STATE OF NEW YORK ________________________________________________________________________ 7568 2023-2024 Regular Sessions IN ASSEMBLY May 25, 2023 ___________ Introduced by M. of A. PAULIN -- read once and referred to the Committee on Health AN ACT to amend the public health law, in relation to state aid for home health care and hospice services 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. Subdivision 1 of section 3607 of the public health law, as 2 amended by chapter 891 of the laws of 1990, is amended to read as 3 follows: 4 1. The commissioner is hereby authorized, within the amount allocated 5 pursuant to subdivisions one, two and three of section thirty-six 6 hundred fifteen of this article, to make [grants] funds available to 7 certified [public and voluntary non-profit] home health agencies for the 8 purpose of increasing the availability of home health care services. 9 Such [grants] funds shall be utilized to increase the number of persons 10 provided services, the kind of services provided, including medical, 11 social and environmental services, the sharing of services or to improve 12 or expand the method or frequency of the delivery of home health care 13 services. [Grant applications] Agencies shall include specific plans to 14 provide the following: 15 a. an expansion of the types and methods of services made available or 16 delivered to persons at home as provided for in subdivision two of 17 section thirty-six hundred two of this chapter; 18 b. an increase in the number of persons provided home care services by 19 the certified home health agency, directly or through contractual 20 arrangement, or to provide for the availability of certified home health 21 agency services on a seven-day-a-week basis; 22 c. an increase in home health care services delivered to high-cost or 23 high-need populations, populations in remote or underserved regions, 24 diverse populations and/or populations evidencing health disparity, 25 populations with special care needs, or for otherwise increasing health EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD11555-02-3
A. 7568 2 1 care services for populations and/or areas of the state deemed by the 2 commissioner as underserved or hard to serve, or other specific care 3 populations identified as particularly in need; 4 d. the development of recruitment, specialized training, and retention 5 initiatives for staff including but not limited to tuition assistance, 6 transportation assistance, childcare support, clinical preceptorship 7 programs, and employee assistance programs such as peer mentoring, 8 mental health counseling, and other; 9 e. the development of training programs approved by the commissioner 10 to improve the quality of services provided by the certified home health 11 agency; 12 [d.] f. the development of programs to coordinate the work of the 13 certified home health agency with other community resources, including 14 but not limited to other certified home health agencies, hospitals, and 15 social services agencies; 16 [e.] g. demonstration projects to provide care in the home by using 17 methods, programs, or arrangements not ordinarily used by certified home 18 health agencies, and that will help to determine the most appropriate 19 means of reducing institutional care and of providing better quality 20 home care services, most cost-effective home care services, and more 21 accessible home care services; 22 [f.] h. the development of programs to improve home care patients' 23 access to primary health services; [or 24 g.] i. the development of "home care volunteer programs for maternal 25 and child health" pursuant to subdivision two of this section[.]; or 26 j. the acquisition and implementation of technology, systems, or 27 equipment that would support the delivery of the identified expanded 28 services. 29 § 2. Section 3615 of the public health law, as amended by chapter 884 30 of the laws of 1990, subdivision 10 as amended by section 30 of part A 31 of chapter 58 of the laws of 2010, is amended to read as follows: 32 § 3615. State aid to certified home health agencies. 1. State aid 33 shall be provided to certified home health agencies to assist in devel- 34 oping and ensuring their capacity to meet community need. Funds for such 35 aid shall be made available each year in [an amount equal to twenty-five 36 cents per capita of the population within each health systems agency 37 region, as established pursuant to article twenty-nine of this chapter, 38 or two hundred thousand dollars, whichever is greater. Two million five 39 hundred thousand dollars shall be for the state's share of payments 40 provided pursuant to subdivision five of section thirty-six hundred 41 fourteen of this article. The remaining amount shall be for purposes of 42 providing grants pursuant to this section and sections thirty-six 43 hundred seven and thirty-six hundred nine of this article] amounts 44 appropriated and distributed to agencies in the form of increased 45 medical assistance rates and/or direct grants, as best maximizes an 46 agency's ability to receive and utilize funds for the purposes under 47 this section, and as maximizes, where applicable, federal medical 48 assistance participation. 49 2. [For the purpose funding grants pursuant to sections thirty-six 50 hundred seven and thirty-six hundred nine of this article and grants 51 pursuant to this section, the commissioner shall allocate the proportion 52 of funds among the health systems agency regions using the last preced- 53 ing federal census or other census data approved by the comptroller] The 54 commissioner shall allocate funds for the purposes of supporting and/or 55 expanding access to certified home health care agency services as 56 provided for in section thirty-six hundred seven of this article, and/or
