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04/01/20 OPWDD Update

In preparation for today’s call at 9 a.m., here’s the update of yesterday’s OPWDD COVID-19 call courtesy of Tom McAlvanah at IAC  – thanks to Tom for this:

Hi All,
Today’s update is as follows:

Temporary Housing: OPW is welcoming the ability for our vacant Day Hab, Respite and other sites to be developed as needed temporary housing. The rate structure is being completed as discussion continues about the population who would be given priority usage of these community resources. The first priority is for people who are returning from a hospital stay and recovering from the virus. The second group is for others who are not in need of hospitalization but also tested positive and shouldn’t return to their certified residence dispute to the inability to be quarantined effectively(such as the lack of a dedicated bathroom) A third group are those who need an emergency respite placement not due to virus; an alternate respite site would accommodate that population. The Regional Offices will be the gatekeepers for these “stabilization centers.” As the guidance is comIng, we await both the programmatic and fiscal parameters. Of course, this only works with sufficient staffing and the ability to provide the incentive they need/deserve to help work in these steps-down’ units. Leaving it there.
Day Hab Waiver Update: the work with CMS is continuing daily, and they are close to a final agreement, they say. Tomorrow looks like the final submission to CMS; we understand that CMS Directors from all over the country are working with the States, so a good deal of education(about the State, the waiver contents, etc.) comes along with this renewal and thus, more time prior to approval. Nothing more to share.

Fiscal Update: as we hear the NYS budget process is moving to completion by tonight or tomorrow, we remain on hold. Again, both of the 2% increases for Direct Support are still in there and waiting for release. Kevin V is also formulating the added increase to the Residential rate structure we have heard about, with the addition of 6 hours per day for those Residential providers that do not have Day Hab associated with the folks in that residence. Again, let’s wait for the funding formulas to see the devil in the details.

Criminal Background Checks: there is some movement, but only with certain categories of staff. If a staff person is employed in one agency, they may be able to work in a different agency through a streamlined process and turned around, in one day they say, by the Justice Center. The second category of staff that can have expedited screening will be those who have worked in other “O” agencies through a similar process. The third category is for new hires who may be able to work under supervision after they clear the SEL check. More to come with an ADM shortly.

Recoupments: an exasperating topic area. We still haven’t been able to get DOH to budge on this. The Governor’s office reiterated their position on this call that they cannot stop the cycles once the data is loaded into the system. The cash flows, the extra pay for staff, the dire need and our own spending on supplies…they hear us, but…

I’ll leave it at frustrating.

Membership phone call tomorrow at 10:05 AM.

Next OPWDD call on Friday.

One final mention, on this and the previous calls, both Parent organization reps and Self Advocacy were on the phone, which is a good thing. We then, are not the only ones voicing our concerns loudly. They also hear how limited their response has been to it all.

Have a good evening,

Tom

3/30/20 OPWDD Update -Waivers, Respite, Triage

On today’s OPWDD COVID-19 update, the following issues were covered – we’re sorry to report that there was not a lot of new information offered:

  1. Waiver Update – Retainer day payment for day hab for 30 days (until Apr. 17); developing an enhanced residential service for people in certified settings for daytime supports; COVID-19 response service, community based services to support people and families; looking at temporary emergency respite initiative.  Still in negotiations with CMS.
  2. Abiba Kindo presented the temporary emergency respite opportunities that they will be “standing up” in mostly downstate communities.   They will be sending out a response form to gather information on people who might be in need of this service, particularly people in a hospital who might be appropriate for this “step down” service. The regional office document has more information and contact information about who might be eligible for this service.  Providers asked for county by county need and the criteria OPWDD is using in making approvals.  Guidance document will be sent out this evening.
  3. Commissioner Kastner welcomed families and stated their goal is to protect the safety of people enrolled in our program, the staff and families.  Explained closure of day programs and implementation of visitation policies, leaving many people disconnected and shortages in DSPs.  He repeated once again that they follow DOH’s lead on policy and tailor it to our system.   Asked for their understanding and support. Blah, blah, blah.  When asked about the triaging of resources, where will the I/DD community stand in decisions made care and resources used for people with I/DD?  Roger Beardon responded that there are procedural protections built into the legal system to ensure care for people with disabilities, missing the point of the question – what will OPWDD do to prevent discriminatory decisions in health care resource allocation.
  4. Resources for people with I/DD and families:  there’s a new web site that is intended to be more accessible and they are working on a new list serve.
  5. Budget Update – Kevin Valenchis offered that the State’s budget focus has been to negotiate provisions that have sign off on fiscally – no additional resources added for next year and there will be a status quo budget.  Things are still being negotiated and details can change.  Expectation is that the budget will be passed on time, i.e., by April 1.

