Cayuga County health staff seek committee support to relinquish licensed home care service agency licensure; legislators express mixed views

Cayuga County Health Department staff asked the Health & Human Services Committee for a sense of support to relinquish the county's Licensed Home Care Service Agency (LHCSA) licensure, saying the department has not provided billable home-visitation services in about six years and that other community agencies now cover most home-based maternal and child health supports.

The department described the LHCSA's regulatory background and practical implications: maintaining licensure requires ongoing policies, staffing and periodic surveys under Article 36 of the state public health law. Kathleen Cuddy told the committee that local demand for billable home nursing services has been low, the department has not billed for home care services for several years, and the county's current work is concentrated on prenatal and postpartum maternal-child visits and referrals to community programs. The department's board of health voted to support relinquishing the license.

Several legislators said they were concerned about losing flexibility. One legislator said it would be harder to reestablish licensed services later and preferred retaining licensure as an asset. Others said counties across New York are increasingly relinquishing LHCSA licensure and noted that a county can reapply for licensure but that reestablishment would require paperwork and recruiting clinical staff.

Cuddy said that even without LHCSA licensure the department could perform up to six home visits per individual for maternal-child health needs without a doctor's order, and that the department would retain policies and records that would help restart licensure if necessary. The committee did not record a formal vote on relinquishment during the meeting; members offered a mix of support and caution and asked staff to bring additional information back to the board and the legislature.

Legislators asked about local alternatives; Cuddy identified community partners such as Healthy Families and other agencies that provide supportive home visitation. Committee members also asked what would be needed to reapply for licensure; staff said reapplication would take several months and require recruitment of additional clinical personnel and updated paperwork.

The item will return for further consideration; the Board of Health already voted in support.