DOH Moving Forward with HCBS eFMAP Directed Payment Process for Eligible LHCSAs
On Dec. 23rd, specified Licensed Home Care Services Agencies (LHCSAs) belonging to an eligible provider class received a communication from the Department of Health (DOH) that their agencies are potentially slated to receive Home and Community-Based Services Enhanced Federal Medical Assistance Percentage (HCBS eFMAP) funding through Managed Long Term Care (MLTC) plans via directed payments. This funding is part of a workforce funding allocation being distributed to agencies by the State per the federal American Rescue Plan (ARP) enacted in 2021. The process by which the State is structuring these payments is contingent on Centers for Medicare and Medicaid Services (CMS) approval.
The communication to eligible LHCSAs (draft sample is here) includes a potential rough funding amount, an overview of the funding program, payment logistics and spending categories, spending and reporting requirements, and a draft attestation and survey to review and sign. At this time, it is unclear if DOH has communicated this new information to MLTC plans.
The State is in conversation with CMS and has made a few updates to its spending process for this funding based on feedback from CMS. DOH will be holding a webinar on Jan. 6th, and LeadingAge NY will provide members with more information at that time. Deadlines for attestations are likely to be one week after the webinar.
Members should note that if they have not received this communication, their agency is not slated for funding at this time. LeadingAge NY is seeking to obtain the full list of eligible LHCSAs and has communicated to DOH its concern that funding should be distributed to ensure that there is adequate distribution of workforce funds geographically across the state, as well as distribution to smaller quality and culturally competent LHCSAs. We are concerned that a lack of funding will put many quality LHCSAs on a disparate playing field compared to those that do receive funds. At this time, DOH is directing funding to agencies generating the top third of revenue with MLTC plans. We have asked DOH to carry out an assessment of regional impacts based on DOH’s current funding structure.
DOH is not providing the list of eligible agencies at this time, as the spending plan for this allocation is not yet approved by CMS. They have assured us that there will be opportunities to revise the spending plan quarterly. This current tranche will provide approximately $361 million in funding. There will be another tranche of $1.1 billion to be spent from April 1, 2022 through March 31, 2023.
Questions can be sent to DOH at LHCSA.FMAP@health.ny.gov.