MSSNYeNews: Trying Times – March 20, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
March 20, 2020

Vol. 23  Number 12


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Colleagues:

The other night, after finally catching up with email, hospital alerts, and various text messages, I fell asleep during a story about physicians’ reporting shortages of Personal Protective Equipment (PPE)

While dreaming about life during wartime, who should show up but Rudyard Kipling. Kipling was sharing a few beers with some British soldiers, having a grand old time. He turned to me and whispered, “You docs have quite a bit in common with our unsung heroes here, you know.” At that, I awoke with a start and found a copy of his poem Tommy on my desk. I knew what I had to do. The result, you see below.

Please share.

Tommy D.

Went to the local grocery to fetch a loaf of bread
Counterman yelled “Stand far away, I’m ‘fraid of being dead.”
Customers talked among themselves, seeing only an empty shelf
I turned around, went outside and mumbled to myself.
It’s greedy this, rent seeker that, old one percenter guy
But it’s thank you Dr Thomson when the baby’s fever’s high

Mocking folks in white coats who treat you when you’re ill
Is cheaper than those white coats, cheaper than that pill.
And calling out tired doctors when they can hardly stand
Seems better for campaigning than giving them a hand.
So it’s greedy this, rent seeker that, old one percenter guy
But it’s savior of the country when pandemic time is nigh.

We don’t feel we’re heroes and not your villains to fear.
We’re merely human beings, just like your neighbors here.
If something that we do rubs folks the wrong way
Remember fellow humans, this isn’t All Saints Day.

So it’s greedy this, rent seeker that, old one percenter guy
But it’s savior of the country when the body count is high.
It’s greedy this, rent seeker that, say anything you please
Your doctor’s not a bloody fool, you bet your doctor sees.

Please make no mistake. We will continue answering the call. It’s what we do. Like the FDNY on September 11, we run into the burning buildings. The difference is that we are fighting fires often without respirators, without hoses and without water. We don’t ask for praise. That’s not why we’re here. We do ask for society’s support without having to keep one eye elsewhere. If we all pull together, I’ve no doubt we’ll pull through. We have no choice. All our lives depend on it.

Comments? comments@mssny.org@mssnytweet; @sonodoc99

Arthur Fougner, MD
MSSNY President




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Details from Governor Cuomo’s Announcement
Summary of Governor’s Press Conference today, including cancelation of non-critical elective surgeries next week and 100% work at home requirement for businesses that are not essential.

When out in public, New Yorkers will be required to “practice social distancing of at least six feet from others. This is the most drastic action we can take,” Cuomo said today.

  • Planning to cancel all elective, non-critical surgeries. Setting date next week.
  • Hospitals instructed to double room capacity (current capacity is 50k).
  • NYS will pay a premium for Personal Protective Equipment (PPE). Governor asking companies to get creative on production in order to meet PPE needs.  Governor is looking at state production as well.  Governor cannot mandate but will offer financial incentives – Companies to contact NYS.
  • For Funding to start up PPE Production – 212-803-3100
  • For Sales – 646-522-8477
  • Expansion of hand sanitizer production.
  • Asking closed medical offices to offer their PPE to needed areas.
  • Regulated health facility ordered by DOH to make ventilators. Will purchase, but asking for donations call DOH
  • NYS On Pause – Executive Order will be issued today. Only essential business will be functioning with in-person staff.  100% of the workforce must stay home.
  • Remain inside. “This is the most drastic action we can take.”
  • Specific Rules for personal conduct of vulnerable people:

-Remain indoors
-Go outside for solitary exercise
-Pre-screen visitors by taking temperature
-Don’t visit households with multiple people
-All vulnerable people should wear masks when in company of others
-Everyone in presence of vulnerable people should wear mask
-Stay six feet away from others
-Do not take public transport unless necessary

  • These provisions are legal and will be enforced. Civil fines and mandatory closure for businesses not in compliance

NYS has a coronavirus hotline at 1-888-364-3065.
The New York State Department of Health has established a provider email account for physicians to ask questions about COVID-19: Covidproviderinfo@health.ny.gov

COVID-19 Elective Surgeries and Non-Essential Procedures Recommendations
Earlier today at the White House Task Force Press Briefing, the Centers for Medicare & Medicaid Services (CMS) announced that all elective surgeries, non-essential medical, surgical, and dental procedures be delayed during the 2019 Novel Coronavirus (COVID-19) outbreak.

