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LeadingAge NY Meets with DOH on HCBS Issues

On March 23rd, LeadingAge NY and other home care and hospice provider groups met with Heidi Hayes and Seon Davis of the Department of Health (DOH) Division of Home and Community-Based Services (HCBS) for a regular standing meeting on current issues of importance to providers and the Department.

HCP Masking Guidance

The recently issued masking guidance for health care personnel (HCP) was discussed, and attendees asked for additional clarification regarding some of the nuances regarding home care. It is our interpretation that individuals working for agencies in billing and supply offices that are patient-restricted areas are not subject to the masking requirement. Providers should be referring to the Centers for Disease Control and Prevention's (CDC) community transmission rates for COVID-19 organized by county. The guidance defers to CDC recommendations on masking, and HCBS providers should put in place policies and procedures for personnel. More information is provided in this Intelligence article.

Staffing Updates

Mikhail Pankov will no longer be heading the HCBS Division in the Metropolitan Area Regional Office (MARO) region; there is no replacement as of yet. Communications should be sent to the general mailbox for the MARO region. The Central NY office's HCBS director, Paula Williams, has retired, and Colleen Clancy will be filling her position.

The HCBS Division Director in the central office will be announced soon. We will provide members with an update when that happens.

LHCSA Registration

The licensed home care services agency (LHCSA) registration process occurred at the end of last year, with agencies completing a short form submission by Dec. 31st. Currently, over 100 LHCSAs have failed to register this year and will be required to pay the $500/month penalty. Some agencies have been delinquent for the past two years, and the Department plans to follow up with penalties.

Currently, there are 1,400 licensed LHCSAs in the state. 120 have not registered in the last two years.

LHCSA Statistical Report

The Department is still helping a few outliers complete the LHCSA Statistical Report. Please contact the Department immediately if your agency needs to do this.

The Department's work plan will include reviewing the Statistical Report to remove redundancies, and they will be creating a workgroup to carry out this process.

Survey Trends

Plans of Correction: The Department is finding that LHCSAs are resistant to making changes when doing Plans of Correction (POCs) and often submit several iterations with no changes made. Meeting attendees communicated that the Department needs to be able to update items on surveys that are not deemed deficiencies and are resolved, so that they are not referenced or reflected in the final survey or POC. The Department is looking into how to allow this. 

CHRC: The Department is also finding that certified home health agencies (CHHAs) and LHCSAs are not documenting termination or separation of employees in the criminal history record check (CHRC); this should be done within 30 days.

LHCSA and CHHA Discharge Planning: Surveys are finding that agencies are not documenting patient notification regarding changes in status, not documenting education of patients, and not including summaries of care.

DOH stated that they will be developing modules to help LHCSAs and CHHAs understand requirements for the discharge process. Attendees supported this and also asked for additional training on surveys and the CHRC.

Telehealth

There was discussion regarding inclusion of HCBS providers more fully in the practice of telehealth, like other providers. The current Medicaid Update addressing telehealth post-federal Public Health Emergency does not specifically include home care and other HCBS providers, but does indicate that additional regulation or guidance may be issued for such providers.

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