A. 7568 3 1 to support such access and services for high-cost or high-need popu- 2 lations, populations in remote or underserved regions, diverse popu- 3 lations, populations evidencing health disparity, populations with 4 special care needs, or otherwise in regions underserved or identified as 5 particularly in need. 6 3. Such annual funds allocated [to each health systems agency region] 7 shall be made available [for grants] in a form under subdivision one of 8 this section to applicants within [each such region which are determined 9 eligible and approved by the commissioner] all regions of the state 10 pursuant to the provisions of this section and [sections] section thir- 11 ty-six hundred seven [and thirty-six hundred nine] of this article as 12 approved by the commissioner. 13 4. In order to be considered eligible for receipt of [a grant] funds 14 pursuant to this section, a certified home health agency shall submit an 15 application to the department. Such application shall demonstrate, to 16 the satisfaction of the commissioner, that the agency: 17 (a) received a certificate of approval pursuant to the provisions of 18 section thirty-six hundred eight of this article at least two years 19 prior to the date of the application and that such certificate has not 20 been revoked or annulled subsequent to its receipt and is not limited as 21 of the time of application; 22 (b) shall utilize [grant] such funds [to provide home care services to 23 persons whose residence is in an area which, due to location, is more 24 costly to serve, or persons whose conditions require a more intensive 25 level of home care than typically provided in a visit] to maintain or 26 increase home health care services for the purposes specified in subdi- 27 vision two of this section; 28 (c) [shall undertake reasonable efforts to maintain financial support 29 from public and community contributed funding sources; 30 (d)] shall [make every reasonable effort to collect payments for 31 services from third party insurance payers, governmental payers and 32 self-paying patients] demonstrate a service commitment to the under- 33 served or hard to serve areas for which funds would be applied; and 34 [(e)] (d) shall have professional assistance available on a seven day 35 per week, twenty-four hour per day basis[; 36 (f) shall establish a reasonable relationship between costs and charg- 37 es, or establish charges at approximate cost; and 38 (g) has no other available financial resources to serve the popu- 39 lations as identified in paragraph (b) of this subdivision]. 40 5. For the purpose of this section and [sections] section thirty-six 41 hundred seven [and thirty-six hundred nine] of this article, [a grant] 42 an applicant for funds shall submit a copy of its application to the 43 [health systems agency in whose region the applicant is located] depart- 44 ment. 45 6. For the purpose of this section and [sections] section thirty-six 46 hundred seven [and thirty-six hundred nine] of this article, [each 47 health systems agency shall convene an advisory group with represen- 48 tatives from, but not limited to, local departments of health, including 49 those organized and unorganized as county and part-county health 50 districts, social services districts, offices for the aging, certified 51 home health agencies, and consumers of home health agency services. Such 52 advisory group, after considering recommendations from persons involved 53 in or knowledgeable about home care services delivered in that region, 54 shall, consistent with state and regional health plans, identify priori- 55 ty regional and local needs for the purposes identified in this section 56 and sections thirty-six hundred seven and thirty-six hundred nine of
A. 7568 4 1 this article. The health systems agency shall provide to the commis- 2 sioner the recommendations of the advisory group regarding which grant 3 applications meet regional and local needs, as well as the advisory 4 group's prioritization of applications. 5 7. For the purposes of this section and sections thirty-six hundred 6 seven and thirty-six hundred nine of this article,] the commissioner 7 shall approve applications for [grants] funds which meet the require- 8 ments of this section pursuant to which the application is submitted and 9 rules and regulations adopted pursuant thereto. [In approving such 10 applications, the commissioner shall take into prime consideration the 11 recommendations of the advisory group convened by the health systems 12 agency in whose region the applicants are located and also take into 13 consideration other applications submitted by the same applicant for 14 grants submitted pursuant to such sections. The commissioner shall noti- 15 fy each advisory group and each applicant in writing of his approval or 16 disapproval and, if disapproval, shall state the reasons for disap- 17 proval. 18 8. Grants] 7. Funds approved for the purposes of this section may be 19 made each year for up to a two-year period [or until the costs for such 20 services provided by virtue of receipt of the grant are included in 21 rates of payment, whichever is sooner]. Certified home health agencies 22 which receive [grants] funds pursuant to this section may reapply for 23 [grants] funds and may be approved if the applicant satisfies the 24 requirements of subdivision four of this section and rules and regu- 25 lations adopted pursuant to this section. 