A copy of the press release is here.

A copy of the guidance is here.


Check COVID-9 Websites Regularly for Updates
This is a rapidly changing situation. Please regularly check the NYSDOH COVID-19 website and the CDC COVID-19 website for updates.

Others:


How to Set Up Telehealth for Free
Dr. Tom Madejski and Dr. Danial Choi have easy to follow directions on how to set up telemedicine in your office. Since HIPAA has removed its requirement that all telehealth programs be HIPAA qualified, this do it yourself system is free. All you need is your cellphone or tablet.

Please see this video for more information.


NYSDOH Seeking Retired Physicians if Crisis Worsens
In the event that the novel coronavirus crisis worsens, we need the help of qualified retired health professionals and related professionals to supplement our hospital capacity on a temporary basis to treat seriously ill coronavirus patients including those that may need to be intubated. The NYS Dept. of Health will recertify you for the purpose.  The forms are available here.

MEDICAL CORPS: One thousand retired doctors and nurses signed up to join the city’s medical reserve corps, joining 9,000 existing members, as part of preparation for a wave of Covid-19 hospitalizations, the New York Post reported.


Researchers Say Digestive Symptoms Are Common in Patients with Coronavirus
Researchers from the Wuhan Medical Treatment Expert Group for COVID-19 say that digestive symptoms, including diarrhea, are common in patients infected with coronavirus, according to a study in the American Journal of Gastoenterology. The researchers also found that “patients without digestive symptoms were more likely to be cured and discharged than those with digestive symptoms (60% versus 34%).”


People May Hesitate to Seek Treatment for Coronavirus Due to Cost
The New York Times (3/19) reports that the federal government has passed legislation that would eliminate out-of-pocket costs for patients seeking coronavirus testing, and many states, insurers, and employers are also taking action to limit patients’ costs for testing or treatment for coronavirus. However, even if the cost of testing is covered for everyone, experts say people may be reluctant to seek treatment if they are concerned that treatment may be costly.


Recently Released Guidance Documents Related to Home Care

Dear Prevention Partners: Home Care Guidance Documents
Please see several recently released guidance documents related to home care. 

  1. Dear Administrator Letter (DAL): DHCBS 20-08, COVID-19 Guidance for Home Health Care Agencies and Hospice Providers – March 14, 2020

The purpose of this letter is to provide guidance from the New York State Department of Health (NYSDOH) to certified home health agencies, long term home health care programs, hospices, and licensed home care services agencies pertaining to the current novel coronavirus (COVID-19) outbreak.

  1. Interim Guidance for Home Care Services Regarding COVID-19 – March 16, 2020

This document provides agencies and organizations with information about home and community-based services as it relates to the 2019 novel coronavirus disease (COVID-19). Includes an Appendix for Recommended Screening Questions.

  1. Guidance on the Contacts of a Close or Proximate Contact of a Confirmed or Suspected Case of COVID-19

MSSNY: How Telehealth Helps Prevent the Spread of COVID-19
The time for telehealth is now. Healthcare and government leaders have both advocated for the use of telehealth in the fight against the coronavirus.

Through virtual visits, clinicians can remotely screen those who may be infected with COVID-19 without the risk of exposing other patients and providers.

MSSNY endorses the use of telehealth and secure messaging technologies to assess and treat patients remotely, including Backline by DrFirst. Use Association Code MSSNY when registering for Backline Telehealth.

