Bill Text: NY A07568 | 2023-2024 | General Assembly | Introduced

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Bill Title: Provides for state aid for home health care and hospice services to meet community need.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Introduced) 2024-01-03 - referred to health [A07568 Detail]

Download: New_York-2023-A07568-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          7568

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                      May 25, 2023
                                       ___________

        Introduced by M. of A. PAULIN -- read once and referred to the Committee
          on Health

        AN ACT to amend the public health law, in relation to state aid for home
          health care and hospice services to meet community need

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. Subdivision 1 of section 3607 of the public health law,  as
     2  amended  by  chapter  891  of  the  laws  of 1990, is amended to read as
     3  follows:
     4    1. The commissioner is hereby authorized, within the amount  allocated
     5  pursuant  to  subdivisions  one,  two  and  three  of section thirty-six
     6  hundred fifteen of this article, to make  [grants]  funds  available  to
     7  certified [public and voluntary non-profit] home health agencies for the
     8  purpose  of  increasing  the  availability of home health care services.
     9  Such [grants] funds shall be utilized to increase the number of  persons
    10  provided  services,  the  kind  of services provided, including medical,
    11  social and environmental services, the sharing of services or to improve
    12  or expand the method or frequency of the delivery of  home  health  care
    13  services.  [Grant applications] Agencies shall include specific plans to
    14  provide the following:
    15    a. an expansion of the types and methods of services made available or
    16  delivered to persons at home as  provided  for  in  subdivision  two  of
    17  section thirty-six hundred two of this chapter;
    18    b. an increase in the number of persons provided home care services by
    19  the  certified  home  health  agency,  directly  or  through contractual
    20  arrangement, or to provide for the availability of certified home health
    21  agency services on a seven-day-a-week basis;
    22    c. an increase in home health care services delivered to high-cost  or
    23  high-need  populations,  populations  in  remote or underserved regions,
    24  diverse populations  and/or  populations  evidencing  health  disparity,
    25  populations  with special care needs, or for otherwise increasing health

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11555-02-3
        A. 7568                             2

     1  care services for populations and/or areas of the state  deemed  by  the
     2  commissioner  as  underserved  or  hard to serve, or other specific care
     3  populations identified as particularly in need;
     4    d. the development of recruitment, specialized training, and retention
     5  initiatives  for  staff including but not limited to tuition assistance,
     6  transportation assistance,  childcare  support,  clinical  preceptorship
     7  programs,  and  employee  assistance  programs  such  as peer mentoring,
     8  mental health counseling, and other;
     9    e. the development of training programs approved by  the  commissioner
    10  to improve the quality of services provided by the certified home health
    11  agency;
    12    [d.]  f.  the  development  of  programs to coordinate the work of the
    13  certified home health agency with other community  resources,  including
    14  but  not limited to other certified home health agencies, hospitals, and
    15  social services agencies;
    16    [e.] g. demonstration projects to provide care in the  home  by  using
    17  methods, programs, or arrangements not ordinarily used by certified home
    18  health  agencies,  and  that will help to determine the most appropriate
    19  means of reducing institutional care and  of  providing  better  quality
    20  home  care  services,  most  cost-effective home care services, and more
    21  accessible home care services;
    22    [f.] h. the development of programs to  improve  home  care  patients'
    23  access to primary health services; [or
    24    g.]  i.  the development of "home care volunteer programs for maternal
    25  and child health" pursuant to subdivision two of this section[.]; or
    26    j. the acquisition  and  implementation  of  technology,  systems,  or
    27  equipment  that  would  support  the delivery of the identified expanded
    28  services.
    29    § 2. Section 3615 of the public health law, as amended by chapter  884
    30  of  the  laws of 1990, subdivision 10 as amended by section 30 of part A
    31  of chapter 58 of the laws of 2010, is amended to read as follows:
    32    § 3615. State aid to certified home  health  agencies.  1.  State  aid
    33  shall  be provided to certified home health agencies to assist in devel-
    34  oping and ensuring their capacity to meet community need. Funds for such
    35  aid shall be made available each year in [an amount equal to twenty-five
    36  cents per capita of the population within  each  health  systems  agency
    37  region,  as established pursuant to article twenty-nine of this chapter,
    38  or two hundred thousand dollars, whichever is greater. Two million  five
    39  hundred  thousand  dollars  shall  be  for the state's share of payments
    40  provided pursuant to subdivision  five  of  section  thirty-six  hundred
    41  fourteen  of this article. The remaining amount shall be for purposes of
    42  providing grants  pursuant  to  this  section  and  sections  thirty-six
    43  hundred  seven  and  thirty-six  hundred  nine  of this article] amounts
    44  appropriated and distributed  to  agencies  in  the  form  of  increased
    45  medical  assistance  rates  and/or  direct  grants, as best maximizes an
    46  agency's ability to receive and utilize funds  for  the  purposes  under
    47  this  section,  and  as  maximizes,  where  applicable,  federal medical
    48  assistance participation.
    49    2. [For the purpose funding grants  pursuant  to  sections  thirty-six
    50  hundred  seven  and  thirty-six  hundred nine of this article and grants
    51  pursuant to this section, the commissioner shall allocate the proportion
    52  of funds among the health systems agency regions using the last  preced-
    53  ing federal census or other census data approved by the comptroller] The
    54  commissioner  shall allocate funds for the purposes of supporting and/or
    55  expanding access to  certified  home  health  care  agency  services  as
    56  provided for in section thirty-six hundred seven of this article, and/or
        A. 7568                             3

