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LeadingAge NY Provides Comment on Proposed Rule Establishing LHCSA Need Methodology

LeadingAge NY submitted a public comment letter to the Department of Health (DOH) regarding a proposed rule establishing a need methodology and stronger financial requirements for new applications for licensure of Licensed Home Care Services Agencies (LHCSAs). The proposed rule includes the following provisions:

  • Counties are designated as separate planning areas.
  • There is a presumption of no need if there are five or more LHCSAs actively serving patients in a planning area.
  • Applications requesting change of ownership serving at least 25 patients are not subject to public need review but must be evaluated for character, competence, and financial feasibility.
  • Determination of need for Assisted Living Program (ALP) LHCSAs or Program of All-Inclusive Care for the Elderly (PACE) LHCSAs is not required unless such agency is serving the broader community.

Factors for determining need include:

  • demographics of an area;
  • documented unduplicated patients waiting to be served;
  • quality of services by existing agencies;
  • number and capacity of existing agencies;
  • availability and accessibility of the workforce;
  • personnel and resources training/adding workers, including committed resources in an organized training program;
  • cultural competency; and
  • subpopulations requiring specialty care.

Among other points, LeadingAge NY voiced its support for flexibility in planning area designations, particularly along county borders where there may be unmet need. Like DOH’s proposed exemption from need review for ALP- and PACE-affiliated LHCSAs not serving the broader community, we requested an exemption for Continuing Care Retirement Community (CCRC)-affiliated LHCSAs serving their contract members. We also opposed the presumption of no need if there are five LHCSAs serving a county, calling it arbitrary and not indicative of need being met, quality, or capacity. LeadingAge NY requested clarification regarding factors and case evidence demonstrating unmet need and encouraged DOH to require strong workforce development plans for new LHCSAs.

Our comment letter and the proposed rule can be accessed here and here. Please contact us if you have questions or concerns.

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