Thank you to all the MLTC Plans and Social Adult Daycare (SADC) providers for your support in completing, reviewing, and submitting the SADC Site Self-Assessments by December 30, 2021. Currently, NYSDOH is working to review all submissions and will be collaborating with the MLTC Plans to address any outstanding assessments, required updates, and/or clarifications. In addition, please be advised of the following: 

• Outstanding Site Self-Assessment Tools: Plans should continue to submit any outstanding Site Self-Assessment tools to NYSDOH on a rolling basis as they work with their SADC network provider sites to address any outstanding issues. This may include general corrections and edits to the Self-Assessments submitted by the network provider sites, as well as working with any non-responding SADC sites to confirm status.
• Feedback on actual vs received Site Self-Assessments: NYSDOH will distribute feedback by end of January or February 2022 on the total SADC Site Self-Assessments expected vs received for each MLTC. Once distributed, NYSDOH will collaborate with MLTC plans to remediate any discrepancies.
• NYSDOH Upcoming FAQs: As NYSDOH continues to track all questions and feedback received, a list of all frequently asked questions (FAQs) will be posted by end of January 2022.

General Reminders: 

Please keep the following in mind for returning the completed SADC Site Self Assessments: 
 
Completing Self-Assessment Tool:

• Please read all instructions provided on page one of the Self-Assessment Tool before completing.
• SADC sites complete the Self-Assessment tool for each Partial Cap and/or MAP Plan (line of business) and location.  Example:  if a site contracts with one MLTC and has two locations and provides both MAP and Partial at each, the site will need to complete 4 Self-Assessment Tools. 
• SADC sites include individual membership totals (“Number of HCBS Waiver Clients Served at the Setting”) for each line of business and location on each Self-Assessment tool.
• If SADC site is reporting “closed/no members” to their MLTC plan, the site should still complete the tool and write the sites status in the comment field for question #1 in the SADC site section 2 table starting on page 5. In addition, sites must indicate (in the comments field) if the site is fully or partially closed, as well as if the closure is permanent or temporary with a description for why (i.e. COVID related) by line of business. Both MLTC plan and DOH will validate the site’s contracting status with the MLTC plan in Phase II via the MLTC plan’s PNDS submission. When those SADC sites prepare to “reopen” those sites are required to meet and have all HCBS SADC standards validated BEFORE re-opening.
• Per the Self-Assessment tool instructions all “Yes” and “No” answers require a comment. 

Instructions: “If answering “No” to a question, thereby potentially demonstrating a lack of HCBS Rule compliance, please provide a brief explanation as to why in the far-right “Comments” column and any remediation efforts in progress. If answering “Yes”, provide a brief explanation in Comments as to how to demonstrate compliance.”

Tool Submission and Due Dates: 

• SADC sites submit each individually completed Self-Assessment tool back to their MLTC contracted plans. The tool should remain in Word Doc format and should not be converted to PDF.  PDF versions will be returned to MLTC plans by SOH and considered not submitted. Only the Word Document format can be collectively merged for analysis by DOH. 
• MLTC plans submit all completed individual SADC Self-Assessments back to DOH via HCS. 

Per the 12/29/21 email: Please share the Person Centered Planning Training information with your staff and Social Adult Dare Care Providers. 

MLTC Policy Documents: Please ensure that your staff and Social Adult Daycare Providers are aware of all MLTC Policy Documents including but not limited to the following: 

• 13.03:  (CBLTSS definition)
• 13:05:  (Social Daycare Services Q&A- eligibility for CBLTCSS POC)
• 13.11:  (Social Daycare Services Q&A and letter to MTLC plans from Medicaid Director Jason Helgerson)
• 13.14:  (Questions Regarding Managed Long Term Care (MLTC) Eligibility)
• 15.01(a):  (REVISED Social Adult Day Care and MLTC: Implementation of New Social Adult Day Care Certification Process)
  
  
•  Social Adult Day Care (SADC) Certification 
• SADC Certification
• SADC Certification FAQ

21.05:  (HCBS SADC site compliance)

• HCBS SADC Fact Sheet - (Web) - (PDF) - 12.3.2021
• MLTC SDC HCBS Self-Assessment Tool - (DOCX)
• All Plan Meeting slide presentation - (Web) - (PDF) - 11.16.2021
• HCBS SADC Site Self-Assessment Compliance Webinar - 12.9.2021
  • Presentation Slides (Web) - (PDF)
  • Recording (YouTube) Transcript (PDF)

Any questions? Contact: [email protected].

Home & Community-Based Services (HCBS) Final Rule

In 2014, the Centers for Medicare and Medicaid Services (CMS) published the HCBS Final Rule related to Medicaid-funded Home and Community-Based Services (HBCS). This rule implements a number of changes to home and community-based waivers and imposes new requirements on what is considered an appropriate home and community-based setting for all authorities in its scope.

The information linked below contains the most recent amended HCBS Final Rule Statewide Transition Plan (STP), to come into compliance with the federal regulation, that has been submitted to CMS. The first link is to the HCBS STP that received initial approval from CMS in November of 2018, with the approval letter and feedback for the final approval letter beneath. The additional resources provide an overview of the Statewide Transition Plan, amendments made to the Plan, our public comment process, the final rule, and person-centered planning tools and education.

https://www.health.ny.gov/health_care/medicaid/redesign/home_community_based_settings.htm