LeadingAge National recently released a new white paper, Home and Community-Based Settings Rule: How Regulation Intended to Ensure Access to Medicaid Funded Services Falls Short, and Changes Needed to Fix It, which explains how the flawed policy fails to achieve its intent of ensuring access to person-centered care. The report recommends urgently needed solutions, including a two-year delay in implementation for providers serving older adults.

LeadingAge NY and the Adult Day Health Care Council provided a significant amount of information to bolster the report, including the many requirements waiver providers, social and adult day health care (ADHC) programs, and Assisted Living Programs (ALPs) must comply with that add bureaucratic tape and inefficiencies, significant increased costs to programs, and make little sense for the individuals they serve.

The HCBS Settings Rule went into effect on March 17, 2023 after many years of policy development and then a lull during COVID-19. While there are some valuable aspects to the rule, including community integration and person-centered care planning that help guide providers in delivering the care individuals desire, much of the rule is geared toward younger individuals with disabilities and does not consider cognitive impairment and the skilled services some providers are required to deliver in program.

Both ALPs and ADHC programs in New York are undergoing visits this summer by the Centers for Medicare and Medicaid Services (CMS) and continue to work with the Department of Health (DOH) on compliance with the rule. LeadingAge NY will continue to provide members with updates on this initiative.

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