Given that not much happened on today’s call, we will hold the next call for Affiliates on Thursday, April 2 at 9 a.m. with hopes that there will be information helpful to you.

To participate in the next call, please dial:

 

1-800-411-0160  

Passcode:  489140#

Background checks waived for qualified individuals

In the Governor’s most recent Executive Order, the state will allow current employees of OPWDD or OPWDD approved providers who have previously undergone background checks to be employed by a different OPWDD approved provider and/or OCFS licensed or certified program and/or OASAS certified, funded or authorized program and/or OMH licensed, funded ‘or approved program without undergoing new background checks.

These provisions are also waived to the ‘extent necessary to allow providers the discretion to permit, already qualified individuals and who are not listed on the Staff Exclusion List to work unsupervised while an updated background check is completed.

Read the entire EO here.

3/28/20 OPWDD Update

First, attached and below are a number of important notices from OPWDD on training and health advisories re: return to work, isolation, etc.

On today’s OPWDD call:

1) Reviewed the guidance documents issued this afternoon: on releasing someone from quarantine containing DOH/CDC guidance and changes the quarantine period from 14 days to 72 hours post recovery (plus additional criteria); also return to work guidance for essential personnel and another for health care workers.  Please be sure to read carefully and understand the conditions of both.

2) How would we pay for emergency triage/residential capacity?  Programs would potentially be reimbursed at intensive respite fee – this will require claiming rules to be changed to allow for this limited period of time capability (it’s likely to be a medical leave — allowing providers to bill a retainer day).  The Commissioner clarified that these beds/places would be to take people out of the hospital to free up hospital beds and contribute to the greater good.  The Governor’s office clarified that the plan is for first priority to help people move out of the hospital and secondarily to support needs in the community – both are goals.  Criteria and mission still need to be agreed upon and more work will be done on this.  OPWDD is developing a document that provides information on what the sites need to have; how it will be staffed, etc., which should be out to folks in a few days.   There are two things going on here: relocating for isolation versus emergency housing and they need to be separated in the thinking of how they are approved.

3) Abiba Kindo explained that the crisis support teams will be repurposed to respond to COVID related emergencies, non-housing group and a separate team for housing issues; will be out in the next 48 hours.

4) PPE – heated discussion on the need; State says we have been heard and they are working to ensure all understand where we stand in the priority list with homeland security/NYS.

5) Paperwork issues – state and local DOH have been working on following this:  call the Justice Center with information; OPWDD will not collect contact information upfront, rather providers would call staff and anyone else perhaps being exposed and then follow up after the fact and let OPWDD know who you’ve contacted and if there’s any problem reaching any of those people.  Also, please advise agencies just let them know that they need one contact for reporting.

6) They are hopeful that in a future executive order to have a change in the requirements for criminal background checks in a future executive order.

 

3/24/20 OPWDD Update

On today’s OPWDD Update call, the following key items were presented:

  1. OPWDD is moving forward with CMS; Appendix K submitted today and it’s not subject to public comment and they expect they will soon receive authorization from CMS.  On the 1135, they are working closely on the getting both that and the 1115 waivers expanded to allow NYS the flexibility it needs to support the DD sector.
  2. OPWDD received a letter from Providers regarding COVID-19 funding priorities (attached) and OPWDD staff said they are reviewing and that they will be able to answer the points at tomorrow’s provider briefing.
  3. PPE – OPWDD is trying to help agencies triage and again told providers to put their ticket/request into the county OEM’s with specific requests.  Identify if your agency can’t take people back from hospital due to not having PPE; please get ticket number, date of submission, address of submitting agency if you want follow up assistance from the State.   Email for incident reporting:  Opwdd.sm.incident.management@opwdd.ny.gov
  4. Emergency Housing Proposal – a group met with OPWDD today and will regroup tomorrow morning to provide additional feedback on the OPWDD plan/proposal.  More to come.
  5. OPWDD’s policy on people going home to their families is still under review by OPWDD regarding whether they can return to the certified home before the crisis is over; they expect to provide it soon. (IT WAS JUST RELEASED – SEE LINK BELOW/ATTACHED)
  6. If providers receive inconsistent guidance from local DOH, we have been instructed to send issues to incident management.  OPWDD is working to ensure that there are ways to ensure most recent relevant information is available.
  7. Providers identified an inability to meet Matilda’s law – there is no way any agency will be able to comply with the mask requirement.  If we don’t have the equipment – how can we comply?  OPWDD is working on guidance related to this problem.
  8. Contact tracking form – OPWDD has been working to eliminate redundancy in the form and a few of the items; the Justice Center fields will be incorporated into the form. OPWDD hopes to have an updated and streamlined process/form by Thursday.
  9. CBC flexibility – no new information at this point, but the abbreviated training guidance was issued today (see below).

