2023 New York Laws › PBH - Public Health › Article 36 - Home Care Services › 3605 - Licensure of Home Care Services Agencies.

§  3605.  Licensure  of  home  care  services agencies. 1. After April
first, nineteen hundred eighty-six, no home care services  agency  which
is  engaged  in  providing,  directly  or  through contract arrangement,
nursing services, home health aide services, or personal  care  services
shall  be  operated  without  a  license  issued  by the commissioner in
accordance with the  standards  set  forth  in  this  section;  provided
however,  an  agency  which provides personal care or home care services
exclusively to individuals pursuant to a program administered,  operated
or  regulated  by  another  state agency or an organization licensed and
operating exclusively as a nurses' registry pursuant to  article  eleven
of  the  general  business  law  shall  be  exempt  from  the  licensure
requirements of this chapter. The licensure requirements of this chapter
shall not apply to sole practitioners licensed pursuant to sections  six
thousand  nine  hundred  five  and  six thousand nine hundred six of the
education law.
1-a. (a) Core public  health  services,  as  defined  in  section  six
hundred  two  of  this  chapter,  when provided in the home by the local
health department of a county or of the city  of  New  York,  shall  not
require  licensure  under  this  section  if  such  core public services
require  only  minimal  patient  contact.  Patient  contact   shall   be
considered minimal if it is of limited duration for acute or non-chronic
conditions,  including but not limited to any health conditions posing a
potential threat to public health, and treatment is  generally  expected
to  require  no  more than six patient visits; provided, however, that a
local health department may exceed six visits in the interest of patient
safety and public health.
(b) Core public health services that may be provided without a license
pursuant  to  this  subdivision  include  but  are   not   limited   to:
immunizations;  testing for tuberculosis and observation of tuberculosis
self-directed  therapy;  verbal  assessment,  counseling  and   referral
services;   and  such  other  services  as  may  be  determined  by  the
department, provided that such services shall not  include  home  health
aide  services, personal care services, or nursing services that require
more than minimal patient contact.
1-b. Core public health services, as defined in  section  six  hundred
two  of  this  chapter, when provided by local health departments in the
home as authorized under subdivision  one-a  of  this  section,  may  be
eligible  for  reimbursement  under  title  XIX  of  the  federal Social
Security  Act,  provided  that  the  services  meet  federal  and  state
requirements for such reimbursement.
2.  The  commissioner  shall  not  issue  a  license  to any home care
services agency except with the written approval of  the  public  health
and  health  planning  council issued pursuant to the provisions of this
section.
3. An application for licensure as a home care services  agency  shall
be  filed  with  the  public health and health planning council together
with such other forms and information as  shall  be  prescribed  by,  or
acceptable   to,   the   public  health  and  health  planning  council.
Thereafter, the public health and health planning council shall  forward
for  comment,  if  any,  a  copy  of  the  application for licensure and
accompanying documents to the health  systems  agency,  if  any,  having
geographical jurisdiction of the area where the services of the proposed
agency  are to be offered. The public health and health planning council
shall act upon such application, after the health systems agency has had
reasonable time to submit  its  comments,  based  solely  upon  criteria
provided  for  in subdivision four of this section. If the public health
and health planning council proposes to disapprove the  application,  it
shall  notify  the applicant, provide reasons for disapproval and afford

the applicant a hearing on the application, if requested, or on its  own
motion.  Any  hearing held pursuant to this subdivision may be conducted
by the public health and health planning council or  by  any  individual
designated by the public health and health planning council.
4.  The public health and health planning council shall not approve an
application for licensure unless it is satisfied as to: (a)  the  public
need  for  the existence of the licensed home health care service agency
at the time and place and under  the  circumstances  proposed;  (b)  the
character,  competence  and standing in the community of the applicant's
incorporators, directors, sponsors, stockholders or operators;  (c)  the
financial  resources  of  the proposed licensed home health care service
agency and its sources of financial revenues; and (d) such other matters
as it shall deem pertinent.
5. A license shall not be issued by the commissioner unless  he  finds
that  the  equipment, personnel, rules, standards of care, and home care
services are fit and adequate, and that the home care services  will  be
provided  in  the  manner  required  by  this  article and the rules and
regulations thereunder.
6. Neither tax status nor profit-making status shall be  criteria  for
licensure.
7.  An agency licensed pursuant to this section shall be authorized to
provide nursing services, home health aide  services  or  personal  care
services.
8.  Agencies  licensed  pursuant  to  this  section  but not certified
pursuant to section three thousand six hundred eight  of  this  article,
shall  not be qualified to participate as a home health agency under the
provisions of title XVIII or XIX of  the  federal  Social  Security  Act
provided, however, an agency which has a contract with a state agency or
its locally designated office or, as specified by the commissioner, with
a  managed  care  organization participating in the managed care program
established pursuant to section three hundred sixty-four-j of the social
services law or with a managed long term care plan established  pursuant
to  section  forty-four  hundred  three-f  of  this chapter, may receive
reimbursement under title XIX of the federal Social Security Act.
* 9. An entity which seeks approval as a limited  home  care  services
agency  must  meet  the  requirements  of  this  section,  the rules and
regulations of the department, and must be a certified  operator  of  an
adult  home or enriched housing program pursuant to article seven of the
social  services  law.  The  commissioner  shall  approve   only   those
applicants  that  the  commissioner of the department of social services
has listed as eligible pursuant to the requirements of paragraph (a)  of
subdivision eleven of this section.
* NB Expires June 30, 2025
* 10. The department shall notify the department of social services of
any action taken against a limited home care services agency pursuant to
section thirty-six hundred five-a of this article.
* NB Expires June 30, 2025
* 11.  For  purposes  of this subdivision, eligibility of limited home
care services agencies licensed by the department shall be as follows:
(a) Only those certified operators of adult homes and enriched housing
programs that provide services that are consistent  with  the  needs  of
each  resident,  meet  the  standards  governing  the  operation of such
facilities in accordance with the provisions of  article  seven  of  the
social services law, and provide quality care shall be considered by the
department as eligible for licensure.
(b) An operator that has received current official written notice from
the  department of social services of any enforcement action pursuant to