About Backline

Backline makes telehealth and care collaboration easy. A simple text from the provider using Backline goes straight to the patient’s mobile phone to initiate a secure, HIPAA-compliant virtual visit. There’s no patient registration process or app for patients to download. There are no limits on usage or per-session fees.  Plus, Backline gives you communication features you won’t find in other telemedicine offerings.

Please join us in combatting the spread of the coronavirus.  Switch to virtual visits powered by Backline.

Register for Backline Today
Use Association Code MSSNY when registering for Backline Telehealth. 


URGENT TELEMEDICINE UPDATE: Able to Conduct Tele-Visits Now
The CMS has announced that additional emergency measures have been put into place to temporarily expand the use of telemedicine. These measures will include allowing providers to conduct telemedicine visits with patients who are located in their homes. The provider must use an interactive audio and video telecommunications system that permits real-time communication between the distant site (i.e., physician’s office or other location) and the patient at home. “SEE MSSNY WEBSITE FOR EASY DO-IT-YOURSELF INSTRUCTIONS or SIGN UP WITH BACKLINE ABOVE AT $300 PER USER. (See article above)


Small Business Loans Available in Five Counties
There are Small Business Administration loans available for the counties of Bronx, New York, Orange, Rockland, Westchester. Other counties may also qualify as the disease progresses. The loans are available for businesses impacted by COVID-19. The loan is called Economic Injury Disaster Loan Assistance.  Loans have an interest rate of 2.75% with long term repayments in order to keep payments affordable, terms are determined on a case by case basis.  Additional SBA disaster assistance customer service is: 1-800-659-2955 or email at disastercustomerservice@sba.gov or by going to https://disasterloan.sba.gov/ela


“Psychosocial Dimensions of Infectious Outbreaks” WEBINAR April 1st @ 7:30am
REGISTRATION NOW OPEN HERE

MSSNY’s has expedited the presentation of the next Medical Matters webinar “Psychosocial Dimensions of Infectious Outbreaks” on Wednesday April 1st at 7:30am.  This program is a companion piece to the March 18th coronavirus webinar.  This program provides physicians with vital information to care for patients, staff, family and themselves during this unprecedented pandemic.

Faculty for this program is Craig Katz, MD.

Educational Objectives are:

  • Understand common human reactions to infectious outbreaks
  •  Explore factors that influence how people react
  • Describe how to apply historical lessons to your own medical practice

Medical Matters is a series of Continuing Medical Education (CME) webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. A copy of the flyer for this program can be accessed here. To register, please: click here.

For more information, contact: Melissa Hoffman at mhoffman@mssny.org or call (518) 465-8085
Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.


MSSNY COVID-19 Podcast by Dr. Valenti, Chair of Infectious Disease Committee
Dr. William Valenti, Clinical Associate Professor of Medicine (Infectious Diseases)
University of Rochester School of Medicine Senior Vice-President Chair of MSSNY’s Infectious Diseases Committee, discusses the current coronavirus outbreak.



“Coronaviruses 2020: COVID-19 An Evolving Story” CME Webinar Recorded on March 18th Now Available Online
Medical Matters: Coronaviruses 2020: COVID-19 An Evolving Story recorded on March 18th is now available at https://cme.mssny.org .  William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee along with Elizabeth DuFort, MD, Medical Director in the Division of Epidemiology at the New York State Department of Health served as faculty for this program. And Marcus Freidrich, MD, MBA, Chief Medical Officer – Office of Quality of Patient Safety – New York State Department of Health offered additional information.

If you do not already have an account at the MSSSNY CME website, you will need to create one.

Educational objectives:

  • Become familiar with the epidemiology and clinical features of coronaviruses
  • Understand the physician’s role int eh public health response to an infectious disease outbreak
  • Identify the circumstances that have contributed to the rapid spread of COVID-19

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

* Please note that while the recording time of this webinar is approximately two hours, there is only one credit available.  The second hour is an extra question and answer period.