     1  to  support  such  access  and services for high-cost or high-need popu-
     2  lations, populations in remote or  underserved  regions,  diverse  popu-
     3  lations,  populations  evidencing  health  disparity,  populations  with
     4  special care needs, or otherwise in regions underserved or identified as
     5  particularly in need.
     6    3.  Such annual funds allocated [to each health systems agency region]
     7  shall be made available [for grants] in a form under subdivision one  of
     8  this section to applicants within [each such region which are determined
     9  eligible  and  approved  by  the  commissioner] all regions of the state
    10  pursuant to the provisions of this section and [sections] section  thir-
    11  ty-six  hundred  seven  [and thirty-six hundred nine] of this article as
    12  approved by the commissioner.
    13    4. In order to be considered eligible for receipt of [a  grant]  funds
    14  pursuant to this section, a certified home health agency shall submit an
    15  application  to  the  department. Such application shall demonstrate, to
    16  the satisfaction of the commissioner, that the agency:
    17    (a) received a certificate of approval pursuant to the  provisions  of
    18  section  thirty-six  hundred  eight  of  this article at least two years
    19  prior to the date of the application and that such certificate  has  not
    20  been revoked or annulled subsequent to its receipt and is not limited as
    21  of the time of application;
    22    (b) shall utilize [grant] such funds [to provide home care services to
    23  persons  whose  residence  is in an area which, due to location, is more
    24  costly to serve, or persons whose conditions require  a  more  intensive
    25  level  of  home care than typically provided in a visit]  to maintain or
    26  increase home health care services for the purposes specified in  subdi-
    27  vision two of this section;
    28    (c)  [shall undertake reasonable efforts to maintain financial support
    29  from public and community contributed funding sources;
    30    (d)] shall [make every  reasonable  effort  to  collect  payments  for
    31  services  from  third  party  insurance  payers, governmental payers and
    32  self-paying patients] demonstrate a service  commitment  to  the  under-
    33  served or hard to serve areas for which funds would be applied; and
    34    [(e)]  (d) shall have professional assistance available on a seven day
    35  per week, twenty-four hour per day basis[;
    36    (f) shall establish a reasonable relationship between costs and charg-
    37  es, or establish charges at approximate cost; and
    38    (g) has no other available financial  resources  to  serve  the  popu-
    39  lations as identified in paragraph (b) of this subdivision].
    40    5.  For  the purpose of this section and [sections] section thirty-six
    41  hundred seven [and thirty-six hundred nine] of this article,  [a  grant]
    42  an  applicant  for  funds  shall submit a copy of its application to the
    43  [health systems agency in whose region the applicant is located] depart-
    44  ment.
    45    6. For the purpose of this section and [sections]  section  thirty-six
    46  hundred  seven  [and  thirty-six  hundred  nine]  of this article, [each
    47  health systems agency shall convene an  advisory  group  with  represen-
    48  tatives from, but not limited to, local departments of health, including
    49  those  organized  and  unorganized  as  county  and  part-county  health
    50  districts, social services districts, offices for the  aging,  certified
    51  home health agencies, and consumers of home health agency services. Such
    52  advisory  group, after considering recommendations from persons involved
    53  in or knowledgeable about home care services delivered in  that  region,
    54  shall, consistent with state and regional health plans, identify priori-
    55  ty  regional and local needs for the purposes identified in this section
    56  and sections thirty-six hundred seven and  thirty-six  hundred  nine  of
        A. 7568                             4