26 [9.] 8. In the event that a public certified home health agency is 27 approved for [a grant] funds, pursuant to this section, funds [provided 28 under the grant] shall not reduce the amount of aid otherwise reimbursa- 29 ble to such agency pursuant to article six of this chapter. 30 [10.] 9. The commissioner is authorized to promulgate such rules and 31 regulations, as are necessary to carry out the provisions of this 32 section. Such rules and regulations may include, but not be limited to, 33 minimum and maximum [grant] funding levels provided to individual agen- 34 cies under this section. 35 [11.] 10. Recipients of [grants] funds shall submit to the commission- 36 er reports on the use of [grants] funds provided under this section at 37 such times and in such format as the commissioner may prescribe. 38 § 3. The public health law is amended by adding a new section 3616-b 39 to read as follows: 40 § 3616-b. State aid to licensed home care services agencies for commu- 41 nity need. 1. Notwithstanding any inconsistent provision of law or 42 department rule or regulation, the commissioner is hereby authorized and 43 directed to provide, within the amount allocated pursuant to subdivision 44 two of this section, grants or rate increases for the purpose of 45 supporting and increasing home care services availability and capacity 46 by licensed home care services agencies to meet community need. Such 47 funds shall be utilized to increase the number of persons provided 48 services, the kind of services provided, including medical, social and 49 environmental services, the sharing of services or to improve or expand 50 the method or frequency of the delivery of services. Funding applica- 51 tions shall include, but not be limited to specific plans to provide the 52 following: 53 (a) an expansion of the types and methods of services made available 54 or delivered to persons at home;
A. 7568 5 1 (b) an increase in the number of persons accessing home care and 2 services, or to support a licensed home care services agency's avail- 3 ability to patients on a seven-day-a-week basis; 4 (c) an increase in services delivered to high-cost, high-need persons, 5 and those in remote, underserved areas of the state, and special care 6 populations; 7 (d) services to diverse populations, populations with special care 8 needs, or otherwise underserved, hard to serve, or identified as partic- 9 ularly in need; 10 (e) the development of recruitment, specialized training, and 11 retention initiatives for staff including but not limited to tuition 12 assistance, transportation assistance, childcare support, clinical 13 preceptorship programs, and employee assistance programs such as peer 14 mentoring, mental health counseling, and other such programs; 15 (f) the development of training programs approved by the commissioner 16 to improve the quality of services provided; 17 (g) the development of programs to coordinate the work of the home 18 care agency with other community resources, including but not limited to 19 other licensed home care services agencies, certified home health agen- 20 cies, hospices, hospitals, social services agencies, and community based 21 organizations; 22 (h) demonstration projects to provide care in the home by using meth- 23 ods, programs, or arrangements not ordinarily used by licensed home care 24 services agencies, and that will help to determine the most appropriate 25 means of reducing institutional care and of providing better quality 26 care services, most cost-effective services, and more accessible 27 services; 28 (i) the development of programs to improve home care patients' access 29 to primary health services, or 30 (j) the acquisition and implementation of technology, systems, or 31 equipment that would support the delivery of the identified expanded 32 services. 33 2. State aid shall be provided to licensed home care services annually 34 to assist in developing and ensuring their capacity to meet community 35 need. Funds for such aid shall be made available annually in amounts 36 appropriated and distributed to agencies in the form of increased 37 medical assistance rates and/or direct grants, as best maximizes an 38 agency's ability to receive and utilize funds for the purposes under 39 this section, and as maximizes, where applicable, federal medical 40 assistance participation. 41 3. Such annual funds allocated shall be made available under subdivi- 42 sion two of this section to applicants within all regions of the state 43 pursuant to the provisions of this section and as approved by the 44 commissioner. 45 4. (a) The commissioner shall establish a mechanism and parameters for 46 the allocation of funds to agencies which provides for transparency to 47 the agency and also, if through Medicaid rates, transparency to a Medi- 48 caid managed care plan, managed long term care plan, program of all-in- 49 clusive care for the elderly, certified home health agency, long term 50 home health care program, hospice or other similar program or entity 51 with which a licensed home care agency has a contract for services and 52 payment and provides a rate payment to the licensed agency. 53 (b) Such funding shall be provided either directly to the licensed 54 agency, or where provided through contracted rate, shall supplement the 55 rate payment to the licensed agency and shall not be subject to offset 56 or negotiation against the agency's base rate with such contractor.
