Applied Self Direction Shares CMS Issued COVID-19 Health Care Providers Fact Sheet
The Centers for Medicare and Medicaid Services (CMS) have issued a COVID-19 Emergency Declaration Health Care Providers Fact Sheet. This fact sheet should prove helpful to our members as they navigate the challenges of the Coronavirus, or COVID-19.
One of the many challenges associated with this virus is that direct care may not be able to be provided as it normally is. Per this fact sheet, we encourage states to seek program flexibilities by submitting Section 1135 Waiver Requests. Section 1135 Waiver Requests can be submitted directly to Jackie Glaze, CMS Acting Director, Medicaid & CHIP Operations Group Center for Medicaid & CHIP Services by email (Jackie.Glaze@cms.hhs.gov) or letter. Neither a special form nor format are required for this request, although CMS-recommended best practices for developing Section 1135 Waiver Requests may be found here.
We encourage our FMS and Stakeholder Members to consider the program flexibilities you require to ensure your clients receive needed services and to submit those as soon as possible to your State Medicaid contacts. You know your programs and clients best, but some ideas include:
- Waiving restrictions on certain family members providing direct care.
- Temporarily waiving certain background check requirements so workers can be approved to provide care more quickly.
- Waiving certain prior authorization requirements.
- Waiving certain individual budget amendment requirements.
- Waiving requirements for face-to-face meetings to be replaced by phone or videoconference meetings.
CMS has also produced a helpful Disaster Response Toolkit.
If you are having trouble contacting your State Medicaid representatives, please let us know and we will assist.
We are available to work with our State, FMS and Stakeholder members to consider program flexibilities. Please contact us for assistance.
We know our members and their staff are resilient and well-prepared to work through this crisis. We are thinking of you and the challenges you face and available via email and phone to support.
Booklet about the Coronavirus from SARTAC
This easy to read booklet about the Coronavirus is from SARTAC. It is in English and Spanish. It was written by and for people with developmental disabilities. It focuses on “need to know” information (not “nice to know” information). Please share it widely. Our goal is to keep people with disabilities healthy during this national crisis. Let us know if you have suggestions on how to improve this booklet.
Plain Language Booklet on Coronavirus https://selfadvocacyinfo.org/wp-content/uploads/2020/03/Plain-Language-Information-on-Coronavirus.pdf
Spanish Plain Language Booklet on Coronavirus – many thanks to the California DD Council for translating our booklet into Spanish. https://selfadvocacyinfo.org/resource/plain-language-information-on-covid-19-spanish-version/
SARTAC is the Self Advocacy Resource and Technical Assistance Center https://selfadvocacyinfo.org/ This booklet was created by Green Mountain Self-Advocates, a SARTAC partner.
Maryland Department of Health Presciption Refill Waiver
In an effort to give timely notice to the pharmacy community concerning important pharmacy topics, the Maryland Department of Health (MDH) Office of Pharmacy Services (OPS) has developed the Maryland Medicaid Pharmacy Program Advisory. To expedite information timely to the pharmacy and prescriber communities, an email network has been established which incorporates the email lists of the Maryland Pharmacists Association, EPIC, CARE, Long Term Care Consultants, headquarters of all chain drugstores and prescriber associations and organizations. It is our hope that the information is disseminated to all interested parties. If you have not received this email through any of the previously noted parties or via MDH, please contact the OPS representative at 410-767-1455.
No. 206 March 11, 2020
Novel Coronavirus 2019 (COVID-19): Waiving Early Refill Edits
Maryland Medicaid Fee-for-Service (FFS) Program
On March 6, 2020, Governor Hogan released a Coronavirus Update directing all state health insurers to waive any time restrictions on prescription medical refills. (https://governor.maryland.gov/2020/03/06/coronavirus-update-governor-hogan-announces-new-directive-requiring-state-insurers-to-waive-costs-for-testing-provides-additional-details-on-confirmed-cases/)
To comply with the directive, the Maryland Medicaid Fee-for Service (FFS) Program, instructed our claims processor, Conduent, to relax the early refill edits that are currently in place for the FFS Program and allow a one-time early refill of at least 30-day supply of the participant’s medication (up to 90-day supply for maintenance medication), before the participant uses 85% of their medication. This change will become effective on Tuesday, March 10, 2020.
In order to obtain an early refill prior authorization, please call Conduent at 1-800-932-3918.
Thank you in advance for your timely assistance.
Maryland Prescription Waiver
The CDC announced that, effectively immediately, they are suspending non-emergency inspections by state survey agencies and accrediting organizations who will instead limit their inspections to infection control and serious health and safety issues (abuse, etc). Click here for details.