     1  this  article.    The health systems agency shall provide to the commis-
     2  sioner the recommendations of the advisory group regarding  which  grant
     3  applications  meet  regional  and  local  needs, as well as the advisory
     4  group's prioritization of applications.
     5    7.  For  the  purposes of this section and sections thirty-six hundred
     6  seven and thirty-six hundred nine of  this  article,]  the  commissioner
     7  shall  approve  applications  for [grants] funds which meet the require-
     8  ments of this section pursuant to which the application is submitted and
     9  rules and regulations  adopted  pursuant  thereto.  [In  approving  such
    10  applications,  the  commissioner shall take into prime consideration the
    11  recommendations of the advisory group convened  by  the  health  systems
    12  agency  in  whose  region  the applicants are located and also take into
    13  consideration other applications submitted by  the  same  applicant  for
    14  grants submitted pursuant to such sections. The commissioner shall noti-
    15  fy  each advisory group and each applicant in writing of his approval or
    16  disapproval and, if disapproval, shall  state  the  reasons  for  disap-
    17  proval.
    18    8.  Grants]  7. Funds approved for the purposes of this section may be
    19  made each year for up to a two-year period [or until the costs for  such
    20  services  provided  by  virtue  of  receipt of the grant are included in
    21  rates of payment, whichever is sooner]. Certified home  health  agencies
    22  which  receive  [grants]  funds pursuant to this section may reapply for
    23  [grants] funds and may  be  approved  if  the  applicant  satisfies  the
    24  requirements  of  subdivision  four  of this section and rules and regu-
    25  lations adopted pursuant to this section.
    26    [9.] 8. In the event that a public certified  home  health  agency  is
    27  approved  for [a grant] funds, pursuant to this section, funds [provided
    28  under the grant] shall not reduce the amount of aid otherwise reimbursa-
    29  ble to such agency pursuant to article six of this chapter.
    30    [10.] 9. The commissioner is authorized to promulgate such  rules  and
    31  regulations,  as  are  necessary  to  carry  out  the provisions of this
    32  section. Such rules and regulations may include, but not be limited  to,
    33  minimum  and maximum [grant] funding levels provided to individual agen-
    34  cies under this section.
    35    [11.] 10. Recipients of [grants] funds shall submit to the commission-
    36  er reports on the use of [grants] funds provided under this  section  at
    37  such times and in such format as the commissioner may prescribe.
    38    §  3.  The public health law is amended by adding a new section 3616-b
    39  to read as follows:
    40    § 3616-b. State aid to licensed home care services agencies for commu-
    41  nity need. 1. Notwithstanding  any  inconsistent  provision  of  law  or
    42  department rule or regulation, the commissioner is hereby authorized and
    43  directed to provide, within the amount allocated pursuant to subdivision
    44  two  of  this  section,  grants  or  rate  increases  for the purpose of
    45  supporting and increasing home care services availability  and  capacity
    46  by  licensed  home  care  services agencies to meet community need. Such
    47  funds shall be utilized to  increase  the  number  of  persons  provided
    48  services,  the  kind of services provided, including medical, social and
    49  environmental services, the sharing of services or to improve or  expand
    50  the  method  or  frequency of the delivery of services. Funding applica-
    51  tions shall include, but not be limited to specific plans to provide the
    52  following:
    53    (a) an expansion of the types and methods of services  made  available
    54  or delivered to persons at home;
        A. 7568                             5

