Overview • General Information • Regulatory Response • ACA/NY Response • Supporting Our Members 2
General Information 3
General Information As you know, the COVID-19 pandemic has changed how we all live our lives. ACA/NY is committed to supporting our members, their families, and our workforce. This forum is an opportunity to discuss the effects of COVID-19 on our country, our government, and ACA/NY operations as a Care Coordination Organization Health Home. 4
General Information Federal Guidance Per the President of the United States, the following guidance was extended through 4/30/2020: Work or engage in schooling from home whenever possible. • Avoid social gatherings in groups of more than 10 people. • Avoid discretionary travel, shopping trips, and social visits. • Practice good hygiene. • 5
General Information Federal Guidance Recovery Rebate Under the 2020 CARES Act Automatically sent to anyone in the income limit who filed taxes in 2018 or 2019, • received Social Security payments, or veterans' benefits. To check on the status of this payment: https://www.irs.gov/coronavirus/get-my-payment • • SSI recipients who did not file taxes will not need to do so. SNAP , SSI, & Medicaid will not consider this income/resource for the year. • Sources: 4/13/2020 OPWDD “Advisory: Medicaid Eligibility Processes During Emergency Period”, 4/21/2020 OPWDD Care Coordination E-Visory Issue #7-20 6
General Information New York State Guidance The Governor of NY issued a Statewide Executive Order extended through 5/15/2020 which provides the following guidance for New Yorkers: Everyone in New York should wear masks or face coverings in public, • including when taking public or private transportation. Remain indoors, however you can go outside for solitary exercise. • Pre-screen all visitors by taking their temperature. • • Do not visit households with multiple people. Vulnerable people and anyone in their presence should wear a mask. • • Always stay at least 6 feet away from other people. Do not take public transportation unless urgent and necessary. • 7
General Information New York State Guidance • Business and entities that provide essential services must implement rules that help facilitate social distancing of at least 6 feet. Employers must provide essential workers with masks free of charge to wear • when interacting with the public. • Sick individuals should not leave their home unless to receive medical care and only after telehealth visits to determine if leaving the home is in the best interest of their health. New York State Resources Novel Coronavirus Hotline: 1 -888-364-3065 • COVID-19 Emotional Support Hotline: 844-863-9314 , 8am-7pm every day • • For more information: https://coronavirus.health.ny.gov/home 8
General Information The 7 Care Coordination Organization Health Homes in New York State came together to develop consistent tools and processes to help facilitate the health and safety of members during this crisis. • The emphasis is advocacy for our collective membership, keeping OPWDD and providers aware of the needs of our members. An assessment tool was created to determine health and safety needs. • • A monitoring tool was created to allow for the continued monitoring of member’s needs as a follow up, for continuity of care and continued coordination of support and needs. • The 7 CCOs are collectively providing statewide data regarding members that are more vulnerable. This collaboration and unification would not have been possible before • 7/1/2018, with hundreds of Medicaid Service Coordination providers. 9
General Information ACA/NY Response to Federal and State Guidance ACA/NY was one of the first CCOs to implement a policy on working • from home, dramatically reducing the risk of exposure for everyone. In this environment, staff are still able to provide effective support to our members. We have daily contact with OPWDD, the Department of Health and • provider associations to remain up-to-date on regulatory changes. • We provide regular updates and guidance to ACA/NY staff through twice weekly webinars that are fully attended by our workforce. 10
Regulatory Response 11
Regulatory Relief Face-to-Face Requirements • The New York State Department of Health waived face-to-face requirements for Care Management effective 3/14/2020. In lieu of face-to-face contact, Care Managers utilize telephonic • or telehealth capabilities. In certain situations, face-to-face may still prove to be clinically • indicated. Agencies must have policies and protocols in place to assess the necessity and process for any in person contact. Source: 3/14/2020 New York State Department of Health “COVID -19 Guidance for Health Homes” 12
