facemask should be assigned to a
single staff member. Always perform hand hygiene immediately after touching the
facemask.
o When splashes or sprays are anticipated, use a face shield covering the entire front and
sides of the face. Use goggles if face shields are not available.
o The use of cloth masks, or other homemade masks (e.g., bandanas, scarves), for
clinical and direct support staff providing direct care to individuals, is not recommended.
o For further information, consult the CDC guidance entitled “Strategies for Optimizing the
Supply of Facemasks”, available at https://www.cdc.gov/coronavirus/2019-
ncov/hcp/ppe-strategy/face-masks.html.
• N95 Respirators
o All staff wearing N95 respirators should undergo medical clearance and fit testing.
o N95 Respirators offer a higher level of protection and should be worn, if available, for
any aerosol-generating procedures or similar procedures where there is the potential for
uncontrolled respiratory secretions.
o As needed, implement extended use of N95 respirators. Wear the same respirator for
multiple individuals without removing between individuals. Change only when soiled,
wet, damaged, or difficult to breathe through. Do not touch the respirator.
o If necessary, use expired N95 respirators; refer to CDC guidelines entitled “Release of
Stockpiled N95 Filtering Facepiece Respirators Beyond the Manufacturer-Designated
Shelf Life: Considerations for the COVID-19 Response”, available at
https://www.cdc.gov/coronavirus/2019-ncov/hcp/release-stockpiled-N95.html.
o If necessary, implement limited re-use for individuals with COVID-19, if possible with
decontamination between uses; refer to FDA guidance entitled “Personal Protective
Equipment Emergency Use Authorization”, available at https://www.fda.gov/medicaldevices/emergency-situations-medical-devices/emergency-useauthorizations#covid19ppe. In addition to the approved method, refer to CDC guidance
entitled “Decontamination and Reuse of Filtering Facepiece Respirators using
Contingency and Crisis Capacity Strategies”, available at
https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/decontamination-reuserespirators.html. If not decontaminated, an important risk is that the virus on the outside
of the respirator might be transferred to the wearer’s hands, leading to transmission to
the health care personnel or other individuals. It is critical to avoid touching the
respirator while worn and during or after doffing and to perform rigorous hand hygiene.
Assign to a single staff person and store in a breathable container, such as a paper bag,
between uses. For further information consult the CDC guidance entitled
“Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering
Facepiece Respirators in Healthcare Settings”, available at
https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html.
• Eye Protection
o Put on eye protection (i.e., goggles or a disposable face shield that covers the front and
sides of the face) upon entry to an individual’s room or care area. Personal eyeglasses
and contact lenses are NOT considered adequate eye protection.
o Remove eye protection before leaving the individual’s room or care area.
o Reusable eye protection (e.g., goggles) must be cleaned and disinfected according to
manufacturer’s reprocessing instructions, prior to re-use. Disposable eye protection
should be discarded after use.
• Gloves
o Put on clean, non-sterile gloves upon entry into an individual’s room or care area.
o Change gloves if they become torn or heavily contaminated.
o Remove and discard gloves when leaving the individual’s room or care area, and
immediately perform hand hygiene.
• Gowns
o Put on a clean isolation gown upon entry into an individual’s room or care area. Change
the gown if it becomes soiled. Remove and discard the gown in a dedicated container
for waste or linen when leaving the individual’s room or care area. Disposable gowns
should be discarded after use. Cloth gowns should be laundered after each use.
o If there are shortages of gowns, they should be prioritized for:
▪ Aerosol-generating procedures;
▪ Care activities where splashes and sprays are anticipated;
▪ High-contact individual care activities that provide opportunities for transfer of
germs to the hands and clothing of staff. Examples include:
▪ Dressing;
▪ Bathing/showering;
▪ Transferring;
▪ Providing hygiene;
▪ Changing linens;
▪ Changing briefs or assisting with toileting;
▪ Device care or use; and
▪ Wound care.

J. What to Do When PPE Supply is Low

Critical PPE needs should be communicated to the respective local Office of Emergency
Management, with the appropriate information provided at the time of request. Requests MUST
include:
• Type and quantity of PPE by size;
• Point of contact at the requesting facility or system;
• Delivery location;
• Date request is needed to be filled by; AND
• Record of pending orders.
Contingency strategies can help stretch PPE supplies when shortages are anticipated at a facility.
Crisis strategies can be considered during severe PPE shortages and should be used with the
contingency options to help stretch available supplies for the most critical needs. As PPE availability
returns to normal, healthcare facilities should promptly resume standard practices.
Facilities should review the following guidance on Strategies for PPE shortages:
OPWDD guidance issued April 6, 2020, available at
https://opwdd.ny.gov/system/files/documents/2020/04/4.6.2020-opwdd-memo-regarding-covid19-
ppeshortage_0.pdf.
CDC guidance regarding specific strategies for the conservation of facemasks, eye protection,
isolation gowns and N95 respirators is available at https://www.cdc.gov/coronavirus/2019-
ncov/hcp/ppe-strategy/index.html.
Staff are encouraged to download and use the following PPE posters from the CDC:
https://www.cdc.gov/coronavirus/2019-ncov/communication/factsheets.html#healthcare.
Facilities should also refer to the following documents for more information:
https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-prevent-spread.html.