Use the Right Codes for Telemedicine
Billing for telemedicine can be somewhat confusing due to the vast variety of codes.  For simplicity, please be aware that most plans, including Medicare and Medicaid, will accept the normal E&M AMA-CPT codes (99201-99215) with the GT modifier to reflect telemedicine.  Keep it simple. (Be sure to get your patient’s consent to provide your service in this way and note their agreement in their medical record.

Note, during this national state of emergency/pandemic, CMS has expanded telemedicine rules to allow the use of non-public face-to-face technology such as an iPhone or similar equipment.  Additionally, the Office of Civil Rights has relaxed the HIPAA regulations during this event.

If more information is required, email Regina McNally at rmcnally@mssny.org.


UPDATED CASE NUMBERS
TODAY, Governor Cuomo confirmed 1,008 new cases of coronavirus in New York State, bringing the statewide total to 2,382 positive cases.

• We now have 46 deaths

• Today, the Governor announced new cases in Chenango, Essex, Hamilton, Warren and Washington

• Here is the geographic breakdown in NYC and 32 counties:

o   4,408 NYC (695 new)

o   1,091 Westchester (158 new)

o   754 Nassau (52 new)

o   371 Suffolk (32 new)

o   61 Albany (13 new)

o   84 Orange (17 new)

o   101 Rockland (8 new)

o   36 Dutchess (4 new)

o   32 Monroe (4 new)

o   24 Saratoga (5 new)

o   21 Schenectady (9 new)

o   12 Ulster (1 new)

o   31 Erie (same)

o   8 Rensselaer (3 new)

o   7 Tompkins (1 new)

o   7 Putnam (same)

o   2 Allegany (same)

o   2 Greene (same)

o   2 Montgomery (1 new)

o   2 Onondaga (same)

o   2 Broome (same)

o   1 Delaware (same)

o   2 Herkimer (same)

o   1 Tioga (same)

o   3 Ontario (same)

o   2 Wyoming (same)

o   2 Clinton (same)

o   8 Sullivan (same)

o   2 Chenango (1 new)

o   1 Essex (1 new)

o   2 Hamilton (1 new)

o   1 Warren (1 new)

o   1 Washington (1 new)

• New York is still the most impacted state in the nation with 34% of all cases in the U.S. There are 201 deaths in the U.S.

• To date, there are 272,367 positive cases around the world and 11,375 deaths. So far, there are 87,966 total recoveries and 113,913 pending cases worldwide.

• Current Hospitalization Count: 549 out of 2,382 positive cases are currently hospitalized (23% of cases).

• Recovered: 108 people with coronavirus have been discharged from the hospital.

• Testing: 14,597 people have been tested statewide.

• Governor Cuomo’s messages to all New Yorker’s today:

o   “We are fighting a war against this pandemic and we know that two of the most effective ways to stop it is by reducing density and increasing our hospital capacity, so our healthcare system is not overwhelmed.” 

o   “The deployment of the USNS Comfort to New York is an extraordinary but necessary step to help ensure our state has the capacity to handle an influx of patients with COVID-19 and continue our efforts to contain the virus.”

o   Partnering with the private sector to require nonessential employees to work from home will also go a long way toward bending the curve. My number one priority is protecting the public health so that a wave of new cases doesn’t crash our hospital system, and we will continue taking any action necessary to achieve that goal.”


TODAY’S ANNOUNCEMENT

NAVY HOSPITAL SHIP: Today Governor Cuomo announced the Navy hospital ship USNS Comfort will be deployed to New York harbor and is expected to arrive in April.

o   The 1,000-bed hospital ship has 12 fully-equipped operating rooms and will significantly increase New York’s hospital surge capacity.

