COVID-19 Guidance for Medicaid Providers

Guidance on Providing Adult Social Day Care (SDC) Services Telephonically

  • Guidance is also available in Portable Document Format (PDF)

April 7, 2020

Re: COVID–19 Guidance for Providing Adult Social Day Care (SDC) Services Telephonically

Dear Adult Social Day Care Program Administrators and Managed Long Term Care Plans:

The New York State Department of Health (NYSDOH) is issuing this guidance to adult Social Day Care (SDC) programs (also referred to as Social Adult Day Care (SADC)) and Managed Long Term Care Plans (MLTCPs) regarding social day care services provided and covered during the COVID–19 public health emergency, including telephonic services. This guidance is provided following the state disaster emergency declared by Executive Order No. 202, in response to COVID–19, and shall remain in effect until subsequent notice from the NYSDO H, which will be provided prior to, or upon the expiration of, such state disaster emergency.

Background

The health and safety of the State´s health care providers, and our ability to provide and support patient care, remain NYSDOH´s top priorities. Community–wide transmission of COVID–19 has occurred in the United States (US) and the number of both Persons Under Investigation (PUIs), and confirmed cases, is increasing in NYS. The situation with COVID–19 infections identified in the US continues to evolve and is rapidly changing. It is important for all agencies to keep apprised of current guidance by regularly visiting the NYSDOH COVID–19 website, the Centers for Disease Control and Prevention (CDC) website, as well as the NYSDOH Health Commerce System (HCS), for the most up–to–date information. Those resources are available at:

It is important to keep staff updated as the situation changes and educate them about the disease, its signs and symptoms, and necessary infection control measures to protect themselves, and the people they serve. NYSDOH distributes alerts and advisories on its website. It is vital that providers maintain up–to–date contact with both the CDC and NYSDOH. Providers may wish to provide internal contact information for their staff and clients to call with concerns, reports, or questions.

Providing Adult Social Day Care (SDC) Services to Managed Long Term Care Plan Enrollees During the COVID–19 Public Health Emergency

Adult SDC can provide an invaluable service in this uncertain time, where isolation and anxiety are widespread. SDC is a structured program that provides functionally impaired individuals with socialization, supervision and monitoring, and nutrition, in a protective setting during any part of the day, but for less than a 24–hour period. Under the Medicaid program, this benefit is available exclusively through MLTCPs.

To help ensure access to SDC services during the COVID–19 public health emergency, SDC providers that contract with MLTCPs may provide SDC services telephonically or via permitted telehealth platforms. SDC services delivered telephonically or via telehealth platforms shall be reimbursed under the provision of the contract between a MLTCP and SDC, and in accordance with NYSDOH guidance: Medicaid Update Special Edition: Comprehensive Telehealth Guidance. SDC activities delivered telephonically or via telehealth platforms, including those discussed below, must be offered at the participant´s option and reflect the participant´s interest, goals, and preferences, as identified and documented in the SDC care plan.

Socialization: Contracted SDCs should develop a series of remote activities that address participants´ need for interaction, engagement, and activity. Methods for delivering remote activities include using Skype, Google Meet, Zoom, FaceTime, smartphones, or other modalities, to engage participants with stretching activities, games, educational activities, arts and crafts, and other group activities.

For information regarding options and resources f or participants with limited, or lack of access, to devices and services, please see Medicaid Update Special Edition: Comprehensive Telehealth Guidance.

For participants without internet or smart phone/computers, staff of the SDC may deliver audio books and players, music players, arts and craft supplies, and games, and set up times to phone in to sing–alongs or group games held remotely. Any deliveries should be made while adhering to social distancing and infection control guidance issued by NYSDOH and the CDC for home care. Guidance related to home care services and close or proximate contact of a confirmed or suspected case of COVID–19 is available:

Monitoring: Contracted SDC providers may use appropriate level staff to call participants, to ensure the health and well–being of the individual. The conversation should give the SDC staff an indication of the health and well–being of the participant. Expressed anxiety or issues with food security, adequate supplies and required medications, should be addressed by providing assurances, or delivering groceries, needed supplies, and medication. Home delivered meals should be arranged by the MLTC plan. SDCs should immediately, or as soon as practicable, notify the MLTCP of any need for intervention, or other indications, where intervention may be required.

Transportation: For the duration that this guidance remains in effect, as described above, SDC providers should not provide transportation to MLTC members. MLTCPs should arrange for the non–emergent transportation of their members and follow the requirements included in transportation guidance issued by NYSDOH.

Instructions for Provider Personnel who are at Risk of Being a Person Under Investigation (PUI) (i.e. someone suspected of having COVID–19 due to symptoms or close, unprotected exposure to someone who has the virus)

Staff are exposed to the general community every day and could become infected with COVID–19. Providers should have a policy in place to speak with staff , prior to them conducting face–to–face visits with enrolled members, in order to screen the staff for symptoms or contacts that might have put them at risk for COVID–19. It is important that providers strictly enforce their illness and sick leave policies. Staff showing symptoms of illness should not be permitted to remain at work or visit members. Staff should only return to work in accordance with NYSDOH guidance on Protocols for Essential Personnel to Return to Work Following COVID–19 Exposure or Infection.

Staff who have been potentially exposed to someone with confirmed COVID–19, or to someone who is a person under investigation (PUI) for COVID–19, might be placed under movement restrictions by public health officials, based on exposure risk for having contracted COVID–19 and any presenting symptoms.

If a staff person is found to be ill upon screening, the agency should send the person home immediately, and suggest that they contact their primary care physician or refer them to immediate medical care, if necessary.

Where can I direct my questions about COVID–19?

Questions can be directed to the following email address: icp@health.ny.gov or to the toll–free call center at 888–364–3065.

Where can I direct my questions about this guidance?

Please send any questions relating to this guidance to MLTCinfo@health.ny.gov.

Your diligence in implementing appropriate measures for COVID–19 preparedness is appreciated.