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DOH Provides HCBS Settings Rule Update for Social Adult Day Care Programs

The Department of Health (DOH) provided an update on social adult day care (SADC) compliance with the federal Home and Community-Based Services (HCBS) Settings Rule during its Managed Care Policy and Planning Meeting last week. Managed Long Term Care (MLTC) plans should be finalizing the submission of any remaining outstanding SADC site self-assessment tools to the Department. This may include general corrections and edits to the self-assessment in sections one or two, as well as notifying DOH of any SADC sites that have recently closed or are no longer contracting with the MLTC plan.

Within the next two weeks, each MLTC plan will also receive a DOH meeting invitation and feedback spreadsheet regarding the SADC self-assessment tool submissions. Plans will be instructed on due dates for remediation and/or clarification, heightened scrutiny flags, and if that site is also reporting results with another plan. DOH will continue to collaborate with plans to remediate any discrepancies, prepare sites for public comment this fall, and validation to remove non-compliant sites from network before March 17, 2023. DOH will be tracking to ensure consistency among submissions with the different MLTC plans. DOH is developing an evaluation tool and video tutorial for MLTC annual SADC site evaluations, which should be out by the end of May 2022.

SADC programs currently closed should note that if programs are not compliant, they will be removed from the MLTC network by next spring (March 17, 2023), which is the compliance deadline for the Settings Rule. All actively contracted SADC sites, even if a site is temporarily closed, will need to be in full compliance with the HCBS Settings Rule by March 17, 2023 in order to stay in network and serve members. This also applies to any new and returning sites that are coming back into network. Therefore, plans will want to ensure that all contracted SADC sites meet all the requirements outlined in the HCBS SADC self-assessment in order to remain in network after March 17, 2023.

Please see the slide deck of the meeting here for slides relevant to this issue, starting with Slide 21. Providers can submit questions to HCBSSADCsiteassessments@health.ny.gov.

Contact: Meg Everett, meverett@leadingageny.org, 518-929-9342