The Department of Health (DOH) updated representatives of Managed Long Term Care (MLTC) plans last week regarding the status of Social Adult Day Care (SADC) compliance with the Home and Community-Based Services (HCBS) Settings Rule. The rule requires person-centered service planning and community integration of registrants participating in social day programs if programs are paid with HCBS Medicaid dollars through MLTC plans.

Identification of SADC programs for heightened scrutiny and public comment activities are planned for August and September 2022. DOH is required to report the status of all SADC sites to the Centers for Medicare and Medicaid Services (CMS) as part of the HCBS Settings Rule transition plan in August. SADC programs should be working with their contracting MLTC plans to demonstrate compliance via a self-assessment process laid out by DOH in December 2021, and they should be replying to all requests for information from DOH. If an SADC program or its MLTC plan does not respond to requests, DOH will determine and report to CMS that the SADC program is not compliant with the final rule.

Provided are several slides of interest to members as the HCBS Settings Rule compliance process undergoes further implementation. Note that MLTC plans must remove non-compliant SADC programs from their contracted networks and terminate the site agreements within 60 days of notice from DOH.

Please take a look here at slides 18-22 for those specific to the HCBS Settings Rule. Resources for SADC compliance are provided on the last slide and here.

Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871