Situation Report | December 20, 2021
On December 13, 2021 the Department of Health issued MLTC Policy 21.06 – Changes to Consumer Directed Personal Assistance Program (CDPAP) Regulations and 21 OHIP ADM-04 to Local Departments of Social Services (LDSS) Commissioners to provide guidance to Medicaid Managed Care Organizations (MMCOs) and LDSS regarding regulatory changes impacting the Consumer Directed Personal Assistance Program (CDPAP) and Personal Care Services (PCS) that were effective November 8, 2021. These apply to all managed care/LDSS programs, organizations or demonstrations covering personal care and/or consumer directed personal assistance services funded by New York State Medicaid.
The guidance provides instruction to the MMCOs/LDSS pertaining to several aspects of the regulatory changes, including:
- Eliminating the MMCO Requirement to Annually Notify Home Care Recipients about Consumer Directed Personal Assistance Services (CDPAS);
- Requiring Consumers/Designated Representatives to Work with Only One Fiscal Intermediary (FI) at a Time;
- Defining Additional Responsibilities of Designated Representatives;
- Changing Routine Reassessment Timeframe;
- Ordering Practitioners for Personal Care (PCS) and Consumer Directed Personal Assistance (CDPAS) Services;
- Codifying Supervision and Cueing; and
- Updates to the Requirements for the Continuation, Denial, Reduction or Discontinuation of Services.
The policies also include an updated CDPAP Member/Designated Representative/MCO Agreement and templates for outreach to CDPAP consumers working with more than one FI.
The policies do not implement any aspects of the Independent Assessment process, nor changes to the minimum eligibility criteria as the revised regulations allow the Department to permit the current assessment process to continue until such time as the Independent Assessor has been implemented.
Questions on the policy should be sent to independent.assessor@health.ny.gov (for MMCOs) or services@health.ny.gov (for LDSS).