A. 7568 6 1 5. The commissioner shall convene a technical advisory group to 2 provide consultation, recommendations and technical assistance on the 3 development of the methodology for allocation of the funds, and may 4 include such other advice and consultation regarding implementation of 5 this section as the commissioner may seek. Such technical advisory group 6 shall include but not be limited to representation from licensed home 7 care services agencies geographically reflective of the state's regions, 8 and representatives of statewide home care provider and health plan 9 associations. The commissioner shall consider the recommendations of the 10 technical advisory group in implementation, and shall implement funding 11 expeditiously with the start of each state fiscal year. 12 § 4. The public health law is amended by adding a new section 4012-c 13 to read as follows: 14 § 4012-c. State aid for hospice community need. 1. The commissioner is 15 hereby authorized, within the amount allocated pursuant to subdivision 16 two of this section, to make grants or rate increases to hospices for 17 the purpose of supporting and increasing hospice services availability 18 and capacity to meet community need. Such funds shall be utilized to 19 increase the number of persons provided services, the kind of services 20 provided, including medical, social, and environmental services, the 21 sharing of services, or to improve or expand the methods of delivery of 22 hospice care. Funds shall be allocated based on an application process 23 established by the commissioner, which shall include but not be limited 24 to the hospice's specific plans to provide for the following: 25 (a) improvement in timely education, referral and entry of patients 26 into hospice; 27 (b) increase in the number of persons provided hospice and palliative 28 care services commensurate with need, or to support hospices' availabil- 29 ity to patients on a seven-day-a-week basis; 30 (c) services to diverse populations, populations with special care 31 needs, and/or populations and/or areas of the state deemed by the 32 commissioner as underserved or hard to serve; 33 (d) expansion of the types and methods of hospice services made avail- 34 able; 35 (e) acquisition and implementation of technology supporting the deliv- 36 ery, coordination, or management of services; 37 (e) development of recruitment, training and retention initiatives for 38 hospice personnel, including but not limited to: (i) basic training and 39 in-service training support; (ii) specialized training, including train- 40 ing to improve the quality of care; and (iii) retention initiatives that 41 may be offered by the hospice and that may include tuition assistance, 42 transportation assistance, childcare support, clinical preceptorship 43 programs, peer mentoring, and employee assistance programs; 44 (f) development of programs to coordinate the work of the hospice with 45 other community resources, including but not limited to other hospices, 46 physicians, home health agencies, hospitals, social services agencies, 47 and community based organizations; and 48 (g) such other purposes as the commissioner may approve and are 49 consistent with provisions of this subdivision. 50 2. State aid shall be provided to hospices annually, in amounts as are 51 appropriated, to assist in developing and ensuring their capacity to 52 meet community need in all regions of the state. Such amounts shall be 53 distributed to hospices in the form of direct grants, or increased 54 medical assistance rates, as best maximizes a hospice's ability to 55 receive and utilize funds for the purposes under this section.
A. 7568 7 1 3. In order to be considered eligible for receipt of funds pursuant to 2 this section, a hospice shall submit an application to the department. 3 Such application shall demonstrate, to the satisfaction of the commis- 4 sioner, that the hospice: 5 (a) received a certificate of approval pursuant to the provisions of 6 this article at least two years prior to the date of the application and 7 that such certificate has not been revoked or annulled subsequent to its 8 receipt and is not limited as of the time of application; 9 (b) shall utilize such funds to support or increase hospice services 10 for the purposes specified in subdivision two of this section; 11 (c) shall undertake reasonable efforts to maintain financial support 12 from public and community contributed funding sources; and 13 (d) shall demonstrate a service commitment to the populations or areas 14 for which funds would be applied. 15 4. The commissioner shall approve applications for funds which meet 16 the requirements of this section. 17 5. Funds approved under this section for hospices may be made each 18 year for up to a two-year period. Hospices may reapply for funds subject 19 to the requirements of this section. 20 6. The commissioner is authorized to promulgate guidance as necessary 21 to carry out the provisions of this section. Such guidance may include, 22 but not be limited to, minimum and maximum funding levels provided to 23 individual hospice agencies under this section. 24 7. Recipients of funds shall submit to the commissioner reports on the 25 use of funds provided under this section at such times and in such 26 format as the commissioner may prescribe. 27 § 5. This act shall take effect on the first of April next succeeding 28 the date on which it shall have become a law; provided however, that the 29 amendments to section 3615 of the public health law made by section two 30 of this act shall not affect the expiration of such section and shall 31 expire therewith. Effective immediately, the addition, amendment and/or 32 repeal of any rule or regulation necessary for the implementation of 33 this act on its effective date are authorized to be made and completed 34 on or before such effective date.