NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A1198
SPONSOR: Paulin TITLE OF BILL:
An act to amend the social services law, in relation to removing certain
restrictions on access to home care services; and to repeal certain
provisions of such law relating thereto
PURPOSE OR GENERAL IDEA OF BILL:
To repeal limitations on certain eligibility requirements for an indi-
vidual to receive personal care and private duty nursing services under
Medicaid.
SUMMARY OF SPECIFIC PROVISIONS:
The bill amends Social Services Law § 365-a and § 365-f to eliminate the
requirement that applicants for Medicaid services in the home have to be
obsessed as needing at least limited assistance with physical maneuver-
ing with activities of daily living.
The current law requires an individual to need assistance with three o'r
more activities of daily living, or for persons with dementia or
Alzheimer's diagnosis, as needing assistance with two or more activities
of daily living.
JUSTIFICATION:
Activities of daily living include such tasks as dressing, using the
bathroom, moving about one's home, housekeeping, and meals. Assisting
persons who are elderly or have disabilities so they may remain in their
homes prevents the higher cost of them entering institutional care. This
bill will restore eligibility criteria for home care services and
consumer directed personal assistance (CDPA) to the form in which it
existed prior to the 2020 legislation. This bill will ensure that New
York continues to comply with federal requirements under the Olmstead
Decision and Community First Choice (CFC. Eligibility criteria for home
care services must remain less stringent than that of nursing homes to
ensure that services in the least restrictive Setting are prioritized as
set forth by Olmstead. Additionally, for the State to remain in compli-
ance with CFC, avoid• lawsuits, and retain the additional federal fund-
ing from the CFC program, we must eliminate any difference in services
offered based on type of disability.
Though enacted in the SFY 2020-21 budget, the provisions of the statute
were delayed due to 'requirements under federal COVID aid that prevented
New York from restricting or reducing the Medicaid benefit to enrollees
as a condition of receiving funding. The goal of this legislation is to
allow individuals to continue to receive these needed services in their
homes. For most people, home is the safest, healthiest, and preferred
option. Congregate settings should be the last resort and are typically
much more costly than home care services. This bill will help minimize
institutionalization.
PRIOR LEGISLATIVE HISTORY:
2023-2024: A6346-referred to ways and means/ Same as S328, committed to
rules.
2021-2022: A5367A - referred to Ways & Means
FISCAL IMPLICATIONS:
To be determined. In 2020, the Division of Budget estimated that this
proposal would cost $277 million.
EFFECTIVE DATE:
Immediately
STATE OF NEW YORK
________________________________________________________________________
1198
2025-2026 Regular Sessions
IN ASSEMBLY
January 9, 2025
___________
Introduced by M. of A. PAULIN, SIMON, EPSTEIN, JACKSON, ANDERSON,
FORREST, LUPARDO, STECK, BRABENEC, MITAYNES, MAMDANI, KELLES, ROSEN-
THAL, McMAHON, SAYEGH, REYES, SHRESTHA, RAMOS, GALLAGHER, McDONOUGH,
SEAWRIGHT, SANTABARBARA, LUNSFORD, GONZALEZ-ROJAS, DAVILA, GALLAHAN,
RAGA, ANGELINO -- read once and referred to the Committee on Health
AN ACT to amend the social services law, in relation to removing certain
restrictions on access to home care services; and to repeal certain
provisions of such law relating thereto
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subparagraph (i) of paragraph (e) of subdivision 2 of
2 section 365-a of the social services law, as amended by section 2 of
3 part MM of chapter 56 of the laws of 2020, is amended to read as
4 follows:
5 (i) personal care services, including personal emergency response
6 services, shared aide and an individual aide, subject to the provisions
7 of subparagraphs (ii), (iii), (iv)[, (v)] and (vi) of this paragraph,
8 furnished to an individual who is not an inpatient or resident of a
9 hospital, nursing facility, intermediate care facility for individuals
10 with intellectual disabilities, or institution for mental disease, as
11 determined to meet the recipient's needs for assistance when cost effec-
12 tive and appropriate, and when prescribed by a qualified independent
13 physician selected or approved by the department of health, in accord-
14 ance with the recipient's plan of treatment and provided by individuals
15 who are qualified to provide such services, who are supervised by a
16 registered nurse and who are not members of the recipient's family, and
17 furnished in the recipient's home or other location;
18 § 2. Subparagraph (v) of paragraph (e) of subdivision 2 of section
19 365-a of the social services law is REPEALED.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD00585-01-5
A. 1198 2
1 § 3. Paragraph (c) of subdivision 2 of section 365-f of the social
2 services law, as amended by section 3 of part MM of chapter 56 of the
3 laws of 2020, is amended to read as follows:
4 (c) has been determined by the social services district, pursuant to
5 an assessment of the person's appropriateness for the program, conducted
6 with an appropriate long term home health care program, a certified home
7 health agency, or an AIDS home care program or pursuant to the personal
8 care program, as being in need of home care services or private duty
9 nursing and [as needing at least limited assistance with physical maneu-
10 vering with more than two activities of daily living, or for persons
11 with a dementia or Alzheimer's diagnosis, as needing at least super-
12 vision with more than one activity of daily living, provided that the
13 provisions related to activities of daily living in this paragraph shall
14 only apply to persons who initially seek eligibility for the program on
15 or after October first, two thousand twenty, and] who is able and will-
16 ing or has a designated representative, including a legal guardian able
17 and willing to make informed choices, or a designated relative or other
18 adult who is able and willing to assist in making informed choices, as
19 to the type and quality of services, including but not limited to such
20 services as nursing care, personal care, transportation and respite
21 services; and
22 § 4. This act shall take effect immediately.