     1    (b)  an  increase  in  the  number  of persons accessing home care and
     2  services, or to support a licensed home care  services  agency's  avail-
     3  ability to patients on a seven-day-a-week basis;
     4    (c) an increase in services delivered to high-cost, high-need persons,
     5  and  those  in  remote, underserved areas of the state, and special care
     6  populations;
     7    (d) services to diverse populations,  populations  with  special  care
     8  needs, or otherwise underserved, hard to serve, or identified as partic-
     9  ularly in need;
    10    (e)   the   development  of  recruitment,  specialized  training,  and
    11  retention initiatives for staff including but  not  limited  to  tuition
    12  assistance,   transportation  assistance,  childcare  support,  clinical
    13  preceptorship programs, and employee assistance programs  such  as  peer
    14  mentoring, mental health counseling, and other such programs;
    15    (f)  the development of training programs approved by the commissioner
    16  to improve the quality of services provided;
    17    (g) the development of programs to coordinate the  work  of  the  home
    18  care agency with other community resources, including but not limited to
    19  other  licensed home care services agencies, certified home health agen-
    20  cies, hospices, hospitals, social services agencies, and community based
    21  organizations;
    22    (h) demonstration projects to provide care in the home by using  meth-
    23  ods, programs, or arrangements not ordinarily used by licensed home care
    24  services  agencies, and that will help to determine the most appropriate
    25  means of reducing institutional care and  of  providing  better  quality
    26  care   services,  most  cost-effective  services,  and  more  accessible
    27  services;
    28    (i) the development of programs to improve home care patients'  access
    29  to primary health services, or
    30    (j)  the  acquisition  and  implementation  of technology, systems, or
    31  equipment that would support the delivery  of  the  identified  expanded
    32  services.
    33    2. State aid shall be provided to licensed home care services annually
    34  to  assist  in  developing and ensuring their capacity to meet community
    35  need.  Funds for such aid shall be made available  annually  in  amounts
    36  appropriated  and  distributed  to  agencies  in  the  form of increased
    37  medical assistance rates and/or direct  grants,  as  best  maximizes  an
    38  agency's  ability  to  receive  and utilize funds for the purposes under
    39  this section,  and  as  maximizes,  where  applicable,  federal  medical
    40  assistance participation.
    41    3.  Such annual funds allocated shall be made available under subdivi-
    42  sion two of this section to applicants within all regions of  the  state
    43  pursuant  to  the  provisions  of  this  section  and as approved by the
    44  commissioner.
    45    4. (a) The commissioner shall establish a mechanism and parameters for
    46  the allocation of funds to agencies which provides for  transparency  to
    47  the  agency and also, if through Medicaid rates, transparency to a Medi-
    48  caid managed care plan, managed long term care plan, program of  all-in-
    49  clusive  care  for  the elderly, certified home health agency, long term
    50  home health care program, hospice or other  similar  program  or  entity
    51  with  which  a licensed home care agency has a contract for services and
    52  payment and provides a rate payment to the licensed agency.
    53    (b) Such funding shall be provided either  directly  to  the  licensed
    54  agency,  or where provided through contracted rate, shall supplement the
    55  rate payment to the licensed agency and shall not be subject  to  offset
    56  or negotiation against the agency's base rate with such contractor.
        A. 7568                             6

