New York DOH Submits Emergency 1115 Request for COVID-19 Assistance

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What is happening?

This past Monday, the New York State Department of Health (NYSDOH) submitted an 1115(a) demonstration application to CMS in response to the COVID-19 public health emergency. The application requests $2.75 billion to supplement providers who have been greatly affected by COVID-19, to leverage existing MRT resources, such as Performing Provider Systems (PPS), and to alleviate key regulatory burdens as the state continues to address the COVID-19 crisis.

What are the details?

  • $2.75B in new federal funding for the period March 1, 2020 — March 31, 2021. (Funding would expire either on the state’s proposed end date of March 31, 2021, or 60 days after the currently declared public health emergency ends.)
  • The funding request is split across two funding pools, which in turn will fund three key investments.
    • The Emergency Capacity Assurance Fund (ECAF) ($1.85B), which will fund:
      • Emergency Capacity Assurance ($1.2B), which will protect against degradation of access to key healthcare services, limit unproductive disruption, and avoid gaps in the health delivery system that have arisen due to the COVID-19 public health emergency.
      • Rapid Facility Conversion ($650M), which will support investments in facility conversion at the local level to support changing needs and demands in the COVID-19 public health emergency.
    • Regional Coordination and Emergency Deployment Fund (RCEDF) ($900M), which will fund:
      • Regional Coordination and Workforce Deployment ($900M), which will leverage the existing PPS network to support regional coordination, deploy telehealth infrastructure, expand adoption of Promising Practices related to care coordination and care management, and workforce redeployment efforts to enhance local capacity in the COVID-19 public health emergency.
    • Additionally, the state seeks regulatory flexibilities to support the health care delivery system’s response to COVID-19, shifts the requests made in its 1335 waiver to this new application, and seeks extension of up to 12 months of all the current terms and conditions of its MRT Waiver (currently set to expire in March 2021).

If approved this would allow New York to design “a more flexible, strategic, community-focused health care system that responds dramatically more effectively in times of a national or state health emergency.”

Then what?

The Emergency Capacity Assurance funds would move into an application phase with CMS. CMS will publish requirements on its website, followed by a 10-day application period, and then decide upon awards. Rapid Facility Conversion will follow suit and then the State would work with local counties, public health organizations to distribute funding.

The Regional Coordination and Workforce Deployment funding for PPS across the State will also be an application process with a quick turnaround. Eligibility is open to the 25 PPSs across the state who would submit a regional coordination plan. “Special consideration” towards awarded funds will be given to those with strong community-based organization partnerships along with an “inclusive” provider network. “Overlapping coordination” for regions with two or more PPS for the sake reaching the various communities served. 50% of funding would be available upon approval of a PPS’ coordination plan; performance will dictate the remaining funds via submitted reports on the 45- and 90-day marks. As new needs come about, unused funds can be reallocated to other PPS.

Please reach out with any questions to Scott Emery at scott.emery@mshallassociates.com