Effective Nov. 8, 2021, several New York State Department of Health (NYDOH) regulations were amended to clarify supervision and cueing (cognitive prompts) as forms of assistance with PCS. This change expands allowable supervision and cueing to include assistance with nutritional and environmental support functions (Level 1 services) and supersedes the NYSDOH document GIS 03 MA/003, which addresses Level 2 services.
However, supervision and cueing are not a stand-alone personal care service and cannot be authorized or reimbursed by EmblemHealth unless provided as a means of assistance with a recognized Level 1 or 2 service. Similarly, safety monitoring, as a stand-alone function while no personal care services task is being provided, is not a recognized service.
For instance, a member may be authorized for four hours a week of assistance with shopping, meal preparation, and/or laundry. These tasks may be provided through hands-on assistance, supervision, or cueing, but the member may not be authorized for supervision and cueing that is not associated with the authorization for shopping, meal preparation, and/or laundry.
In this example, the personal care aide may do the shopping or accompany the member to the market to ensure they purchase adequate and appropriate food. The aide may supervise meal preparation to make sure the member practices safe food handling, turns off appliances, and puts everything away. In addition, the aide may provide cues to ensure the member properly completes their laundry (placing the sheets in the washer, putting them in the dryer, bringing them to the bedroom so the member can make their bed later). However, the aide may not remain in the home to make sure the individual doesn’t wander or turn the stove on inappropriately after the cooking task is completed.
NOTE: For those who only need nutritional and environmental supports, services remain capped at eight hours per week. By extension, this service limit applies to the authorization of supervision and cueing as well.
Further information on the regulatory changes impacting Consumer Directed Personal Assistance Program (CDPAP) and PCS are available on the NYSDOH website.
JP #56547 2/2022
