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LeadingAge NY Submits Additional Comments on Proposed Personal Care and CDPAS Regulations

LeadingAge NY submitted comments on Sept. 14th on proposed regulations implementing changes in the processes for assessing and determining eligibility for personal care services (PCS) and consumer directed personal assistance services (CDPAS). These comments follow a broader letter sent in August to the Department of Health (DOH) addressing contractual and implementation issues, as well as the text of the regulations.

As previously reported, the proposed regulations implement changes adopted as part of the State Fiscal Year (SFY) 2020-21 budget and the Medicaid Redesign Team II (MRT II) deliberations. They incorporate a new eligibility standard for PCS and CDPAS, set forth an independent assessment process and independent medical evaluation process for determining eligibility, and include a clinical review process for cases involving more than 12 hours daily of PCS or CDPAS.

LeadingAge NY's comments addressed a variety of issues related to the accessibility, accuracy, and timeliness of the new independent assessment, medical evaluation, and clinical review processes. They recommended the creation of an objective process for resolving errors in the independent assessment and medical evaluation processes. In addition, the comments identified conflicts between federal Program of All-Inclusive Care for the Elderly (PACE) rules and the State regulations. They recommended explicitly exempting PACE program applicants and enrollees from the State's new eligibility standard for PCS and CPDAS, as this standard is inconsistent with the federal PACE program standard. In addition, the comments recommended exempting PACE program enrollees from the independent assessment process for changes in condition and service requests due to potential conflicts with federal requirements and timeframes.

DOH has acknowledged that the planned Oct. 1st launch date for these new processes will likely be delayed. Implementation is likely to begin at the end of this or early next year.

Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8838