DOH Posts Initial 2017 Personal Care Rates
Last week, the Department of Health (DOH) posted the initial 2017 personal care/consumer directed program reimbursement rates to the Health Commerce System (HCS). The rates reflect the time of Jan. 1, 2017 to Dec. 31, 2017. The Dear Administrator Letter (DAL) includes information on the following:
Trend factor – reflects the application of a zero-roll factor adjustment. Remember: the 2016 and 2017 trend factors were both reduced to zero because of enacted state budgets, and in this year’s final budget, the zero-trend factor was continued until March 31, 2019.
Administrative and General (A&G) cap – the A&G costs in the 2017 personal care rates are limited to no more than 28 percent of the total costs. The A&G for consumer directed services continues to be 18 percent.
Aide and training ceilings – the 2017 rates include the adjustment to the live-in ceiling for both personal care and consumer directed to be based upon 13 hours of care; see MLTC policy 14-08.
Criminal history record check reimbursement – effective Jan. 1, 2017 and subsequent years cannot include a payment for background and fingerprinting reported in the base-year cost report.
Worker recruitment and retention – add-on of 8.16 percent is the adjustment to reimburse non-NYC personal care providers for the uniform additional hourly Fair Labor Standards Act (FLSA) add-on amount as determined in the FLSA adjustment rates effective Oct. 13, 2015.
The DAL continues: “effective October 13, 2015, $0.34 was added to the Personal Care rates which was reimbursed as part of the Recruitment and Retention percentage of 8.70 percent for the 2015 rate. Because the 2017 rates are based on the agencies’ 2015 cost reports, approximately 2.5 months of increased FLSA costs are already included in the base year cost data. Consequently, the recruitment and retention percentage for non-NYC personal care rates for 2017 has been revised to 8.16 percent ((9.5 X 12 months (8.70%-6.08%)) + 6.08%).”
Rate Hotline – the process to address any mistakes in the rates will be continued this year and will be in effect until June 30, 2017. Providers may call the Bureau of Long Term Care Reimbursement with inquiries; however, no rate change will be made unless the Bureau has received an inquiry, in writing. The letter should be scanned and emailed to the Bureau mail log at doh.sm.BLTCR-PCA before June 30, 2017.
Appeals – an appeal to the initial 2017 rate computation must be filed and postmarked no later than Aug. 25th in an email to doh.sm.BLTCR-PCA.
Questions regarding your rates should be sent to bltc-pc@health.ny.gov.
Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871