Directs the commissioner of health to provide authorizations to all fiscal intermediaries that timely submit a request for authorization prior to January 1, 2026; details information required for such authorizations; makes related provisions.
STATE OF NEW YORK
________________________________________________________________________
5145
2025-2026 Regular Sessions
IN SENATE
February 19, 2025
___________
Introduced by Sens. COMRIE, ADDABBO, CLEARE, FERNANDEZ, MARTINEZ, MYRIE,
SALAZAR, SANDERS, SEPULVEDA -- read twice and ordered printed, and
when printed to be committed to the Committee on Health
AN ACT to amend the social services law, in relation to certain authori-
zations to fiscal intermediaries
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Paragraph (b) of subdivision 4-a of section 365-f of the
2 social services law, as amended by section 2 of part HH of chapter 57 of
3 the laws of 2024, is amended to read as follows:
4 (b) [Notwithstanding section one hundred sixty-three of the state
5 finance law, section one hundred twelve of the state finance law, or
6 section one hundred forty-two of the economic development law the
7 commissioner shall enter into a contract under this subdivision with an
8 eligible contractor that submits an offer for a contract, provided,
9 however, that:
10 (i) the department shall post on its website:
11 (A) a description of the proposed statewide fiscal intermediary
12 services to be provided pursuant to a contract in accordance with this
13 subdivision;
14 (B) the criteria for selection of the statewide fiscal intermediary,
15 which shall include at a minimum that the eligible contractor is capable
16 of performing statewide fiscal intermediary services with demonstrated
17 cultural and language competencies specific to the population of consum-
18 ers and those of the available workforce, has experience serving indi-
19 viduals with disabilities, and as of April first, two thousand twenty-
20 four is providing services as a fiscal intermediary on a statewide basis
21 with at least one other state;
22 (C) the manner by which prospective contractors may seek such
23 selection, which may include submission by electronic means;
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD05945-01-5
S. 5145 2
1 (ii) all offers that are received from prospective contractors in a
2 timely fashion and that meet the criteria set forth in clause (B) of
3 subparagraph (i) of this paragraph shall be reviewed by the commission-
4 er; and
5 (iii) the commissioner shall award such contract to the contractor
6 that meets the criteria for selection and offers the best value for
7 providing the services required pursuant to this section and the needs
8 of consumers.] The commissioner shall provide authorizations under this
9 subdivision to all fiscal intermediaries that timely submit a request
10 for authorization prior to January first, two thousand twenty-six, and
11 meet the requirements of this section. No entity shall provide, direct-
12 ly or through contract, fiscal intermediary services without having
13 received an authorization as a fiscal intermediary issued by the commis-
14 sioner in accordance with this subdivision, or that has a pending
15 authorization timely submitted and currently in processing, review,
16 appeal, or legal challenge.
17 (i) An application for authorization as a fiscal intermediary shall be
18 filed with the commissioner, together with such other forms and informa-
19 tion as shall be prescribed by, or acceptable to the commissioner. Such
20 information shall consist of the following:
21 (A) the name and employer identification number, of the entity,
22 including any subsidiary corporations, if applicable, and any name
23 under which the entity does business;
24 (B) all addresses at which the organization operates;
25 (C) the names, titles and contact information of all officers and
26 directors in a not-for-profit company or business, or managers in a
27 limited liability company, as well as the name and employment history of
28 the individual ultimately accountable for operation of the fiscal inter-
29 mediary; and for a not-for-profit entity, the number of director posi-
30 tions set by the company's by-laws, and how many are currently filled;
31 (D) a history of the organization, along with an overview of the
32 organization and all services it offers, including any relationships
33 with outside agencies that may influence in any way the ability of the
34 organization to provide fiscal intermediary services consistent with the
35 manner described in its application;
36 (E) all policies and procedures of the fiscal intermediary, including
37 any contracts or other documents used in communications with consumers;
38 (F) plans to solicit and consider input from the fiscal intermediary's
39 consumers, staff, personal assistants and other interested parties which
40 may be charged with roles including, but not limited to, quality assur-
41 ance review, referral, program monitoring or development or establishing
42 and responding to community needs; such input may be in the form of a
43 board of directors, committee, survey, or other mechanism, provided that
44 the majority of input obtained as part of this process must be from
45 individual consumers and consumer advocates of the fiscal intermediary;
46 (G) the organization's plan to address the needs of consumers and
47 their personal assistants in a timely manner, regardless of where they
48 live, including, but not limited to, input from consumers, obtaining
49 physicals and other health information from personal assistants, obtain-
50 ing time records for payroll, and timely processing of payroll; and
51 (H) a written sworn statement by an officer of the entity disclosing
52 any pending litigation, unsatisfied judgments or penalties, convictions
53 for fraud or sanctions imposed by government authorities.
