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DHS COVID-19 PROVIDER RESOURCES // OLTL

FAQ: CMP Application for Communicative Technology Requests for State Medicaid Agencies 

Issued: May 18, 2020; Updated: June 24, 2020

1. What is the application for communicative technology? 

The Centers for Medicare & Medicaid Services (CMS) has issued Guidance for Infection Control and Prevention of COVID-19.1 This guidance directs nursing homes to significantly restrict visitors and nonessential personnel to protect nursing home residents. Recognizing that visitor restrictions may be difficult for residents and families, CMS has developed this application template for requests for the use of Civil Money Penalty (CMP) Reinvestment funds to provide residents with adaptive communicative technologies. 

2. Will applications requesting CMP funds for communicative technology be expedited? 

State agencies can approve applications that meet the defined CMS parameters without review by CMS. CMS anticipates that this process will reduce the amount of time needed to review and approve the use of funds for communicative technology.

The purpose of this application is to provide a template to potential applicants so they provide all the required information for the State Agency to make a timely determination on the request for the use of funds.

3. When can States approve CMP applications without CMS review? 

States must first retain 60 percent or $1 million (whichever is lowest) of their available CMP funds for emergencies. If they have not retained this amount, they must send an email to their CMS Branch Office confirming they will hold this amount in reserve.

Applications must meet all the following criteria: 

    1. Applications must be on the COVID-19 Communicative Technology Application Template.
        • If the application is for communicative technology but is not on the template, the state may follow up with the applicant to request they resubmit on the template. 
    2. Applicants must only include requests for funds to purchase communicative technology devices (e.g. iPads, tablets, webcams) and accessories (e.g. headphones, protective covers).
        • The application should not include requests for items identified as prohibited (travel, administrative costs).
    3. Devices should be shared among residents, with a ratio of 1 device to 7-10 residents. Facilities will not be permitted to purchase personal devices for any resident. Devices should not be shared between COVID-19 positive (or suspected) and other residents (COVID-19 negative or observation status). Devices must be cleaned and disinfected between residents. 
    4. Facilities may use up to $3,000 for communicative technology. Applications or requests for exceptions could be considered in certain circumstances, such as in the case of a facility with a large number of residents. These applications should be forwarded to the CMS LTC Branch to be reviewed on a case by case basis.

4. When should the SA deny an application? 

    • Devices must be able to support both virtual social and telehealth visits (e.g. the devices must connect to the internet, have appropriate installed software such as FaceTime or GoogleMeet).
        • If the application does not indicate that the technology can or will be used to facilitate such visits, the application should be denied by the SA. 

5. What if an applicant fails to use the CMP COVID-19 Communicative Technology Application Template? 

Communicative technology applications submitted via formats other than the provided CMP COVID-19 Communicative Technology Application Template can NOT be approved by the State. These applicants should be provided a copy of the correct template and advised to resubmit their request. 

6. What are examples of devices that promote virtual visits?

Devices

    • iPad or iPad Mini
    • Facebook portal
    • Amazon Echo Show
    • Kindle Fire
    • Microsoft Surface
    • Samsung Galaxy Tablet
    • Or any other device

7. What are examples of allowable accessories?

Accessories

    • Protective covers that allows for cleaning and disinfection
    • Cleaning and disinfection products in accordance with recommendations of the device manufacturer; Review the EPA’s Disinfectant List for Use Against SARS-CoV-2 to determine if the disinfectant listed in the manufacturer’s instructions are listed
    • Headphones (for individual use)
    • Assistive/adaptive equipment
    • Tripods (floor or table top)

8. How can an applicant determine that the devices can be used to enable virtual visits? 

The applicant should determine if facility has internet and WIFI (if WIFI is necessary for the design of the program). The applicant should also determine what software will used for the virtual visits. Examples of free software are below.

Free software options

    • WhatsApp (international)
    • FaceTime (Apple)
    • Google Meet
    • Facebook Messenger
    • Skype

9. What expenses are prohibited for communicative technology requests? 

These applications are for devices and accessories only. Prohibited expenses include:

    • Travel
    • Internet or software subscription fees
    • Administrative fees
    • Indirect Costs. For example: federally determined indirect (facilities and administrative-F&A) costs such as staff fringe benefits or facility maintenance. 

10. How can a facility prevent the transmission of COVID-19 in the facility while using electronic devices? 

Ensure appropriate infection prevention and control practices. Devices should not be shared between COVID-19 positive (or suspected) and other residents (i.e., COVID-19 negative or observation status). Prior to submitting an application, review the electronic device and/or wipeable cover manufacturer’s instructions for cleaning and disinfection to ensure this guidance exists and the facility can be compliant. Devices must be cleaned and disinfected between resident use. Review the EPA’s Disinfectant List for Use Against SARSCoV-2 to determine if the disinfectant listed in the manufacturer’s instructions are listed. 

Facilities should consider:

    • Does the device and accessory manufacturer describe how the items can be cleaned and disinfected between uses?
    • Does the manufacturer include the use of a disinfectant that is on the EPA’s List for Use Against SARS-CoV-2?
    • How will the facility train and monitor nursing home staff responsible for disinfecting devices and accessories after resident use?

11. What must be included in the application budget (Application Template Section 5)? 

Applicants must provide a line-item budget for all devices (e.g. tablet, webcam) and accessories, broken down per facility for which CMP funding is requested. 

12. How should funds be tracked by states? 

In accordance with 42 CFR 488.433, states shall maintain a list of all nursing homes receiving CMP reinvestment funds for communicative devices during the COVID-19 Public Health Emergency. This information should be entered into the Annual CMP Reinvestment Tracker completed by each state