K. ADDITIONAL RESOURCES
More information on the NYS Department of Health (DOH) and the Center for Disease Control and
Prevention (CDC) recommendations can be found at:
• DOH: https://coronavirus.health.ny.gov/home
• CDC: https://www.cdc.gov/coronavirus/2019-ncov/index.html

Susan Constantino, Ed Matthews honored by National Historic Recognition Project

CP State President and CEO Susan Constantino and ADAPT Community Network CEO Ed Matthews have received the honor of being recognized as Essential Change Agents by the National Historic Recognition Project: 2000-2020.

The National Historic Recognition Project: 2000-2020 continues the legacy of the 20th Century Historic Recognition Project in recognizing the key people that transformed the field of I/DD within the United States over the past 20 years, contributing to the historical record of the field.  

Recipients of the Essential Change Agents honor are recognized for their significant regional contributions to or impact in the field of I/DD in the U.S. between 2000 and 2020. These individuals were often engaged in service, public policy, and advocacy initiatives that were significant in their region, contributed to the national dialogue, and enhanced the quality of life of people with I/DD.

Constantino is recognized as an Essential Change Agent for her work in shaping service delivery for people with I/DD in New York. She currently serves on numerous governmental task forces, councils, and statewide committees representing the interests of CP of NYS, its affiliates, and the I/DD community.

Matthews is recognized as an Essential Change Agent for his work following the consent decree for the Willowbrook State School securing community homes for residents with very high support needs, and his influential testimony a decade later, when state was sued over its compliance with the decree.

A commemorative booklet, the 2020 National Honors Recognizing Significant Contributions in the Field of Intellectual and Developmental Disabilities in the U.S. Between 2000 and 2020, was created to celebrate these remarkable individuals in lieu of a celebratory gathering at this time. The commemorative booklet also contains the following essays that highlight key trends in the I/DD field:

  • Changing Service, Changing Workforce
  • Workforce: Recruiting and Retaining Talent in the Field
  • Advocacy in Action: Power in Working Together
  • The Importance of Defining Quality of Life Through Personal Outcomes
  • The Growth & Evolution of Community System of Supports

New York authorizes Choice Model for implementing Electronic Visit Verification (EVV)

CP State is very pleased that the New York State announced on April 14 that they have elected the Choice Model for implementing Electronic Visit Verification (EVV).  This will allow individual providers to choose and select the EVV vendor that best meet their Affiliate/agency’s needs.

From the DOH:

Following a series of engagements with a wide variety of stakeholders and carefully considering input from Medicaid beneficiaries, family caregivers, providers, advocates, partner agencies and Electronic Visit Verification (EVV) solution providers, including information gathered from a Request for Information (RFI), New York has elected to proceed with the Choice Model for implementing EVV.

New York selected the Choice Model for the following reasons: (1) it best ensures that consumers will have EVV options from which to consider when selecting a provider; (2) it gives providers of service the flexibility to select an option that best meets their business needs and the needs of the consumers they serve; and (3) it recognizes that many providers serving New York’s Medicaid consumers have already implemented EVV systems that meet the requirements of the Cures Act, preserving the investment that has already been made, avoiding duplicative costs, and eliminating disruption to consumers and caregivers. New York has notified CMS it has selected the Choice Model – please see letter at https://www.health.ny.gov/health_care/medicaid/redesign/evv/repository/index.htm

Summarized feedback received through the web-based and in-person Listening Sessions was collected in an EVV Stakeholder Convening Report which is available at https://www.health.ny.gov/health_care/medicaid/redesign/evv/repository/docs/2019-stakeholder_conven_rpt.pdf, and a summary of the responses to the RFI conducted in 2019 is posted on the RFI website at https://www.health.ny.gov/funding/rfi/evv/index.htm

To immediately begin to help providers select and implement an EVV solution under the New York State EVV Choice Model, the Department of Health (DOH) has published EVV Program Requirements, including Considerations for Selecting an EVV system in its EVV Resource Library at https://www.health.ny.gov/health_care/medicaid/redesign/evv/repository/index.htm

DOH will also be setting up a Technical Assistance Forum to allow for continued collaboration and communication with EVV stakeholders.  The first session will be held on April 20, 2020.  The schedule for subsequent sessions will be available on the NY Medicaid Electronic Visit Verification Program Event Calendar at https://www.health.ny.gov/health_care/medicaid/redesign/evv/calendar.htm

If you have general EVV inquiries or if you would like to submit written comments, please email EVVHelp@health.ny.gov

Thank you.

Telehealth webinar on April 17

On Friday, April 17, there will be a webinar to talk about the tools and methods clinics are using for telehealth.  Many of you may be aware of them but we thought this could be a useful way to connect and learn how all of you are doing during this time frame since we last spoke.  If you have any questions, please email Deb Williams at DWilliams@cpstate.org.

There is no need to register ahead of time.  We will record the meeting so if you can’t join, the recording will be available after the close of the webex call.

The two tools to be discussed are

  1. doxie.me
  2. iPad and Zoom platforms for “telehealth” audio/visual feed

Once we get through the presentations we can open the discussion for other issues – so please feel free to send me any specific questions you may want raised and we will work to get as many answers.  We have not heard yet about the clinic funding from OPWDD but advocacy continues.

