Bill Text: NY S08103 | 2009-2010 | General Assembly | Introduced


Bill Title: Provides for the establishment of a senior care choices program to give care and services at home to senior citizens; sets criteria for such program; directs application for a federal waiver.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2010-06-08 - REFERRED TO AGING [S08103 Detail]

Download: New_York-2009-S08103-Introduced.html
                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         8103
                                   I N  S E N A T E
                                     June 8, 2010
                                      ___________
       Introduced  by  Sen.  STACHOWSKI  -- read twice and ordered printed, and
         when printed to be committed to the Committee on Aging
       AN ACT to amend the elder law, in relation to establishing a senior care
         choices program in the office for the aging
         THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section  1.  Section  214  of the elder law is amended by adding a new
    2  subdivision 8 to read as follows:
    3    8. SENIOR CARE CHOICES PROGRAM. (A) NOTWITHSTANDING ANY OTHER  LAW  TO
    4  THE  CONTRARY, THE DIRECTOR SHALL FILE, OR CAUSE TO BE FILED, WITHIN ONE
    5  HUNDRED TWENTY DAYS OF THE EFFECTIVE DATE OF THIS SUBDIVISION AN  APPLI-
    6  CATION  FOR  A  FEDERAL  WAIVER  PURSUANT TO SECTION 1115 OF THE FEDERAL
    7  SOCIAL SECURITY ACT, OR ANY SUCCESSOR THERETO, FOR A SENIOR CARE CHOICES
    8  PROGRAM, UNDER WHICH THE  OFFICE  SHALL  AND  IS  HEREBY  AUTHORIZED  TO
    9  PROVIDE  DIRECTLY OR BY CONTRACT A COORDINATED PLAN OF CARE AND SERVICES
   10  AT HOME TO SENIORS IN A SEAMLESS NETWORK  THAT  SHALL  INCLUDE  SERVICES
   11  PROVIDED BY AND THROUGH THE OFFICE AND ANY ADDITIONAL SERVICES AS MAY BE
   12  NECESSARY  TO MAINTAIN SUCH PERSONS AT HOME AS AUTHORIZED IN THIS SUBDI-
   13  VISION. EVERY STATE AGENCY IS HEREBY EMPOWERED AND DIRECTED TO COOPERATE
   14  WITH THE OFFICE AND TO COMPLY WITH ANY REQUEST FOR THE  FILING  OF  SUCH
   15  WAIVER  IF  THE  DIRECTOR  SHALL LACK POWER AND AUTHORITY TO FILE SUCH A
   16  WAIVER. AS USED IN THIS SUBDIVISION, THE TERM "SENIOR" MEANS PERSONS WHO
   17  ARE AGED SIXTY AND OLDER WHO ARE MEDICALLY ELIGIBLE FOR PLACEMENT  IN  A
   18  LONG-TERM  CARE  FACILITY, AS SUCH TERM IS DEFINED IN SECTION TWENTY-ONE
   19  HUNDRED NINETY-ONE OF THE PUBLIC HEALTH LAW.
   20    (1) THE SENIOR CARE CHOICES PROGRAM SHALL BE PROVIDED IN THE  SENIOR'S
   21  HOME  OR  IN  THE  HOME  OF  A RESPONSIBLE RELATIVE OR OTHER RESPONSIBLE
   22  ADULT, AND, OTHER PROVISIONS OF THIS SECTION TO  THE  CONTRARY  NOTWITH-
   23  STANDING,  IF THE WAIVER GRANTED PURSUANT TO SECTION 1115 OF THE FEDERAL
   24  SOCIAL SECURITY ACT OR ANY SUCCESSOR THERETO SHALL SO PROVIDE, MAY  ALSO
   25  BE  PROVIDED  IN  ADULT CARE FACILITIES, OTHER THAN SHELTERS FOR ADULTS,
   26  CERTIFIED PURSUANT  TO  SECTION  FOUR  HUNDRED  SIXTY-B  OF  THE  SOCIAL
   27  SERVICES LAW, PROVIDED THAT THE SENIOR MEETS THE ADMISSION AND CONTINUED
