LeadingAge NY and the Adult Day Health Care Council (ADHCC) recently met with the Department of Health (DOH) regarding the Oct. 2, 2023 Dear Administrator Letter (DAL) regarding provision of telehealth services by adult day health care (ADHC), home care agencies, and adult care facilities (ACFs), including assisted living programs (ALPs). A previous LeadingAge NY Intelligence article on the DAL is available here.

The guidance offers guardrails for home and community-based services (HCBS) providers as they offer telehealth in the community, as opposed to an immediate broad application of telehealth services. The guidance states:

While telehealth may generally be acceptable in various circumstances with patient consent, it is not acceptable:

• For in-person initial medical, clinical, mental health, or dental assessments and follow-up visits;
• To perform the Functional Supplement component of the Uniform Assessment System-New York (UAS-NY);
• At any time when the patient is not able to access a secure location; or
• As a substitute for in-person delivery of any personal care services by a provider licensed under Article 36 of the Public Health Law, or for the delivery of meals or congregate or rehabilitative activities or for required resident/patient supervision services in any setting.

DOH stated that ADHC programs should no longer be providing telehealth services as a substitution for an in-person ADHC program. Heidi Hayes, Director of the Center for Long-Term Care Survey and Operations in the Office of Aging and Long-Term Care (OALTC), stated that long-term telehealth for ADHC registrants is no longer allowed. Several scenarios were discussed that allow for intermittent services via telehealth in ADHC when someone has had a fall, COVID, a behavioral episode, or is post hospitalization, and highlighted the services that could be provided as a bridge in getting the registrant back to program. DOH stated that this might be appropriate and would take it back for review.

LeadingAge NY provided a follow-up email with examples of services currently delivered by certified home health agencies (CHHAs) and licensed home care services agencies (LHCSAs), as well as services provided by providers in ACFs. Mental health services delivered by telehealth in ACFs are common practice and necessary, as providers are often not accessible in person.

The Department is collecting several questions and examples of telehealth from other provider associations, and hopefully will shed more light on what is permissible.

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