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DOH Issues DAL Regarding Ordering of Home Care Services

The Department of Health (DOH) issued a Dear Administrator Letter (DAL) on Nov. 30th clarifying that the State recognizes recent federal law authorizing nurse practitioners (NPs) and physician assistants (PAs) to order home care services.

As stated in the DAL:

Since 2015, New York State Public Health Law 3602 has expressly stated that Nurse Practitioners (NPs) could prescribe and order home health aide and personal care services as long as it was “not prohibited by federal law or regulation.” With the adoption of the CARES Act and implementing regulations in March 2020, no federal prohibition remained for a nurse practitioner to order home care services. However, Section 505.14(b)(3) of Title 18 NYCRR required that orders be signed by a physician.

Effective November 8, 2021, 18 NYCRR § 505.14 is revised to permit Nurse Practitioners and Physician Assistants (PAs) to sign home care orders. The Department will exercise enforcement discretion regarding NP and PA signatures on orders received during the state disaster emergency.

As this DAL references amendments to the personal care regulations only, LeadingAge NY will clarify with the Department whether this permits PAs and NPs to order home health services as well, or if additional regulations are necessary. Please send any questions to homecare@health.ny.gov.

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