S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    464
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 8, 2025
                                ___________
 
 Introduced  by  M.  of  A.  STECK,  SHIMSKY, SEAWRIGHT, JONES, LUNSFORD,
   BENDETT, RA, REYES -- Multi-Sponsored by -- M. of  A.  WALSH  --  read
   once and referred 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

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

                                                            LBD00675-01-5
 A. 464                              2
 
 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.
   (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.