As part of our ongoing efforts to support our clients and friends through these trying times we will be making you aware of various programs being implemented by both the public and private sectors to help ease the financial stress being put on many of your businesses as a result of the ongoing COVID-19 pandemic and the measures implemented to stop the spread. Below are some resources that your businesses may be able to utilize to address the impact of COVID-19.

HELP FOR NEW YORK NON-PROFITS NYC COVID-19 RESPONSE AND IMPACT FUND

A group of leading New York philanthropic organizations have established a $75 million fund to provide no-interest loans and grants to human service organizations and arts and cultural non-profits based in New York City to address the following needs:

  • New and emergency requirements to meet community demands, particularly for service offerings outside normal operations necessary to respond to social distancing, isolation and quarantine;
  • Technology to support remote work and services – laptops and remote calling capacity (e.g. Zoom), securing staffing and training to fulfill their mission;
  • Temporary staff support to cover shortages caused by employees who are ill, have to quarantine or stay home to care for family members or children during school closures;
  • Equipment and supplies such as masks, hand sanitizer, gloves and cleaning supplies;
  • Additional cleaning services to augment in-house operations;
  • Support to aid the loss of operational revenue from facility closings, cancelled programs, etc.;

To be eligible an organization must meet the following criteria:

  • 501(c)(3) non-profit organization;
  • Based in New York City;
  • Recipient of New York City or New York State government funding;
  • Annual operating budget of up to $20 million (excluding government contracts);
  • Have a record of delivering effective programs and services for New York City residents.

Application forms are available commencing March 23, 2020.

NEW YORK CITY EMPLOYEE RETENTION GRANT PROGRAM

New York City has launched the Employee Retention Grant Program to assist small business impacted by the COVID-19 crisis to help retain employees.  The Program is available to small businesses with 1-4 employees who can apply for a grant of up to $27,000 to cover 40% of payroll costs for two months to help retain employees.  To be eligible, the applicant must demonstrate a decrease of at least 25% in revenue, must be located in New York City, have been in operation for at least 6 months, and have no tax liens or legal judgments.

NEW YORK CITY SMALL BUSINESS CONTINUITY FUND

New York City businesses with less than 100 employees can apply for 0% loans to cover revenue losses.  Eligible businesses need to be located within New York City, evidence at least a 25% decrease in revenue caused by the COVID-19 outbreak, demonstrate an ability to repay the loan and have no outstanding tax liens or judgments. As part of the application process, the required revenue decrease must be evidenced by point-of-sales reports, bank statements, quarterly sales tax filings, 2019 tax returns and CPA certified profit and loss statements.

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If you would like further information about these or any other programs, or if you want to discuss strategic alternatives for your business, please contact the Garfunkel Wild attorney with whom you regularly work.

Click Here to download the Legal Alert.

 

To provide support to small businesses and private, non-profit organizations suffering economic injury due to the ongoing COVID-19 pandemic, the U.S. Small Business Administration is making low-interest federal disaster loans available to eligible borrowers in designated states and territories, including New York, New Jersey and Connecticut.

SBA Economic Injury Disaster Loan Terms

  • The SBA’s Economic Injury Disaster Loans offer up to $2,000,000 in assistance to help eligible borrowers overcome temporary revenue losses.
  • Interest rates under the loans are 3.25% for small businesses and 2.75% for non-profit organizations.
  • Borrowers may use the loan proceeds to pay fixed debts, payroll, and accounts payable, and to fund other working capital needs not being met due to the impact of COVID-19.
  • The loans offer long loan terms, of up to a maximum of 30 years, in order to keep repayment obligations affordable. Loan terms are determined by the SBA on a case-by-case basis, based on each borrower’s ability to repay.
  • For expedited loan application processing, the business must have been operating for at least one year prior to the disaster.
  • Applicants must provide their gross revenues for the past twelve months, cost of goods sold for the past twelve months, and (for rental properties only) lost rents due to the crisis.
  • Eligibility considerations will include compensation available from other sources to offset the economic injury. Other sources include grants or other reimbursement (including loans) from government agencies or private organizations, and (2) claims for civil liability against other individuals, organizations or governmental entities.
  • Loans are available to eligible businesses located in Arizona, California, Colorado, Connecticut, Delaware, the District of Columbia, Georgia, Illinois, Indiana, Louisiana, Maine, Maryland, Massachusetts, Michigan, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Utah, Virginia, Washington, and West Virginia (as well as those located in certain designated counties in Alabama, Arizona, Arkansas, Idaho, Iowa, Kentucky, Mississippi, Missouri, North Dakota, Oregon, Texas, Vermont, Wisconsin, and Wyoming contiguous to one or more of those states) where that state’s Governor has submitted a request to the SBA for EIDL assistance.