Regulatory Relief Life Plan Meetings • OPWDD and the New York State Department of Health have agreed to provide relief to Life Plan deadlines retroactively to 3/7/2020. • Care Managers are not required to hold Life Plan meetings or develop new annual Life Plans during this time. • In some circumstances, when able to do so, Care Managers are making every effort to hold the meeting as scheduled. If we can make it work in a virtual environment, we will. Source: 4/17/2020 OPWDD “Interim Guidance Regarding Care Planning Activities” 13
Regulatory Relief Medicaid Coverage • Medicaid coverage will not stop for anyone during the COVID-19 pandemic. If you received a notice that your Medicaid was discontinued after 3/18/2020 it • should have been reinstated so there is no gap in coverage. • Individual's in the Medicaid Buy-In program who lose their job will have a grace period of 6 months. New Applications: Districts must allow self-attestation on eligibility criteria. • • Care Managers can sign on behalf of individuals and must submit DOH-5147 form (or MAP-3044 form). There remains no changes to fair hearings currently. • Questions can be directed to your local Medicaid district. • Sources: 3/18/2020 New York State Department of Health “New York State Medicaid Coverage and Reimbursement Policy for Services Related to Coronavirus Disease 2019 (COVID –19)”, 4/13/2020 Office of People with Developmental Disabilities “Advisory: Medicaid Eligibility Processes During Emergency Period” 14
Regulatory Relief OPWDD Guidance to Providers • OPWDD suspended in person services at all Day Habilitation, Day Treatment, and Prevocational Services locations across the state. Providers evaluate if an individual may benefit from Community Habilitation, • Respite and Day Habilitation services by alternative means. If face-to-face interactions must happen, social distancing measures should be in • effect between individual and worker. Care Managers in conjunction with providers will evaluate the need to create a • LP addendum based on service changes Source: 3/19/2020 “Message from OPWDD Commissioner Kastner Regarding Day Program Services” 15
Regulatory Relief OPWDD Update: Community Habilitation Community Habilitation may be delivered to children during • school hours as of 4/13/2020. Community Habilitation must be within authorized levels in order • to be delivered during the day. Care Management can advocate around coordination of services • with other providers and should keep this information in mind. Source: 4/13/2020 Office of People with Developmental Disabilities COVID-19 Update Meeting 16
Regulatory Relief Suspension of Community Outings and Home Visits All community outings and home visits for certified residential • settings suspended effective 3/25/2020. Individuals on home visits can return to their residence. • • A health screening is required, and precautionary quarantine is possible. • Goals and services related to community outings should be met by alternative means whenever possible. Source: 3/24/2020 OPWDD Guidance “COVID -19 Suspension of Community Outings and Home Visits” 17
Regulatory Relief OPWDD Front Door • Service Authorization Requests do not need to be accompanied by a Life Plan or in-process Life Plan during the COVID-19 emergency. Front Door staff can use documents previously considered, including documents • needed to establish OPWDD eligibility and Level of Care Determinations. • Virtual Front Door Information Sessions will be held on Thursday 4/23/2020 (Spanish) and Thursday 4/30/2020 (English) from 10am – 12pm. Pre-registration is required. Registration should be sent by email to Soreth • Mitchell: Soreth.X.Mitchell@opwdd.ny.gov • Email should include the individual’s name, DOB, parent/advocate name, home address, email address, and phone number. Source: 3/27/2020 “Important Updates for Front Door Staff” e -mail from OPWDD.SM.CCOProjectManagement 18
Regulatory Relief Emergency Respite OPWDD has welcomed vacant Day Hab, Respite and other sites to be developed as temporary housing for people impacted by COVID-19. First priority will be given for those returning from hospital stays and • recovering from COVID-19. • Second priority is for those who tested positive for COVID-19 but are not in need of hospitalization. Third priority is for those needing emergency respite placement. • If emergency respite is needed contact your Care Manager. • Source: 3/30/2020 OPWDD Memorandum “Temporary Emergency Respite Capacity in Response to COVID- 19” 19
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