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DOH Adopts Revised ADHC Part 425 Regulations

The Department of Health (DOH) adopted new adult day health care (ADHC) Part 425 regulations last week incorporating many of the federal Home and Community-Based Services (HCBS) Rule provisions regarding person-centered care planning, community integration, and related policies and procedures into the regulations. The link above provides the text of the new regulations as well as public comment and Department responses prior to adoption. The regulations are effective March 20, 2024.

The proposed rule provides guidance to the operators of ADHC facilities, reflecting the Centers for Medicare and Medicaid Services’ (CMS) intent to ensure that individuals receiving services and supports through Medicaid’s HCBS programs have full access to the benefits of community living and are able to receive services in the most integrated setting.

Other provisions amended in the new Part 425 include:

  • Allowing recommendation for ADHC by a facility’s medical director, in addition to a registrant’s primary care practitioner in the community;
  • Removing the reference to Managed Long Term Care (MLTC) plans under the unbundled services payment section, potentially opening up this payment framework to other payor sources; and
  • Amending the nursing services section to remove the reference permitting the use of a licensed practical nurse (LPN) in an ADHC on the site or campus of a nursing home with the supervision of a registered nurse (RN) in the nursing home.

The Adult Day Health Care Council (ADHCC) plans to discuss the above provisions with the Department to obtain clarifications so that plans are clear on regulations moving forward.

ADHCC will soon schedule a webinar providing details on the new changes after it seeks some clarifications from the Department on some of the amended language in the new regulations.

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