NY State Senate Bill 2023-S8599

Current 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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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Feb 20, 2024	referred to health

co-Sponsors

2023-S8599 (ACTIVE) - Details

See Assembly Version of this Bill:: A9034
Current Committee:: Senate Health
Law Section:: Public Health

2023-S8599 (ACTIVE) - Summary

Requires the state Medicaid director to establish a program for specific individuals to become complex care assistants and provide private duty nursing services to certain Medicaid enrollees under increased reimbursement rates.

2023-S8599 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S8599

SPONSOR: MAYER
 
TITLE OF BILL:

An act relating to complex care assistants and home care services and
supplementing

 
PURPOSE OR GENERAL IDEA OF BILL:

Authorizes New York State to allow family member of medically fragile
children) to be trained and paid to provide care as complex care assist-
ant

 
SUMMARY OF PROVISIONS:

Section 1 sets out applicable definitions.

§ 2. Provides that the state Medicaid director within the New York State
Department of Health establish the program pursuant to this act; sets
out training and certification requirement(s) for a family member to
become a complex care assistant or complex care technical assistant;

establishes rates of pay and provisions for rate increases; and sets out
reporting requirements.

§ 3. Directs the state Medicaid director to adopt rules and regulations
necessary for implementation.

§ 4. Requires the state Medicaid director to apply for all plan amend-
ments and waivers to implement this act and secure federal financial
participation for state Medicaid expenditures.

§ 5. Sets the effective date.

 
JUSTIFICATION:

Since the COVID-19 pandemic, the home health care staffing shortage has
reached crisis levels. Nowhere is this felt more than by parents of
medically fragile children who require a private duty nurse to attend to
their children's daily needs. Currently 50 to 70% of private duty nurs-
ing shifts in the U.S. go unfilled.1

According to the 2019-20 New York State Profile of Children and Youth
with Special Health Care Needs (CYSHCN), defined as "children who have
or are at increased risk for a chronic physical, developmental, behav-
ioral, or emotional condition and who also require health and related
services of a type or amount beyond that required by children general-
ly"2:

Families of CYSHCN face more financial strain and spend more time coor-
dinating their child's care than families without a CYSHCN. One in 10
families with CYSHCN reported spending at least one hour per week coor-
dinating their child's health care. Families of CYSHCN were more likely
to reduce or stop working due to their child's health, have high out-of-
pocket medical expenses, and have problems paying medical bills. Nine-
ty-nine percent of NYS CYSHCN have health insurance coverage all year;
however, families of CYSHCN were less likely to have adequate health
insurance or insurance benefits that meet their child's needs.3

According to a 2019 analysis in Health Affairs,

Parents of chronically ill children are less likely to work more than
twenty hours per week and more likely to participate in casual than in
regular employment compared to parents with otherwise healthy children.
A national survey of family caregivers of children with a rare disease
reported that 52 percent of family members had to go to part-time work
or cut hours, 42 percent took a leave of absence, 31 percent turned down
a promotion, 23 percent lost a job benefit, and 21 percent gave up work-
ing or retired early to meet the care needs of their children.4

Currently, the money allocated by the state for private duty nursing is
not being utilized by providers because of a severe staffing shortage of
private duty nurses. Many parents must leave employment to ensure care
for their children, resulting in even more financial hardship for these
families.

New York's Medicaid program currently permits eligible adults to be
cared for by a family member, but does not permit care of medically
fragile children by a family member. To ensure the safety and quality of
life for such children and their families, it is time for New York State
to allow for family members to be certified and paid to provide this
necessary care.

 
PRIOR LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPLICATIONS:

To be determined.

 
EFFECTIVE DATE:
This act shall take effect immediately.
1 Private Duty Nursing Makes Community Living Possible. Advocacy by The
Arc, May 15, 2023, available at https://thearc.org/blog/private-duty-
nursingmakes-community- living-possible-how-you-can-help/
2 New York State Profile of Children and Youth with Special Health Care
Needs, 2019-2020, available at
https://www.health.ny.gov/community/special_needs/docs/cshcn_profile_201
9-20.pdf
3 Id at 5.
4 Home Health Care For Children With Medical Complexity: Workforce Gaps,
Policy, And Future Directions I Health Affairs, Vol. 3 No. 6, June 2019
, available at
https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05531

2023-S8599 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8599
 
                             I N  S E N A T E
 
                             February 20, 2024
                                ___________
 
 Introduced  by  Sen.  MAYER  -- read twice and ordered printed, and when
   printed to be committed to the Committee on Health
 
