On-Site HCBS Settings Rule Assessments to Be Conducted in ACF and Assisted Living Settings

The Department of Health (DOH) issued a Dear Administrator Letter (DAL) to adult care facilities (ACFs) and assisted living providers regarding upcoming on-site assessments to determine levels of compliance with the federal home and community based settings (HCBS) rule. While not all providers will be assessed, we wanted to ensure that providers were aware of the possibility that they may be contacted for a visit. Click here to view the DAL and here to view the tool that will be used in the site assessment process.

The Department is working with an independent contractor to conduct the visits. They plan to visit some Medicaid Assisted Living Programs (ALPs), including some ALP programs that are pre-operational. They will also conduct assessments of some ACFs that serve the Medicaid population, but do not have ALP beds.

By way of background, the federal rule applies to the services that are provided under a federal home and community based waiver and the settings in which those people receive services. The rule has broad implications in New York because the enrollment of Medicaid-eligible individuals into managed care and managed long term care is done under a federal home and community based waiver. Thus, the rule will eventually apply to the services provided to virtually all Medicaid-eligible individuals and the settings in which they receive those services. Click here for a fact sheet put out by the Centers for Medicare and Medicaid Services (CMS) and here for an overview of the regulatory requirements also issued by CMS. Additional information can be found on the CMS website here.

The state is currently in the process of refining a transition plan to bring its programs into compliance with the rule by 2022. The on-site assessments will help the Department to identify what steps need to be taken for ACF and assisted living settings to come into full compliance by that time.

LeadingAge NY and our partners at LeadingAge have been following the development of this rule closely, and have been advocating to ensure that the rule is implemented in a way that works for the senior population. Members are encouraged to contact us with any questions or concerns.

Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828