NY State Senate Bill 2015-S5535

Senate Bill S5535

2015-2016 Legislative Session

Relates to the transition of traumatic brain injury waiver and nursing home transition and diversion waiver program services to Medicaid managed care programs

download bill text pdf

Archive: Last Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

View Actions

	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 06, 2016	referred to health
Jun 25, 2015	recommitted to rules ordered to third reading cal.1893
Jun 09, 2015	reported and committed to rules
May 28, 2015	reported and committed to finance
May 14, 2015	referred to health

Votes

- Jun 25, 2015 - Rules Committee Vote
  S5535
  
  23
  
  Aye
  
  0
  
  Nay
  
  0
  
  Aye with Reservations
  
  1
  
  Absent
  
  1
  
  Excused
  
  0
  
  Abstained
  - - Rules Committee Vote: Jun 25, 2015
      
      aye (23)
      
      Bonacic
      
      Breslin
      
      Carlucci
      
      DeFrancisco
      
      Dilan
      
      Espaillat
      
      Farley
      
      Flanagan
      
      Gianaris
      
      Hannon
      
      Hassell-Thompson
      
      Krueger
      
      LaValle
      
      Larkin
      
      Little
      
      Marcellino
      
      Montgomery
      
      Nozzolio
      
      Seward
      
      Skelos
      
      Stewart-Cousins
      
      Valesky
      
      Young
      
      absent (1)
      
      Parker
      
      excused (1)
      
      Perkins
  May 28, 2015 - Health Committee Vote
  S5535
  
  15
  
  Aye
  
  0
  
  Nay
  
  0
  
  Aye with Reservations
  
  0
  
  Absent
  
  2
  
  Excused
  
  0
  
  Abstained
  - - Health Committee Vote: May 28, 2015
      
      aye (15)
      
      Farley
      
      Felder
      
      Golden
      
      Hannon
      
      Hoylman-Sigal
      
      Larkin
      
      Little
      
      Martins
      
      Montgomery
      
      Murphy
      
      Panepinto
      
      Seward
      
      Stavisky
      
      Valesky
      
      Young
      
      excused (2)
      
      Hassell-Thompson
      
      Rivera
  Jun 9, 2015 - Finance Committee Vote
  S5535
  
  35
  
  Aye
  
  0
  
  Nay
  
  1
  
  Aye with Reservations
  
  0
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  - - Finance Committee Vote: Jun 9, 2015
      
      aye (35)
      
      Bonacic
      
      Breslin
      
      DeFrancisco
      
      Diaz
      
      Dilan
      
      Espaillat
      
      Farley
      
      Gallivan
      
      Golden
      
      Hannon
      
      Hassell-Thompson
      
      Kennedy
      
      Krueger
      
      LaValle
      
      Lanza
      
      Larkin
      
      Little
      
      Marcellino
      
      Martins
      
      Montgomery
      
      Nozzolio
      
      O'Mara
      
      Parker
      
      Peralta
      
      Perkins
      
      Ranzenhofer
      
      Ritchie
      
      Rivera
      
      Robach
      
      Savino
      
      Seward
      
      Squadron
      
      Stavisky
      
      Valesky
      
      Young
      
      aye wr (1)
      
      Griffo

co-Sponsors

2015-S5535 (ACTIVE) - Details

See Assembly Version of this Bill:: A7598
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §4403-f, Pub Health L

2015-S5535 (ACTIVE) - Summary

Relates to the transition of traumatic brain injury waiver and nursing home transition and diversion waiver program services to Medicaid managed care programs.

2015-S5535 (ACTIVE) - Sponsor Memo

                                BILL NUMBER:S5535

TITLE OF BILL:

An act to amend the public health law, in relation to the transition of
traumatic brain injury waiver and nursing home transition and diversion
waiver program services to Medicaid managed care programs

PURPOSE OR GENERAL IDEA OF BILL:

This bill delays the transition of persons receiving services under the
traumatic brain injury (TBI) waiver or nursing home transition and
diversion (NHTD) waiver into Medicaid managed care and creates a work
group to develop recommendations relating to that transition.

SUMMARY OF SPECIFIC PROVISIONS:

Section 1. Adds a new sub-paragraph (v-a) to paragraph (b) of subsection
(7) of section 4403-f of the public health law delaying the transition
of TBI and NHTD waiver populations into Medicaid managed care until at
least April 1, 2017; provides that the commissioner shall convene a work
group to develop recommendations on transitioning these populations and
spells out membership and responsibilities of the work group.

Section 2. Effective date - immediate

JUSTIFICATION:

Over the past 20 years, the traumatic brain injury (TBI) waiver and
nursing home transition and diversion (NHTD) waiver have allowed highly
sensitive populations to be cared for by specialized providers in the
community, avoiding costly institutionalized care. Patients' families
and providers have raised concerns about the scheduled transition of
these populations out of the TBI and NHTD programs and into Medicaid
managed care. While the State plans to transfer these populations into
Medicaid managed care in January 2016 (NHTD) and April 2016 (TBI), many
questions remain about these populations' access to appropriate provid-
ers and ability to stay in the community under the new system.

