A02527 Summary:

BILL NO    A02527 

SAME AS    No Same as 

SPONSOR    Englebright

COSPNSR    

MLTSPNSR   

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.
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A02527 Actions:

BILL NO    A02527 

01/16/2015 referred to aging
01/06/2016 referred to aging
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A02527 Votes:

There are no votes for this bill in this legislative session.
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A02527 Memo:

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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A02527 Text:



 
                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.
                                                                   LBD06500-01-5

        A. 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 exceed

        A. 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.
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