Please join my meeting on April 17 at 1 p.m. from your computer, tablet or smartphone.

https://global.gotomeeting.com/join/311357005

You can also dial in using your phone.
United States: +1 (646) 749-3131

Access Code: 311-357-005

Join from a video-conferencing room or system.
Dial in or type: 67.217.95.2 or inroomlink.goto.com
Meeting ID: 311 357 005
Or dial directly: 311357005@67.217.95.2 or 67.217.95.2##311357005

New to GoToMeeting? Get the app now and be ready when your first meeting starts:
https://global.gotomeeting.com/install/311357005

COVID-19 Updated Guidance for Hospital Operators Regarding Visitation

The following guidance is issued by the New York State Department of Health on April 10, 2020, and replaces all previously issued guidance regarding hospital visitation:

For patients for whom a support person has been determined to be essential to the care of the patient (medically necessary) including patients with intellectual and/or developmental disabilities (I/DD), and patients with cognitive impairments including dementia, the Department considers one support person at a time as essential to patient care in the emergency room or during hospitalization. For these hospitalized patients, especially with prolonged hospitalizations, the patient or family/caregiver may designate two support people; but only one support person may be present at a time.

This support person can be the patient’s family, caregiver, or another person they chose. In these settings, the person will be the only support person allowed to be present during the patient’s care. This restriction must be explained to the patient and support person in plain terms, upon arrival or, ideally, prior to arriving at the hospital. Hospital staff should ensure that patients fully understand this restriction, allowing them to decide who they wish to identify as their support person. Individuals age 70 years or older, are not encouraged to be support persons at this time due to increased risk of COVID-19 infection.

Effective immediately, hospitals must suspend all visitation except for patient support persons, or family members and/or legal representatives of patients in imminent end-of-life situations.

 Hospitals are required to permit a patient support person at the patient bedside for:

  • Patients in labor and delivery;
  • Pediatric patients;
  • Patients for whom a support person has been determined to be essential to the care of the patient (medically necessary) including patients with intellectual and/or developmental disabilities and patients with cognitive impairments  including dementia.

During this unprecedented time, a support person for the patients described above may  be critical to avoid negative health outcomes unrelated to the COVID-19 public health emergency. Given the risk of COVID-19 in healthcare settings, healthcare providers should thoroughly discuss the potential risks and benefits of a support person’s presence at the bedside with both the patient (if 18 years of age or older) and the support person. For those patients and support persons who through informed decision making determine a support person at the bedside is essential for the patient’s care, hospitals  should develop protocols for ensuring a  support person at bedside minimizes risk of potential COVID-19  transmission,  including  when  the patient is confirmed or suspected to have COVID-19.

Read the details in the official memo.

Group home residents contracting coronavirus at five times the city rate

The following appeared in Crain’s Health Pulse on April 9, 2020.


The residents of group homes for people with intellectual and developmental disabilities in New York City are getting sick with Covid-19 at about five times the rate of the overall city population, according to data shared with Crain’s from a coalition of agencies that operate the residences.

The New York Integrated Network and AHRC New York City said they had confirmed 117 cases among their 2,800 residents as of April 5. Nearly two-thirds of those individuals needed to be hospitalized, and 17 people had died. The organizations reporting data operate about one-fifth of the city’s residential beds regulated by the state Office for People with Developmental Disabilities.

“These are individuals who work together, socialize together. And staff come in every day,” said Arthur Webb, executive director of New York Integrated Network. “It’s a 24/7 model. It’s been a real struggle to do containment, quarantine or isolation in the homes. These were not set up as treatment centers, unlike nursing homes.”

The coalition is hoping to receive state support to purchase more protective equipment for its workers, pay staff for overtime and get more clinical support in the homes.

The agencies also reported 92 staff members had been diagnosed with Covid-19, and three had died as of April 5.

The homes provide residential care to individuals with a wide range of conditions, including autism and cerebral palsy. To comply with state guidelines, the facilities have canceled day programming and work opportunities.

Webb attributed the higher hospitalization rate among clients to the degree to which residents have underlying conditions, such as chronic obstructive pulmonary disease and congestive heart failure.

The homes have used an existing telemedicine relationship with StationMD to keep clients out of emergency departments.

Cerebral Palsy Associations of New York State, part of the coalition, received a $13 million grant to expand telemedicine at the residences last year.

“The telemedicine has been just a fantastic added value, and fortunately we were ahead of the curve in using it,” Webb said. —J.L.

CP of NYS Day & Employment Committee Updates

TO: CP of NYS Day & Employment Committee

 Below are updates for OPWDD & ACCES-VR

 HCBS APPENDIX K WAIVER

The HCBS Appendix K waiver has been approved and it is very complex and will need detailed review/presentations.  

  • SEMP  is NOT INCLUDED for retainer days.  We are extremely disappointed.  The provider associations and CCOs are discussing creative/alternative ways to provide these services
  • There is a webinar tomorrow, April 9 at 2:00PM for  day hab, pre-voc and com hab providers.   If you haven’t already registered for the webinar use this link.
    1. There may be another webinar on Monday focusing on day services.  

ACCES-VR-

CP of NYS joined a call with IAC, DDAWNY and the NY Alliance to discuss ACCES-VR to preserve services. Thanks to Toni Sullivan for representing CP of NYS.

The goal is to work with ACCES-VR to look at the big picture including:

·       We must take swift action and think outside of the box to preserve VR services for people who currently depend on them and for those students who will be graduating and need support in the future

·       The milestone billing concept will be inadequate to support the infrastructure and we suggest quarterly payments instead, with different deliverables

·       Deliverables will be designed to support people as they need it now and to prepare them for future job success when the pandemic and subsequent economic devastation is over

·       Guiding principles that would keep things moving forward, although quite differently, include

o   Paperless everything

o   Nearly every service to be delivered remotely (we thank ACCES-VR for being forward thinking in looking at remote service delivery and think we can do even more)

o   Implementation of electronic signatures ASAP

o   Allowing vendors to provide entry services so cases can continue to be opened

 If you have time, Jim Scutt has asked to gather some deliverables, i.e. what are you currently going in ACCES Extended and Intensive that is either currently considered a deliverable or for which you are not getting   directly reimbursed?  Please send these to Toni Sullivan Toni.Sullivan@aspirewny.org by Friday.