The 1999 Supreme Court Olmstead decision ruled that unjustified segre-
gation of persons with disabilities constitutes discrimination in
violation of the Americans with Disabilities Act.

Consistent with the State's obligations under Olmstead, to ensure that
these populations continue receiving community-based services whenever
possible and are not inadvertently redirected to nursing home settings,
this bill would delay implementation for a year and establish a trans-
parent process through which consumers, providers, payers and other
stakeholders could provide input in developing an operationally viable
transition plan.

PRIOR LEGISLATIVE HISTORY:

New bill

FISCAL IMPLICATIONS:

None

EFFECTIVE DATE:

Immediate

2015-S5535 (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  5535

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                              May 14, 2015
                               ___________

Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the public health law, in relation to the transition  of
  traumatic  brain  injury waiver and nursing home transition and diver-
  sion waiver program services to Medicaid managed care programs

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  Paragraph  (b)  of subdivision 7 of section 4403-f of the
public health law is amended by adding a new subparagraph (v-a) to  read
as follows:
  (V-A)  NOTWITHSTANDING  SUBPARAGRAPH  (V) OF THIS PARAGRAPH, NO PERSON
RECEIVING SERVICES UNDER THE TRAUMATIC BRAIN INJURY  WAIVER  OR  NURSING
HOME  TRANSITION  AND  DIVERSION  WAIVER  MAY BE REQUIRED TO ENROLL IN A
MANAGED CARE OR MANAGED LONG TERM CARE PROGRAM BEFORE APRIL  FIRST,  TWO
THOUSAND  SEVENTEEN;  AND  PROVIDED  FURTHER THAT THE COMMISSIONER SHALL
CONVENE A WORK GROUP TO DEVELOP RECOMMENDATIONS ON TRANSITION  OF  THESE
WAIVER  SERVICES  TO  MANAGED  CARE.  MEMBERSHIP OF THE WORK GROUP SHALL
INCLUDE PAYERS, CONSUMER REPRESENTATIVES AND PROVIDERS OF SUCH SERVICES,
AND THE CHAIRS OF THE ASSEMBLY AND SENATE HEALTH COMMITTEES. IN DEVELOP-
ING RECOMMENDATIONS ON TRANSITIONING THESE POPULATIONS TO A MANAGED CARE
ENVIRONMENT, THE WORK GROUP SHALL CONSIDER:
  (1) TRACKING OF LEGACY WAIVER POPULATIONS TO ENSURE  CONTINUED  ACCESS
TO COMMUNITY-BASED SERVICES AND IDENTIFY AGGREGATE COSTS OF CARE;
  (2)  ONGOING TRACKING AND IDENTIFICATION OF PEOPLE WITH A DIAGNOSIS OF
A BRAIN INJURY AND SIMILAR POPULATIONS TO ENSURE THAT NECESSARY COMMUNI-
TY-BASED SERVICES WILL BE PROVIDED TO  THESE  POPULATIONS  AND  IDENTIFY
AGGREGATE COSTS OF CARE;
  (3)  HOW CONTINUITY OF SERVICES WILL BE ACCOMPLISHED BEYOND AN INITIAL
TRANSITION PERIOD OF NINETY DAYS;
  (4) ENSURING ACCESS TO A QUALIFIED WORKFORCE, EXPERIENCED WORKING WITH
THESE POPULATIONS;

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD11174-01-5

S. 5535                             2

  (5) DEVELOPMENT OF ACTUARIALLY SOUND CAPITATION  REFLECTING  THE  HIGH
ACUITY OF THESE POPULATIONS; AND
  (6)  DEVELOPMENT  OF  ANNUAL  REPORTING  BY THE COMMISSIONER ON, AMONG
OTHER THINGS, AGGREGATE COSTS OF CARE FOR THESE POPULATIONS AND  WHETHER
THE TRANSITION OF THESE POPULATIONS IN MANAGED CARE HAS INCREASED UTILI-
ZATION OF NURSING HOME OR OTHER INSTITUTIONALIZED CARE.
  THE RECOMMENDATIONS OF SUCH WORK GROUP SHALL BE DUE TO THE COMMISSION-
ER  AND THE LEGISLATURE ON OR BEFORE DECEMBER THIRTY-FIRST, TWO THOUSAND
SIXTEEN. TO THE EXTENT THE DEPARTMENT'S FINAL IMPLEMENTATION  PLAN  DOES
NOT  REFLECT  ONE OR MORE RECOMMENDATIONS OF THE WORK GROUP, THE COMMIS-
SIONER SHALL PROVIDE A WRITTEN EXPLANATION FOR SUCH  OMISSION  OR  VARI-
ATION.
  S  2.  This  act shall take effect immediately; provided however, that
the amendments to paragraph (b) of subdivision 7 of  section  4403-f  of
the  public  health law made by section one of this act shall not affect
the repeal of such section and shall be deemed repealed therewith.

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Senate Bill S5535

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Kemp Hannon