EXECUTIVE ORDER FOR BUSINESSES: The Governor also announced he will issue an executive order directing non-essential businesses to implement work-from-home policies effective Friday, March 20.

o   Businesses that rely on in-office personnel must decrease in-office workforce by 50 percent.

o   The executive order exempts essential service industries, including shipping, media, warehousing, grocery and food production, pharmacies, healthcare providers, utilities, banks and related financial institutions, and other industries critical to the supply chain. 

o   The Governor also recognized the following partners in this effort:

    • The Business Council of NY
    • Retail Council of NYS
    • ABNY
    • Partnership for New York City

REGIONAL APPROACH: Today the Governor announced that Pennsylvania has joined New York, New Jersey and Connecticut in a regional approach to the combating COVID-19.

o   Governor Cuomo, Governor Murphy, Governor Lamont and Governor Wolf directed temporary closure of all indoor portions of retail shopping malls, amusement parks & bowling alleys – effective by 8 PM Thursday.

STATE GOVERNMENT EMPLOYEES: On Monday, Governor Cuomo directed nonessential state employees statewide to work from home.

o   The Governor also directed local governments to reduce their overall workforce by 50 percent and allow nonessential employees to work from home.

ARMY CORPS OF ENGINEERS: The Governor is meeting with leadership of the Army Corp of Engineers today to discuss ways to increase hospital capacity in New York. 

ACTION PLAN: Today the Governor outlined the State’s ACTION PLAN components:

o   1- Flatten Curve thru Density Reduction

o   2-Increase Current Hospital Capacity

o   3-Identify New Hospital Beds

o   And do all three simultaneously

ID NEW HOSPITAL BEDS: Governor met yesterday with hospital administrators to increase bed capacity and…

o   Waive DOH regulations related to hospital beds

o   Discuss ways to add more staff, including reserve staff

o   And bring in staff from nursing schools, medical schools, retired healthcare workers; and,

o   Convert available facilities into extra hospital space.

DENSITY REDUCTION: Gov. Cuomo reiterated the following density reduction actions:

o   VOLUNTARY: work from home

o   MANDATORY: closed schools statewide

o   MANDATORY: reduce state and local workforce

o   MANDATORY: new 4-state regional agreement to close bars, restaurants and gyms

ESTIMATED VIRUS PEAK: Experts estimate the coronavirus will peak in about 45 days. 

DRIVE-THROUGH TESTING: continues in locations including New Rochelle in Westchester County, Jones Beach in Nassau County…Staten Island and Rockland County.

o   Drive-through mobile testing facilities help keep people who are sick or at risk of having contracted coronavirus out of healthcare facilities where they could infect other people.

o   These facilities are a critical part of the Governor’s nation-leading program to test thousands of people per day for COVID-19 by this week.


YESTERDAY’S ANNOUNCEMENTS

• THREE-WAY AGREEMENT / PAID SICK LEAVE: Governor Cuomo announced a three-way agreement with the Legislature on a bill guaranteeing job protection and pay for New Yorkers who have been quarantined as a result of novel coronavirus, or COVID-19.

o   The program bill also includes the permanent comprehensive paid sick leave policy first advanced in the Governor’s FY 2021 Executive Budget proposal.

o   This follows the Governor’s announcement last week that the state will guarantee two full weeks of paid leave for all state workers who are subject to a mandatory or precautionary order of quarantine as a result of the novel coronavirus.

• SUPPLEMENT HEALTHCARE PERSONNEL: The state is reaching out to qualified former doctors, nurses and other healthcare professionals to supplement the personnel at hospitals.

o   The State Department of Health and the State Education Department have sent letters to retired health care professionals and all schools of nursing, public health and medicine encouraging qualified health care personnel to sign up for on-call work during the COVID-19 crisis.

o   Healthcare professionals who wish to volunteer can contact the State Department of Health at health.ny.gov/assistance.

• CHILD CARE: Governor Cuomo also directed the Greater New York Hospital Association and the Healthcare Association of New York State to work with 1199 SEIU to develop a plan to create drop-in childcare opportunities and expand childcare facilities at their hospitals to ensure childcare for hospital workforce. They will submit a joint plan to the state by Friday.

