COVID-19 Resources for Hospices

HPCANYS will post on this page, information related to COVID-19 relevant for hospice and palliative care providers.  Your will note that we are attaching links to bring you to either DOH, NHPCO, CDC or CMS for the source documents as they are change/ updated regularly.

CDC Website
       * 4/13 Provider Education

NYS GUIDANCE:
DOH COVID-19 website for providers: 
NY State EMAIL for concerns for providers only  covidproviderinfo@health.ny.gov

• July 3 Health Advisory:Revised Protocols for Personnel in Healthcare and other Direct Care Settings to Return to Work following COVID-19 Exposure of Infection. outlines when you have to quarantine for the 14 days and when you can go to work and not quarantine.
• April 29 DAL Nursing Home Administrators on how their staff who test positive return to work. 
• June 24-28-   travel restrictions and quarantine from high concentration COVID areas
  •  Executive Order 205 ordered quarantine restrictions for travelers from high concentration COVID areas, imposing a 14 day strict quarantine requirement.  this includes anyone from NY who goes to those designated states, upon return must quarantine.  These areas that are designated high concentration will change over time and is dependent on the penetration within the state.  the definition of high density is more than 10 per 100,000 residents, or higher than a 10% positive test rate over a seven-day rolling average.(attached)
  • Dr. Zucker on 6/24 published Interim Guidance for Quarantine Restrictions on Travelers Arriving in New York.     This document has a section on essential workers- but it is for those coming and going for essential jobs and not for vacations. 
  •  Executive Order 202.45  COVID 19 Sick leave requirements did not apply to someone who was in quarantine because they went on vacation or had non essential travel to a COVID high density state- that is to say that the employer would not be required to pay for that time in quarantine.  
  • On June 28th, Dr. Zucker sent out Notice 103908, dated June 25th clarifying the employers responsibility for paid sick leave pay when an employee tests positive for COVID.  It placed a limit on the number of times quarantine w ill be paid for when you test positive.
  •  COVID 19 Sick Leave is dependent on size and net income with 1-10
• March 19, 2020 updated FAQ's for nursing home and ACF staff twice weekly testing- now applies to hospice 
• March 2020 Notification_10330 : Extension of Healthcare Personnel Influenza Vaccination report - available in health commerce system   and at the link. on the DOH website for the link, go to the section on Data Collection and Reporting  and look for the one dated 3/1/2020 
• 4/26/2020 Notification_103307 Updated Interim Guidance: Protocol for COVID-19 Testing Applicable to all heath care providers and local health departments.  
• NY Medicaid on line application process: 
• 4/10/2020: Notification_103136: Home Health Aide Training Programs:   waivers part of in person training
• 4/10/2020: DAL:Guidance of Homecare Regulations Temporarily Suspended:  includes hospice- references hospice federal 1135 waivers, new employee screening found in the health commerce system
• 4/2/2020: Health Advisory: Options when Personal Protective Equipment (PPE) is in Short Supply or Not Available- found in the health commerce system
• 3/28/2020 dated in HCS- Page dated 3/31: Updated Protocols for Personnel in Healthcare and Other Direct Care Settings to Return to Work Following COVID-19 Exposure or Infection  Applies to all health care workers.  Available on the Health Commerce System 
• 3/31/2020 dated in HCS- Page dated 3/31: Health Advisory: COVID-19 Release From Home Isolation 
• 3/31/2020: NY Medicaid Telehealth Rules: Frequently Asked Questions (FAQs) on Medicaid Telehealth Guidance during the Coronavirus Disease 2019 (COVID-19) State of Emergency.  
• 3/23/2020 -1135 CMS Waiver Request: Made by NY State which includes hospice 
• 3/16 Interim CHHA Guidance:   includes a screening algorithm and when to wear a mask during a visit

PROCESS TO ASK FOR PPE:   New Directive on how to ask for PPE from DOH  and hotline for non NYC is  

• call you local OEM first:   if you are still in need, call the state hotline: 518-292-2391
• Call your local OEM County Office-    listing of offices is in the OEM link. Some have the request for PPE on their websites 
• COUNSELING RESOURCES:  NY DOH has made available counseling resources: 8 am - 10 pm 7 days a week.  1-844-863-9314

GOVERNOR'S EXECUTIVE ORDERS: 

• Executive Order 202-14:  includes ability for guardians to designate a person in writing to speak for their relative if they are unable, PPE moving from one organization to another and ability to witness remotely.  

CMS/ MEDICARE/ FEDERAL INFORMATION- most recent listed first:

• 3/29/2020 CMS Blanket Hospice Waivers
• 3/23/20 Nursing Home Survey documentation that specifies on page 8 that hospice can visit: 
• 3/20/2020 Requests for Advancing funds   Fact Sheet
• 3/2020 Provider Burden Relief FAQ's 
• CMS Answers NHPCO Questions on Flexibility NHPCO requested additional written clarification on flexibilities for hospice. On 3/24/2020,  [CMS] writes: "are aware of the need to issue additional guidance to hospices about the flexibilities already included in the CoPs when it comes to determining on a case-by-case basis how a visit should be made. As we [CMS] stated on the call [with NHPCO], the hospice CoPs don’t specify how or how often direct clinical visits are made. Hospice providers are required to provide services that meet the needs of the patient based on the plan of care that is person-centered and individualized. CMS encourages hospices to address these issues on a case by case basis and make sure to document how the hospice is meeting the goals of care in a safe and appropriate manner. We are working on issuing revised guidance, but do not have a projected release date at this time."
• 3/17/2020 CMS Telehealth guidance
  •  Telehealth Resources : new CMS website went live on 4/22/2020 to provide information about the latest federal efforts to support and promote telehealth services. It provides helpful information about telemedicine and links to tools and resources for practitioners
• 3/9/2020: Hospice guidance: CMS issued guidance for hospice providers

FINANCIAL RESOURCES:
CARES ACT 
FEMA- NY- how to apply for monitory assistance- briefings are available 
Sequestration  suspended till end of 2020.  NHPCO resource on analysis.

NHPCO:  
NHPCO Virtual Visit guidance and helpful tips
NHPCO COVID-19 Resources:

CAPC
CAPC has multiple resources:   and search for COVID-19.  symptom control medications, referrals to palliative care, a toolkit, etc are there and being update Toolkit