   28  STAY  CRITERIA  FOR  SUCH FACILITY, EXCEPT THAT SERVICES PROVIDED BY THE
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD06159-02-9
       S. 8103                             2
    1  PROGRAM SHALL NOT DUPLICATE OR  REPLACE  THOSE  WHICH  THE  FACILITY  IS
    2  REQUIRED BY LAW OR REGULATION TO PROVIDE.
    3    (2) IN FILING SUCH WAIVER FOR THE OPERATION OF THE PROGRAM, THE OFFICE
    4  SHALL  SEEK  TO  PROVIDE SERVICES PURSUANT TO THE PRINCIPLE THAT SENIORS
    5  HAVE THE PRIMARY AUTHORITY TO MAKE CHOICES  THAT  WORK  BEST  FOR  THEM,
    6  REGARDLESS  OF THE NATURE OR EXTENT OF THEIR DISABILITY OR THE SOURCE OF
    7  PAYMENT FOR SERVICES. IN DESIGNING THE PROGRAM AND  PROVIDING  SERVICES,
    8  THE  OFFICE  IS AUTHORIZED TO WAIVE ANY PROVISION OF THE SOCIAL SERVICES
    9  LAW OR THE PUBLIC HEALTH LAW, OR  ANY  RULE  OR  REGULATION  PROMULGATED
   10  THEREUNDER, WHICH IN THE JUDGMENT OF THE OFFICE RESTRICTS ITS ABILITY TO
   11  PROVIDE SERVICES AS REQUIRED BY THIS SUBDIVISION, SO LONG AS SUCH WAIVER
   12  IS  CONSISTENT  WITH ANY FEDERAL WAIVER GRANTED PURSUANT TO SECTION 1115
   13  OF THE FEDERAL SOCIAL SECURITY ACT OR ANY SUCCESSOR THERETO.
   14    (3) THE OFFICE SHALL SEEK TO EXPAND SOURCE OF PAYMENT FOR THE PROGRAM,
   15  INCLUDING SEEKING PAYMENTS FROM VOLUNTARY AND WILLING  PRIVATE  SOURCES,
   16  INSURANCE PLANS, CHARITIES AND FOUNDATIONS, AND INDIVIDUALS.
   17    (4)  THE  OFFICE  IS  HEREBY  EMPOWERED TO PROVIDE OR CONTRACT FOR THE
   18  PROVISION OF SUCH SENIOR CARE CHOICES PROGRAM IN ANY COUNTY  WITHIN  THE
   19  STATE.  THE  OFFICE  SHALL  SEEK TO COORDINATE SERVICES WITH ANY CURRENT
   20  PROVIDER OF SERVICES. NO STATE AGENCY SHALL IMPOSE A LIMITATION  ON  THE
   21  NUMBER  OF ELIGIBLE INDIVIDUALS SERVED IN THIS PROGRAM. THE OFFICE SHALL
   22  NOT BE SUBJECT TO AUDIT, ASSESSMENT, SUSPENSION, SANCTION, OR REPORT  BY
   23  A STATE AGENCY FOR A PROGRAM CONDUCTED PURSUANT TO THE AUTHORITY OF THIS
   24  SUBDIVISION,  EXCEPT  THAT IT SHALL BE SUBJECT TO AUDIT BY THE OFFICE OF
   25  THE STATE COMPTROLLER TO THE EXTENT THAT SUCH PROGRAMS WOULD  HAVE  BEEN
   26  SUBJECT TO AUDIT BUT FOR THIS PARAGRAPH.
   27    (B)  IF  A SENIOR DEEMED BY HIS OR HER PHYSICIAN ABLE TO REMAIN IN HIS
   28  OR HER OWN HOME OR THE HOME OF A RESPONSIBLE RELATIVE OR OTHER RESPONSI-
   29  BLE ADULT IF THE NECESSARY SERVICES ARE PROVIDED APPLIES  FOR  ADMISSION
   30  TO  THE  PROGRAM,  THE  OFFICE  IN  CONSULTATION  WITH  THE LOCAL SOCIAL
   31  SERVICES COMMISSIONER SHALL ORDER AN ASSESSMENT TO  BE  PERFORMED  USING
   32  THE ASSESSMENT INSTRUMENT DEVELOPED PURSUANT TO THE PROVISION OF SECTION
   33  THIRTY-SIX  HUNDRED SIXTEEN OF THE PUBLIC HEALTH LAW, AND IN ADDITION AN
   34  ASSESSMENT OF THE INFORMAL CAREGIVING NETWORK AND  SUPPORTS  CAPABLE  OF
   35  PROVIDING  SOCIAL AND NON-MEDICAL SERVICES TO THE SENIOR. IF THE RESULTS
   36  OF THE ASSESSMENT INDICATE THAT THE SENIOR CAN RECEIVE  THE  APPROPRIATE
   37  LEVEL  OF  CARE  AT  HOME OR IN THE HOME OF SUCH RESPONSIBLE RELATIVE OR
