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A08006 Summary:

BILL NOA08006
 
SAME ASSAME AS S07626
 
SPONSORGottfried
 
COSPNSRLupardo, Simon, McDonald, Sayegh, Galef, Abinanti, Wallace, Ashby
 
MLTSPNSR
 
Amd §4012, Pub Health L; amd §461-l, Soc Serv L
 
Authorizes residents of assisted living programs to receive hospice services; directs the commissioner of health to convene a workgroup of stakeholders to make recommendations as to coordination and division of services, responsibilities, and reimbursement of assisted living programs and hospice programs.
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A08006 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A8006
 
SPONSOR: Gottfried
  TITLE OF BILL: An act to amend the public health law and the social services law, in relation to authorizing residents of assisted living programs to receive hospice services   PURPOSE OR GENERAL IDEA OF BILL: To enable residents of adult care facilities continue to be enrolled in the Medicaid assisted living program while receiving hospice care.   SUMMARY OF SPECIFIC PROVISIONS: The bill makes parallel amendments to Public Health Law § 4012 and to Social Services Law § 461-L to clarify that residents of adult care facilities may receive both hospice and assisted living program (ALP) services without having to disenroll in either. A workgroup of stake- holders will convene to study and recommend how the two programs will coordinate services, responsibilities, and reimbursement, to avoid duplicate payments.   JUSTIFICATION: Hospice programs provide medical and social supports to terminally ill persons so that they receive end-of-life palliative care in their home environment. NYS and Federal regulations allow hospice care to be provided both home based and institutional settings, including the terminally ill individual's home, the home of a relatives or friend, free-standing Hospice residences, skilled nursing facilities, and in general hospitals. However, if the patient happens to live in an adult care facility (ACF) and is enrolled in the NYS Medicaid assisted living program to receive home care services in that ACF, it gets unduly complicated for the person to also receive hospice care. Since 2002, NYS has required ALP-enrolled residents who choose Hospice care to disenroll from ALP. This means the loss of the home care services they still need. This process is morally and fiscally wrong for the patient and for the operators of the homes where they live. New York ranks 50th in the nation for Hospice utilization, with this another bather to hospice care. A conservative estimate suggests that allowing ALP residents to access Hospice services would save the Medicaid program $13 million a year through avoiding costly hospitalizations and nursing home stays. There are complex regulations and practices that interfere with hospice access for ALP residents. The workgroup, comprised of representatives from all parties associated in the delivery of this care including ALP and Hospices providers and Departmental officials, will recommend chang- es to policies, practices, and billing guidance so that all Medicaid recipients can benefit from hospice care at their end of life.   PRIOR LEGISLATIVE HISTORY: New bill, based on A.10459-A of 2019 (Lupardo) which was vetoed.   FISCAL IMPLICATIONS: Expected Medicaid savings.   EFFECTIVE DATE: Sections 1 and 2 take effect 180 days after becoming a law, section 3, the workgroup, takes effect immediately.
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A08006 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          8006
 
                               2021-2022 Regular Sessions
 
                   IN ASSEMBLY
 
                                      June 4, 2021
                                       ___________
 
        Introduced  by  M. of A. GOTTFRIED, LUPARDO -- read once and referred to
          the Committee on Health
 
        AN ACT to amend the public health law and the social  services  law,  in
          relation  to  authorizing  residents  of  assisted  living programs to
          receive hospice services
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1. Section 4012 of the public health law is amended by adding
     2  a new subdivision 4 to read as follows:
     3    4. Eligible individuals shall be permitted to receive hospice services
     4  from a provider under this article while  continuing  to  reside  in  an
     5  adult  care  facility  under  title  two  of article seven of the social
     6  services law and enrolled in the assisted living  program.  The  commis-
     7  sioner  shall  make regulations and take other actions reasonably neces-
     8  sary and appropriate to implement this subdivision.
     9    § 2. Paragraph (d) of subdivision 2 of section  461-l  of  the  social
    10  services  law  is  amended  by adding a new subparagraph (iv) to read as
    11  follows:
    12    (iv) Eligible  individuals  shall  be  permitted  to  receive  hospice
    13  services  from  a  provider under article forty of the public health law
    14  while continuing to reside in an adult care facility  under  this  title
    15  and enrolled in the assisted living program. The commissioner shall make
    16  regulations  and take other actions reasonably necessary and appropriate
    17  to implement this subparagraph.
    18    § 3. The commissioner of health shall convene  a  workgroup  including
    19  representatives  of  associations  representing assisted living programs
    20  and hospice programs, and other interested parties  as  appropriate,  to
    21  make  recommendations  as  to  coordination and division of services and
    22  responsibilities, and reimbursement, of  assisted  living  programs  and
    23  hospice  programs  under  subdivision  4  of  section 4012 of the public
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11724-01-1

        A. 8006                             2
 
     1  health law and paragraph (d) of subdivision 2 of section  461-l  of  the
     2  social services law.
     3    §  4.  This  act shall take effect immediately, provided that sections
     4  one and two of this act shall take effect on the one  hundred  eightieth
     5  day after it shall have become a law.
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