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DOH Revises Proposed LHCSA Public Need Rule

The Department of Health (DOH) presented the Public Health and Health Planning Council (PHHPC) with a revised version of the proposed regulations that establish a public need methodology and stronger financial requirements for applications for licensure as a Licensed Home Care Services Agency (LHCSA). PHHPC approved the revised version, which incorporates some of LeadingAge NY’s recommendations.

The revised proposed regulation can be found here on page 159. Changes include:

  • An exemption to the need methodology for LHCSAs affiliated with Continuing Care Retirement Communities (CCRCs) and Nurse Family Partnership (NFP) programs, unless such LHCSA proposes to serve the broader community. Previously, the proposed regulation only allowed an exemption for LHCSAs affiliated with an Assisted Living Program (ALP) or a Program of All-Inclusive Care for the Elderly (PACE), serving individuals in their programs. DOH will require any entity that limits its LHCSA to its specific program population to have it noted on the LHCSA license. Any ALP, PACE, CCRC, or NFP-affiliated LHCSA proposing to serve the broader community will be subject to need review.
  • Authorization for applicants to provide a rebuttal argument to DOH’s presumption of no need when there are five or more LHCSAs in a county.
  • A requirement for DOH to review the adequacy of the need methodology and issue a report within three years instead of the earlier proposed six.
  • DOH's elimination of “and who cannot be served adequately in other settings” as a qualifier regarding documented evidence that providers would have to demonstrate to show public need. LeadingAge NY argued that this would be an onerous requirement for applicants.
  • A requirement for LHCSA applicants to agree “to serve populations that have difficulty gaining access to LHCSA care due to minority status, age, medical history, case complexity, and payment source.” LeadingAge NY was successful in adding “geographic location” to this list.

We will notify members when the rule is finalized. The moratorium on LHCSA license applications is due to expire March 31, 2020.

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