Home » 2013 Issues » May 15, 2013 » HLT-43-12-00009-A Certified Home Health Agency (CHHA) and Licensed Home Care Services Agency (LHCSA) Requirements
HLT-43-12-00009-A Certified Home Health Agency (CHHA) and Licensed Home Care Services Agency (LHCSA) Requirements
5/15/13 N.Y. St. Reg. HLT-43-12-00009-A
NEW YORK STATE REGISTER
VOLUME XXXV, ISSUE 20
May 15, 2013
RULE MAKING ACTIVITIES
DEPARTMENT OF HEALTH
NOTICE OF ADOPTION
I.D No. HLT-43-12-00009-A
Filing No. 451
Filing Date. Apr. 30, 2013
Effective Date. May. 15, 2013
Certified Home Health Agency (CHHA) and Licensed Home Care Services Agency (LHCSA) Requirements
PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following action:
Action taken:
Amendment of Parts 763 and 766 of Title 10 NYCRR.
Statutory authority:
Public Health Law, section 3612(5), (6) and (7)
Subject:
Certified Home Health Agency (CHHA) and Licensed Home Care Services Agency (LHCSA) Requirements.
Purpose:
To expand access to palliative care and eliminate physician from the LHCSA quality improvement committee.
Text or summary was published
in the October 24, 2012 issue of the Register, I.D. No. HLT-43-12-00009-P.
Final rule as compared with last published rule:
No changes.
Text of rule and any required statements and analyses may be obtained from:
Katherine Ceroalo, DOH, Bureau of House Counsel, Reg. Affairs Unit, Room 2438, ESP Tower Building, Albany, NY 12237, (518) 473-7488, email: regsqna@health.state.ny.us
Revised Regulatory Impact Statement
Statutory Authority:
Public Health Law (“PHL”) § 3612(5) authorizes the Public Health and Health Planning Council to adopt and amend rules and regulations to effectuate the provisions and purposes of PHL Article 36 with respect to certified home health agencies. Section 3612(6) and (7) requires the Commissioner of Health to adopt, and amend as needed, rules and regulations to effectuate the purposes of Article 36 regarding quality of care and services.
Legislative Objectives:
PHL Article 36 was intended to promote the quality of home care services provided to residents of New York State and to assure adequate availability as a viable alternative to institutional care.
Needs and Benefits:
On February 24, 2011 Governor Cuomo accepted a report from the Medicaid Redesign Team (MRT) designed to meet the Medicaid savings targets contained in the Executive Budget for 2011-12. The report included 79 recommendations to redesign and restructure the Medicaid program to be more efficient and achieve better outcomes for patients. Included among the recommendations accepted were MRT proposal numbers 109 and 147.
MRT Proposal 109 sought to expand access to palliative care services. In furtherance of that objective, the proposed amendments to the regulations add a requirement that the plans of care and medical orders required for patients of certified home health agencies (CHHAs) and licensed home care services agencies (LHCSAs) address the patient’s need for palliative care.
MRT Proposal 147 aimed to reduce regulatory burdens on providers. Accordingly, the proposed changes to the regulations eliminate the need for a physician to serve on the quality improvement (QI) committee of LHCSAs.
Finally, the proposed changes reflect minor amendments made to align these regulations with federal requirements and to correct errors. First, the amendments eliminate the requirement that CHHAs provide more than one qualifying service directly to coincide with the federal standards as defined in 42 CFR § 484.14(a). The current regulation appears to require CHHAs to provide more than one service directly, which the Department of Health does not require, and this has led to confusion among interested agencies.
Second, the amendments change the maximum period of time that may lapse before a comprehensive assessment is reviewed from 62 days to 60 days, as this was an error in the regulations as originally drafted. Federal regulations, at 42 CFR § 484.55(d)(1), require review at least every 60 days.
Costs:
The only new requirement imposed on agencies by these regulations is the requirement that the plan of care address palliative care, which is not anticipated to result in any appreciable burden to agencies and should not add additional costs to current operations. All other amendments are cost neutral or will decrease costs.
Local Government Mandates:
There are no mandates in this rule specific to local government. There are 28 existing county-based LHCSAs and approximately 29 county based CHHAs, and these entities will be required to comply with the same requirements as other licensed agencies.
Paperwork:
Providers are not expected to have increased paperwork as a result of these amendments.
Duplication:
The proposed regulatory changes are not duplicative of other requirements.
Alternatives:
The MRT proposals are specific in their mandates. The Department has made only those changes required to implement the MRT proposals.
Federal Standards:
There are no federal health care standards for LHCSAs. This provider type is a New York State construct. Federal regulations governing CHHAs are at 42 CFR Part 484.
Compliance Schedule:
Compliance is expected upon notice of adoption in the State Register.