• EMPLOYEE PROTECTIONS: To address the immediate need of employees affected by COVID-19 who are subject to mandatory or precautionary orders of quarantine or isolation, the Governor’s legislation will provide the following:

o   Employers with 10 or fewer employees and a net income less than $1 million will provide job protection for the duration of the quarantine order and guarantee their workers access to Paid Family Leave and disability benefits (short-term disability) for the period of quarantine including wage replacement for their salaries up to $150,000.

o   Employers with 11-99 employees and employers with 10 or fewer employees and a net income greater than $1 million will provide at least 5 days of paid sick leave, job protection for the duration of the quarantine order, and guarantee their workers access to Paid Family Leave and disability benefits (short-term disability) for the period of quarantine including wage replacement for their salaries up to $150,000.

o   Employers with 100 or more employees, as well as all public employers (regardless of number of employees), will provide at least 14 days of paid sick leave and guarantee job protection for the duration of the quarantine order.

• TIMING OF PROVISIONS: The provisions of the quarantine legislation are set to take effect immediately upon passage, ensuring that New York workers will be able to take advantage of these benefits.

• MORE ON PAID SICK LEAVE: The legislation also includes the comprehensive paid sick leave proposal that was advanced by the Governor as part of his State of the State and FY 2021 Executive Budget, which will be effective 180 days after enactment. Specifically, the legislation provides:

o   Employers with 4 or fewer employees and a net income less than $1 million will provide at least 5 days of unpaid sick leave each year.

o   Employers with 5-99 employees and employers with 4 or fewer employees and a net income greater than $1 million will provide at least 5 days of paid sick leave each year.

o   Employers with 100 or more employees will provide at least 7 days of paid sick leave each year.

• HALT ON STUDENT DEBT: Governor Cuomo and Attorney General Letitia James announced that — effective immediately — the state will temporarily halt the collection of medical and student debt owed to the State of New York and referred to the Office of the Attorney General for collection, for at least a 30-day period, in response to growing financial impairments resulting from the spread of 2019 novel coronavirus, or COVID-19.

o   In an effort to support these workers and families and ease their financial burdens, the OAG will halt the collection of medical and student debt owed to the State of New York and referred to the OAG for collection from March 16, 2020 through April 15, 2020.

o   After this 30-day period, the OAG will reassess the needs of state residents for a possible extension.

o   Additionally, the OAG will accept applications for suspension of all other types of debt owed to the State of New York and referred to the OAG for collection.


ADDITIONAL INFORMATION / PREVIOUS ANNOUNCEMENTS

• HOSPITAL CAPACITY: Governor Cuomo issued an Executive Order allowing the state to increase hospital capacity to prepare the state’s healthcare system to handle the potential influx of patients suffering from COVID-19.

o   The State will organize the National Guard and work with building unions and private developers to find existing facilities — such as dormitories and former nursing homes — that can most easily be converted to medical facilities, with the goal of creating an additional 9,000 beds.

o   The Governor also asked local governments, especially those in the most impacted areas, to help identify available facilities for this purpose.

o   The State Department of Health is also suspending regulations to allow existing hospitals to increase space and capacity.

• HOSPITAL SURGE CAPACITY COUNCIL: The Governor has asked the Greater New York Hospital Association President Ken Raske and Northwell Health President Michael Dowling to lead a council to develop hospital surge capacity.

• ELECTIONS DELAYED: Governor Cuomo issued an executive order delaying village elections statewide until the April 28 primary election.

o   Delaying village elections will help ensure poll workers and voters are not potentially exposed to the virus and at the same time maintain integrity in our election system.

• SCHOOL CLOSINGS UPDATE: Governor Cuomo signed an executive order directing all schools in New York to close by Wednesday, March 18 for two weeks ending April 1.

o   At that time, the state will reassess whether to extend the school closures further and continue to suspend the 180-day instructional requirement. Schools that exceed the closure period without state authorization will not be exempted from the 180-day rule.

o   About 86% of all schools in the state have closed already.

