Updates on the Fair Labor Standards Act (FLSA) and the Quality Incentive Vital Access Provider Pool (QI/VAPP)
Fair Labor Standards Act (FLSA) Frequently Asked Questions (FAQs) and Other Guidance Information
On Mar. 8th, Department of Health (DOH) released the FLSA FAQs, which provides some guidance on how to implement the funding for the incurred FLSA home care costs since Oct. 2015. DOH did accept some of our suggestions to clarify the FAQs. We will continue our on-going discussion with DOH to clarify other areas, especially in light with what was shared by DOH at the Managed Care Policy and Planning on Mar. 10th and the additional information that was posted on Mar. 11th.
There still remains numerous outstanding issues including, can the funds be used to comply with FLSA or only used for overtime and travel expenses? We have heard both from DOH staff. In the latest additional information document from DOH it states, “distributing funds to their network providers to cover from both, overtime, travel, and other requirements.” Plans continue to have flexibility on how to distribute the funds. According to the Mar. 11th information, “Plans are expected to employ a reasonable methodology when distributing funds to their network providers to cover overtime, travel, and other requirements. Contrary to previous Department guidance, plans are no longer responsible for receiving attestations from their network providers, all attestations should be sent directly to the Department. These funds must be distributed as soon as possible but no later than April 8, 2016.” Plans are not permitted to retain any of the funds. Plans who send in the attestations to DOH should include the methodology utilized in the disbursement of the funds.
FLSA and Quality Incentive/Vital Access Provider Pools (QIVAPP) Update from the Managed Care Policy and Planning meeting
FLSA
DOH staff addressed questions concerning the FLSA payments to MLTC plans released earlier this month. They stressed that the funds must be used for the benefit of the worker to cover additional overtime and travel time expenses incurred as a result of the implementation of the new FLSA regulations. These payments cannot be used to cover expenses associated with reducing overtime expenses, such as recruitment and training expenses.
Plans are required to develop reasonable methodologies for allocating these payments among the home care agencies in their networks and must report these methodologies to DOH. Any of the methodologies outlined in the DOH “Frequently Asked Questions” (FAQs) document would be considered reasonable. The discussion included the appropriate action to take in the event that the funds received by the plan exceed the amount to be allocated to agencies based on the plan’s distribution methodology. DOH indicated that it will have to give further consideration to its approach to situations in which the amount allotted to a plan exceeds the FLSA costs incurred by its contracted providers. DOH is also still considering options for covering FLSA-related costs on a prospective basis after April 1, 2016.
DOH clarified that plans do not have to collect attestation forms from home care agencies related to the use of the funds. These forms should be submitted to DOH. DOH will be releasing a survey through Mercer to home care agencies shortly, to collect information about their FLSA expenses for purposes of distributing the full amount of the funds once federal approval is granted. When asked if there would be a retrospective reconciliation of the funds, DOH was non-committal.
QIVAPP
The IPRO audits of home care agency hours for purposes of the 2014-2015 QIVAPP distribution is in the final stages. The federal share of QIVAPP will be distributed after completion of DOH review of the audit report. In 2015-16, QIVAPP will be continued at the $70M level and distributed based on the criteria used in 2014-15. However, in 2016-17, the funds will be incorporated into plan rates and the criteria may be modified.
Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8383 ext. 124. or Cheryl Udell, cudell@leadingageny.org, 518-867-8871