NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A1493A
SPONSOR: Paulin TITLE OF BILL:
An act to amend the public health law, in relation to state aid for home
health care to meet community need
PURPOSE:
To update the current public health law provisions for annual state aid
to meet community need for Certified Home Health Agency services across
regions of NYS.
SUMMARY OF SPECIFIC PROVISIONS:
SECTION 1: Declares the legislative necessity of the act to meet the
statutory, policy, and community-need requirements for Certified Home
Health Agency services in NYS.
SECTION 2: Amends public health law section 3615 to update the state's
statutory provisions for annual state aid for Certified Home Health
Agency services need.
Current statute targets state aid for home health for purposes that
Include home health service access, quality, and coordination with
hospital partners. This bill would update these provisions to Include:
*Services to high-need, remote, underserved, diverse, or special care
patient needs.
*Specialized recruitment, training, retention, and safety initiatives to
provide for supply, and reduce vacancies, in home health nurses, thera-
pists, social workers and aide personnel.
*Technology support for delivery and efficiency of services, including
workforce efficiency and access.
Incorporates standards, expectations, and demonstrated record of service
commitment of agencies for receipt and use of state aid funds; specifies
the agency application process: provides that agencies may reapply for
ensuing years. Authorizes the State Department of Health to issue guid-
ance governing the provisions of the program,
SECTION 3: Sets forth the effective date as the first of April next
succeeding the date of enactment.
JUSTIFICATION:
Certified Home Health Care Agencies deliver essential health, therapeu-
tic and life-sustaining services for nearly 500,000 patients across NYS.
Services range from maternal, infant and pediatric care, to pre and
post-surgical care, to pre-acute, acute and post-acute care and rehabil-
itation, to clinically complex care, to care of the chronically III, to
palliative care, to public health, primary and preventive services, and
more. Certified Home Health Agencies are integral services in the health
care system. They function as part of the vital continuum of care for
patients, and are partner with physicians, hospitals, primary care prac-
titioners, mental/behavioral providers, health plans, and others, Certi-
fied Home Health Agency Services Include professional nursing, thera-
pies, social work, home health aide, care management, telehealth, •
medical supplies, and other community and in-home supports. These agen-
cies deploy health care professionals to homes daily, keeping vulnerable
New Yorkers in their homes, out of hospitals and nursing facilities,
saving valuable health care dollars in the process. Yet, currently,
nearly two-thirds of NY's home health agencies are functioning well
below sustainable fiscal margins, and are eroding rather than Increasing
their capacity as patient demands skyrocket. There are shortages in home
health nurses, therapists and direct care workers, combined with high
vacancy rates across the board In all areas. Moreover, the severe
under-capacity and shortage of home health services, greatly exacerbates
the access crises currently facing hospitals, emergency rooms, nursing
homes and community health settings across NYS.
This legislation would update and ensure funding for the state's current
statutory structure providing state aid for Certified Home Health Agency
services. The funding needs supported in this legislation are those not
typically reimbursed in the Medicaid, Medicare or commercial rate struc-
ture, nor in the negotiated rate or wage methodologies relied on by the
state. Rather, these are core structural service needs that in other
sectors, such as hospitals, are supported by public funding pools
outside of the rate process and are vital to public need. This legis-
lation is critical to ensuring updates and funding for NY's home health
state aid program, for the medically needy population, and for the
community health system as a whole that relies on these services for
health- and life-dependent support.
LEGISLATIVE HISTORY:
New legislation
FISCAL IMPLICATIONS:
All-payor savings from access to home health care necessary to avert
preventable hospital, nursing home and emergency services and expenses,
as well as to enable less costly ambulatory surgical and interventional
options for patient care. Annual state aid for certified home health
agencies under the bill would total (federal/ state shares combined) $70
million, or such amounts the Legislature and Governor shall annually
appropriate for this purpose in the state budget.
EFFECTIVE DATE:
First day of April next succeeding the date of enactment.
STATE OF NEW YORK
________________________________________________________________________
1493--A
2025-2026 Regular Sessions
IN ASSEMBLY
January 10, 2025
___________
Introduced by M. of A. PAULIN, LEVENBERG, STECK, GRAY, McDONALD -- read
once and referred to the Committee on Health -- committee discharged,
bill amended, ordered reprinted as amended and recommitted to said
committee
AN ACT to amend the public health law, in relation to state aid for home
health care 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. Legislative intent. The legislature finds and declares
2 this necessity to act to further support the state's home health care
3 policy and goals as set forth in public health law section thirty-six
4 hundred, current public health law sections thirty-six hundred seven and
5 thirty-six hundred fifteen providing a mechanism for annual state aid to
6 certified home health agencies and supplemental to the rate structure,
7 to meet state and regional home health community services need.