FROM OPWDD DAY HAB WEBINAR (OPWDD BILLING GUIDANCE ATTACHED – WE WILL GO OVER THIS ON TOMORROW’S 9 a.m. CALL):

Reviewed Billing rules presented on the afternoon’s webinar; implementing parts of the waiver although it hasn’t been approved by CMS. Interim guidance on retainer day billing will be provided later today – for the period 3/18/20 – 3/31/20.  Billing for retainer days must be for active participants and only for the individual’s pre-existing schedule to ensure continuity of revenue.  Can bill the regular schedule for day services, and supports provided do not need to be delivered on the days the retainer is billed – continuity of care is critical.  Use existing provider ID, use existing rate codes for half and full units for day hab and pre-voc – use existing 15 minute units for community pre-voc.  Use revenue code:  “0180 – Leave of Absence” for retainer day billing.

Flexibility and Relief Measures – services may be delivered in an alternate location to the best of our ability; day hab can be provided in residences.

Face-to-face Service delivery may be provided remotely (phone or other technology) used for com hab, prevoc, pathway to employment, support brokerage, day hab, supported employment and intensive behavioral service. Sound clinical judgment can determine use of telehealth.

Documentation:  they would like (it’s not required) documentation of what happened – service provided and start/end time, not necessarily correlated with the claim (not a formal documentation requirement).

ABBREVIATED TRAINING GUIDANCE

From: opwdd.sm.info <info@opwdd.ny.gov>
Sent: Tuesday, March 24, 2020 9:28 AM
To: opwdd.sm.info <info@opwdd.ny.gov>
Subject: COVID-19 Interim Guidance Related to Abbreviated/Refresher Training and Recertifications

OPWDD has released the below interim guidance related to

Abbreviated/Refresher Training and Recertifications to Address COVID-19 Emergency Response:

https://opwdd.ny.gov/system/files/documents/2020/03/3.24.2020-refresher-training-and-recertification-final.pdf

Find more guidance on COVID-19 at the following link:

https://opwdd.ny.gov/coronavirus-guidance

 **(Please note, OPWDD has launched its new website and the page at the above link will appear differently than it has from prior emails. All of the guidance can be found under Guidance for Providers if you scroll down the page.)

COMMUNITY OUTING AND HOME VISIT GUIDANCE

OPWDD has released the below interim guidance related to Community Outings and Home Visits:

Suspension of Individual Community Outings and Home Visits

Find more guidance on COVID-19 at the following link:

https://opwdd.ny.gov/coronavirus-guidance

**(Please note, OPWDD has launched its new website and the page at the above link will appear differently than it has from prior emails. All of the guidance can be found under Guidance for Providers if you scroll down the page.)

FAMILY CARE GUIDANCE

From: opwdd.sm.info <info@opwdd.ny.gov>
Sent: Tuesday, March 24, 2020 3:07 PM
To: opwdd.sm.info <info@opwdd.ny.gov>
Subject: REVISED: COVID-19 Interim Guidance Related to Family Care Services

OPWDD has released the below revised interim guidance related to Family Care services updated on 3/24/2020:

Management of Coronavirus/COVID-19 in OPWDD Family Care Homes

Find more guidance on COVID-19 at the following link:

https://opwdd.ny.gov/coronavirus-guidance

**(Please note, OPWDD has launched its new website and the page at the above link will appear differently than it has from prior emails. All of the guidance can be found under Guidance for Providers if you scroll down the page.)

