BILL NUMBER: S9008

SPONSOR: MAY
 
TITLE OF BILL:

An act to amend the elder law, in relation to programs for the aging

 
PURPOSE OF THE BILL:

AN ACT to amend the Elder Law in relation to authorizing a private pay
program This bill would amend subsection 12 of section 203 of the elder
law which authorizes the Director to implement a private pay program for
programs administered by the Office that are funded by a state appropri-
ation to decreak the income threshold for client participation in the
program from 400% of the federal poverty level to 250% of the federal
poverty level.

 
SUMMARY OF PROVISIONS:

Section 1 of the bill amends subsection 12 of section 203 of the elder
law so that private payments under this bill shall not be required of
individuals with incomes below 250% of the federal poverty level.  This
              

subdivision shall not prevent cost sharing for the programs established
pursuant to section two hundred fourteen of the elder law.

Section 2 of the bill would require the act to take effect immediately.

 
JUSTIFICATION:

When this law was enacted in 2019 participation in the private pay
program was limited to those individuals whose income is at or above
400% of the federal poverty level. However, this threshold has prevented
many older New Yorkers who could benefit from receiving aging programs
and services from area agencies on aging and their providers from
participating in the program. Because of the way law is currently writ-
ten no one whose income is below 400% of the federal poverty level can
participate in the program. There is a large number of older New Yorkers
whose income is at or above the newly proposed 250% income threshold who
need aging services but are unable to access them due to limited program
funding and/or unavailability of providers. The current 400% thresholds
require individuals to have an income at or above $51,520 to participate
in the private pay program.

The rules and regulations governing the Expanded In-home Service for the
Elder Program (EISEP) requires individuals at or above 250% of the
federal poverty level to pay the full cost of the services received
through EISEP. So, it would not be incongruent with current standards to
allow individuals with an income at or above 250% of poverty to pay
privately for aging related programs and services if they so desire.
Participation in the private pay program is purely voluntary and indi-
viduals who are currently between those 400% and 250% thresholds are
faced with the very real possibility of not receiving services. As a
result, it seems clear that individuals at or above 250% of the federal
poverty level should be allowed to participate in the private pay
program.

The programs and services that are offered by designated area agencies
and their contractors are valuable, are in demand, assist in reducing
Medicaid spend-down and nursing home placement, are key to addressing
the social determinants of health and are central to safe discharges
from acute care and longterm care facilities as well as reducing
preventable hospital readmissions.  Jennifer WashingtonJanuary 7, 2022

The ability of the Area Agencies on Aging to serve more individuals by
allowing individuals whose income is at or above 250% of the federal
poverty level to pay for certain services thereby generating revenue
that must be reinvested back into service provision thereby reducing
waiting lists and meeting new and emerging needs.

In addition to the benefits of increased revenue, there are many other
benefits for entering a private pay marketplace including:

* Leveraging the over 50 years of experience of the network of aging
professionals who have strong cross systems community partnerships and
who are required by law to strengthen and maintain partnerships in vari-
ous systems - i.e. health, legal, law enforcement, adult protective,
service providers, community-based organizations, volunteer, etc.

* Having strong partnerships with local agencies, to streamline and
coordinate multi-system issues

* State certified and trained professional staff who are required to be
objective and be person-centered in their approach to care

* Cost effective, non-medical services

* Important part of the Governor's Prevention Agenda, health Across All
Policies Approach, Age Friendly New York and Olmstead Plan Implementa-
tion,

* The majority of older New Yorkers are not recipients of Medicaid and
the provision of these services provide needed non-medical services to
avert spenddown

The most recent economic statistics for New York, almost 2.6 million
people over the age of 60 have incomes at or above 250% of poverty
($32,200 per year).

 
PRIOR LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
This act shall take effect immediately.