DOH Issues Administrative Directive and MLTC Policy on Regulatory Changes to Personal Care and CDPAP

This week, the Department of Health (DOH) issued Administrative Directive 21 OHIP ADM-04 to Local Departments of Social Services (LDSSs) and Managed Long Term Care (MLTC) Policy 21.06 related to changes to Personal Care (PCS) and Consumer Directed Personal Assistance Services (CDPAS) regulations.

These documents provide guidance and instruction to LDSSs and MLTC plans and Mainstream Medicaid Managed Care Organizations (MMCOs), including Medicaid Advantage Plus (MAP) and Program of All-Inclusive Care for the Elderly (PACE) plans, regarding several aspects of the regulatory changes impacting CDPAS and PCS that were effective Nov. 8, 2021, including:

Eliminating the MMCO Requirement to Annually Notify Home Care Recipients about CDPAS;
Requiring Consumers/Designated Representatives (DRs) to Work with Only One Fiscal Intermediary (FI) at a Time;
Defining Additional Responsibilities of DRs;
Changing Routine Reassessment Timeframe;
Ordering Practitioners for PCS and CDPAS;
Codifying Supervision and Cueing; and
Updates to the Requirements for the Continuation, Denial, Reduction, or Discontinuation of Services.

They also include updated CDPAP Consumer/DR Agreements and templates for outreach to CDPAP consumers working with more than one FI.

To conform with changes to the CDPAP as outlined in A-C above, the Department has also revised the agreement template between the MMCO and the consumer/DR.

This policy does not implement any aspects of the Independent Assessment process or changes to the minimum eligibility criteria. 18 NYCRR §§ 505.14(b)(8) and 505.28(m) allow the Department to permit the current assessment process to continue until such time as the Independent Assessor has been implemented.

Questions on the ADM or Policy should be sent to independent.assessor@health.ny.gov.

Contact: Darius Kirstein, dkirstein@leadingageny.org, or Meg Everett, meverett@leadingageny.org. Both can be reached at 518-867-8383.