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DOH Second Quarterly Report on HCBS eFMAP Spending Plan Includes ALP Directed Payment

The Department of Health (DOH) posted its Feb. 15th second quarterly report on the State's Spending Plan for Home and Community-Based Services (HCBS) Enhanced Federal Medical Assistance Percentage (eFMAP) monies. DOH has sent this report to the Centers for Medicare and Medicaid Services (CMS) to provide them with a progress report and update on modifications to spending proposals, lessons learned, plans for sustainability, and individual activity updates for each spending proposal.

LeadingAge NY is pleased to announce that the Spending Plan now includes the addition of $20 million in workforce support for Medicaid-funded Assisted Living Programs (ALPs). We had been working to ensure that the ALP was included in the HCBS eFMAP initiatives and had drafted a proposal in partnership with another association.

DOH proposes to use a time-limited program that would provide payments to ALP service providers who offer one or more workforce development strategies. As a Medicaid service that requires significant training and experience in order to serve older adults with functional and/or cognitive impairment and who need these valuable services to remain in a home and community-based setting, DOH will set specific goals for this funding to impact recruitment and retention rates.

Recommendations for ALP support include:

  • Tuition reimbursement;
  • Loan forgiveness;
  • Hiring and sign-on incentives;
  • Longevity pay;
  • Training funding inclusive of home health aide and personal care aide certification, continuing education units (CEUs), and professional licenses; the development of mentoring or apprenticeship programs; and the development of infection prevention and control;
  • Differential pay for nights and weekends;
  • Retirement contributions, extending health insurance benefits, supporting day care, or other fringe benefits for staff; and
  • Building appropriate personal protective equipment (PPE) stockpiles from State-authorized sources for ensuring that ALP workers are able to deliver care in a safe and effective manner through the end of COVID-19 and beyond.

Other significant changes in the Spending Plan include the following:

  • Eliminates the spending category for natural growth of Consumer Directed Personal Assistance Services (CDPAS) and personal care. This was likely eliminated due to the requirement to supplement and not supplant existing State funds. Funding general growth of an HCBS service does not qualify as supplemental in nature.
  • Changes workforce funding amounts for select Licensed Home Care Services Agencies (LHCSAs) from $1.1 billion to roughly $800 million. DOH will reassess the current select provider distribution process and determine if it will reinforce funding or distribute to additional providers – Adult Day Health Care (ADHC), Social Adult Day Care (SADC), or CDPAS programs.
  • DOH continues to work on guidance for Certified Home Health Agency (CHHA) Transportation funds of $10 million.
  • Adds the Home Care Worker Bonus program to the plan at $417.8 million.
  • Expands Community First Choice Option (CFCO) to the Developmentally Disabled population at $46 million. 
  • DOH is working with CMS to develop spending authority for Program of All-Inclusive Care for the Elderly (PACE) support at $40 million. 
  • Modifies and strengthens NY Connects spending to engage in data collection and update resources for additional populations, including individuals with physical disabilities, children with special needs, the Intellectual/Developmental Disability (IDD) population, and those with serious behavioral health conditions. Requires program to track and collect service utilization, care, case management, referrals, admin, reporting, and more.

DOH is in the process of establishing a general directed payment process to allow for distribution of many of these funds. LeadingAge NY will keep members informed of other updates regarding this initiative as they occur.

Contact: Meg Everett, meverett@leadingageny.org