54 (ii) The entity shall reasonably promptly notify the department of any
55 change in the information submitted to the department for authorization
56 under this subdivision.
S. 5145 3
1 (iii) The commissioner shall not withhold approval of any application
2 for authorization that demonstrates the fiscal intermediary's ability to
3 provide fiscal intermediary services, in accordance with the manner
4 required by this subdivision and the rules and regulations hereunder.
5 All such applications shall be approved by the commissioner.
6 (iv) If the commissioner denies an application for authorization, he
7 or she shall include a narrative explanation of the reason or reasons
8 for its denial and provide the fiscal intermediary with sixty days to
9 submit additional information for reconsideration by the commissioner.
10 (v) The commissioner shall consider and evaluate any response received
11 by the fiscal intermediary before reaching a final determination, which
12 likewise shall be accompanied by a narrative explanation, if the appli-
13 cation is still denied.
14 (vi) All orders or determinations under this subdivision shall be
15 subject to review as provided in article seventy-eight of the civil
16 practice law and rules.
17 § 2. Subparagraphs (i) and (ii) of paragraph (a) of subdivision 4-a of
18 section 365-f of the social services law, as amended by section 1 of
19 part HH of chapter 57 of the laws of 2024, are amended to read as
20 follows:
21 (i) "Statewide fiscal intermediary" means an entity that provides
22 fiscal intermediary services and has a contract for providing such
23 services with [the department of health and is selected through the
24 procurement process described in paragraph (b) of this subdivision.]:
25 (A) a local department of social services; an organization licensed
26 under article forty-four of the public health law; or
27 (B) an accountable care organization certified under article twenty-
28 nine-E of the public health law or an integrated delivery system
29 composed primarily of health care providers recognized by the department
30 as a performing provider system under the delivery system reform incen-
31 tive payment program.
32 (ii) Fiscal intermediary services shall include the following
33 services, performed on behalf of the consumer to facilitate the consum-
34 er's role as the employer:
35 (A) wage and benefit processing for consumer directed personal assist-
36 ants;
37 (B) processing all income tax and other required wage withholdings;
38 (C) complying with workers' compensation, disability and unemployment
39 requirements;
40 (D) maintaining personnel records for each consumer directed personal
41 assistant, including time records and other documentation needed for
42 wages and benefit processing and a copy of the medical documentation
43 required pursuant to regulations established by the commissioner;
44 (E) ensuring that the health status of each consumer directed personal
45 assistant is assessed prior to service delivery pursuant to regulations
46 issued by the commissioner;
47 (F) maintaining records of service authorizations or reauthorizations;
48 (G) monitoring the consumer's or, if applicable, the designated repre-
49 sentative's continuing ability to fulfill the consumer's responsibil-
50 ities under the program and promptly notifying the authorizing entity of
51 any circumstance that may affect the consumer's or, if applicable, the
52 designated representative's ability to fulfill such responsibilities;
53 (H) complying with regulations established by the commissioner speci-
54 fying the responsibilities of fiscal intermediaries providing services
55 under this title;
S. 5145 4
1 (I) entering into a department approved memorandum of understanding
2 with the consumer that describes the parties' responsibilities under
3 this program[; and
4 (J) other related responsibilities which may include, as determined by
5 the commissioner, assisting consumers to perform the consumers' respon-
6 sibilities under this section and department regulations in a manner
7 that does not infringe upon the consumer's responsibilities and self-di-
8 rection].
9 § 3. Paragraph (c) of subdivision 4-d of section 365-f of the social
10 services law, as added by section 7 of part G of chapter 57 of the laws
11 of 2019, is amended to read as follows:
12 (c) Where a fiscal intermediary is suspending or ceasing operation
13 pursuant to an order under subdivision four-b of this section, [or has
14 failed to submit an offer for a contract, or has been denied a contract
15 under this section,] all the provisions of this subdivision shall apply
16 except subparagraph (i) of paragraph (a) of this subdivision, notice of
17 which to all parties shall be provided by the department as appropriate.
18 § 4. This act shall take effect immediately and shall be deemed to
19 have been in full force and effect on and after April 1, 2025.