3/26/20 OPWDD Update

On today’s OPWDD Coronavirus activities update call, the following items were covered:

  1. There was significant news on the Appendix K – OPWDD is going to be responding to CMS questions and amending the application to now include (in addition to the previously announced day services) these services in their plan for obtaining approval for retainer days billing: respite, SEMP, com hab, and self-direction with budget authority for 14 days, with another extension (from 15-30 days) through the 1115 waiver.  The waiver would be for period 3/18 – 3/31 under the K, with the 15-30 day period filing right after under the 1115 waiver; anything beyond that is yet to be negotiated, but continued retainer day payments for this additional group of services will be part of the negotiations.
  2. The providers indicated they need immediate cash relief; the old way of doing business is not going to work.  Governor’s office staff indicated that they will work on this with DOB; there is no ability to guarantee an across the board rate increase at this time given the Governor’s projection that there might be a $15 billion budget shortfall.
  3. Suspension of recoupments – Kerri Neifeld from the Governor’s office indicated that the earliest that the stop on recoupments could go into effect would be with the April 22 payment, and State would have until Tuesday, March 31 to make that happen. She is fairly confident that those recoupments will be postponed and will let us know by Tuesday for certain.
  4. PPE – It remains a significant issue. Please report orders/issues with PPE to: opwdd.sm.incident.management@opwdd.ny.gov
  5. CAS Assessment – OPWDD will have an update for tomorrow on what the continuation of the assessments means.
  6. Tracking report – draft will be out tonight/tomorrow.
  7. OPWDD will take suggested word changes to the some of their guidance that is difficult to implement– no guarantee that they will be made, but they are looking to update as providers see appropriate.
  8. Emergency housing update – they have one provider who is interested and they are meeting internally to finalize the process.

3-27-20 OPWDD Update

  1. Kate Marlay presented the overview to clarify retainer day payments and residential enhancements: Meeting planned for Monday to review revised Appendix K, including what has been seen in other states.  There’s three major constructs they want to achieve through Appendix K and the 1115.  1) Residential Rate revision – looking to increase rates to address the fact that there’s going to be a need for increased daytime hours for people who did not participate in that provider’s day services; retroactive to 3/18.  2). Payment of retainer days to occur in 2 phases; 1st phase is not budget neutral because it pays both the day provider and residential provider.  This will be a 4 week period for day programs and SEMP, respite, com hab, self direction. Phase 2 will have a very different methodology than the 1st phase but will be held to budget neutrality component.  In Phase 2, likely to begin April 17, they are creating “COVID-19 response service” is an umbrella program to encompass day, community hab, pre-voc, and respite services and will compile revenue to guarantee providers 80% of expected revenue that would have been billed for all those services – day hab, com hab, respite, pre-voc services (SEMP is not included in the 2nd phase) – with the providers to produce 20% of the services to achieve 100% of funding. The umbrella allows you to compile funds for all services and use for staff to be directed to needed redeployment and staffing supports for serving both enrolled and community members.  If you go over 100% of the Phase 2 billing, there will be a clawback of the overbilled amount.  Phase 2 is open to OPWDD providers that agree to: have a residential program in place or agreement with a residential provider with an expectation that provider has retained staff; incentive to provide services and to figure out how to support people in that community.
  2. Emergency housing update – OPWDD has developed temporary emergency residential opportunities protocol, outlined the process including the roll of care managers.  For housing, COVID related or not – they would keep the housing separate (obviously); they have 3 providers willing to develop temporary housing opportunities that OPWDD is evaluating; regional offices will be accepting applications to become sites.  OPWDD is looking at opportunities for push in supports as well as the development of the sites being examined for use.  How is this funded? – They have not decided a funding mechanism as yet.
  3. Maintaining Article 16 service providers – the providers are unlikely to make it through this crisis.  OPWDD is open to listening to provider ideas on managing the clinics.
  4. CAS Assessment – OPWDD will cease activity by Maximus — pause it for the time being.
  5. Supervision level – OPWDD will try to navigate on a case by case level.
  6. Contact tracking report – discussions have continued with revisions still being made with a rough agreement.
  7. OPWDD provided an overview of the Executive Order issued today: Modifies the MH law to address the emergency housing plans to allow res services in other/alternative sites that are set up; the second one permits abbreviated training and recerts.
  8. Day services for ICFs will be paid for under the 1115 waiver allowances; provider should continue to build the day service and the residential services.  It will be done secondarily to the K.

