STATE OF NEW YORK
________________________________________________________________________
8529
2011-2012 Regular Sessions
IN ASSEMBLY
July 13, 2011
___________
Introduced by M. of A. P. RIVERA -- read once and referred to the
Committee on Health
AN ACT to amend the public health law and the social services law, in
relation to specialized nursing services
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Paragraph (c) of subdivision 11 of section 3614 of the
2 public health law, as added by section 5 of part C of chapter 109 of the
3 laws of 2006, is amended to read as follows:
4 (c) Such rate adjustments shall be in the form of a uniform percentage
5 add-on to the rates, as determined by the department, based on the
6 proportion of the total allocated adjustment dollars, as determined in
7 paragraph (b) of this subdivision, to the total medicaid expenditures
8 for services provided for certified home health agencies, long-term home
9 health care programs, AIDS nursing, personal care assistants and
10 [private duty] specialized nurses services in local social services
11 districts which do not include a city with a population over one
12 million.
13 § 2. Paragraphs (a) and (1) of subdivision 2 of section 365-a of the
14 social services law, paragraph (a) as amended by chapter 47 of the laws
15 of 1996 and paragraph (1) as amended by chapter 81 of the laws of 1995,
16 are amended to read as follows:
17 (a) services of qualified physicians, dentists, nurses, and [private
18 duty] specialized nursing services shall be further subject to the
19 provisions of [section three hundred sixty-seven-o of] this chapter,
20 optometrists, and other related professional personnel;
21 (l) care and services of podiatrists which care and services shall
22 only be provided upon referral by a physician, nurse practitioner or
23 certified nurse midwife in accordance with the program of early and
24 periodic screening and diagnosis established pursuant to subdivision
25 three of this section or to persons eligible for benefits under title
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD09768-01-1
A. 8529 2
1 XVIII of the federal social security act as qualified medicare benefici-
2 aries in accordance with federal requirements therefor and [private
3 duty] specialized nurses which care and services shall only be provided
4 in accordance with regulations of the department of health; provided,
5 however, that [private duty] specialized nursing services shall not be
6 restricted when such services are more appropriate and cost-effective
7 than nursing services provided by a home health agency [pursuant to
8 section three hundred sixty-seven-l];
9 § 3. Paragraph (c) of subdivision 2 of section 365-f of the social
10 services law, as added by chapter 81 of the laws of 1995, is amended to
11 read as follows:
12 (c) has been determined by the social services district, pursuant to
13 an assessment of the person's appropriateness for the program, conducted
14 with an appropriate long term home health care program, a certified home
15 health agency, or an AIDS home care program or pursuant to the personal
16 care program, as being in need of home care services or [private duty]
17 specialized nursing and is able and willing or has a legal guardian able
18 and willing to make informed choices, or has designated a relative or
19 other adult who is able and willing to assist in making informed choic-
20 es, as to the type and quality of services, including but not limited to
21 such services as nursing care, personal care, transportation and respite
22 services; and
23 § 4. Section 367-p of the social services law, as added by chapter 81
24 of the laws of 1995, is amended to read as follows:
25 § 367-p. Responsibilities of local districts for personal care
26 services, home care services and [private duty] specialized nursing.
27 Consistent with the provisions [of section three hundred sixty-seven-n]
28 of this title, local social services district responsibilities for
29 personal care services, home care services and [private duty] special-
30 ized nursing shall include the following:
31 (a) local districts with programs which place individuals discharged
32 from hospitals solely into certified home health agencies shall ensure
33 that those individuals are reviewed for possible placement into personal
34 care services within two weeks of discharge and, if appropriate, placed
35 into personal care services within four weeks thereof;
36 (b) each local district shall, by September first, nineteen hundred
37 ninety-five, review that plan of care for every recipient receiving
38 personal care on a continuous basis pursuant to [sections three hundred
39 sixty-seven-k and three hundred sixty-seven-l of] this title;
40 (c) each local district shall ensure access to a consumer directed
41 personal assistance program operated pursuant to section three hundred
42 sixty-five-f of this title is available in the district to allow persons
43 receiving home care pursuant to this title to directly arrange and pay
44 for such care; and
45 (d) local districts shall not restrict, and shall not be restricted
46 from approving, the provision of [private duty] specialized nursing as
47 an alternative to nursing services provided by a home health agency
48 where appropriate and cost-effective [pursuant to section three hundred
49 sixty-seven-l].
50 § 5. Section 367-r of the social services law, as amended by section
51 58-a of part A of chapter 57 of the laws of 2006, subdivision 1-a as
52 amended by section 10 of part C of chapter 109 of the laws of 2006, is
53 amended to read as follows:
54 § 367-r. [Private duty] Specialized nursing services worker recruit-
55 ment and retention program. 1. The commissioner of health shall, subject
56 to the provisions of subdivision two of this section and to the avail-
A. 8529 3
1 ability of federal financial participation, increase medical assistance
2 rates of payment by three percent for services provided on and after
3 December first, two thousand two, for [private duty] specialized nursing
4 services for the purposes of improving recruitment and retention of
5 [private duty] specialized nurses.
6 1-a. Medically fragile children. In addition, the commissioner shall
7 further increase rates for [private duty] specialized nursing services
8 that are provided to medically fragile children to ensure the availabil-
9 ity of such services to such children. In establishing rates of payment
10 under this subdivision, the commissioner shall consider the cost
11 neutrality of such rates as related to the cost effectiveness of caring
12 for medically fragile children in a non-institutional setting as
13 compared to an institutional setting. Medically fragile children shall,
14 for the purposes of this subdivision, have the same meaning as in subdi-
15 vision three-a of section thirty-six hundred fourteen of the public
16 health law. Such increased rates for services rendered to such children
17 may take into consideration the elements of cost, geographical differen-
18 tials in the elements of cost considered, economic factors in the area
19 in which the [private duty] specialized nursing service is provided,
20 costs associated with the provision of [private duty] specialized nurs-
21 ing services to medically fragile children, and the need for incentives
22 to improve services and institute economies and such increased rates
23 shall be payable only to those [private duty] specialized nurses who can
24 demonstrate, to the satisfaction of the department of health, satisfac-
25 tory training and experience to provide services to such children. Such
26 increased rates shall be determined based on application of the case mix
27 adjustment factor for AIDS home care program services rates as deter-
28 mined pursuant to applicable regulations of the department of health.
29 The commissioner may promulgate regulations to implement the provisions
30 of this subdivision.
31 2. [Private duty] Specialized nursing services providers which have
32 their rates adjusted pursuant to this section shall use such funds sole-
33 ly for the purposes of recruitment and retention of [private duty]
34 specialized nurses or to ensure the delivery of [private duty] special-
35 ized nursing services to medically fragile children and are prohibited
36 from using such funds for any other purpose. Funds provided under this
37 section are not intended to supplant support provided by a local govern-
38 ment. Each such provider, with the exception of self-employed [private
39 duty] specialized nurses, shall submit, at a time and in a manner to be
40 determined by the commissioner of health, a written certification
41 attesting that such funds will be used solely for the purpose of
42 recruitment and retention of [private duty] specialized nurses or to
43 ensure the delivery of [private duty] specialized nursing services to
44 medically fragile children. The commissioner of health is authorized to
45 audit each such provider to ensure compliance with the written certif-
46 ication required by this subdivision and shall recoup all funds deter-
47 mined to have been used for purposes other than recruitment and
48 retention of [private duty] specialized nurses or the delivery of
49 [private duty] specialized nursing services to medically fragile chil-
50 dren. Such recoupment shall be in addition to any other penalties
51 provided by law.
52 § 6. This act shall take effect immediately.