• LOCAL GOVTS: The Governor also directed local governments to reduce their overall workforce by 50 percent and allow nonessential employees to work from home. But local governments must keep a minimum 50 percent capacity to deal with community response efforts.

• PARK FEES WAIVED: The Governor also announced New York State will waive all fees for state, local and county parks.

• SUPPORTING CHILDREN and PARENTS:  The Governor also called on 1199 SEIU, NYSNA, Greater New York Hospitals Association and United Federation of Teachers to work together to ensure children who rely on school breakfast and lunch programs will continue to receive that support.

• DMV: The Governor also directed DMV to move to appointment only to limit person to person contact and revert to regular hours rather than the extended hours the state implemented in recent weeks to help reduce lines.

• WORKING WITH COUNTIES: The Governor also tasked SUNY Empire State College President Jim Malatras with working with counties to develop contingency plans in preparation for school closings, including how to provide meals to food insecure children and ensuring families have adequate access to childcare.

• NYS COURT SYSTEM:  Governor Cuomo asked Chief Judge Janet DiFiore to develop a plan to reduce density in the court system, including limiting nonessential proceedings, without disrupting criminal justice system.

• ELECTION PETITIONS: In an effort to keep New Yorkers safe during the COVID-19 pandemic, Governor Andrew M. Cuomo today signed an executive order temporarily modifying election procedures to help reduce the spread of the novel coronavirus.

o   Governor Cuomo said: “This executive order modifies the election process in a way that both protects public health and ensures the democratic process remains healthy and strong regardless of the ongoing pandemic.”

o   The executive order suspends the candidate petitioning process — effective 5PM on Tuesday — for the June primaries for Congressional, State Senate, State Assembly and Judicial races.

o   The executive order also modifies the signature requirements for ballot access; candidates will only need to collect 30 percent of the statutory threshold.

o   For Congress, candidates would need 375 signatures rather than 1,250.

o   For State Senate, candidates would need 300 signatures rather than 1,000.

o   For State Assembly, candidates would only need 150 signatures rather than 500.

o   The executive order also modifies deadlines and procedures to better allow New Yorkers to vote absentee for the Queens Borough President special election on March 24. It extends the current deadline to register to vote absentee to March 23, the day before the special election. Absentee votes must be postmarked or delivered in person up until the day of the election on March 24.

• TELEMEDICINE: Governor Cuomo today announced the State Department of Financial Services will require insurance companies to waive co-pays for telehealth visits.

o   This action will encourage New Yorkers to seek medical attention from their homes rather than visit a hospital or doctor’s office — ultimately reducing strain on the healthcare system and preventing further spread of the virus.

• INCREASING TESTING CAPACITY: The addition of a mobile testing facility on Long Island is part of the State’s initiative to replicate the New Rochelle Mobile Testing Center model at other locations, helping the state to run at least 6,000 tests per day starting next week — six times the state’s target goal when this outbreak first came to New York.

o   This is on top of the testing that will be conducted at the 28 public and private labs across the state and the out of state labs that New York is already contracting with.

o   All of this is a result of the proactive steps taken by Governor Cuomo and the Department of Health to get as many New Yorkers tested as possible.

• TESTING GUIDANCE: We have received lots of questions around testing guidance and who can or should get tested now. Here’s an excerpt from the current guidance.

• Testing for COVID-19 shall be authorized by a health care provider when:

o   An individual has come within proximate contact (same classroom, office, or gatherings) of another person known to be positive; or

o   An individual has traveled to a country that the CDC has issued a Level 2 or Level 3 Travel Health Notice, and shows symptoms of illness; or

o   An individual is quarantined (mandatory or precautionary) and has shown symptoms of COVID-19 illness; or

o   An individual is symptomatic and has not tested positive for any other infection; or

o   Other cases where the facts and circumstances warrant as determined by the treating clinician in consultation with state and local department of health officials.