     1    5.  The  commissioner  shall  convene  a  technical  advisory group to
     2  provide consultation, recommendations and technical  assistance  on  the
     3  development  of  the  methodology  for  allocation of the funds, and may
     4  include such other advice and consultation regarding  implementation  of
     5  this section as the commissioner may seek. Such technical advisory group
     6  shall  include  but  not be limited to representation from licensed home
     7  care services agencies geographically reflective of the state's regions,
     8  and representatives of statewide home  care  provider  and  health  plan
     9  associations. The commissioner shall consider the recommendations of the
    10  technical  advisory group in implementation, and shall implement funding
    11  expeditiously with the start of each state fiscal year.
    12    § 4. The public health law is amended by adding a new  section  4012-c
    13  to read as follows:
    14    § 4012-c. State aid for hospice community need. 1. The commissioner is
    15  hereby  authorized,  within the amount allocated pursuant to subdivision
    16  two of this section, to make grants or rate increases  to  hospices  for
    17  the  purpose  of supporting and increasing hospice services availability
    18  and capacity to meet community need. Such funds  shall  be  utilized  to
    19  increase  the  number of persons provided services, the kind of services
    20  provided, including medical, social,  and  environmental  services,  the
    21  sharing  of services, or to improve or expand the methods of delivery of
    22  hospice care. Funds shall be allocated based on an  application  process
    23  established  by the commissioner, which shall include but not be limited
    24  to the hospice's specific plans to provide for the following:
    25    (a) improvement in timely education, referral and  entry  of  patients
    26  into hospice;
    27    (b)  increase in the number of persons provided hospice and palliative
    28  care services commensurate with need, or to support hospices' availabil-
    29  ity to patients on a seven-day-a-week basis;
    30    (c) services to diverse populations,  populations  with  special  care
    31  needs,  and/or  populations  and/or  areas  of  the  state deemed by the
    32  commissioner as underserved or hard to serve;
    33    (d) expansion of the types and methods of hospice services made avail-
    34  able;
    35    (e) acquisition and implementation of technology supporting the deliv-
    36  ery, coordination, or management of services;
    37    (e) development of recruitment, training and retention initiatives for
    38  hospice personnel, including but not limited to: (i) basic training  and
    39  in-service training support; (ii) specialized training, including train-
    40  ing to improve the quality of care; and (iii) retention initiatives that
    41  may  be  offered by the hospice and that may include tuition assistance,
    42  transportation assistance,  childcare  support,  clinical  preceptorship
    43  programs, peer mentoring, and employee assistance programs;
    44    (f) development of programs to coordinate the work of the hospice with
    45  other  community resources, including but not limited to other hospices,
    46  physicians, home health agencies, hospitals, social  services  agencies,
    47  and community based organizations; and
    48    (g)  such  other  purposes  as  the  commissioner  may approve and are
    49  consistent with provisions of this subdivision.
    50    2. State aid shall be provided to hospices annually, in amounts as are
    51  appropriated, to assist in developing and  ensuring  their  capacity  to
    52  meet  community  need in all regions of the state. Such amounts shall be
    53  distributed to hospices in the  form  of  direct  grants,  or  increased
    54  medical  assistance  rates,  as  best  maximizes  a hospice's ability to
    55  receive and utilize funds for the purposes under this section.
        A. 7568                             7

     1    3. In order to be considered eligible for receipt of funds pursuant to
     2  this section, a hospice shall submit an application to  the  department.
     3  Such  application  shall demonstrate, to the satisfaction of the commis-
     4  sioner, that the hospice:
     5    (a)  received  a certificate of approval pursuant to the provisions of
     6  this article at least two years prior to the date of the application and
     7  that such certificate has not been revoked or annulled subsequent to its
     8  receipt and is not limited as of the time of application;
     9    (b) shall utilize such funds to support or increase  hospice  services
    10  for the purposes specified in subdivision two of this section;
    11    (c)  shall  undertake reasonable efforts to maintain financial support
    12  from public and community contributed funding sources; and
    13    (d) shall demonstrate a service commitment to the populations or areas
    14  for which funds would be applied.
    15    4. The commissioner shall approve applications for  funds  which  meet
    16  the requirements of this section.
    17    5.  Funds  approved  under  this section for hospices may be made each
    18  year for up to a two-year period. Hospices may reapply for funds subject
    19  to the requirements of this section.
    20    6. The commissioner is authorized to promulgate guidance as  necessary
    21  to  carry out the provisions of this section. Such guidance may include,
    22  but not be limited to, minimum and maximum funding  levels  provided  to
    23  individual hospice agencies under this section.
    24    7. Recipients of funds shall submit to the commissioner reports on the
    25  use  of  funds  provided  under  this  section at such times and in such
    26  format as the commissioner may prescribe.
    27    § 5. This act shall take effect on the first of April next  succeeding
    28  the date on which it shall have become a law; provided however, that the
    29  amendments  to section 3615 of the public health law made by section two
    30  of this act shall not affect the expiration of such  section  and  shall
    31  expire  therewith. Effective immediately, the addition, amendment and/or
    32  repeal of any rule or regulation necessary  for  the  implementation  of
    33  this  act  on its effective date are authorized to be made and completed
    34  on or before such effective date.