State Health and Value Strategies (SHVS), in partnership with Manatt Health, Georgetown’s Center on Health Insurance Reforms (CHIR), State Health Access Data Assistance Center (SHADAC), Bailit Health, and GMMB developed this resource page to serve as an accessible “one-stop” source of COVID-19 information for states. This resource is designed to support states seeking to make coverage and essential services available to all of their residents, especially high risk and vulnerable people, during the COVID-19 pandemic. SHVS will update this page frequently with new resources as they become available.
| If you have materials you are willing to share with other states through this page, or if there are topics of particular concern that you would like addressed, please contact SHVS. |
HHS announced nearly $4.9 billion in awards for over 13,000 skilled nursing facilities (SNFs) in a new targeted allocation of the $175 billion Provider Relief Fund, made available through the CARES and PPPHCE Acts. Skilled Nursing Facilities (SNFs) with six or more certified beds are eligible for payments and may use the payments for critical needs such as labor, scaling up testing capacity, acquiring personal protective equipment and a range of other expenses directly linked to the pandemic. Each SNF will receive a fixed distribution of $50,000, plus a distribution of $2,500 per bed. Recipients must attest that they will only use Provider Relief Fund payments for permissible purposes, as set forth in the Terms and Conditions, and agree to comply with future government audit and reporting requirements.
New York’s Department of Health issued a directive determining that COVID-19 testing of nursing home and adult care facility personnel is medically necessary and twice weekly testing is essential. The health directive was accompanied by a concurrent New York Department of Financial Services directive to insurers requiring coverage of twice weekly testing of all nursing home and adult facility personnel without cost sharing.
New York’s Department of Financial Services released a directive to insurers requiring coverage of twice weekly testing of all nursing home and adult facility personnel without cost sharing. The directive applies broadly to insuers, including Medicaid and Marketplace plans. The insurance directive was accompanied by a concurrent New York’s Department of Health directive determining that COVID-19 testing of nursing home and adult care facility personnel is medically necessary and twice weekly testing is essential.
CDC issued a set of health considerations for states, tribes, localities, and territories as they begin phased re-openings of summer camps, schools, youth sports organizations, institutes of higher education, restaurants, and bars. Considerations are framed as strategies to assist leaders with promoting healthy behaviors, environments, and operations as well as mitigation strategies in the event of incident COVID-19 cases.
CMS issued FAQs for state and local officials, providing recommendations for maintaining infection control and prevention of COVID-19 in nursing homes as states begin phased re-openings. The FAQs address reopening, visitation, and testing requirements.
This document outlines COVID-19 emergency declaration “blanket waivers” for healthcare providers and is regularly updated by CMS. The May 11 update includes several new flexibilities, including, for example:• Relaxed requirements for hospitals to offer “swing-bed” services to patients who qualify for SNF-level care, subject to certain restrictions;• Reduced training requirements for paid feeding assistants in LTC facilities; and,• Expanded the list of clinicians who may perform home health initial and comprehensive assessments (prior waiver added OTs, new waiver adds PTs and speech language pathologists).
CMS issued an interim final rule with comment period (IFC) that provides additional flexibilities for Medicare, Medicaid, and Exchange coverage programs as a result of COVID-19 and also implements regulations in response to recently enacted stimulus legislation.
CMS issued a toolkit on mitigating COVID-19 prevalence in nursing homes that catalogs solutions designed at the state level sourced from healthcare providers, state Governors, and other stakeholders. State actions catalogued in the toolkit include those related to: cleaning/disinfection, reporting/guidance, testing, workforce and staffing, nursing home communications, procuring and improving utilization of PPE, housing and sheltering, patient transfer, and telehealth (among others).
CMS issued a memo regarding new COVID-19 infection control and reporting rules for nursing homes in the recent interim final rule. The memo indicates CMS will be publicly posting facility-level data from the CDC National Healthcare Safety Network.
This updated document outlines COVID-19 emergency declaration 1135 “blanket waivers” for healthcare providers and is regularly updated by CMS. The April 30 updates add new telehealth-related flexibilities, relax physical environment requirements for providers, and make changes to a number of policies related to Community Mental Health Centers and long term care providers.
The Administration for Community Living (ACL) released an FAQ on $85 million distributed to Centers for Independent Living to address needs of individuals with disabilities and allow them to remain safely in their communities. The FAQ covers funding allocation methodologies, allowable uses of funding, and reporting requirements.
CMS provided additional information on the $100 million in CARES Act supplemental funding for survey and certification efforts of nursing homes, noting it intends to make $81 million of the $100 million available to states through September 30, 2023.
Webinar recording and slide deck from webinar hosted on March 18, 2020.
ACL announced that it is awarding $905 million in CARES Act funding for older adults and people with disabilities.
ACL announced $955 million in CARES Act grants for support of older adults and people with disabilities. These grants will fund services such as home-delivered meals, care services in the home, and respite care; the majority of these funds are being awarded to states, territories, and tribes for subsequent allocation to local service providers.
Guidance from CMS increasing nursing home transparency related to COVID-19, including through reporting cases to the CDC, and notifying residents and families of confirmed cases.
ACL recently opened a competitive funding opportunity for states with Aging and Disability Resource Centers (ADRCs) to support immediate response to urgent needs resulting from COVID-19. $50 million available through this opportunitity and applications are due by April 27.
CMS issues guidance for long-term care facilities transferring or discharging residents between facilities for the purpose of cohorting residents based on COVID-19 status (i.e., positive, negative, unknown/under observation).
CMS released guidance for intermediate care facilites for individuals with intellectual disabilities, and for psychiatric residental treatment facilities, to address infection control and prevention practices.
Guidance from New York State Department of Heatlh on the provision of community based long-term services and supports covered by Medicaid.
This expert perspective, written by experts at Manatt Health, discusses strategies state Medicaid and CHIP agencies can pursue as part of their response to COVID-19.
CMS, in consultation with CDC, issues guidance to state and local governments and nursing homes to help mitigate the spread of COVID-19 in nursing homes.
Summary of five key challenges that long term care providers are facing that require rapid responses and real-time decisions in an evolving COVID-19 policy, regulatory and clinical environment.
This page includes federal background information on Section 1135 waivers and a CMS-developed template for states and territories.
CMS released an interim final rule with comment period that proposes several changes to the Medicaid and Medicare programs. For the Medicaid program, the rule amends health home regulations by allowing other licensed practitioners to order home health services, without physician sign-off.
This guidance allows practitioners further flexibility in prescribing and dispensing buprenorphine to new and existing patients with opioid use disorder via telephone without examination in person or via telemedicine.
Compilation of resources for state on Medicare, Medicaid, and CHIP, including transcripts and recordings of all-state calls
Resources on waivers and flexibilities available to states and providers
This page catalogs CMS’s approved COVID-19 State Section 1135 waivers.
Information for PACE Organizations Regarding Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19)
This page includes 1915(c) Waiver Appendix K templates, instructions, and CMS ‘s approved COVID-19 State Appendix K documents.
This page includes guidance and a template for COVID-19 1115 waiver demonstrations.