Let me know if you have any questions.

Stay healthy!

Barbara

Barbara Crosier

Vice President, Government Relations

Cerebral Palsy Associations of NYS

3 Cedar Street Extension, Suite 2

Cohoes, NY 12047

Phone:  (518) 436-0178, Ext. 104

Cell:  (518) 424-3198

Fax:  (518) 436-8619

E-mail:  bcrosier@cpstate.org

Please note that our emails have changed. 

Please update your contact for me.  Thank you!

How does the enacted State Budget affect our field?

The State Assembly completed passage of final state budget bills for State Fiscal Year 2021 just before 4 a.m. on April 3 and the Senate completed its work the afternoon of April 2.

The bills were signed by Governor Cuomo on April 3, 2020 and put in place “a nearly on-time” budget deal which came together in the midst of an “all hands on deck” state response to the COVID-19 pandemic and a growing budget deficit due to the collateral impact of the pandemic on New York State’s economy. With a compressed period of time to debate and agree on the FY2021 State Budget, the Legislature employed remote debating and voting procedures to limit physical proximity. There was little time to discuss the projected $10 to $16 billion revenue shortfall due to the Coronavirus or the other issues that both the Legislature and the Governor wanted to include in the final budget, and as a result, was the most closed budget process that anyone can remember.

Even prior to the Coronavirus’ effect on State tax receipts, there was a reported a $6 billion deficit entering into this fiscal year, $2.5 billion attributed by the Governor to Medicaid overspending. The final $177 billion budget, attempts to put in place a balanced spending plan through a series of borrowing and cost shifting maneuvers along with federal assistance payments via the CARES Act, enhanced Medicaid (FMAP) reimbursement, as well as enacting Medicaid reforms pursuant to the Medicaid Redesign Team 2 (MRT II) recommendations (in some cases with a delayed effective date to draw down the FMAP funds) and granting the Governor the authority to make adjustments up or down, depending on changes in revenue. Adjustments can be made in early May, early July, and after December 31, 2020 with limited legislative oversight. This is an unprecedented abdication of authority by the State Legislature.

We have included many provisions in the final budget to illustrate that the budget documents include both the budget and some session priorities. Needless to say, we did not get the 3for5 increase, but the final budget is an impressive document given our current state of affairs.

Here are the sections of the final 2020-2021 budget relevant to our programs and services:

OPWDD

  • #bFair2DirectCare Increases and Minimum Wage Funding: The budget contains $127 million (state and federal) in funding to cover the continuation of the 1/1/20 2% increase for 100 & 200 CFR Code positions and another 2% for the 4/1/20 increase for 100, 200 & 300 CFR Codes. $44 million (state and federal) is included to continue the minimum wage
  • Development: The budget includes additional State resources that can leverage up to $120 million” all shares fully annualized (state and federal) in additional funding available for “Program ”
  • Housing: $15 million in capital funds to develop affordable, independent living
  • Extends ABA Exemption: Extends from July 1, 2020 to July 1, 2025, the exemption allowing OPWDD, OMH and OCFS to employ qualified professionals for services, which may otherwise fall within the scope of practice for Applied Behavior
  • “Improve Accountability and Oversight”: Provides OPWDD with the authority to issue operating certificates to providers of certain programs and Medicaid State Plan “The purpose of this legislation is to create more direct authority for oversight and ensure quality of services by providers…and to eliminate duplication of efforts between multiple State agencies.”
    • Health Homes for DD population – Transfers oversight of Medicaid funding for community-based services, including those provided  by  Health  Homes  to  Such providers will be subject to OPWDD oversight and will no longer be subject to the separate NYSDOH Criminal History Record Check.
    • Autism Awareness and Research Fund – Includes the Executive Budget proposal to transfer responsibility for this fund from NYSDOH to
    • CCO’s – OPWDD will provide $178 million and will assume oversight of CCO’s from DOH.
  • Individualized Residential Alternatives (IRAs): Extends the notification requirements upon the closure or transfer of state operated IRAs until March 31,
  • Children and Youth with Special Health Care Needs (CYSHCN) Program: Makes amends to the program within a county with a population of less than 150,000, allowing the county health director to serve as director of the
  • Telehealth: Expands telehealth services by adding OPWDD  services  as  allowable providers. Pursuant to federal participation, NYSDOH is authorized to include additional modalities including audio-only and on-line portals, to expand access to care for behavioral health, oral health and other
  • “Promote More Efficient Use of State Resources”: “OPWDD will leverage federal Medicaid funding, utilize other supplemental aid where available and take other actions to more cost- effectively support the provision of person-centered programs.” Recoupments of surpluses in supplemental room and board and other state fund payments should yield $10 million, reduced State Operations overtime payments should produce $7

Note: While the OPWDD 2% across the board cut effective 7/1/20 was not included in any budget proposals or documents, it is included in the state financial plan. Talks are ongoing in an effort to prevent it.