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As this situation unfolds, recommendations and requirements are being updated and changed at a rapid pace. If you need any assistance in understanding or addressing these concerns, please contact the Garfunkel Wild attorney with whom you regularly work.

Click Here to download the Legal Alert.

 

Garfunkel Wild Complimentary Webinar – Operationalizing State-Wide Ban on Elective Surgery

Tuesday, March 24, 2020
3:00 PM – 4:00 PM EDT

Speakers:  Andrew E. Blustein, Stacey L. Gulick 

Garfunkel Wild Chairman Andrew E. Blustein and Partner Stacey L. Gulick  will present the webinar “Operationalizing State-Wide Ban on Elective Surgery” on March 24, 2020. New York State is banning elective procedures at hospitals and ASCs for the unforeseeable future. This webinar will explore what the scope of these bans and some suggestion on how to operationalize these limitations. This webinar is especially useful for ambulatory surgery centers who typically rely on elective volume.

Click Here To View Webinar

 

New York State’s rapidly evolving response to COVID-19 has resulted in a number of new Executive Orders (“Orders”) from Governor Cuomo, as well as various regulatory waivers and guidance from the Centers for Medicare and Medicaid Services, the New York State Department of Health and other state agencies.  We understand that nursing homes are on the front lines of this unprecedented health crisis, and that you may not have time to keep up with all of the regulatory changes.  Please know that Garfunkel Wild stands ready to assist you at this critical juncture.

For your convenience, we have summarized the most relevant information and guidance below.  We will continue to post updates as new directives are issued, so please monitor our web site or call the Garfunkel Wild attorney with whom you work for more information.

Staffing

  • Physicians licensed and in current good standing in any state are permitted to practice medicine in New York without civil or criminal penalty related to lack of licensure.
  • Physicians licensed and in current good standing in New York, but not registered in New York, are permitted to practice in New York without civil or criminal penalty related to lack of registration.
  • Physician assistants, registered nurses, licensed practical nurses, and nurse practitioners licensed and in current good standing in any state are permitted to practice in New York without civil or criminal penalty related to lack of licensure.
  • Staff with the necessary professional competency and who are privileged and credentialed to work in a facility in compliance applicable laws and regulations, or who are privileged and credentialed to work in a facility in another state in compliance with the applicable laws and regulations of that other state, are permitted to practice in a facility in New York.
  • CMS has also temporarily waived requirements that out-of-state providers be licensed in the state where they are providing services when they are licensed in another state. This applies to Medicare and Medicaid.
  • Requirements concerning the practice of medicine and nursing (Sections 6521 and 6902 of the Education Law, respectively) are suspended to the extent necessary to permit unlicensed individuals, upon completion of training deemed adequate by the Commissioner of Health, to collect throat or nasopharyngeal swab specimens from individuals suspected of being infected by COVID-19, for purposes of testing; and to the extent necessary to permit non-nursing staff, upon completion of training deemed adequate by the Commissioner of Health, to perform tasks, under the supervision of a nurse, otherwise limited to the scope of practice of a licensed or registered nurse.

