Background

On July 23, 2020, the New York State Department of Health (DOH) issued an invitation for Licensed Home Care Services Agencies (LHCSAs) to participate in the NY State of Health Private Pay Home Care Services Pilot Program (Pilot Program) for 2021. The stated goal of the Pilot Program is, in conjunction with the NY State of Health Marketplace, to provide consumers with a resource to help locate private-pay home care aides and care through an LHCSA in order to potentially avoid utilization of comprehensive insurance programs, like Medicaid, that include personal services benefits. The Pilot Program will be rolled out in phases, with the DOH inviting currently licensed LHCSAs serving consumers in Nassau, Suffolk, and Westchester counties to participate in the first phase.

Applicant Eligibility

The DOH has outlined specific eligibility criteria for potential participants. The criteria are set forth below. They require applicants to:

• Be an existing LHCSA licensed by the DOH at the time the application is submitted;
• Be licensed to provide personal care, housekeeping, homemaker and home health aide services (applicants should ideally also have the capacity to provide, at the consumer’s option, remote patient monitoring and store-and-forward technology);
• Be authorized to provide home care services in Nassau, Suffolk or Westchester County;
• Have a minimum of 350 employees who are certified to provide personal care, housekeeping, homemaker or home health aide services in Nassau, Suffolk or Westchester County;
• Submit an attestation demonstrating compliance with state and federal wage and hour laws;
• Be in compliance with all state and federal regulations and provide supporting documentation as evidence;
• Have state-required in-service training and other trainings in place at the time the application is submitted; and
• Be enrolled with NYS Medicaid, render services to Medicaid fee-for-service members and have a contract with one or more Medicaid Managed Long Term Care plan(s) serving at least one of the first-phase pilot counties.

Key Dates

Following the issuance of the invitation, the DOH has outlined the following key dates:

• Interested applicants should submit a Letter of Interest to participate in the Pilot Program no later than July 29, 2020.
• Applicants may submit questions regarding the program via email to NYSOHHomeCare@health.ny.gov no later than July 31, 2020.
• Reponses to questions submitted by potential participants will be posted to the NY State of Health website on or around August 7, 2020.
• Participant proposals are due August 12, 2020.
• Approvals of participants are expected to be announced on September 2, 2020.
• The agreement by and between the DOH and the LHCSA is expected to be entered into on September 30, 2020.
• The Pilot Program effective date is anticipated to be November 1, 2020.