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S08599 Summary:

BILL NOS08599
 
SAME ASSAME AS A09034
 
SPONSORMAYER
 
COSPNSRASHBY, STEC
 
MLTSPNSR
 
 
Requires the state Medicaid director to establish a program for specific individuals to become complex care assistants and provide private duty nursing services to certain Medicaid enrollees under increased reimbursement rates.
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S08599 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          8599
 
                    IN SENATE
 
                                    February 20, 2024
                                       ___________
 
        Introduced  by  Sen.  MAYER  -- read twice and ordered printed, and when
          printed to be committed to the Committee on Health
 
        AN ACT relating to complex care assistants and home  care  services  and
          supplementing
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. As used in this act: (a) "family  member"  means  a  child,
     2  parent,  parent-in-law, sibling, grandparent, grandchild, spouse, domes-
     3  tic partner, or one partner in a civil union couple, or any other  indi-
     4  vidual  related  by blood, and any other individual with a close associ-
     5  ation that is the equivalent of a family relationship; and
     6    (b) "complex care assistant" means a family member who is certified by
     7  the department of health after passing an  in-person  examination  which
     8  tests the proficiency and competence of performing the tasks required to
     9  care for a medically fragile child which can include, but is not limited
    10  to,  medication administration, airway clearance therapies, tracheostomy
    11  care, intravenous line care, ventilator care,  enteral  care  and  other
    12  tasks  approved by the board of nursing for an individual under 21 years
    13  of age.
    14    § 2. (a) No later than one year after the effective date of  this  act
    15  and  receipt of federal approval for the program established pursuant to
    16  this act, the state Medicaid director within the  department  of  health
    17  shall  establish a program under which a family member of an enrollee in
    18  Medicaid may be certified as a complex care assistant and, after receiv-
    19  ing such certification may, under the direction of a  registered  nurse,
    20  provide  complex  care  assistant  services  to  the  enrollee through a
    21  private duty nursing agency under the  reimbursement  rates  established
    22  under  subdivision  (d) of this section, provided that the enrollee is a
    23  medically fragile child as defined in section 4401 of the public  health
    24  law and qualifies for private duty nursing services under Medicaid. Such
    25  program  shall operate as a New York Medicaid private duty nursing bene-
    26  fit. The department shall develop an assessment tool that will allow the
    27  division to identify enrollees who meet these eligibility criteria read-
    28  ily.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD13449-03-4

        S. 8599                             2
 
     1    (b) The program established under this  act  shall  require  a  family
     2  member to complete all training, testing, and other qualification crite-
     3  ria  required under state and federal law for certification as a complex
     4  care assistant. The private duty nursing agency  that  will  employ  the
     5  family member to provide complex care assistant services to the enrollee
     6  shall  pay  all  costs  for  the  family member to become certified as a
     7  complex care assistant and to receive certification as  a  complex  care
     8  assistant from the department of health, before providing services under
     9  the  program established pursuant to this act. In no case shall a family
    10  member who becomes a complex care assistant under the provisions of this
    11  section be required  to  repay  or  reimburse  the  licensed  home  care
    12  services  and  certified  private duty nursing agencies for the costs of
    13  the family member becoming certified as a complex care  assistant  under
    14  the program.
    15    (c)  An  individual  certified to practice as a complex care assistant
    16  must complete a training program and shall pass an in-person examination
    17  approved by the department that demonstrates the applicant's  competence
    18  and  proficiency.  Such  training  program  shall include the following:
    19  medication  administration,  airway  clearance  therapies,  tracheostomy
    20  care,  intravenous  line  care,  ventilator care, enteral care and other
    21  tasks approved by the board of nursing for an individual under 21  years
    22  of age.
    23    (d)  Complex  care assistant services provided by a family member of a
    24  Medicaid enrollee who becomes certified  as  a  complex  care  assistant
    25  under  the  program established pursuant to this act shall be reimbursed
    26  to a private duty nursing agency at a rate of no  less  than  thirty-six
    27  dollars  for  complex care assistant services downstate and thirty-three
    28  dollars upstate. For care assistant high tech services it shall be at  a
    29  rate  no  less than forty-two dollars downstate and thirty-seven dollars
    30  upstate.  Cost of living adjustments to such rates shall be reviewed  by
    31  the  department  bi-annually  and  such rates adjusted accordingly based
    32  upon any increases to the  United  States  bureau  of  labor  statistics
    33  consumer price index.
    34    (e)  The  state Medicaid director, no later than three years after the
    35  date the program is established under this act, shall prepare and submit
    36  a report to the governor and the legislature concerning the viability of
    37  such program and the director's recommendations concerning such program.
    38    § 3. The state Medicaid director shall adopt rules and regulations  as
    39  necessary to implement the provisions of this act.
    40    §  4.  The  state  Medicaid  director  shall apply for such state plan
    41  amendments or waivers as may be necessary to implement the provisions of
    42  this act and secure federal financial participation for  state  Medicaid
    43  expenditures under the federal Medicaid program.
    44    § 5. This act shall take effect immediately.
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