On March 19, 2020, during the Department of Human Services’ (DHS) “Third Thursday Webinar,” DHS discussed communications and recommendations for nursing facilities, home and community-based providers and Managed Care Organizations during the COVID-19 outbreak.
Ongoing Medicare and Medicaid updates are being distributed by the Centers for Medicare & Medicaid Services (CMS). The recent Office of Long Term Living (OLTL) Listserv update included CMS Frequently Asked Questions. The federal emergency declaration allows states to submit 1135 waivers in order to allow regulatory flexibility during national emergencies. OLTL is collaborating with other Department of Human Services (DHS) program offices to submit an 1135 waiver.
Stakeholder communication to the DHS and the Department of Health (DOH) include nursing facility associations regarding staffing and training; home and community-based providers regarding staffing, service authorization flexibility and supplies; participant advocates about Community HealthChoices (CHC)-Managed Care Organization (MCO) emergency preparedness efforts and eligibility flexibility; and suggestions for flexibility and additional supports are all being carefully considered and are largely supported if practical and prudent. The DOH is open to ideas.
The DOH is the lead agency for the commonwealth’s response to COVID-19. Updates are provided frequently on the DOH website.
The OLTL has distributed operational recommendations for Long-Term Services and Supports (LTSS) providers. Recommendations include exercising and promoting hygienic practices, reviewing your agency’s back-up plan and infection control procedures, reporting all suspected cases of COVID-19 to DOH and OLTL and/or the participant’s CHC-MCO, and contacting OLTL before making any changes to your business practice whenever possible. LTSS residential providers should follow state and federally issued guidance, document any actions that were taken and maintain evidence for why actions were taken, and stay Informed.
Until further notice, OLTL is permitting flexibility to choose to conduct monitoring and service plan meetings remotely, using phone or video conferencing solutions. Reference the guidance document issued on March 17th for additional procedures and documentation requirements. Service coordinators should be working with participants to implement their emergency back-up plan. OLTL is asking that reductions in service plans not be implemented during this time of emergency. Service additions and updated authorizations will be expected when necessary.
With regard to nursing facilities, personal care homes, and assisted living residences, DOH has issued guidance on visitation in nursing facilities due to COVID-19. OLTL is asking that all personal care homes and assisted living residences adopt and implement the same guidance.
Upcoming communications from OLTL will address additional updates for personal care homes and assisted living residences in Section 1915(c) Appendix K. All new communications will be distributed through OLTL Listserv. All previously distributed communications can be accessed at the DOH website.
The CHC-MCOs have established protocols to ensure the continuity of operations and services. These protocols continue to be updated as the situation evolves. The CHC-MCOs communication activities include participant letters and communications, provider guidance and updates and frequent discussions with OLTL to address updates and emergent issues.
Below are a few of the questions from the "Third Thursday Webinar" Q&A session.Q. Is there specific guidance for homecare services?
A. This is currently being developed through the DOH and will be published by DOH. Any updates to LTSS will be distributed via the OLTL Listserv.
Q. Should we expect service disruptions?
A. As of now, OLTL not experiencing service disruptions, we are expecting them. That is why we are trying to be more flexible with how our services are being provided to mitigate any risk to our participants.
Q. What is the best way to contact OLTL during this time?
A. OLTL along with other offices across the department, will be working remotely in accordance with the Governor's guidelines. Provider lines are now open and OLTL is able to take calls.
Does your facility need help with Community HealthChoices implementation? Contact Jennifer Matoushek, Senior Consultant, by calling 717-213-3130 or email JMatoushek@LW-Consult.com.