First Meeting of the Home and Community Based Care Work Group

On June 21, the first meeting was held for the newly-formed Home and Community Based Care Work Group. This work group was created in the 2013-14 budget; its charge is to examine and make recommendations on issues which include, but are not limited to:

• State and federal regulatory requirements and related policy guidelines;
• Efficient home and community based care delivery, including telehealth and hospice; and
• Alignment of functions between managed care entities and home and community based providers.

The work group has 11 members. Members of the workgroup include providers, plans, representatives of consumers and direct caregivers with relevant experience. At the first meeting it did not appear anyone at the table was representing telehealth or hospice.

The meeting started with introductions, discussion of the budget language and then the invited associations were asked to present their concerns. LeadingAge NY started the presentations with outlining our concerns, followed by examples and then our specific, time-sensitive recommendations. We distributed our letters to the Commissioner of Health on our concerns with the mandatory enrollment of the LTHHCP into managed care and our letter to Jason Helgerson, Deputy Commissioner requesting a delay with implementing the Uniform Assessment System for New York (UAS-NY). During our presentation we referred to issues outlined in these letters which included:

• Regulatory relief for the LTHHCP/CHHAs - allowing for flexibility and other issues identified in the letter to the Commissioner;
• The future of the LTHHCP - needs to be defined;
• Front line operational concerns - resolving a fundamental disagreement within DOH on how a LTHHCP contracts with managed care plans;
• If the regulatory relief cannot be addressed in a timely manner, then DOH has offered an expedited LHCSA application – what does that mean;
• Contract review process - expediting the process;
• UAS- NY - clarity of how will this drive reimbursement rates and hold program specific webinars and other issues identified in the letter; and
• Conflict-free Case Management - defining what this means in our state and how it impacts the existing Care Management Administrative Agreements contracts.

There were several common themes addressed by the majority of the presenters. The rapid pace of change is upsetting and confusing. Without swift regulatory relief and flexibility, some providers may go out of business. Questions still exist regarding surveillance and emergency preparedness. 

LeadingAge NY will continue to advocate and keep members informed on the work group activities.

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871