LeadingAge NY and the Adult Day Health Care Council Discuss HCBS Settings Rule with DOH and the Governor's Office
LeadingAge NY and the Adult Day Health Care Council met with leaders from the Governor’s Office and the Department of Health (DOH) last week to discuss our concerns about the implementation of the federal home and community-based settings (HCBS) rule in New York. We have been following this issue closely over the years and have been working with LeadingAge on the national level to ensure that the rule is implemented in a way that is not disruptive to the services our members provide.
We discussed concerns about how heightened scrutiny will be applied, and what impact it could have on our members who provide Medicaid-covered HCBS services in the same building as a nursing home, on the same campus as a nursing home, or to a disability-specific population. We also discussed our concerns that the rule does not appreciate the unique needs and wants of the elderly population. We raised questions about the implications for the CMS guidance on new construction, which remain unclear. We also discussed questions regarding the implications for conflict of interest provisions and person-centered planning requirements. Lastly, we noted that there is a cost associated with implementing this rule, and reimbursement needs to be increased to make these changes feasible.
DOH and the Governor’s office expressed an understanding of our concerns. They are working with CMS to obtain answers to many of the questions we raised. The implementation of the rule is very much a work in progress that will unfold as time goes on. We will remain in communication with CMS and with our state contacts as more details are available. Meanwhile, DOH plans to release their revised Statewide Transition Plan, which requires plans to come into compliance with the rule by 2019. We will be reviewing the plan and reporting to members, and encourage members to provide feedback during the 30-day comment period. In addition, DOH agreed that it is important to start training on person-centered planning, and we will work with DOH to ensure that our members receive that information.