This guidance replaces the March 25 guidance and details the minimum standards that Article 16 Clinic providers must meet to deliver in-person services as they reopen during the COVID-19 public health emergency.
The guidance addresses screening practices, infection control and mitigation strategies, managing appointments and workplace activities, proper use of personal protective equipment (PPE) and notification requirements when there is a confirmed positive COVID-19 case.
Several supplemental guidance documents were referenced within this guidance but not linked. We've provided links to these documents for your reference below.
Appendix K Waiver Revisions and State Aid Funding Reduction
On Tuesday, OPWDD informed the provider associations of two significant events.
The Centers for Medicaid and Medicare Services has approved proposed revisions to the Appendix K Waiver. The revisions, which include day program billing flexibility, will be effective through March 2021. Retroactive to July 22, providers will be able to bill for half units of service as 1 hour and 1 service and full units of service as 2 hours and 2 services. This flexibility will have a sunset date in mid-October. It is unclear if OPWDD will seek a renewal of this flexibility. Chapters should prepare for the possibility that there is no renewal. Additionally, Chapters should now review the services that were delivered back to July 22 and identify those that may be billed under the new flexibility. Although the provider association advocated to limit changes to the billing documentation, it appears there will be a separate billing code assigned to the new billing flexibility. OPWDD communicated that this is necessary to identify these billings under future audit.
While nothing has been formally published by OPWDD, we understand that they have drafted and will immediately file emergency regulations, which will be forthcoming in the New York State Register. Additionally, we will monitor for the publication of the revised Appendix K Waiver and share as it becomes available.
The New York State Division of Budget (DOB) has pressed all state agencies to implement a reduction (stated as a "withhold") of 20% of the next quarter payment for all state aid-funded programs. The withhold has been explained as necessary due to a lack of federal support to state and local assistance funding.
Approximately $300 million in state-funded services would be subject to the immediate withhold. This translates to about $15 million withheld in the next quarter. It is unclear if this is a one-time withhold or if DOB will implement it in future quarters. Providers will continue to voucher for services and the withhold will be applied. Delayed and pending vouchers will also be caught up in this withhold.
Some services that are state funded include:
- Family Support Services (Approx. $50M program)
- Individual Residential Alternative State Supplement (Approx. $75M program)
- Individual Support Services (ISS)
- Mirrored Services (Regular Medicaid services for individuals who are not waiver enrolled and 100% state funding is paid) (Approx. $40M program)
- People aging out of private residential schools in state and out of state (not brought into an Intermediate Care Facility or a program that is subject to federal Medicaid funding)
- Local assistance funding (Long-Term Sheltered Employment, direct sheltered workshop contracts, 620/non-620 funding) (Approx. $20M program)
- NY START Program
- Payments to FI' for Self-Direction Budgets, Other Than Personal Services (OTPS)
- Private Residential School funding (in state and out of state) for children who have aged-out
- E-Mods
- MHL clothing allowance funding
- Assistive Support Price funding
This is not an OPWDD action. A similar reduction was levied against OMH and OASAS state aid funding and is anticipated to impact other state aid contracts for other state agencies as well. A DOB memo further detailing this withhold is imminent and will be shared once we receive it.