   38  OTHER RESPONSIBLE ADULT,  AND  THAT  THE  SENIOR  CAN  BE  APPROPRIATELY
   39  SUPPORTED  BY  FAMILY,  INTIMATES,  FRIENDS,  AND  COMMUNITY, THE OFFICE
   40  SHALL, AFTER CONSULTING WITH THOSE WHO PERFORMED THE ASSESSMENT, PREPARE
   41  FOR THAT SENIOR A PLAN FOR THE PROVISION OF SERVICES  THAT  MAY  INCLUDE
   42  ANY  SERVICE  THAT  WOULD  BE RENDERED IN A NURSING HOME PLUS SUCH ADDI-
   43  TIONAL SERVICES AS THE OFFICE  IS  AUTHORIZED  TO  PROVIDE  DIRECTLY  OR
   44  THROUGH  CONTRACT PURSUANT TO THE PROVISIONS OF THE WAIVER AUTHORIZED BY
   45  THIS SUBDIVISION. CONTINUED  PROVISION  OF  SERVICES  PURSUANT  TO  THIS
   46  SUBDIVISION  SHALL  BE  CONTINGENT  ON  ADDITIONAL ASSESSMENTS PERFORMED
   47  EVERY ONE HUNDRED TWENTY DAYS. AT THE TIME OF  THE  INITIAL  ASSESSMENT,
   48  AND  AT  THE  TIME  OF  EACH SUBSEQUENT ASSESSMENT (OR MORE OFTEN IF THE
   49  SENIOR'S NEEDS REQUIRE), THE OFFICE SHALL ESTABLISH A MONTHLY BUDGET FOR
   50  PAYMENT FOR THE SERVICES PROVIDED UNDER SUCH PLAN.  TOTAL ANNUAL EXPEND-
   51  ITURES FOR MEDICAL ASSISTANCE SERVICES MADE PURSUANT TO TITLE ELEVEN  OF
   52  ARTICLE  FIVE OF THE SOCIAL SERVICES LAW FOR ALL SUCH SENIORS WITHIN THE
   53  SOCIAL SERVICES DISTRICT WITHIN WHICH  SUCH  SENIORS  RESIDE  SHALL  NOT
   54  EXCEED  SIXTY-FIVE  PERCENT  OF  THE AVERAGE OF THE ANNUAL RATES PAYABLE
   55  UNDER SUCH TITLE FOR NURSING HOME SERVICES WITHIN  THE  SOCIAL  SERVICES
   56  DISTRICT  IN  WHICH SUCH SENIORS RESIDE, SUCH AMOUNT TO BE DETERMINED BY
       S. 8103                             3
    1  MULTIPLYING THE TOTAL NUMBER OF SENIORS WITHIN THE PROGRAM IN  ANY  YEAR
    2  BY  THE  AVERAGE  OF  THE  ANNUAL  RATES  PAYABLE  FOR SUCH NURSING HOME
    3  SERVICES.
    4    (C)  SERVICES  PROVIDED  UNDER THE SENIOR CARE CHOICES PROGRAM INCLUDE
    5  SERVICES PROVIDED BY THE OFFICE, AND PROVIDED PURSUANT  TO  THE  WAIVER,
    6  INCLUDING  BUT  NOT  LIMITED  TO  SUCH  LONG TERM CARE SERVICES AS CARE,
    7  TREATMENT, MAINTENANCE, AND SERVICES  PROVIDED  IN  A  NURSING  FACILITY
    8  LICENSED  UNDER  ARTICLE  TWENTY-EIGHT  OF  THE  PUBLIC  HEALTH  LAW, OR
    9  PROVIDED BY A HOME CARE SERVICES AGENCY, CERTIFIED HOME HEALTH AGENCY OR
   10  LONG TERM HOME HEALTH CARE PROGRAM, AS  DEFINED  IN  SECTION  THIRTY-SIX
   11  HUNDRED TWO OF THE PUBLIC HEALTH LAW, OR PROVIDED BY AN ADULT DAY HEALTH
   12  CARE PROGRAM IN ACCORDANCE WITH REGULATIONS OF THE DEPARTMENT OF HEALTH,
   13  OR  PROVIDED  BY  A  PERSONAL CARE PROVIDER LICENSED OR REGULATED BY ANY
   14  OTHER STATE OR LOCAL AGENCY, AND SUCH OTHER SERVICES FOR  WHICH  MEDICAL
   15  ASSISTANCE  IS  OR  OTHERWISE  WOULD BE AVAILABLE PURSUANT TO THE SOCIAL
   16  SERVICES LAW INCLUDING THOSE WHICH ARE  DESIGNATED  AS  LONG  TERM  CARE
   17  SERVICES  IN  LAW  OR  REGULATIONS OF THE DEPARTMENT OF HEALTH, CONSUMER
   18  DIRECTED PERSONAL ASSISTANCE SERVICES, AND SUCH OTHER SERVICES  AS  HOME
   19  MODIFICATION, TELEHEALTH, PHARMACY REVIEW, AND PALLIATIVE CARE.
   20    S 2. This act shall take effect immediately.
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