Provides for the establishment of a senior care choices program to give care and services at home to senior citizens; sets criteria for such program; directs application for a federal waiver.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A2527
SPONSOR: Englebright
 
TITLE OF BILL: An act to amend the elder law, in relation to estab-
lishing a senior care choices program in the office for the aging
 
PURPOSE OR GENERAL IDEA OF THE BILL: This bill creates a federally
waivered program under the State Office for the Aging that will help to
keep seniors in their own homes and communities. Using the waiver, the
office would create a seamless provision of services to work with
seniors before their health becomes chronic and their opportunities for
remaining in their own communities limited.
 
SUMMARY OF PROVISIONS: This bill adds a new subdivision 8 to section
541 of the elder law, which are the office of the aging statutes in
order to create the Senior Care Choices Program as a waivered program
under Section 1115 of the Social Security Act. The State Office of the
Aging will provide a coordinated plan of care and services at home to
seniors in a seamless network that includes services already provided by
and through the office and any additional services necessary to maintain
such persons at home. The program may also be provided in the home of a
responsible relative or other responsible adult, and in adult care
facilities, other than shelters for adults.
The measure established the principle for the development of the
program, that seniors have the primary authority to make choices that
work best for them, regardless of the nature or extent of their disabil-
ity of the source of payment for services. SOFA is further permitted to
waive State requirements that restrict its ability to provide services,
so long as the waiver is consistent with the federal 1115 waiver. SOFA
is further required to seek to expand source of payment for the program,
including from voluntary and willing private sources, insurance plans,
charities and foundations, and individuals.
Services provided under the Senior Care Choices Program include services
provided by the office, and provided pursuant to the waiver, including
but not limited to such long term care services as care, treatment,
maintenance, and services provided in a nursing facility licensed under
article twenty-eight of the public health law, or provided by a home
care services agency, certified home health agency or long term home
health care program, as defined in section thirty-six hundred two of the
public health law, or provided by an adult day health care program in
accordance with regulations of the department of health, or provided by
a personal care provider licensed or regulated by any other state or
local agency, and such other services for which medical assistance is or
otherwise would be available pursuant to the social services law includ-
ing those which are designated as long term care services in law or
regulations of the department of health, consumer directed personal
assistance services, and such other services as home modification, tele-
health, pharmacy review, and palliative care.
 
JUSTIFICATION: This legislation will allow the State Office of the
Aging to provide and coordinate services to seniors at home and in their
own communities before they become chronic enough to require placement
in a nursing home or in another chronic care program.
 
LEGISLATIVE HISTORY: 2005-06 A7692 referred to aging 2007-08 A1450
referred to aging 2009-10 A2591 referred to aging 2011-12 A3940 aging
2013-14 A4320 referred to aging
 
FISCAL IMPLICATIONS: To be determined.
 
