Ensures that the state implements federal conflict of interest requirements in a manner that ensures limited disruption of services to persons enrolled in certain Medicaid traumatic brain injury and nursing home transition and diversion waiver programs.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A6221B
SPONSOR: Paulin
 
TITLE OF BILL:
An act to amend the social services law and the public health law, in
relation to ensuring that the state implements certain federal conflict
of interest requirements in a manner that ensures limited disruption of
certain services
 
PURPOSE:
This legislation amends the provisions of the social services and public
health law to ensure that the Department of Health assess and report
.on, the readiness and ability for TBI and NHTD Waiver providers to both
maintain their level of services and comply with federal conflict of
interest rules prior to the implementation of the provisions.
 
SUMMARY OF SPECIFIC PROVISIONS:
Section one of the legislation would amend paragraph, d of subsection
6-a of section 366 of the social services law to add language to ensure
that prior to the implementation of COI provisions as they relate to the
NHTD Waiver program, the Department of Health take two steps.: (1)
survey all participating waiver provider, including voluntary providers,
to identify levels of preparedness to implement such requirements; and
,(2) report by July 1, 2024 to the governor and the chairs of the assem-
bly and senate committees on the ability of the provider system to
continue to meet the requirements of this paragraph related to consumer
choice for service coordination. While these steps final plans for the
transition and conversion of services related to federal conflict of
interest activities will be suspended pending the review and approval of
the recommendations contained within the report.
Section two of the legislation would amend Section 2743 of the public
health law by adding a new subsection 4 that would impose the same
requirements of the TBI waiver program.
Section three of the legislation sets the effective date.
 
JUSTIFICATION:
While the State had developed plans to apply federal conflict of inter-
est requirements to the 1915(c) Medicaid TBI and NHTD Waiver programs,
two intervening issues have arisen which could compromise the stability
of.the waivers and the populations they support. First, the State and
the Waivers have been operating in the context of a public health emer-
gency (PHE), which is coming to an end. The unwinding of the PHE is a
complicated process even without the overlay of implementing the signif-
icant changes required by the COI rules. Second, the Waiver providers -
like other health care employers - have been devastated by workforce
shortages. There remain significant questions as to how the Waivers can
continue to operate and serve their populations with these changes,
which will cause additional significant disruption to the Waiver work-
force.
Pausing implementation efforts while the state, assesses the ability of
the waiver providers to implement the changes without disrupting
services will inform state policymakers about what changes may be needed
to the program to mitigate any disruptive impact.
 
LEGISLATIVE HISTORY:
New legislation for 2023-2024 session
 
FISCAL IMPLICATIONS:
No negative fiscal implications.
 
EFFECTIVE D201ATE :
This act shall take effect immediately.
STATE OF NEW YORK
________________________________________________________________________
6221--B
2023-2024 Regular Sessions
IN ASSEMBLY
April 3, 2023
___________
Introduced by M. of A. PAULIN -- read once and referred to the Committee
on Health -- committee discharged, bill amended, ordered reprinted as
amended and recommitted to said committee -- reported and referred to
the Committee on Ways and Means -- committee discharged, bill amended,
ordered reprinted as amended and recommitted to said committee
AN ACT to amend the social services law and the public health law, in
relation to ensuring that the state implements certain federal
conflict of interest requirements in a manner that ensures limited
disruption of certain services
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Paragraph d of subdivision 6-a of section 366 of the social
2 services law, as amended by chapter 627 of the laws of 2004, is amended
3 to read as follows:
4 d. (i) The commissioner of health shall contract with not-for-profit
5 agencies around the state that have experience with providing community
6 based services to individuals with disabilities, hereinafter referred to
7 as regional resource development specialists, who shall be responsible
8 for initial contact with the prospective waiver participant, for assur-
9 ing the waiver candidates have choice in selecting a service coordinator
10 and other providers, and for assessing applicants including decisions
11 for eligibility for participation in the waiver, which contain the
12 original service plan and all subsequent revised service plans.
13 Regional resource development specialists shall be responsible for
14 approving service plans and the department of health shall provide tech-
15 nical assistance and oversight.
16 (ii) Prior to taking any step to implement the requirements of subpar-
17 agraph (vi) of paragraph (1) of subsection (c) of section 441.301 of
18 title 42 of the code of federal regulations as such provisions relate to
19 the nursing home transition and diversion waiver program authorized
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD10489-04-3
A. 6221--B 2
1 under section 1915(c) of the federal social security act, the commis-
2 sioner of the department of health shall:
3 (1) Survey all participating waiver providers, including voluntary
4 providers, to identify levels of preparedness to implement such require-
5 ments; and
6 (2) Report by July first, two thousand twenty-four, to the governor
7 and the chairs of the assembly and senate committees on health on the
8 ability of the provider system to continue to meet the requirements of
9 this paragraph related to consumer choice for service coordination.
10 (iii) All final plans for the transition and conversion of services
11 related to federal conflict of interest activities shall be suspended
12 pending the review and approval of the recommendations contained within
13 the report required under clause two of subparagraph (ii) of this para-
14 graph.
15 § 2. Section 2743 of the public health law is amended by adding a new
16 subdivision 4 to read as follows:
17 4. (a) Prior to taking any step to implement the requirements of
18 subparagraph (vi) of paragraph (1) of subsection (c) of section 441.301
19 of title 42 of the code of federal regulations as such provisions relate
20 to the traumatic brain injury waiver program authorized under section
21 1915(c) of the federal social security act, the commissioner shall:
22 (i) Survey all participating waiver providers, including voluntary
23 providers, to identify levels of preparedness to implement such require-
24 ments; and
25 (ii) Report by July first, two thousand twenty-four, to the governor
26 and the chairs of the assembly and senate committees on health on the
27 ability of the provider system to continue to ensure consumer choice for
28 service coordination.
29 (b) All final plans for the transition and conversion of services
30 related to federal conflict of interest activities shall be suspended
31 pending the review and approval of the recommendations contained within
32 the report required under subparagraph (ii) of paragraph (a) of this
33 subdivision.
34 § 3. This act shall take effect immediately.