SED

  • School Aid: State support for schools will remain nearly flat for a total of $27.9 billion in school aid. This is a reduction of over $800 million from the Governor’s initial budget proposal. School districts will receive the same Foundation Aid amount as in 2019-20.
  • 4410 & 853 Schools: There was no additional funding for 4410 or 853 schools but there also weren’t any cuts. We anticipate zero growth for our 853 and 4410
  • School Mental Health Funding: Includes $10 million in funding for grants to school districts to improve student access to mental health resources and The program will be administered by OMH, in consultation with SED.

DOH

  • Early Intervention: There was no mention of either the Governor’s January proposals or any provision for a covered lives pool in the final budget.
  • Health Care Facility Transformation Program: Includes $525 million as a re-appropriation for this
  • Healthcare and Professional Liability for COVID-19: The final budget limits the liability for health care professionals, health care facilities and organizations that provide treatment and services related to the COVID-19 state of emergency. This includes immunity from any liability, civil or criminal, for any harm or damages alleged to have been sustained as a result of an act or omission in the course of arranging for or providing health care services. Retains provisions regarding liability for harm caused by willful or intentional criminal misconduct, gross negligence, reckless misconduct, or intentional infliction of “Health Care Facility” includes a hospital, nursing home or other facility licensed or authorized to provide health care services for any individual under Article 28, Article 16, Article 31 of the mental hygiene law or under a COVID-19 emergency rule. “Health care professionals” include agents, volunteers, contractors, employees or otherwise, who are a licensed or certified physician, physician assistant, specialist assistant, chiropractor, pharmacist, pharmacy technician, nurse, midwife, psychologist, social worker, mental health practitioner, respiratory therapist, clinical lab technician, nursing attendant, certified nurse aide, nursing student, EMT, home care worker, health care facility administrator, supervisor, executive, board member, trustee or other person responsible for directing or managing a facility, or anyone else providing health care within the scope of authority permitted by a COVID-19 emergency rule.
  • Public Health Emergency Charitable Trust Fund: Creates this fund in the joint custody of the Commissioner of Taxation and Finance and the State Comptroller to consist of monetary grants, gifts or bequests received by the state. Such monies will be used for goods and services necessary to respond to a public health disaster emergency or aid in responding to such a disaster. Monies shall be kept separate from and shall not be commingled with any other monies in the custody of the Department of Tax & Finance or the

MRT II

The final enacted budget includes most, but not all, of the MRT II recommendations.

The following MRT II recommendations of interest ARE NOT INCLUDED in the enacted budget:

  • Medicaid OTC/Co-Pay Changes: Rejects Executive Budget proposals to limit OTC coverage and increase Medicaid
  • Elimination of Prescriber Prevails: Rejects the MRT II proposal and retains “prescriber prevails” for Fee-for-Service (FFS) and existing classes under Medicaid Managed
  • Elimination of Spousal/Parental Refusal: Rejects the MRT II and Executive recommendation to eliminate the ability of spouses living together in the community and parents living with their child, to refuse to make their income and resources available during the determination of an applicant’s eligibility for

The following MRT II recommendations of interest ARE INCLUDED in the enacted budget:

  • Removal of Medicaid Visit Caps – OT, PT, Speech Therapy: Effective October 1, 2020, Medicaid visit caps for speech therapy, physical therapy, including related rehabilitative services, and occupational therapy are repealed for all Medicaid recipients and not just those with I/DD and
  • Shift Pharmacy Benefit to Fee-for-Service (FFS): Includes language stating that it is in the best interest of the Medicaid program/patients to move the pharmacy benefit from Medicaid Managed Care back to Fee-for-Service. NYSDOH is authorized to establish uniform standards, payment policies and reimbursement methodologies based on actual acquisition costs and professional dispensing fees. This shift includes elimination of the savings that the 340B program in Medicaid managed care provides for Federally Qualified Health Centers (FQHCs) and other safety net providers. The 340B program, authorized under section 340B of the Federal Public Health Service Act, creates a drug discount program that allows safety-net health care providers to buy pharmaceutical drugs at a reduced price. Health centers use the significant 340B savings to expand services for the uninsured and underinsured and help cover essential services that are not billable to Medicaid. For example, health centers use 340B savings to: finance their sliding fee scales; subsidize low cost or free medications for low-income patients; subsidize high deductibles for the underinsured; upgrade information technology infrastructure; train staff, etc. Many health centers have pharmacies located on site, offering unprecedented access and one stop shopping for their patients. Without the 340B discount, in-house pharmacies would be at risk of closing. Fortunately, the final budget language requires NYSDOH to examine all methods of determining actual acquisition costs beginning in the 4/1/21 fiscal year and shall adjust the reimbursement for the 340 B drugs no sooner than 4/1/23.
  • Establishes an Independent Assessor for Personal Care and CDPAP: Includes a recommendation by the MRT II to require NYSDOH to establish or procure an independent assessor to take over from LDSSs, MCOs, and MLTCs the UAS Community Health Assessments and reassessments required for determining needs for personal care services. The use of the independent assessor must be implemented by October 1,
  • Eliminates Notice of the Consumer Directed Program: Adopts a recommendation by the MRT II to eliminate requirement that managed care plans and LDSS educate consumers about the availability of the CDPAP program annually. The final budget expands this provision to limit the ability of individuals to apply for participation in CDPAP only once
  • Independent Review for CDPAP and Personal Care Cases: Includes a recommendation by the MRT II to establish an independent panel of clinicians to determine eligibility for CDPAP cases.
  • Global Spending  Cap/Adjustment  Authority:  Extends  the  global  cap   through   SFY 2022. Requires the NYSDOH Commissioner to assess monthly, known and projected Department of Health state-funded Medicaid expenditures and calls for implementation of a Medicaid savings allocation adjustment if program spending exceeds the projected Department of Health The adjustment would be applied equally across the board unless the Health Commissioner and State Budget Director determine “a specific category or categories of service are responsible for the growth,” in which case the adjustment will be applied to just those areas.
  • Across-the-Board (ATB) Medicaid Cuts: The state will increase the across-the-board Medicaid provider cut from 1%, enacted 1/1/20, to 1.5% effective 4/1/20, for an annual savings of $373 Exempt from reductions are payments pursuant to Article 32, 31 and Article 16 of the mental hygiene law, payments for Federally Qualified Health Centers, Early Intervention, Family Planning services, Hospice services, School Supportive Health Services Program, Preschool Supportive Health Services Program, payments provided by other state agencies including OCFS, SED and DOCCS, among others. Like the original 1% cut, OPWDD services are not affected.
  • Health Homes: Includes $279.35 million, a decrease of $48.7 million from last year’s
  • Patient-Centered Medical Homes (PCMH): Includes reforms to PCMH to achieve $6 million in savings this fiscal
  • Telehealth: Expands telehealth services by adding care managers in Health Homes, PCMHs, hospice, OPWDD services and foster care as allowable providers. Pursuant to federal participation, NYSDOH is authorized to include additional modalities including audio-only and on-line portals to expand access to care for behavioral health, oral health, maternity care and other populations.
  • Private Duty Nursing: Authorizes NYSDOH to increase fees for private duty nursing under Medicaid for medically fragile NYSDOH will also develop a directory of qualified fee for service private duty nursing providers. Includes $12.8 million for this program.
  • VBP Demonstration Program: Authorizes NYSDOH, in consultation with DFS to implement one or more 5-year demonstration programs designed to implement health outcomes and reduce costs, using value based payments based on an actuarially sound pre-paid, capitated rate. The program may offer funding designed to improve health outcomes, develop infrastructure and systems and connect individuals with community-based organizations focused on social determinants of
  • Regional Population Health Improvement: Authorizes NYSDOH, in consultation with DFS, to implement one or more 5-year demonstration programs, beginning January 2022, to accelerate regional population health initiatives using value based payment models and aligning care incentives under an integrated health
  • Pilot Programs Promoting Social Determinants of Health Interventions: Establishes the following pilot programs which will take effect September 1, 2020 or within 90 days of the conclusion of the State of Emergency relating to COVID-19.
  • Medically Tailored Meals for individuals with cancer, diabetes, heart failure, and/or HIV/AIDS and who have had one or more hospitalizations within a
  • Respite programs to provide care to homeless patients who are too sick to be on the streets or a traditional shelter, but not sick enough to warrant
  • Street medicine program to allow diagnostic and treatment centers licensed under Article 28 of the public health law to bill for certain services provided at offsite locations in order to serve the chronically homeless

OMH

  • #BFair2DirectCare: The Budget includes the 2% increase effective 1/1/2020 for 100 & 200 Codes and 2% increase effective 4/1/2020 for 100, 200 & 300 Codes but delays the
  • Housing: $20 million for increased funding for community housing rates which doubles prior year
  • School Mental Health Funding: Includes $10 million in funding for grants to school districts to improve student access to mental health resources and services. The program will be administered by OMH, in consultation with
  • Behavioral Health Parity: Establishes the Behavioral Health Parity Compliance Fund for the collection of penalties imposed on insurance
  • Veterans: Adds $2,017,500 for the Joseph Dwyer Veteran Peer to Peer Services program.
  • Children’s Behavioral Health Services: Includes investment of $1.7 million for such services under
  • Children’s Residential Treatment: Modifies the Executive proposal to streamline pre- admission for children and youth with mental illness entering residential treatment facilities by:
  • Expanding the newly created Advisory Board to include family representatives and medical personnel,
  • Requiring the Advisory Board to issue an annual report to the Governor and Legislature;
  • Limiting medical necessity checks to be done no sooner than 14 days after admission; and
  • Requiring OMH to consult with the residential treatment facility regarding placement before doing so.
  • Services for Sex Offenders: Establishes a separate appointing authority within OMH (Secure Treatment and Rehabilitation Center) for the care and treatment of sex offenders requiring confinement.
  • Comprehensive Psychiatric Emergency Programs (CPEPs): Extends the CPEPs program for four years and:
  • Requires that triage and referral services be provided by a psychiatric nurse practitioner or physician as soon as a person is received into the comprehensive psychiatric emergency program;
  • Requires that if a patient is not discharged within six hours, they must be examined by a physician; and
  • Permits hospitals that operate CPEPs, upon approval of the Commissioner of OMH, to operate satellite facilities. A satellite facility is defined as a medical facility providing psychiatric emergency services that is managed and operated by a hospital who holds a valid operating certificate for a CPEP and is located away from the central campus of the general
  • Extends ABA Exemption: Extends from July 1, 2020 to July 1, 2025, the exemption allowing OPWDD, OMH and OCFS to employ qualified professionals for services, which may otherwise fall within the scope of practice for Applied Behavior
  • MLTC Coverage of Behavioral Health: Authorizes Managed Long-Term Care (MLTC) plans to cover behavioral health services for

MISCELLANEOUS ALL STATE DEPARTMENTS AND AGENCIES

The final budget includes two catchall Emergency Appropriations. A $25 billion Special Federal Emergency Appropriation is established to account for revenues received from the federal government in order to meet unanticipated or emergency expenditures, including public health emergencies. Funds appropriated are subject to all applicable reporting and accountability requirements contained in the act or acts making such federal revenue available. In addition, the final budget includes a $4 billion Special Public Health Emergency Appropriation. This appropriation is for services and expenses related to the outbreak of coronavirus disease 2019 (COVID-19). A portion of these funds may be made available as state aid to municipalities, school districts, public authorities, and eligible nonprofit organizations for services and expenses related to the outbreak of coronavirus disease 2019 (COVID-19).