EFFECTIVE DATE: This act shall take effect immediately.
STATE OF NEW YORK
________________________________________________________________________
2527
2015-2016 Regular Sessions
IN ASSEMBLY
January 16, 2015
___________
Introduced by M. of A. ENGLEBRIGHT -- read once and referred to the
Committee on Aging
AN ACT to amend the elder law, in relation to establishing a senior care
choices program in the office for the aging
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 214 of the elder law is amended by adding a new
2 subdivision 8 to read as follows:
3 8. Senior care choices program. (a) Notwithstanding any other law to
4 the contrary, the director shall file, or cause to be filed, within one
5 hundred twenty days of the effective date of this subdivision an appli-
6 cation for a federal waiver pursuant to section 1115 of the federal
7 Social Security Act, or any successor thereto, for a senior care choices
8 program, under which the office shall and is hereby authorized to
9 provide directly or by contract a coordinated plan of care and services
10 at home to seniors in a seamless network that shall include services
11 provided by and through the office and any additional services as may be
12 necessary to maintain such persons at home as authorized in this subdi-
13 vision. Every state agency is hereby empowered and directed to cooperate
14 with the office and to comply with any request for the filing of such
15 waiver if the director shall lack power and authority to file such a
16 waiver. As used in this subdivision, the term "senior" means persons who
17 are aged sixty and older who are medically eligible for placement in a
18 long-term care facility, as such term is defined in section twenty-one
19 hundred ninety-one of the public health law.
20 (1) The senior care choices program shall be provided in the senior's
21 home or in the home of a responsible relative or other responsible
22 adult, and, other provisions of this section to the contrary notwith-
23 standing, if the waiver granted pursuant to section 1115 of the federal
24 Social Security Act or any successor thereto shall so provide, may also
25 be provided in adult care facilities, other than shelters for adults,
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD06500-01-5
A. 2527 2
1 certified pursuant to section four hundred sixty-b of the social
2 services law, provided that the senior meets the admission and continued
3 stay criteria for such facility, except that services provided by the
4 program shall not duplicate or replace those which the facility is
5 required by law or regulation to provide.
6 (2) In filing such waiver for the operation of the program, the office
7 shall seek to provide services pursuant to the principle that seniors
8 have the primary authority to make choices that work best for them,
9 regardless of the nature or extent of their disability or the source of
10 payment for services. In designing the program and providing services,
11 the office is authorized to waive any provision of the social services
12 law or the public health law, or any rule or regulation promulgated
13 thereunder, which in the judgment of the office restricts its ability to
14 provide services as required by this subdivision, so long as such waiver
15 is consistent with any federal waiver granted pursuant to section 1115
16 of the federal Social Security Act or any successor thereto.
17 (3) The office shall seek to expand source of payment for the program,
18 including seeking payments from voluntary and willing private sources,
19 insurance plans, charities and foundations, and individuals.
20 (4) The office is hereby empowered to provide or contract for the
21 provision of such senior care choices program in any county within the
22 state. The office shall seek to coordinate services with any current
23 provider of services. No state agency shall impose a limitation on the
24 number of eligible individuals served in this program. The office shall
25 not be subject to audit, assessment, suspension, sanction, or report by
26 a state agency for a program conducted pursuant to the authority of this
27 subdivision, except that it shall be subject to audit by the office of
28 the state comptroller to the extent that such programs would have been
29 subject to audit but for this paragraph.
30 (b) If a senior deemed by his or her physician able to remain in his
31 or her own home or the home of a responsible relative or other responsi-
32 ble adult if the necessary services are provided applies for admission
33 to the program, the office in consultation with the local social
34 services commissioner shall order an assessment to be performed using
35 the assessment instrument developed pursuant to the provision of section
36 thirty-six hundred sixteen of the public health law, and in addition an
37 assessment of the informal caregiving network and supports capable of
38 providing social and non-medical services to the senior. If the results
39 of the assessment indicate that the senior can receive the appropriate
40 level of care at home or in the home of such responsible relative or
41 other responsible adult, and that the senior can be appropriately
42 supported by family, intimates, friends and community, the office shall,
43 after consulting with those who performed the assessment, prepare for
44 that senior a plan for the provision of services that may include any
45 service that would be rendered in a nursing home plus such additional
46 services as the office is authorized to provide directly or through
47 contract pursuant to the provisions of the waiver authorized by this
48 subdivision. Continued provision of services pursuant to this subdivi-
49 sion shall be contingent on additional assessments performed every one
50 hundred twenty days. At the time of the initial assessment, and at the
51 time of each subsequent assessment (or more often if the senior's needs
52 require), the office shall establish a monthly budget for payment for
53 the services provided under such plan. Total annual expenditures for
54 medical assistance services made pursuant to title eleven of article
55 five of the social services law for all such seniors within the social
56 services district within which such seniors reside shall not exceed
A. 2527 3
1 sixty-five percent of the average of the annual rates payable under such
2 title for nursing home services within the social services district in
3 which such seniors reside, such amount to be determined by multiplying
4 the total number of seniors within the program in any year by the aver-
5 age of the annual rates payable for such nursing home services.
6 (c) Services provided under the senior care choices program include
7 services provided by the office, and provided pursuant to the waiver,
8 including but not limited to such long term care services as care,
9 treatment, maintenance and services provided in a nursing facility
10 licensed under article twenty-eight of the public health law, or
11 provided by a home care services agency, certified home health agency or
12 long term home health care program, as defined in section thirty-six
13 hundred two of the public health law, or provided by an adult day health
14 care program in accordance with regulations of the department of health,
15 or provided by a personal care provider licensed or regulated by any
16 other state or local agency, and such other services for which medical
17 assistance is or otherwise would be available pursuant to the social
18 services law including those which are designated as long term care
19 services in law or regulations of the department of health, consumer
20 directed personal assistance services and such other services as home
21 modification, telehealth, pharmacy review and palliative care.
22 § 2. This act shall take effect immediately.