Admissions, Discharges and Qualifying Stays

  • CMS has waived the requirement for a 3-day prior hospitalization for coverage of a skilled nursing facility stay, which provides temporary emergency coverage of SNF services without a qualifying hospital stay for individuals who need to be transferred as a result of the disaster.
  • For certain beneficiaries who recently exhausted their SNF benefits, CMS has authorized renewed SNF coverage without first having to start a new benefit period.
  • CMS has waived compliance with the resident assessment requirements set forth at 42 CFR 483.20, in order to provide relief to skilled nursing facilities on the timeframe requirements for Minimum Data Set assessments and transmission.
  • Nursing homes receiving individuals affected by COVID-19 are permitted to: (i) perform comprehensive assessments of residents temporarily evacuated to such nursing homes as soon as practicable following admission, or to forego such assessments for individuals returned to facilities from which they were evacuated; (ii) obtain physician approvals for admission as soon as practicable following admission, or to forego such approval for individuals returned to facilities from which they were evacuated; and (iii) comply with admission procedures as soon as practicable following admission, or to forego such procedures for individuals returned to facilities from which they were evacuated.
  • 10 NYCRR Sections 400.9 and 405.9 are suspended to the extent necessary to permit general hospitals and nursing homes that are treating patients during the pandemic to rapidly discharge, transfer, or receive such patients, as authorized by the Commissioner of Health, provided such facilities take all reasonable measures to protect the health and safety of such patients and residents, including safe transfer and discharge practices, and to comply with the Emergency Medical Treatment and Active Labor Act (42 U.S.C. § 1395dd) and any associated regulations.

Expanded Telehealth Services

With respect to the expansion of telehealth services, we encourage you to view our webinar entitled “Implementing and Expanding Telehealth to Address COVID-19,” which is available for viewing online at:

https://youtu.be/CdxOi4Axy1s

Temporary Provision of Home Hemodialysis to Nursing Home Residents

The Department of Health has indicated it will issue emergency approvals for nursing home residents for the temporary provision of home hemodialysis.  Facilities that previously submitted a Limited Review Application (LRA) must submit a written notice addressed to the Director, Division of Nursing and ICF/IID Surveillance.  SNFs that wish to request emergency approval for nursing home hemodialysis, but have not yet submitted an LRA, may wish to reach out to End State Renal Disease (ESRD) providers that have already been approved by DOH to provide HHD and execute a contract with them to provide services on site.  Note that the project MUST comply with the most current state and federal guidance related to treatment of patients with known or suspected COVID-19.   Requests should be submitted to Sheila McGarvey at Sheila.mcgarvey@health.ny.gov.

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Finally, we encourage you to be familiar with Federal, State and local on-line resources.  Here are a few:

https://www.cms.gov/newsroom/press-releases/cms-takes-action-nationwide-aggressively-respond-coronavirus-national-emergency

https://coronavirus.health.ny.gov/home

https://www1.nyc.gov/site/doh/health/health-topics/coronavirus.page

https://www.nj.gov/health/cd/topics/ncov.shtml

https://portal.ct.gov/DPH/Public-Health-Preparedness/Main-Page/2019-Novel-Coronavirus

https://www.cdc.gov/coronavirus/2019-ncov/index.html

https://asprtracie.hhs.gov/MasterSearch?qt=coronavirus&limit=20&page=1&CurTab=0

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As this situation unfolds, recommendations and requirements are being updated and changed at a rapid pace. If you need any assistance in understanding or addressing these concerns, please contact the Garfunkel Wild attorney with whom you regularly work.

Click Here to download the Legal Alert.

 

We have been heartened by many of our client healthcare facilities and providers developing and offering up unique and creative solutions to address the surge of healthcare needs from the evolving COVID-19 outbreak. We have been working with our clients and the NYS Department of Health (DOH) to facilitate the necessary emergency approvals to implement these proposals in an expeditious manner. As you may know, the NYS Governor’s Executive Order 202.1 gave the DOH the authority to issue these emergency approvals (without a CON).

Different divisions or bureaus at DOH are handling these requests depending on the nature of the facility and the proposal.

If you wish to pursue such a proposal to create additional capacity for COVID-19, while our offices are closed, we are completely set up and are remotely available to help expedite your requests. These requests can include emergency approval for additional capacity or alternative sites for testing, triage, screening or treatment related to COVID-19 surge response. This may include construction or modification requests related to the use of alternative facilities, development of additional capacity or the repurposing of existing space.

Once again, we are proud to consider ourselves part of a healthcare community which has proven itself in this and other crises to be resilient and resourceful. We are here to play our part to help manage these challenging times.

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Should you have any questions, please contact the Garfunkel Wild attorney with whom you regularly work, or contact us at info@garfunkelwild.com. We have attorneys on call 24/7. If you call our main number, 516-393-2200, it will direct you to the on-call attorney.