DOH Issues Guidance Rescinding Previous COVID-19 Guidance for Community-Based Long-Term Services and Supports
The Department of Health (DOH) has issued new guidance, effective July 26, 2021, that rescinds the guidance issued on March 18, 2020 and updated on April 8, 2020 entitled COVID-19 Guidance for the Authorization of Community Based Long-Term Services and Supports Covered by Medicaid. The original guidance was provided in response to the COVID-19 outbreak and the state disaster emergency declared by Executive Order (EO) 202, which expired on June 25, 2021.
The new guidance relates to the following topics:
(1) Physician Orders
Effective immediately, and based on emergency telehealth regulations promulgated, the Department extends the ability of physicians to conduct medical examinations that assess an individual’s needs for personal care services (PCS) or Consumer Directed Personal Assistance Services (CDPAS) via telephonic or telehealth modalities and allows for exams to be completed in person.
However, the ability of physicians to transmit the results of the medical examination and a physician order verbally is rescinded, and a Community Health Assessment (CHA) may no longer be initiated upon receipt of a verbal order. Effective immediately, the physician order form (DOH-4359 or HCSP-M11Q) is required to initiate a CHA.
(2) Initial CHA
Effective immediately, all initial assessments conducted by registered nurses for initial authorizations of the services described above must be conducted in person. In addition, all assessments conducted for requests for change in service authorizations must also be conducted in person. The ability to conduct the CHA via telephonic or telehealth modalities to develop an initial plan of care has been rescinded.
In addition, effective immediately, all CHAs conducted must be completed to be utilized for the purposes of care planning. The Department will no longer allow a partially completed CHA to be used in care plan development. Managed care plans and local departments of social services (LDSSs) must return to conducting face-to-face assessments for care plan development. Conflict-Free Evaluation and Enrollment Center (CFEEC) assessments may no longer be used for care plan development.
(3) Community Health Reassessments
Effective immediately, managed care plans and LDSSs must begin resuming scheduling and performing required face-to-face periodic reassessments and the six-month in-person care management home visits. The resumption process is set forth for members who have not otherwise had a completed in-person, telehealth, or telephonic CHA conducted during the public health emergency until the effective date of the guidance.
(4) Annual Health Assessments for Personal Assistants
Effective immediately, the suspension of Consumer Directed Personal Assistance Program (CDPAP) personal assistant annual health assessments is lifted. CDPAP personal assistants must obtain an annual health assessment, if due, no later than Sept. 30, 2021.
(5) Facility-Based Assessments
Effective immediately, where possible, required facility-based assessments are resumed and are to take place at the facility in a face-to-face modality.
Plans and providers should review the guidance carefully. Please feel free to contact LeadingAge NY with questions.
Contact: Meg Everett, meverett@leadingageny.org, 518-929-9342 or Karen Lipson, klipson@leadingageny.org, 518-867-8383 ext. 124