|SAME AS||No Same As|
|Amd S214, Eld L|
|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.|
|01/16/2015||referred to aging|
|01/06/2016||referred to aging|
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NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A2527 SPONSOR: Englebright
TITLE OF BILL: An act to amend the elder law, in relation to estab- lishing a senior care choices program in the office for the aging   PURPOSE OR GENERAL IDEA OF THE BILL: This bill creates a federally waivered program under the State Office for the Aging that will help to keep seniors in their own homes and communities. Using the waiver, the office would create a seamless provision of services to work with seniors before their health becomes chronic and their opportunities for remaining in their own communities limited.   SUMMARY OF PROVISIONS: This bill adds a new subdivision 8 to section 541 of the elder law, which are the office of the aging statutes in order to create the Senior Care Choices Program as a waivered program under Section 1115 of the Social Security Act. The State Office of the Aging will provide a coordinated plan of care and services at home to seniors in a seamless network that includes services already provided by and through the office and any additional services necessary to maintain such persons at home. The program may also be provided in the home of a responsible relative or other responsible adult, and in adult care facilities, other than shelters for adults. The measure established the principle for the development of the program, that seniors have the primary authority to make choices that work best for them, regardless of the nature or extent of their disabil- ity of the source of payment for services. SOFA is further permitted to waive State requirements that restrict its ability to provide services, so long as the waiver is consistent with the federal 1115 waiver. SOFA is further required to seek to expand source of payment for the program, including from voluntary and willing private sources, insurance plans, charities and foundations, and individuals. Services provided under the Senior Care Choices Program include services provided by the office, and provided pursuant to the waiver, including but not limited to such long term care services as care, treatment, maintenance, and services provided in a nursing facility licensed under article twenty-eight of the public health law, or provided by a home care services agency, certified home health agency or long term home health care program, as defined in section thirty-six hundred two of the public health law, or provided by an adult day health care program in accordance with regulations of the department of health, or provided by a personal care provider licensed or regulated by any other state or local agency, and such other services for which medical assistance is or otherwise would be available pursuant to the social services law includ- ing those which are designated as long term care services in law or regulations of the department of health, consumer directed personal assistance services, and such other services as home modification, tele- health, pharmacy review, and palliative care.   JUSTIFICATION: This legislation will allow the State Office of the Aging to provide and coordinate services to seniors at home and in their own communities before they become chronic enough to require placement in a nursing home or in another chronic care program.   LEGISLATIVE HISTORY: 2005-06 A7692 referred to aging 2007-08 A1450 referred to aging 2009-10 A2591 referred to aging 2011-12 A3940 aging 2013-14 A4320 referred to aging   FISCAL IMPLICATIONS: To be determined.   EFFECTIVE DATE: This act shall take effect immediately.
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STATE OF NEW YORK ________________________________________________________________________ 2527 2015-2016 Regular Sessions IN ASSEMBLY January 16, 2015 ___________ Introduced by M. of A. ENGLEBRIGHT -- read once and referred 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, EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06500-01-5A. 2527 2 1 certified pursuant to section four hundred sixty-b of the social 2 services law, provided that the senior meets the admission and continued 3 stay criteria for such facility, except that services provided by the 4 program shall not duplicate or replace those which the facility is 5 required by law or regulation to provide. 6 (2) In filing such waiver for the operation of the program, the office 7 shall seek to provide services pursuant to the principle that seniors 8 have the primary authority to make choices that work best for them, 9 regardless of the nature or extent of their disability or the source of 10 payment for services. In designing the program and providing services, 11 the office is authorized to waive any provision of the social services 12 law or the public health law, or any rule or regulation promulgated 13 thereunder, which in the judgment of the office restricts its ability to 14 provide services as required by this subdivision, so long as such waiver 15 is consistent with any federal waiver granted pursuant to section 1115 16 of the federal Social Security Act or any successor thereto. 17 (3) The office shall seek to expand source of payment for the program, 18 including seeking payments from voluntary and willing private sources, 19 insurance plans, charities and foundations, and individuals. 20 (4) The office is hereby empowered to provide or contract for the 21 provision of such senior care choices program in any county within the 22 state. The office shall seek to coordinate services with any current 23 provider of services. No state agency shall impose a limitation on the 24 number of eligible individuals served in this program. The office shall 25 not be subject to audit, assessment, suspension, sanction, or report by 26 a state agency for a program conducted pursuant to the authority of this 27 subdivision, except that it shall be subject to audit by the office of 28 the state comptroller to the extent that such programs would have been 29 subject to audit but for this paragraph. 30 (b) If a senior deemed by his or her physician able to remain in his 31 or her own home or the home of a responsible relative or other responsi- 32 ble adult if the necessary services are provided applies for admission 33 to the program, the office in consultation with the local social 34 services commissioner shall order an assessment to be performed using 35 the assessment instrument developed pursuant to the provision of section 36 thirty-six hundred sixteen of the public health law, and in addition an 37 assessment of the informal caregiving network and supports capable of 38 providing social and non-medical services to the senior. If the results 39 of the assessment indicate that the senior can receive the appropriate 40 level of care at home or in the home of such responsible relative or 41 other responsible adult, and that the senior can be appropriately 42 supported by family, intimates, friends and community, the office shall, 43 after consulting with those who performed the assessment, prepare for 44 that senior a plan for the provision of services that may include any 45 service that would be rendered in a nursing home plus such additional 46 services as the office is authorized to provide directly or through 47 contract pursuant to the provisions of the waiver authorized by this 48 subdivision. Continued provision of services pursuant to this subdivi- 49 sion shall be contingent on additional assessments performed every one 50 hundred twenty days. At the time of the initial assessment, and at the 51 time of each subsequent assessment (or more often if the senior's needs 52 require), the office shall establish a monthly budget for payment for 53 the services provided under such plan. Total annual expenditures for 54 medical assistance services made pursuant to title eleven of article 55 five of the social services law for all such seniors within the social 56 services district within which such seniors reside shall not exceedA. 2527 3 1 sixty-five percent of the average of the annual rates payable under such 2 title for nursing home services within the social services district in 3 which such seniors reside, such amount to be determined by multiplying 4 the total number of seniors within the program in any year by the aver- 5 age of the annual rates payable for such nursing home services. 6 (c) Services provided under the senior care choices program include 7 services provided by the office, and provided pursuant to the waiver, 8 including but not limited to such long term care services as care, 9 treatment, maintenance and services provided in a nursing facility 10 licensed under article twenty-eight of the public health law, or 11 provided by a home care services agency, certified home health agency or 12 long term home health care program, as defined in section thirty-six 13 hundred two of the public health law, or provided by an adult day health 14 care program in accordance with regulations of the department of health, 15 or provided by a personal care provider licensed or regulated by any 16 other state or local agency, and such other services for which medical 17 assistance is or otherwise would be available pursuant to the social 18 services law including those which are designated as long term care 19 services in law or regulations of the department of health, consumer 20 directed personal assistance services and such other services as home 21 modification, telehealth, pharmacy review and palliative care. 22 § 2. This act shall take effect immediately.