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S05565 Summary:

S05565 Actions:

S05565 Committee Votes:

S05565 Floor Votes:

S05565 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         5565--B
 
                               2015-2016 Regular Sessions
 
                    IN SENATE
 
                                      May 14, 2015
                                       ___________
 
        Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
          printed to be committed to the Committee on Health -- reported favora-
          bly from said committee and committed to the Committee on  Finance  --
          committee  discharged,  bill amended, ordered reprinted as amended and
          recommitted to said committee -- committee discharged,  bill  amended,
          ordered reprinted as amended and recommitted to said committee
 
        AN  ACT to amend the social services law, in relation to fiscal interme-
          diaries in the consumer directed personal assistance program
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.  Section  365-f  of  the social services law is amended by
     2  adding two new subdivisions 4-a and 4-b to read as follows:
     3    4-a. Fiscal intermediary services. (a) For the purposes of this subdi-
     4  vision:
     5    (i) "Fiscal intermediary" means an entity that provides fiscal  inter-
     6  mediary services and has a contract for providing such services with:
     7    (A) a local department of social services,
     8    (B)  an  organization  licensed under article forty-four of the public
     9  health law, or
    10    (C) an accountable care organization certified under  article  twenty-
    11  nine-E  of  the  public  health  law  or  an  integrated delivery system
    12  composed primarily of health care providers recognized by the department
    13  as a performing provider system under the delivery system reform  incen-
    14  tive payment program.
    15    (ii)   Fiscal   intermediary  services  shall  include  the  following
    16  services, performed on behalf of the consumer to facilitate his  or  her
    17  role as the employer:
    18    (A) wage and benefit processing for consumer directed personal assist-
    19  ants;
    20    (B) processing all income tax and other required wage withholdings;
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11081-05-5
        S. 5565--B                          2
 
     1    (C)  complying with workers' compensation, disability and unemployment
     2  requirements;
     3    (D)  maintaining personnel records for each consumer directed personal
     4  assistant, including time sheets  and  other  documentation  needed  for
     5  wages  and  benefit  processing  and a copy of the medical documentation
     6  required pursuant to regulations established by the commissioner;
     7    (E) ensuring that the health status of each consumer directed personal
     8  assistant is assessed prior to service delivery pursuant to  regulations
     9  issued by the commissioner;
    10    (F)  maintaining  records  of  authorizations  or  reauthorizations of
    11  services;
    12    (G) monitoring the consumer's or, if applicable, the designated repre-
    13  sentative's continuing ability to fulfill  the  consumer's  responsibil-
    14  ities under the program and promptly notifying the authorizing entity of
    15  any  circumstance  that may affect the consumer's or, if applicable, the
    16  designated representative's ability to fulfill such responsibilities;
    17    (H) complying with regulations established by the commissioner  speci-
    18  fying  the  responsibilities  of providers providing services under this
    19  title; and
    20    (I) entering into a department approved  memorandum  of  understanding
    21  with  the  consumer  that  describes the parties' responsibilities under
    22  this program.
    23    (iii) Fiscal intermediaries are not responsible for, and fiscal inter-
    24  mediary services shall not include, fulfillment of the  responsibilities
    25  of  the  consumer or, if applicable, the consumer's designated represen-
    26  tative as established  by  the  commissioner.  A  fiscal  intermediary's
    27  responsibilities  shall not include: managing the plan of care including
    28  recruiting and hiring a sufficient number of individuals  who  meet  the
    29  definition  of  consumer  directed  personal  assistant, as such term is
    30  defined by the commissioner, to provide  authorized  services  that  are
    31  included on the consumer's plan of care; training, supervising and sche-
    32  duling  each  assistant;  terminating  the  assistant's  employment; and
    33  assuring that each consumer directed personal assistant competently  and
    34  safely  performs  the  personal care services, home health aide services
    35  and skilled nursing tasks that are included on the  consumer's  plan  of
    36  care.  A  fiscal intermediary shall exercise reasonable care in properly
    37  carrying out its responsibilities under the program.
    38    (b) No entity shall provide,  directly  or  through  contract,  fiscal
    39  intermediary  services without a license as a fiscal intermediary issued
    40  by the commissioner in accordance with this subdivision.
    41    (c) An application for licensure as a  fiscal  intermediary  shall  be
    42  filed with the commissioner, together with such other forms and informa-
    43  tion  as  shall be prescribed by, or acceptable to the commissioner. The
    44  commissioner shall not approve an application for licensure unless he or
    45  she is satisfied as to the character, competence  and  standing  in  the
    46  community  of the applicant's incorporators, directors, sponsors, stock-
    47  holders or operators and  finds  that  the  personnel,  rules,  consumer
    48  contracts  or  agreements,  and fiscal intermediary services are fit and
    49  adequate, and that the fiscal intermediary services will be provided  in
    50  the  manner  required  by this subdivision and the rules and regulations
    51  thereunder, in a manner determined by the commissioner.
    52    (d) Neither public need, tax status, profit-making status, nor  licen-
    53  sure  or  certification  pursuant  to  article  thirty-six of the public
    54  health law shall be criteria for licensure.    Organizations  authorized
    55  pursuant  to  article  forty-four  of the public health law shall not be
    56  granted a license as a fiscal intermediary.
        S. 5565--B                          3
 
     1    (e) The commissioner shall charge to applicants for the  licensure  of
     2  fiscal intermediaries an application fee of two thousand dollars.
     3    4-b. Proceedings involving the license of a fiscal intermediary. (a) A
     4  license  of  a fiscal intermediary may be revoked, suspended, limited or
     5  annulled by the commissioner on proof that it has failed to comply  with
     6  the  provisions  of  subdivision  four-a  of this section or regulations
     7  promulgated hereunder.
     8    (b) No such license shall be revoked, suspended, limited, annulled  or
     9  denied  without  a  hearing.  However,  a  license  may  be  temporarily
    10  suspended or limited without a hearing for a period  not  in  excess  of
    11  thirty  days  upon written notice to the fiscal intermediary following a
    12  finding by the department that the public health or safety is  in  immi-
    13  nent danger. Such period may be renewed for up to two additional periods
    14  not  in  excess  of  thirty days, each upon written notice, including an
    15  opportunity to submit evidence and written argument in opposition to the
    16  renewal, and a continued finding under this paragraph.
    17    (c) The commissioner shall fix a time and place  for  the  hearing.  A
    18  copy  of  the charges, together with the notice of the time and place of
    19  the hearing, shall be served in person or mailed by registered or certi-
    20  fied mail to the fiscal intermediary at least twenty-one days before the
    21  date fixed for the hearing. The fiscal intermediary shall file with  the
    22  department  not  less  than  eight  days prior to the hearing, a written
    23  answer to the charges.
    24    (d) All orders or  determinations  under  this  subdivision  shall  be
    25  subject  to  review  as  provided  in article seventy-eight of the civil
    26  practice law and rules.
    27    § 2. This act shall take effect on the first of July  after  it  shall
    28  have become a law; provided that, effective immediately, the commission-
    29  er  of  health  shall make regulations and take other actions, including
    30  issuing licenses under section 365-f  of  the  social  services  law  as
    31  amended by this act, to implement this act on that date.