PAID SICK LEAVE

In addition to the recently passed sick leave legislation, which is in effect during the declared emergency for the COVID-19 pandemic, the Budget included permanent paid sick leave requirements that are effective 1/1/2021. The new, post COVID-19 paid sick leave law requires employers to provide the following effective 1/1/2021:

  • For an employer with four or fewer employees, and a net income of less than $1 million: 40 hours unpaid sick leave
  • For an employer with four or fewer employees with a net income of $1 million or more: 40 hours paid sick leave
  • For an employer with 5-99 employees: 40 hours of paid sick leave
  • For an employer with 100 or more employees: 56 hours of paid sick leave

Sick leave is to be paid at the employee’s rate of pay or current minimum wage, whichever is greater.

Accrual:

  • Employees accrue sick leave at a rate of at least one hour for every 30 hours worked
  • Unused sick leave shall be carried over to following calendar year, but employers with fewer than 100 employees may limit use to 40 hours per year, and employers with 100 or more employees may limit use to 56 hours per year

Reasons for Use of Sick Leave:

Employees may make oral or written leave requests for:

  • Mental or physical illness, injury or condition diagnosed or requiring medical care during the time of said
  • When the employee or their family is victim to domestic violence, a sexual offense, stalking or human trafficking, and to complete the following tasks related to such incidents:
  • To obtain services from a domestic violence shelter, rape crisis center or other services program
  • To participate in safety planning, relocation, or other actions to increase safety for the employee or their family member
  • To meet with an attorney or social services provider regarding any criminal or civil proceeding
  • To file a complaint or domestic incident with law enforcement
  • To meet with the District Attorney
  • Enroll children in a new school
  • Other necessary actions

Definition of a Family Member:

  • Employees child, spouse, domestic partner, parent, sibling, grandchild or grandparent
  • A child or parent of the employee’s spouse or domestic partner
  • “Parent” meaning biological, foster, step, adoptive or legal guardian, or anyone who stood in loco parentis (having parental rights) when the child was a minor

PAID TIME OFF TO VOTE

Last year’s budget included new voting provisions including early voting and the requirement that all registered voters be given three hours paid time off, either at the beginning or end of their shift, to vote. The employee had to request this time off not more than ten and not less than two days prior to election day.

This year’s budget has amended the provision so that if an employee has four consecutive hours either between when the polls open and the beginning of their shift or between the end of their shift and the closing of the polls, they “shall be deemed to have sufficient time outside his or her working hours within which to vote.” If the employee has less than four consecutive hours, they may take up to two hours paid time off at the beginning or end of the shift to vote.

Additionally, the employee has to request this time off not more than ten and not less than two days prior to election day. Employers must conspicuously post this information ten days prior to election day and keep it posted until the polls are closed on election day.

PREVAILING WAGE

The final budget includes the Governor’s proposal to expand prevailing wage to certain private projects paid in whole or in part out of public funds ($5 million or 30% threshold) – with exemptions including the following:

  • Affordable housing construction: where at least 25% of the residential units are affordable and shall be retained subject to an anticipated regulatory agreement with a governmental or not-for-profit entity, provided that the period of affordability is at least 15 years from the date of
  • Funds provided for NYC charter school
  • New York City School Construction Authority projects on spaces used as a school under 60,000 square feet (the original carve-out was for spaces under 20,000 square feet).

This new prevailing wage law is effective on January 1, 2022, with a Board to be established effective April 1, 2021. However, “if the Board finds a significant negative economic impact of implementing prevailing wage requirements, the Board may temporarily delay implementation statewide or by region beyond January 1, 2022.”

OTHER FEATURES OF THE ENACTED BUDGET INCLUDE:

