In a Dear Administrator Letter (DAL) issued by the New York State Department of Health (DOH), Licensed Home Care Services Agencies (LHCSA) were notified of "updated" and "streamlined" policies and procedures for the processing of Administrative Licensure Amendments (ALA), including a new filing process, receiving agency and contact information. The new guidelines outlined in the DAL, issued Aug. 8, 2025, are effective immediately.
Generally, ALAs cover the following requests:
- deleting or adding a service
- deleting or adding a county
- adding an additional site
- closing a site/license surrender
- change of address of agency and/or operator
- change of legal entity (corporate) name, change of assumed name (d/b/a) or new assumed name (d/b/a)
- license reprint
The DAL includes specific guidance for each type of request, the most important of which applies to expansion applications. Notably, under the new policy, DOH will approve only ALAs seeking to add a county to a LHCSA license if DOH determines there is need, defined as fewer than five LHCSAs actively serving patients in the requested county. For this and all other ALAs, "actively serving patients" means the LHCSA has a plan of care in place for at least one patient who is receiving services in the home. Stated another way, if there are five or more LHCSAs actively serving patients in the county to be added, the expansion request will not be approved. Excluded from the needs analysis are amendments to exclusively serve within the new county an Assisted Living Program (ALP), Program of All-Inclusivity Care for the Elderly (PACE), Nurse Family Partnership (NFP) or Continuing Care Retirement Community (CCRC).
DOH has not yet announced whether the new requirements will apply to ALAs submitted before the Aug. 8 effective date.
Unlike new establishment applications or changes in ownership (CHOW), which require approval from the Public Health and Health Planning Council, ALAs have historically been submitted by email to the applicable DOH Regional Office. Going forward, ALAs will be reviewed by and require approval from DOH's Bureau of Home and Community Based Services Licensing Unit. Some ALAs, such as requests to close a site or surrender a license, will also require notice to the appropriate Regional Office. Under the new process, LHCSAs must submit a written and signed request on their official letterhead, or a letter from their counsel or consultant on behalf of the LHCSA, to a new email address (LHCSA-Amend@health.ny.gov). This request must be accompanied by a completed Attachment A: LHCSA Administrative Licensure Amendment Request Checklist, along with all required supporting information and documentation as noted in Attachment A.
Holland & Knight attorneys are inquiring with DOH for more information as to how the DAL will be applied to previously filed applications, many of which have been pending for more than a year.
