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applications of sterile dressings by a registered nurse, provided however, that the services provided by such agency are NOT services that must be provided to residents of such facilities pursuant to article seven of the social services law and rules and regulations of the department.

In establishing a reimbursement structure that was consistent with the intent and requirements of the enabling legislation, the Department examined available data to determine what MA home care services were currently being provided to ACF residents and at what cost. Based on average monthly expenditures for ACF recipients, Medicaid monthly expenses for all CHHA, CHHA nursing and personal care services was $216.14 or about $7.20 per day. In an effort to meet the statutory intent, rates were developed for the LLHCSA program as shown in Table 1.

TABLE 1

LLHCSA RATES

Hour

Quarter Hour

$27.00

$6.75

$24.50

$6.13

$11.50

$2.88

$11.00

$2.75

RN Rate Rockland, Westchester, Nassau, Suffolk, Bronx, Kings, New York, Queens and Richmond Counties

Rest of State

Personal Care Rate Bronx, Kings, New York, Queens And Richmond Counties

Rest of State

Program Implementation

In order to establish the program, public notice of the program’s details and process for approval were announced on February 23, 1998 prior to all implementation activities being complete. Several development activities were required. These activities included:

  • Development of an Administrative Directive which advised local districts of program policy and procedures, issued in September 1998;

  • Development of a MMIS enrollment and payment process, created in the Spring of 1999;

  • Negotiation of an MOU with NYC Human Resources Administration to allow for program implementation in that region, completed in 1999;

  • Development of surveillance guidelines for pre-opening surveys of approved organizations, completed in 1999;

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