• NURSING HOMES: There are new limits on visitations to nursing homes – Only Medically Necessary Visits Will Be Allowed to Protect Most Vulnerable.

o   All staff are required to wear masks.

o   All staff will be monitored for symptoms.

o   No non-medical/staff personnel may enter unless there’s an exigent circumstance. In such a case, visitors must then wear protective clothing including masks.

o   NYS DOH sent updated guidance to all nursing home administrators around the state. That guidance is posted on the State Department of Health’s COVID-19 website.

• UNEMPLOYMENT ASSISTANCE: As part of the Governor’s Executive Order, the state will waive the 7-day waiting period for workers in shared work programs to claim unemployment insurance for those that have been put out of work by COVID-19

• SUPPLIES: Local governments seeking to obtain additional stocks of hand sanitizer or other supplies should work with their County’s emergency Manager and local Health Department to submit requests directly into NY RESPONDS, the state’s web-based system which enables both local governments and state agencies to submit and share vital emergency-related information and resource requests.

• STATE GUIDANCE: We are continually updating guidance for our communities, local governments, schools, health care providers, businesses, other institutions, and the public at large.

o   In the last few days, we have provided – and posted to our websites – updated guidance for schools, nursing homes, home care agencies, hospice and more.

o   We have also posted guidance on testing, cleaning & disinfecting, large gatherings and public spaces, and for employees with exposure concerns.

• NEW MASS GATHERING REGULATIONS: Public health experts agree mass gatherings with people making sustained close contact are a place where the novel coronavirus can easily infect many people quickly and continue its spread.

o   So in response, events with 500 or more individuals in attendance will be cancelled or postponed.

o   From zero to 500, we’re reducing the occupancy by 50%. So 50% of your seated capacity is the new capacity for a facility.

o   Those new rules will go into effect five o’clock on Friday, except for the Broadway theaters in Manhattan, which closed as of five o’clock yesterday.

o   Large gatherings and public spaces within the scope of this guidance include, but are not limited to: • Theaters, • Auditoriums, • Concerts, • Conferences, • Worship services, • Sporting events, • Restaurants, • Bars, • Gaming establishments, and • Physical fitness centers.

o   This guidance is not intended for governmental, medical, educational, retail spaces, or mass transportation facilities, including but not limited to: • Schools, • Libraries, • Government Buildings, • Hospitals, • Residential Health Care Facilities, • Retail Establishments, including: o Grocery Stores, o Pharmacies, • Public Transit Facilities: o Trains/Railway Stations, o Subway Terminals, and o Buses and Bus Terminals.

• PUBLIC UTILITIES: The Governor also directed the New York State Department of Public Service to suspend public utilities from cutting off service – including power and heat – to customers affected by COVID-19. The State’s major utilities will take immediate action to suspend service shutoffs to households during the COVID-19 outbreak and will continue to offer deferred payment plans for customers struggling financially due to the outbreak.

• NATIONAL GUARD: At the direction of Governor Cuomo, the New York National Guard has mobilized Army and Air National Guard members in State active duty status to assist in New York State’s efforts to contain the spread of the COVID-19 virus.

o   The soldiers come from units located across New York.

o   The soldiers will be on duty as long as required and are assisting in the distribution of food supplies and state-provided hand sanitizer, aiding with the cleaning and disinfecting of public spaces, and helping with transportation and logistical needs.

• DOCCS: The New York State Department of Corrections and Community Supervision has suspended visitation at facilities statewide.


RESOURCES

• WEBPAGE: That NYS DOH dedicated coronavirus webpage is: (https://www.health.ny.gov/diseases/communicable/coronavirus/). That’s the best place for updated case numbers, guidance, press releases, and additional information.

• HOTLINE: NYS DOH maintains a Coronavirus Hotline (1-888-364-3065) where New Yorkers with questions about the coronavirus can speak with public health experts in their preferred language.


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