DOH Provides Updates on Enablers, EQUAL, and Other ACF Issues
After a long reprieve, we are pleased to report that the Department of Health (DOH) held a meeting with LeadingAge NY and other adult care facility (ACF) and assisted living (AL) associations to discuss various non-COVID-19 issues on July 7th. Below is a summary.
Equipment Waivers
The Department provided a report on the equipment waivers issue. By way of background, in April 2019, DOH issued a Dear Administrator Letter (DAL) announcing revisions to the ACF equivalency list. DOH later issued a checklist to aid providers in submitting complete waiver requests. Members may recall that the Department at that time announced a change, reverting the equivalency process to a waiver request process for hospital beds with ½ side rails, enablers, electronic monitoring devices, and sprinklers in bathrooms. As a result, regional offices were flooded with materials, including waiver submissions for items or devices already in place under the prior equivalency process. The process quickly became overwhelming for the regions and for providers. As a result, DOH put the process on hold, and the ACF/AL associations worked together on recommendations to develop an alternative process for DOH that would streamline the process for both providers and DOH. Unfortunately, the associations were awaiting the Department’s response to the recommendations, and then the pandemic put everything on hold.
At last week’s meeting, DOH reported that operators must now submit waivers requests again, which regions will review. Concern was expressed given the aforementioned issues. It was noted that providers submitted many waiver requests that were never acted on, given that DOH put the process on hold. DOH indicated that there is no need to resubmit a waiver request if already filed. The Department initially said that providers who submitted waivers in 2019 but never got approval and are using equipment could get a violation; however, the associations pushed back, given that the process has been in question since 2019. The associations have resubmitted the recommendations we jointly developed, and DOH agreed to evaluate the issue, determine how many requests are in the queue, and circle back with us. We will report out to members any updates.
Mental Health Evaluation
DOH provided an update on the status of the mental health evaluation. In September, DOH released an updated mental health evaluation and received feedback and suggestions for improvement. Members will see that some of our feedback was incorporated in the updated form issued in June. There was, however, feedback from LeadingAge NY and other stakeholders that was not incorporated into the revised evaluation. Unfortunately, the form remains rather long, and there remains concern that it will not be completed or will be completed inaccurately as a result. LeadingAge NY stressed that the Department must ensure that all parties have a common understanding regarding when a mental health evaluation is needed, as some surveyors have taken a far broader interpretation than we believe was intended. DOH committed to conducting some education to address that issue. Concern was also raised once again about the lack of qualified mental health providers available to conduct such an evaluation in certain parts of the state. Members are encouraged to let us know what your experience is using the new form, and we will continue to advocate with the Department regarding your concerns.
EQUAL Update
DOH reported that they received feedback from the 2020 Enhancing the Quality of Adult Living (EQUAL) program application process. LeadingAge NY had many concerns about the process, which were communicated in discussions with DOH as well as in writing here. DOH is planning to make some changes to the process for 2021-22. It is unclear at this time when that application will be issued. Ultimately, the Department indicates a willingness to provide education regarding some of the changes in the program, now bifurcated into a capital and aid to localities program. They also plan to have the expenditure plan developed after the award amount is known. This is a welcome change, since it is now taking significant time for DOH and providers alike to amend expenditure plans, given that it was unclear at the time of application what amount of funds would be received from either or both categories of funding. DOH is reaching out and having one-on-one conversations with them if there are questions regarding expenditure plans. Members should be aware that, in their awards, DOH ultimately divided the total amount of EQUAL funds available by the total successful applicants, and then each total award was comprised of half capital funding and half aid to localities.
Transition to HFIS for Operating Certificate Management
DOH reported that they transitioned to the Health Facility Information System (HFIS) platform for operating certificates starting at the end of May. The process is reportedly going fairly well. The Department provided a demonstration of how to look up operating certificates through the HFIS application in “My Applications” on the Health Commerce System (HCS). The HFIS has a search function that allows you to search by different fields. Moving forward, operators will print the operating certificates, rather than DOH mailing them. Approval for respite and day care will also be listed on operating certificates. An email is sent to the operator and administrator notifying them that the operating certificate is available.
The Department also reported that renewal application reminder emails are being sent again. Due to the pandemic, this process and the sending of operating certificates were on hold. The Department utilizes the administrator and operator roles within the HCS to send these emails and thus reminds that it is very important that HCS roles are populated and accurate. The Department is currently sending emails for those operating certificates due for renewal in September.
It should be noted that the Department is still requiring checks, if needed, for the renewal of operating certificates to be sent by mail. Not all renewals have a fee, however. Members should be aware that the application requires a Statewide Financial System (SFS) number and a Tax Identification Number (TIN).
ALP Bed Update
DOH provided an update on the Assisted Living Program (ALP) beds. As we previously reported, DOH announced the awards from the 2019 Request for Applications (RFA). In addition, DOH is in the process of reviewing the applications received for existing ALPs to increase their beds by nine or fewer. The deadline for that application has passed. Currently, there is no opportunity to apply for new ALP beds; however, DOH must develop an ALP Certificate of Need (CON) process by 2023. LeadingAge NY participated in a workgroup to advise DOH on the development of the process. Click here for more information on that initiative.
Conclusion
As the Department begins to resume more typical operations, members should anticipate that previously required reports are likely to be reinstated, survey schedules will resume, etc. For example, members are reminded that the ACF second quarter Quarterly Statistical Information Report (QSIR) is due by July 31st.
Members are encouraged to let us know what issues and questions you have, which we will bring to DOH.
Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828