8 The legislature finds that the changes in the state's aging demograph-
9 ics, the rising public and medical care system demand for in-home care,
10 the increasingly complex medical conditions dependent upon such care,
11 and the associated delivery costs of such services, necessitates the
12 updating and commensurate funding of the section thirty-six hundred
13 fifteen state aid mechanism to ensure its intended purpose. Accordingly,
14 the legislature seeks the amendments provided for in this act to address
15 home health community need, with targeted assistance to underserved
16 areas and populations, home health nursing and related staffing, and
17 requisite technology-supports for service capability, access, and effi-
18 ciency.
19 § 2. Section 3615 of the public health law, as amended by chapter 884
20 of the laws of 1990, subdivision 10 as amended by section 30 of part A
21 of chapter 58 of the laws of 2010, is amended to read as follows:
22 § 3615. State aid to certified home health agencies. 1. State aid
23 shall be provided to certified home health agencies to assist in devel-
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD01893-05-5
A. 1493--A 2
1 oping and ensuring their capacity to meet community need. Funds for such
2 aid shall be made available each year in [an amount equal to twenty-five
3 cents per capita of the population within each health systems agency
4 region, as established pursuant to article twenty-nine of this chapter,
5 or two hundred thousand dollars, whichever is greater. Two million five
6 hundred thousand dollars shall be for the state's share of payments
7 provided pursuant to subdivision five of section thirty-six hundred
8 fourteen of this article. The remaining amount shall be for purposes of
9 providing grants pursuant to this section and sections thirty-six
10 hundred seven and thirty-six hundred nine of this article] amounts as
11 may be appropriated and made available therefor, and distributed to
12 agencies in the form of increased medical assistance rates and/or direct
13 payments or grants to such agencies, as best maximizes an agency's abil-
14 ity to receive and utilize funds for the purposes under this section,
15 and as maximizes, where applicable, federal medical assistance partic-
16 ipation.
17 2. [For the purpose funding grants pursuant to sections thirty-six
18 hundred seven and thirty-six hundred nine of this article and grants
19 pursuant to this section, the commissioner shall allocate the proportion
20 of funds among the health systems agency regions using the last preced-
21 ing federal census or other census data approved by the comptroller] The
22 commissioner shall annually allocate funds for the purposes of support-
23 ing and/or expanding access to certified home health care agency
24 services, including but not limited to:
25 a. as provided for in paragraphs a, b, c, d, e, and f of subdivision
26 one of section thirty-six hundred seven of this article;
27 b. for services for high-cost or high-need populations, populations in
28 remote or underserved regions, diverse and underserved populations, or
29 populations with special care needs;
30 c. for development of recruitment, specialized training, and retention
31 initiatives for home health nurses, therapists, social workers and aide
32 personnel, including but not limited to clinical preceptorship support,
33 tuition assistance, transportation assistance, childcare support,
34 employee assistance programs such as peer mentoring programs, mental
35 health counseling, and worker safety; and
36 d. the acquisition and implementation of technology to support the
37 delivery and/or efficiency of services.
38 3. Such annual funds allocated [to each health systems agency region]
39 shall be made available [for grants] pursuant to subdivision one of this
40 section to applicants within each [such] region [which are determined
41 eligible and approved by the commissioner] of the state pursuant to the
42 provisions of this section [and sections thirty-six hundred seven and
43 thirty-six hundred nine of this article].
