§ 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.