COVID-19 Resources and Updates

Here you will find guidance from OPWDD and other state sources, as well as federal guidance and helpful resources from private institutions.

Click here for an archive of CP State COVID-19 Updates.

Click here for information on the NYDA COVID-19 Impact Data Project.

NEW YORK STATE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES (OPWDD)

The Office for People With Developmental Disabilities (OPWDD) is providing speific guidance to caregivers, families, and provider agencies of services or support to individuals with intellectual and developmental disabilities (I/DD).

NEW YORK STATE DEPARTMENT OF HEALTH (DOH)

Department of Health 24/7 Hotline: 1-888-364-3065
Directory of Local Health Departments

NEW YORK STATE EXECUTIVE ORDERS 
CENTER FOR DISEASE CONTROL AND PREVENTION (CDC)
WORLD HEALTH ORGANIZATION (WHO) 
ANCOR
JOHNS HOPKINS 
MANAGED CARE COMMUNITY OF PRACTICE

As always, if you have a question, suggestion, or need help in accessing any of the resources, please do not hesitate to contact William DeVoe, Director of Communications and Advocacy, at wdevoe@cpstate.org or by cell at 518-478-4809.

Information needed in the event of Article 16 Clinic closure

Good afternoon Article 16 Clinic leaders,

OPWDD expects that the VO Article 16 Clinics remain open to provide essential health care services throughout New York State, with exceptions for lack of staffing or other challenges, such as temporary lack of demand for such services.  Further, we encourage Article 16 Clinicians to use their best professional and clinical judgment to prioritize the needs for services and individuals in their communities, based upon the relative acuity or immediacy of their needs.

In the event that an Article 16 Clinic has to temporarily close a clinic site during this state of emergency, the Voluntary Agency needs to submit the following in writing to the OPWDD clinic mailbox (clinic.services.information@opwdd.ny.gov): (1) the date of temporary closure and locations of Article 16 Satellite Clinics, and subsequently, (2) the date that they have re-opened, once that is known.

Note, if the OPWDD Article 16 Satellite Clinics are closed permanently, then a Certificate of Need (CON) needs to be submitted to OPWDD clinic mailbox.

Thank you

-Allison Behan

Allison Behan

Director, Statewide Article 16 Clinics

Statewide Services

NYS Office for People With Developmental Disabilities

44 Holland Avenue, Albany, NY 12229

 

Administrative Support: (518) 474-5673 | Allison.L.Behan@opwdd.ny.gov

Direct: (518) 408-2464

www.opwdd.ny.gov

Register now for FEMA reimbursement of eligible COVIOD-19 expenditures

Federal funding from the Federal Emergency Management Agency (FEMA) may be available under the COVID-19 major disaster declaration.  Please see the attached notification from New York State Homeland Security and Emergency Services for more details.  Additional information can be found on their website at http://www.dhses.ny.gov/recovery/public/active-declarations.cfm.  Virtual applicant briefings will be on several dates next week and will be based on your county location.  You may register through the attached notification.

The Office of Recovery at the Division of Homeland Security and Emergency Services will be holding several virtual Applicant Briefings to discuss the federal funding from the Federal Emergency Management Agency (FEMA) that may be available under the COVID-19 major disaster declaration. The briefing will provide state agencies and authorities, local governments and private non-profits guidance on the eligibility standards for being an applicant under a FEMA disaster grant and what types of activities are reimbursable under this current declaration.

Click here for for the Applicant’s Briefing Schedule. 

Emergency medical care (diagnosis or treatment of mental or physical injury or disease) private non-profits that may be eligible for reimbursement include:

  •  Clinics
  • Facilities that provide in-patient care for convalescent or chronic disease patients
  • Hospices and nursing homes
  • Hospitals and related facilities, including:
    o Central service facilities operated in connection with hospitals
    o Extended-care facilities
    o Facilities related to programs for home health services
    o Laboratories
    o Self-care units
    o Storage, administration, and record areas o
  • Long-term care facilities
  • Outpatient facilities
  • Rehabilitation centers that provide medical

    FEMA makes the final determination on applicant eligibility for private non-profits. The types of information requested for review:
    • DUNS Number
    • Organizational Charter / By-Laws
    • Tax Exempt Letter, 501(c), (d), or (e) IRS designation
    • NYS Comptroller’s W-9 Form
    • Articles of Incorporation
    • PNP Questionnaire

Click here for for the Applicant’s Briefing Schedule.