44 4. In order to be considered eligible for receipt of [a grant] funds
45 pursuant to this section, a certified home health agency shall submit an
46 application to the department. Such application shall demonstrate, to
47 the satisfaction of the commissioner, that the agency:
48 (a) received a certificate of approval pursuant to the provisions of
49 section thirty-six hundred eight of this article at least two years
50 prior to the date of the application and that such certificate has not
51 been revoked or annulled subsequent to its receipt and is not limited as
52 of the time of application;
53 (b) shall utilize [grant] such funds [to provide home care services to
54 persons whose residence is in an area which, due to location, is more
55 costly to serve, or persons whose conditions require a more intensive
56 level of home care than typically provided in a visit] to sustain or
A. 1493--A 3
1 increase home health care services for the purposes specified in subdi-
2 vision two of this section;
3 (c) [shall undertake reasonable efforts to maintain financial support
4 from public and community contributed funding sources;
5 (d)] shall [make every reasonable effort to collect payments for
6 services from third party insurance payers, governmental payers and
7 self-paying patients] demonstrate a service commitment to the under-
8 served or hard to serve areas for which funds would be applied; and
9 [(e)] (d) shall have professional assistance available on a seven day
10 per week, twenty-four hour per day basis[;
11 (f) shall establish a reasonable relationship between costs and charg-
12 es, or establish charges at approximate cost; and
13 (g) has no other available financial resources to serve the popu-
14 lations as identified in paragraph (b) of this subdivision].
15 5. [For the purpose of this section and sections thirty-six hundred
16 seven and thirty-six hundred nine of this article, a grant applicant
17 shall submit a copy of its application to the health systems agency in
18 whose region the applicant is located.
19 6.] For the purpose of this section [and sections thirty-six hundred
20 seven and thirty-six hundred nine of this article, each health systems
21 agency shall convene an advisory group with representatives from, but
22 not limited to, local departments of health, including those organized
23 and unorganized as county and part-county health districts, social
24 services districts, offices for the aging, certified home health agen-
25 cies, and consumers of home health agency services. Such advisory group,
26 after considering recommendations from persons involved in or knowledge-
27 able about home care services delivered in that region, shall, consist-
28 ent with state and regional health plans, identify priority regional and
29 local needs for the purposes identified in this section and sections
30 thirty-six hundred seven and thirty-six hundred nine of this article.
31 The health systems agency shall provide to the commissioner the recom-
32 mendations of the advisory group regarding which grant applications meet
33 regional and local needs, as well as the advisory group's prioritization
34 of applications.
35 7. For the purposes of this section and sections thirty-six hundred
36 seven and thirty-six hundred nine of this article,] the commissioner
37 shall approve applications for [grants] funds which meet the require-
38 ments of this section pursuant to which the application is submitted and
39 rules and regulations, or guidelines of the department, adopted pursuant
40 thereto. [In approving such applications, the commissioner shall take
41 into prime consideration the recommendations of the advisory group
42 convened by the health systems agency in whose region the applicants are
43 located and also take into consideration other applications submitted by
44 the same applicant for grants submitted pursuant to such sections. The
45 commissioner shall notify each advisory group and each applicant in
46 writing of his approval or disapproval and, if disapproval, shall state
47 the reasons for disapproval.
48 8. Grants] 6. Funds approved for the purposes of this section [may]
49 shall be made available for distribution each year [for up to a two-year
50 period or until the costs for such services provided by virtue of
51 receipt of the grant are included in rates of payment, whichever is
52 sooner]. Certified home health agencies which receive [grants] funds
53 pursuant to this section may reapply for [grants] funds and may be
54 approved if the applicant satisfies the requirements of subdivision four
55 of this section and rules and regulations, or guidelines of the depart-
56 ment, adopted pursuant to this section.
A. 1493--A 4
1 [9.] 7. In the event that a public certified home health agency is
2 approved for [a grant] funds, pursuant to this section, funds [provided
3 under the grant] shall not reduce the amount of aid otherwise reimbursa-
4 ble to such agency pursuant to article six of this chapter.
5 [10.] 8. The commissioner is authorized to promulgate such rules and
6 regulations, or guidelines of the department, as are necessary to carry
7 out the provisions of this section. Such rules and regulations, or
8 guidelines of the department, may include, but not be limited to, mini-
9 mum and maximum [grant] funding levels provided to individual agencies
10 under this section.
11 [11.] 9. Recipients of [grants] funds shall submit to the commissioner
12 reports on the use of [grants] funds provided under this section at such
13 times and in such format as the commissioner may prescribe.
14 § 3. This act shall take effect on the first of April next succeeding
15 the date on which it shall have become a law; provided however, that the
16 amendments to section 3615 of the public health law made by section two
17 of this act shall not affect the expiration of such section and shall
18 expire therewith. Effective immediately, the addition, amendment and/or
19 repeal of any rule or regulation necessary for the implementation of
20 this act on its effective date are authorized to be made and completed
21 on or before such effective date.
