MRT/MLTC Home Care Next Steps -

LeadingAge NY Annual Conference Presentation

  • Document is also available in Portable Document (PDF)

MRT / MLTC

Home Care Next Steps

Mark Kissinger
Director, Division of Long Term Care
Office of Health Insurance Programs
May 22, 2012

  • Public Health Law 3614-c establishes a minimum wage within New York City, Nassau, Suffolk and Westchester for home care aides who perform Medicaid reimbursed work for:
    • Certified home health agencies
    • Long term home health care programs
    • Managed care organizations
    • Licensed home care services agencies who contract with a CHHA, LTHHCP, or MCO to provide services to clients in those locations
  • Applies to all dually eligible cases where Medicaid is the payer in part or in whole
  • Providers must:
    • Pay defined home care aides at the minimum rates established and published by November 1, of each year
    • Provide the Commissioner of the DOH written certification that all services provided are in full compliance with the terms of the Parity Law
    • Must obtain a written certification that attests that the contracted entities are in compliance with the Law
    • Maintain records of compliance for at least 10 years which must be made available to the Department upon request
  • DAL: DHCBS 11-09 - Home Care Worker Wage Parity August 22, 2011
  • Home Care Worker Wage Parity FAQ - October 28, 2011
  • Home Care Worker Wage Parity Frequently Asked Questions (FAQs) January 2012
  • Home Care Worker Wage Parity Frequently Asked Questions (FAQs) February 2012
  • Address for questions via email is:
  • Effective July 1, 2012 Personal Care - Dual eligible enrollment phased in by service type by county by zip code
    • Recipients will be given 60 days to choose the type of MLTC plan
    • Continuity of care will be ensured through the use of current vendors
  • January 2013 initiate enrollments citywide of LTHHCP, home health cases over 120 days, adult day health care program and private duty nursing cases
    • Upstate counties phased in through 2013 See Draft Enrollment Plan
  • CHHA RFA
  • Decisions Pending
  • Policy Questions on Capacity
  • DAL HCBS 12-04: LTHHCP Opportunity to Become a General Purpose CHHA was issued on 5/10/12:
    • Information on how LTHHCPs apply as a general purpose CHHA
    • LTHHCPs that did not submit a response to the RFA are being provided an opportunity to submit a CON application
    • LTHHCPs must notify the Department in writing by 5/24 of their intent to submit a CON
    • Information regarding the submission of the CON application is available on the Department´s website.
    • The CON must be submitted using the NYS E-CON system by 6/15/12
    • Questions should go to Becky Gray via e-mail at: homecare@health.state.ny.us
  • System to facilitate uniform assessments for home and community-based programs in NYS
    • Improve access to programs and services
    • Eliminate duplicative assessment data
    • Improve consistency in the assessment process
  • Based on a uniform data set that will standardize and automate needs assessments for home and community-based programs in New York
  • UAS-NY is a web-based software application that will be used by multiple long term care programs:
    • Assisted Living Program
    • Personal Care Services Program
    • Consumer Directed Personal Assistance Program
    • Adult Day Health Care
    • Long Term Home Health Care Program
    • Nursing Home Transition and Diversion Program
    • Traumatic Brain Injury Waiver
    • HCBS Care at Home Waiver
    • Managed Long Term Care
  • Development and Implementation of the UAS-NY Phases:
  • Development and Design
  • Beta testing to evaluate the system and related business processes
    • 40 representative organizations will provide insight into
      • System technical stability
      • Statewide roll-out strategy
      • Organizational ability to integrate UAS-NY into business practices
      • Impact on assessed individuals
      • Online courses are being developed for training purposes
  • Questions:
  • MLTC Rollout Implications
  • Care Management for All MRT Waiver
  • Duals Demonstration Project
  • Federal Budget Situation
  • State Budget Situation
  • Send to me 5 regulatory or policy changes to make implementation of all of these reforms easier.
  • What are the top 5 things that keep you up at night?
  • Stay engaged and active.
  • Work with LeadingAge to provide quality feedback.

Mark Kissinger: mlk15@health.state.ny.us 518-402-5673