The Department of Health (DOH) has just reopened the licensure application process for new Licensed Home Care Services Agencies (LHCSAs). DOH issued a Dear Administrator Letter (DAL) last week setting forth the requirements, process, and application documents. New LHCSAs will also have to undergo character and financial competence review in addition to the need methodology process. There are several documents attached to the DAL.

The public need methodology applies to all applications for licensure submitted on or after April 1, 2020. Note exceptions below:

• The public need methodology includes a rebuttable presumption of no need for additional LHCSAs in a county if there are five or more LHCSAs actively serving patients within the county as of April 1, 2020. The target date for the Department to determine need has been adjusted to April 1, 2022, and the counties with need are identified in the attached LHCSA County No Need Report.
• A LHCSA applicant can overcome the presumption of no need based on local factors related to an applicant’s services or planning area, including, but not limited to:
  • the demographics and/or health status of the patients in the planning area or the state, as applicable;
  • documented evidence of the unduplicated number of patients on waiting lists who are appropriate for and desire admission to a LHCSA, but who experience a long waiting time for placement;
  • the number and capacity of currently operating LHCSAs;
  • the quality of services provided by existing agencies;
  • the availability and accessibility of workforce;
  • personnel and resources dedicated to adding and training additional members of the workforce, including committed resources in an organized training program;
  • cultural competency of existing agencies; and
  • subpopulations requiring specialty services.
• Applications for licensure based on change of ownership for LHCSAs actively serving at least 25 patients will not be subject to public need review and shall be evaluated only on financial feasibility and the character and competence of the proposed operator, unless the proposed operator seeks to serve patients outside of the agency’s approved counties.
• LHCSAs affiliated with an Assisted Living Program (ALP), Program of All-Inclusive Care for the Elderly (PACE), Nurse Family Partnership (NFP), or Continuing Care Retirement Community (CCRC) will be exempt from the public need methodology if the agency exclusively serves patients within those programs. The agency will be subject to the need methodology if they apply to serve patients outside of the specific program. Any exemption will be noted on the agency’s license.

There are several attachments to the DAL that members should review, including licensure and need methodology regulations, licensure applications, data on the recent LHCSA Patient Count, Financial Feasibility Review, Quality Assurance Guidelines, and an extensive Frequently Asked Questions (FAQ) document. The FAQ provides detail on the licensure and submission process, the need methodology, application fees, changes in ownership, financial review, and other regulatory requirements. All documents can be found in the DAL and on DOH's LHCSA page here.

For reference, the February 2022 DAL delineating new protocols for administrative amendments to existing LHCSA licenses is also provided here.

Members are encouraged to reach out with questions or comments.

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