  • Prescription Drugs: Caps insulin co-payments at $100 per month for insured patients and establishes a commission to study the feasibility and benefits of a Canadian drug importation program
  • Banning the “Pink Tax”: Prohibits gender-based pricing discrimination for substantially similar or like kind goods and
  • $3 Billion to Restore Mother Nature Bond Act: Funding for projects focused on reducing flood risk, investing in resilient infrastructure, restoring freshwater and tidal wetlands, preserving open space, conserving forest areas, and reducing pollution from agricultural and storm water runoff. It will also fund up to $700 million in projects to fight climate change, including green It also aims to spend 35 percent of the funds on projects to benefit underserved areas of the state. The Budget Director will assess the state’s finances and the economic outlook later this year and make a determination as to whether to move forward with the Bond Act.
  • Permanently Bans Hydrofracking: Cuomo administratively banned high-volume hydraulic fracturing in 2014 which could have been overturned by another The budget contains a statutory ban on high-volume hydraulic fracturing which would require repeal by the Legislature and the Governor.
  • Accelerating Renewable Energy Projects and Driving Economic Growth as Part of Nation- Leading Climate Agenda: The Act will create a new Office of Renewable Energy Permitting to improve and streamline the process for environmentally responsible and cost-effective siting of large-scale renewable energy projects including the mandate to obtain 70 percent of the state’s electricity from renewable sources as identified under the state’s Climate Leadership and Community Protection
  • Banning the Distribution and Use of Styrofoam: Prohibits the distribution and use of Styrofoam, single-use food containers and packing peanuts, will go into effect by January 1, 2022
  • Campaign Finance Reforms: Effective after the 2022 elections, candidates will have to meet certain fundraising thresholds to The maximum contribution limits for candidates will also drop to $18,000 for statewide candidates, down from about $70,000 now. Third parties, such as Working Families, Conservative, Independence parties, will have to tally at least 130,000 votes — or 2 percent of the total, whichever is larger — on their line in presidential and gubernatorial elections to maintain their automatic spot on the ballot. Previously, the threshold was 50,000 votes in gubernatorial elections.
  • Legalizing Gestational Surrogacy in New York State: For LGBTQ couples and couples struggling with
  • “New York Hate Crime Anti-Terrorism Act”: Classifying “domestic act of terrorism motivated by hate” crime as a new A-1 class felony punishable by up to life in prison without
  • Comprehensive Tobacco Control Policy: Prohibits the sale or distribution of e-cigarettes or vapor products that have a characterizing flavor unless approved as part of an FDA pre- market approval and may other protections regarding availability of tobacco and e-cigarette products.
  • High Speed Rail: Convenes a team to recommend a new plan for how to build faster, greener, more reliable high-speed rail in New
  • Investing in Roads and Bridges: The FY2021 Enacted Budget supports $6 billion for the Department of Transportation capital plan in FY2021, including $2.6 billion for Upstate roads and
  • Banning Fentanyl Analogs: Designates certain fentanyl analogs as controlled substances in New York
  • Adjustments to 2019 Criminal Justice Reform Law: Clarifies the 2019 law to make sure judges know all the options available to them with respect to non-monetary conditions for release; enhances the options upon which a judge can condition release, including mental health referrals and requirements to attend counseling; and it adds several offenses that can be bail eligible, including sex trafficking offenses, money laundering in support of terrorism in the 3rd and 4th degree, child pornography offenses, repeat offenders, and those who commit crimes resulting in
  • Counting Every New Yorker in the 2020 Census: Provides additional funding to ensure a fair and complete count of every New Yorker in the upcoming 2020
  • Strengthening Disclosure Laws: Amends New York Executive Law 172, requiring disclosures of political relationships and behaviors widely recognized to be influential by streamlining the reporting process for 501(c)(3) and 501(c)(4) organizations.
  • Medical Transparency Website: Sets up a new website created by NYSDOH & DFS called “NY Healthcare Compare,” where New Yorkers can easily compare the cost and quality of health care procedures at hospitals around the
  • Making the “New York Buy American” Act Permanent: Set to expire in April 2020, requires State agencies to use high-quality American-made structural iron and steel, continuing to support the State’s steel and iron

NY on Pause extended through April 29

Amid the ongoing COVID-19 pandemic, Governor Andrew M. Cuomo today announced all NYS on Pause functions will be extended for an additional two weeks. The Governor also directed schools and nonessential businesses to stay closed for an additional two weeks through April 29th. The state will re-evaluate after this additional two-week period.

Governor Cuomo also announced the state is increasing the maximum fine for violations of the state’s social distancing protocol from $500 to $1,000 to help address the lack of adherence to social distancing protocols. The Governor reminded localities that they have the authority to enforce the protocols.

Read more.

OPWDD Provider Update

5/21

On today’s OPWDD call, they covered the following:

 

  1. Willow covered the visitation document that was issued yesterday via a Commissioner’s message that reminded people that visitation restrictions remain in place, and that providers had an obligation to facilitate meaningful communication between parents and residents.
  2. Data update –  As of 5/20 – 2,611 confirmed positive cases; 2,148 lived in certified residential programs, 392 resulted in deaths; of those county breakdown over 90% downstate; similar trends 90% in certified residence; 50 or older 83%; similar sex and comorbidity breakouts to last week.  The State then took credit for their steps they’ve taken to bring down the rate of infection.
  3. Fiscal Update – Kevin Valencis reported the 1/1 and 4/1 rates have been calculated and the package is on its way through DOH and will be processed by DOB once they receive the rates from DOH and they realize it is a priority; status of retainer day units – they have received DOH calculations and provided feedback to DOH and they hope to see them out in the next few business days; they are checking on a SNAP benefits decision in the state to count unemployment income for eligibility – one Affiliate had heard from their local food stamps office that the SNAP benefit would be discontinued for a resident who receives the $600 benefit because they no longer meet income requirements for SNAP (this is a state by state decision on whether those funds would be counted for eligibility).  Can providers question/challenge the units? OPWDD said they don’t have an appeals mechanism, but they used claims data and think it’s going to prove to be correct; if there seem to be substantial issues, they may look at it. Also mentioned ISS is also using $600 unemployment payment being used in rent subsidy calculations. For changes in service levels for day retainer program, it may be handled during the reconciliation process – not promised, but they’ll look at increases in service level to see if increased units above the 6 month average can be used.   Where is self-direction budget approval? Providers have been waiting for some time – where is the guidance we’ve been promised for weeks? Will there be a retainer program for self-direction?  Any update on ICF billing? OPWDD indicated the 1115 has been submitted and is under review by CMS.
  4. Any update on guidance for reopening, particularly for those not able to comprehend the social distancing and other rules?  Jill P. explained her staff are working on a document to assist on that front.