DOH Releases Invitation for LHCSAs to Participate in Private Pay Program

Situation Report | July 27, 2020

As announced in an alert to members on Thursday, the state Department of Health (DOH) has posted an “Invitation and Requirements” for Licensed Home Care Services Agencies (LHCSAs) to Participate in the “NY State of Health Private Pay Home Care Services Pilot Program.”

Applicants are requested to submit non-binding letters of interest by July 29. Written questions will be accepted until July 31 at NYSOHHomeCare@health.ny.gov.

According to DOH, this new initiative is intended to build on the “marketplace model” and provide private-paying consumers with a “trusted” source through which they can select a home care aide and make arrangements for care with licensed agencies that have met and agreed to criteria under contract with DOH.

DOH plans to initially pilot the program in Nassau, Suffolk and Westchester counties starting on or about November 1, 2020.

As stated in the announcement, this program, which was part of the 2020-21 state budget, is intended to “allow individuals to more easily connect to private-pay home care services from LHCSAs, and potentially delay the need for more comprehensive insurance affordability programs.”

More information and eligibility requirements are here.

Certified Home Health Agencies (CHHAs) are not specified in the announcement but the appropriateness of CHHA inclusion has been raised with DOH, as discussed further below.

DOH will review whether applicant LHCSAs meet all minimum participation standards. Those that do (and who sign an agreement) will be selected and eligible to offer home care services through the Marketplace.

This invitation is the only opportunity being given at this time for LHCSAs to apply. However, LHCSAs that do not apply for participation in the pilot program now — or that do not qualify based on the terms and conditions of the 2021 pilot program — will have an opportunity to apply at a later date during any program expansions beyond the pilot.

HCA participated in a meeting last week with other provider associations at which this program was briefly discussed and we emphasized that CHHAs should also be included. We intend to continue to advocate on this issue and also provide other feedback to DOH on this initiative, including the process by which the state intends to allow consumers to select a home care aide based on their preferences.