•  Summary 
 
•  Actions 
 
•  Committee Votes 
 
•  Floor Votes 
 
•  Memo 
 
•  Text 

A00810 Summary:

A00810 Actions:

A00810 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
 submitted in accordance with Assembly Rule III, Sec 1(f)



 
BILL NUMBER: A810
 
SPONSOR: Gunther (MS)

 
TITLE OF BILL:  An act to amend the public health law, in relation to
creating a rural home health flexibility program
 
 
PURPOSE OR GENERAL IDEA OF BILL: To provide for regulatory flexibility
in the establishment and provision of home care services in rural areas,
in order to provide for access and efficiency of care and to facilitate
overall rural health care systems.
 
 
SUMMARY OF PROVISIONS: Creates a new § 3622 of the public health law,
the "Rural Home Health Flexibility Program. Authorizes; provides a

framework for, and directs the State Commissioner of Health to consider
proposals from providers operating in rural counties for regulatory'
flexibility for the establishment and/or operation of new and/or exist-
ing home care services for the community, including proposals to enhance
the administration, services, and quality of care provided by a home
care agency or program in such an area.
 
 
JUSTIFICATION: There are enormous challenges to the provision and
accessibility of home health care and long term home health "care
program services in rural areas. Limitations in the health care work-
force, service diversity and volume combine with large geographic
distances and difficult topography, sparse population, small-size econo-
my and other characteristics to create extraordinary obstacles to
service.
 
Especially in this context, well intended, but often ridged, inordinate-
ly costly and/or unattainable regulations risk the viability and

sustainability of rural home care agencies and their mission. This is
made exponentially more difficult in the state's current fiscal climate,
with constant reimbursement reductions and the lack of new sources of
funding to respond to these challenges.
 
This proposed Rural Home Health Flexibility Program is necessary to
provide vital regulatory flexibility to support the development and
maintenance of rural home health capacity as well as the operation and
innovativeness of rural agencies and their delivery of patient services.
The establishment and sustainability of these services is further crit-
ical to the operation and cost-efficiency of the entire rural health
system, which depends upon viable home care.
 
 
PRIOR LEGISLATIVE HISTORY:  2013-14: A1721 referred to Health 2011-12:
A7895 referred to Health/S5448 referred to Health
 
 
FISCAL IMPLICATIONS: Potential cost-savings to the state and rural

home care providers and communities through regulatory flexibility and
through sustainability of cost-effective home care services in these
communities as a result of this legislation.
 
 
EFFECTIVE DATE: This act takes effect immediately.

A00810 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                           810
 
                               2015-2016 Regular Sessions
 
                   IN ASSEMBLY
 
                                     January 7, 2015
                                       ___________
 
        Introduced  by  M.  of  A.  GUNTHER,  LIFTON,  STECK, COOK, PALMESANO --
          Multi-Sponsored by -- M. of A. DUPREY -- read once and referred to the
          Committee on Health
 
        AN ACT to amend the public health law, in relation to creating  a  rural
          home health flexibility program
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Section 3622 of the public health  law,  as  renumbered  by
     2  section  22  of  part C of chapter 58 of the laws of 2004, is renumbered
     3  section 3623 and a new section 3622 is added to read as follows:
     4    § 3622. Rural home health  flexibility  program.  1.  The  legislature
     5  finds  and  declares that the provision and accessibility of home health
     6  care and long term home health care  program  services  in  rural  areas
     7  necessitates regulatory flexibility in order for limited resources to be
     8  best utilized and maximized to meet the health care needs of rural citi-
     9  zens  and to promote the efficiency of the delivery of services in rural
    10  areas. The legislature therefore establishes a rural home health  flexi-
    11  bility program for such purposes.
    12    2.  Pursuant  to  the  purposes  of  this  section,  the commissioner,
    13  notwithstanding any inconsistent provision of law or  regulation,  shall
    14  consider  for  approval  proposals  from  providers operating under this
    15  article and serving rural counties to:
    16    (a) Create and operate a long term home health care program which does
    17  not provide all the required services specified in  regulations  of  the
    18  department, provided that:
    19    (i)  there  is demonstrated need for such program in the service area;
    20  and
    21    (ii) the applicant to provide such program demonstrates to the commis-
    22  sioner's satisfaction that such applicant has  made,  and  continues  to
    23  make,  all appropriate efforts to provide all required services but that
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD01654-01-5
        A. 810                              2
 
     1  the lack of available health personnel within the  service  area  is  an
     2  obstacle.
     3    (b)  Establish  or operate a certified home health agency or long term
     4  home health care program which serves a geographic  area  less  than  an
     5  entire planning area when:
     6    (i) no other provider otherwise serves the entire planning area;
     7    (ii)  collaborative approaches to the service of citizens in the plan-
     8  ning area is appropriate for feasibility and efficiency; and
     9    (iii) the department is satisfied that such collaboration will  result
    10  in  accessible  and  economically-feasible  services within the planning
    11  area.
    12    (c) Qualify for home telehealth reimbursement pursuant to this article
    13  when all of the conditions ordinarily required for such reimbursement or
    14  services are unable to be met, provided that the applicant demonstrates,
    15  and continues to undertake, best efforts to meet such  requirements  and
    16  that  the  quality or safety of patient care will not be diminished as a
    17  result.
    18    (d) Be exempted from the applicability of a regulatory requirement, or
    19  any part thereof, that imposes adverse impacts on such  rural  providers
    20  when:
    21    (i)  such  impacts  have been identified by the department pursuant to
    22  article two of the state administrative procedure act; and
    23    (ii) compliance with such  requirements  would  be  overly  burdensome
    24  because  of  the constraints or demands of the provider's rural area, or
    25  the provider's resources.
    26    (e) Receive approval for such other areas of flexibility  the  commis-
    27  sioner  identifies,  with  the assistance of the workgroup authorized in
    28  subdivision three of this section, appropriate to the purposes  of  this
    29  section, including proposals to enhance the administration, services and
    30  quality of care provided by a home care agency or program, provided that
    31  such  flexibility does not compromise the quality and safety of services
    32  provided.
    33    3. The commissioner shall convene a temporary workgroup  comprised  of
    34  representatives of certified home health agencies, long term home health
    35  care  programs  and  licensed  home care services agencies serving rural
    36  counties, as well as  rural  consumers  and  rural  workforce  represen-
    37  tatives,  to  assist  in identifying additional areas for flexibility in
    38  the department's rules,  regulations  and  administrative  requirements,
    39  consistent with the purposes of this section.
    40    § 2. This act shall take effect immediately.