 AN ACT relating to complex care assistants and home  care  services  and
   supplementing
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. As used in this act: (a) "family  member"  means  a  child,
 parent,  parent-in-law, sibling, grandparent, grandchild, spouse, domes-
 tic partner, or one partner in a civil union couple, or any other  indi-
 vidual  related  by blood, and any other individual with a close associ-
 ation that is the equivalent of a family relationship; and
   (b) "complex care assistant" means a family member who is certified by
 the department of health after passing an  in-person  examination  which
 tests the proficiency and competence of performing the tasks required to
 care for a medically fragile child which can include, but is not limited
 to,  medication administration, airway clearance therapies, tracheostomy
 care, intravenous line care, ventilator care,  enteral  care  and  other
 tasks  approved by the board of nursing for an individual under 21 years
 of age.
   § 2. (a) No later than one year after the effective date of  this  act
 and  receipt of federal approval for the program established pursuant to
 this act, the state Medicaid director within the  department  of  health
 shall  establish a program under which a family member of an enrollee in
 Medicaid may be certified as a complex care assistant and, after receiv-
 ing such certification may, under the direction of a  registered  nurse,
 provide  complex  care  assistant  services  to  the  enrollee through a
 private duty nursing agency under the  reimbursement  rates  established
 under  subdivision  (d) of this section, provided that the enrollee is a
 medically fragile child as defined in section 4401 of the public  health
 law and qualifies for private duty nursing services under Medicaid. Such
 program  shall operate as a New York Medicaid private duty nursing bene-
 fit. The department shall develop an assessment tool that will allow the
 division to identify enrollees who meet these eligibility criteria read-
 ily.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD13449-03-4
 S. 8599                             2
 
   (b) The program established under this  act  shall  require  a  family
 member to complete all training, testing, and other qualification crite-
 ria  required under state and federal law for certification as a complex
 care assistant. The private duty nursing agency  that  will  employ  the
 family member to provide complex care assistant services to the enrollee
 shall  pay  all  costs  for  the  family member to become certified as a
 complex care assistant and to receive certification as  a  complex  care
 assistant from the department of health, before providing services under
 the  program established pursuant to this act. In no case shall a family
 member who becomes a complex care assistant under the provisions of this
 section be required  to  repay  or  reimburse  the  licensed  home  care
 services  and  certified  private duty nursing agencies for the costs of
 the family member becoming certified as a complex care  assistant  under
 the program.
   (c)  An  individual  certified to practice as a complex care assistant
 must complete a training program and shall pass an in-person examination
 approved by the department that demonstrates the applicant's  competence
 and  proficiency.  Such  training  program  shall include the following:
 medication  administration,  airway  clearance  therapies,  tracheostomy
 care,  intravenous  line  care,  ventilator care, enteral care and other
 tasks approved by the board of nursing for an individual under 21  years
 of age.
   (d)  Complex  care assistant services provided by a family member of a
 Medicaid enrollee who becomes certified  as  a  complex  care  assistant
 under  the  program established pursuant to this act shall be reimbursed
 to a private duty nursing agency at a rate of no  less  than  thirty-six
 dollars  for  complex care assistant services downstate and thirty-three
 dollars upstate. For care assistant high tech services it shall be at  a
 rate  no  less than forty-two dollars downstate and thirty-seven dollars
 upstate.  Cost of living adjustments to such rates shall be reviewed  by
 the  department  bi-annually  and  such rates adjusted accordingly based
 upon any increases to the  United  States  bureau  of  labor  statistics
 consumer price index.
   (e)  The  state Medicaid director, no later than three years after the
 date the program is established under this act, shall prepare and submit
 a report to the governor and the legislature concerning the viability of
 such program and the director's recommendations concerning such program.
   § 3. The state Medicaid director shall adopt rules and regulations  as
 necessary to implement the provisions of this act.
   §  4.  The  state  Medicaid  director  shall apply for such state plan
 amendments or waivers as may be necessary to implement the provisions of
 this act and secure federal financial participation for  state  Medicaid
 expenditures under the federal Medicaid program.
   § 5. This act shall take effect immediately.

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Senate Bill S8599

Sponsored By

Current Bill Status - In Senate Committee Health Committee

co-Sponsors

2023-S8599 (ACTIVE) - Details

2023-S8599 (ACTIVE) - Summary

2023-S8599 (ACTIVE) - Sponsor Memo

2023-S8599 (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S8599

Share this bill

Sponsored By

Shelley B. Mayer

Current Bill Status - In Senate Committee Health Committee

co-Sponsors

Jacob Ashby

Brad Hoylman-Sigal

Daniel G. Stec

2023-S8599 (ACTIVE) - Details

2023-S8599 (ACTIVE) - Summary

2023-S8599 (ACTIVE) - Sponsor Memo

2023-S8599 (ACTIVE) - Bill Text download pdf

Comments