The CDC has issued additional guidance for hospitals and nursing homes that includes information that may be relevant to IDD providers.
- Guidance for Infection Control and Prevention Concerning Coronavirus Disease (COVID-19): FAQs and Considerations for Patient Triage, Placement and Hospital Discharge
- Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in nursing homes
Governor Hogan/DDA Announcement
Governor Hogan declared a State Of Emergency yesterday regarding the containment of COVID-19 (coronavirus), DDA would like to reach out to all providers to ensure that your agency would be ready and able to implement your emergency plan (including closures, infection control, shelter in place, emergency staffing patterns, etc.) if needed.
This is also a reminder that if you do need to implement an emergency plan that you must notify leadership at the regional office if during business hours, or via our on-call system after hours, when the plan is initiated. The phone number to our after hours, on-call phone number is 410-974-4695.
For up-to-date information regarding this topic, navigate to the Maryland Department of Health’s website at https://health.maryland.gov/pages/home.aspx and view “News and Announcements”.
COVID-19 Updates from ACL
The volume of information is growing, so we have added sub-sections in an attempt to make key information easier to find. We also have published several FAQs and other new resources. For example, we created a section explicitly for the aging and disability networks. That’s where you will find program-specific guidance as it’s available, as well as links to information from CMS, CDC and others that is specifically applicable to the networks. In that section, you’ll now find:
- FAQs for the following Older Americans Act programs:
- Health Promotion and Disease Prevention
- Senior Nutrition
- State Long-Term Care Ombudsman (we’ve also added the planning resource created for this program in 2015)
- HCBS and Elder Justice currently are combined into one FAQ
- CMS guidance on HCBS waivers and nursing home visitation
- Interim guidance from the CDC for getting an organization ready for an outbreak
We also have added:
- On the home page: We’ve added a Spanish-language version of much of the content for older adults and people with disabilities. (Thank you to the Instituto de Deficiencias en el Desarrollo, the ACL’s University Center for Excellence in Developmental Disabilities in Puerto Rico for the assist!)
- More from the CDC: Including a link to a video on what older adults need to know about the virus.
- A link to the New Hampshire UCEDD’s COVID-19 page, which includes language assistance resources.
- Information about scams and how to protect yourself from them.
We are updating this page regularly, so please check back often for the latest information.
ASD Update on COVID-19
As you know, the United States is currently experiencing a major coronavirus (COVID-19) outbreak. Older adults and people who may be immunocompromised face the highest risk of experiencing severe complications from the virus.
As stakeholders in self-direction, protecting the health and safety of the participants we serve is paramount. If COVID-19 is spreading in communities near you, the Centers for Disease Control (CDC) recommends avoiding large gatherings and nonessential travel. This is particularly important for older adults and people who may be immunocompromised. More CDC recommendations on steps to prevent illness can be found here.
Applied Self-Direction is maintaining close contact with federal agencies regarding emergency preparedness in self-direction and will continue to share information with members as it becomes available. For now, the list below may help states, FMS entities, and others prepare for the impact of coronavirus on programs they serve:
- Remain in close contact with your state’s aging and disability offices to stay informed regarding the latest guidance and updates.
- If you operate in a state that has declared a state of emergency, review your governor’s emergency proclamation to determine what authority is available to state personnel to suspend “business as usual” laws and regulations, and contact your state’s office of emergency preparedness to determine what steps may reasonably be taken for programs in which you operate.
- Consider any steps that can be legally and reasonably taken to protect beneficiaries’ health and safety. For example, is it possible to conduct in-person meetings over the phone or internet? Can the review process for participants’ COVID-19-related service plan modification requests be expedited?
- Remind participants to review their emergency backup plans and make any needed changes in the event their primary caregiver is unable to come to work.
- Remind participants to communicate to their staff that they should not show up to work if they feel sick or are displaying symptoms of COVID-19. According to the CDC, symptoms of COVID-19 include fever, shortness of breath, and coughing.
- For programs that use Agency with Choice FMS, the Agency with Choice FMS entity is usually covered under the Family and Medical Leave Act (FMLA). The Department of Labor has prepared a short FAQ about COVID-19 and employers’ FMLA obligations available here.
- The Department of Labor has also released reminder guidance for employers related to Fair Labor Standards Act (FLSA) obligations during the COVID-19 outbreak, available here. In short, workers in self-direction who are paid on an hourly or otherwise non-salaried basis are not required to be paid under the FLSA when they are unable to work due to illness. Only hours worked by these employees must be paid under the FLSA.
We hope you, your families, and the participants you serve stay safe and healthy during this difficult time, and we will continue to share COVID-19 information as it emerges.
Best, ASD Membership