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.
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.
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.