section four hundred sixty-d of the social services  law  shall  not  be
eligible for such certification.
(c) Such current enforcement action, when resolved to the satisfaction
of  the  commissioner  of  social services, shall not itself preclude an
otherwise eligible  applicant  from  licensure  approval  but  shall  be
considered  by  the department in determining the character, competence,
and standing in the community of the applicant pursuant  to  subdivision
four of this section.
(d)  If  the  department receives notice from the department of social
services that a certified operator of an adult home or enriched  housing
program  that  is  licensed  as  a limited home care services agency has
received official written notice from the department of social  services
of  a proposed enforcement action taken pursuant to section four hundred
sixty-d of the social services law,  the  department  shall  review  the
delivery  of  home  care  services  to  determine whether such agency is
meeting all applicable regulations and standards.
* NB Expires June 30, 2025
* 12. Notwithstanding any law to the contrary, the commissioner  shall
have  the  authority  to  limit  the  number of adult homes and enriched
housing programs eligible for licensure under this section.
* NB Expires June 30, 2025
13. The commissioner shall charge to applicants for the  licensure  of
home  care services agencies an application fee of two thousand dollars.
All fees pursuant to this section shall be payable to the department  of
health for deposit into the special revenue funds - other, miscellaneous
special revenue fund - 339, certificate of need account.
14.  Notwithstanding  any contrary provision of law and subject to the
availability of federal financial  participation,  for  periods  on  and
after April first, two thousand fourteen, the commissioner is authorized
to  make  temporary periodic lump-sum Medicaid payments to licensed home
care service agencies ("LHCSA") principally engaged  in  providing  home
health services to Medicaid patients, in accordance with the following:
(a) Eligible LHCSA providers shall include:
(i) providers undergoing closure;
(ii) providers impacted by the closure of other health care providers;
(iii)  providers  subject  to mergers, acquisitions, consolidations or
restructuring;
(iv) providers impacted by the merger, acquisition,  consolidation  or
restructuring of other health care providers; or
(v) providers seeking to ensure that access to care is maintained.
(b)  Providers  seeking Medicaid payments under this subdivision shall
demonstrate through submission of a written proposal to the commissioner
that the additional resources provided by such  Medicaid  payments  will
achieve one or more of the following:
(i) protect or enhance access to care;
(ii) protect or enhance quality of care;
(iii)  improve  the  cost effectiveness of the delivery of health care
services; or
(iv) otherwise protect or enhance the health care delivery system,  as
determined by the commissioner.
(c)  (i)  Such written proposal shall be submitted to the commissioner
at least sixty days prior to the requested commencement of such Medicaid
payments and shall include a proposed budget to achieve the goals of the
proposal. Any Medicaid payments  issued  pursuant  to  this  subdivision
shall  be  made  over  a  specified period of time, as determined by the
commissioner, of up  to  three  years.  At  the  end  of  the  specified
timeframe  such payments shall cease. The commissioner may establish, as
a condition of receiving such Medicaid payments, benchmarks and goals to

be achieved in  conformity  with  the  provider's  written  proposal  as
approved  by  the  commissioner  and  may also require that the provider
submit  such  periodic  reports  concerning  the  achievement  of   such
benchmarks  and  goals  as  the commissioner deems necessary. Failure to
achieve satisfactory progress, as determined  by  the  commissioner,  in
accomplishing  such benchmarks and goals shall be a basis for ending the
provider's  Medicaid  payments  prior  to  the  end  of  the   specified
timeframe.
(ii) The commissioner may require that applications submitted pursuant
to this subdivision be submitted in response to and in accordance with a
Request  For  Applications  or  a  Request  For  Proposals issued by the
commissioner.