BILL NUMBER: S328
SPONSOR: RIVERA
 
TITLE OF BILL:
An act to amend the social services law, in relation to removing certain
restrictions on access to home care services; and to repeal certain
provisions of such law relating thereto
 
PURPOSE OR GENERAL IDEA OF BILL:
To repeal limitations on certain eligibility requirements for an indi-
vidual to receive personal care and private duty nursing services under
Medicaid.
 
SUMMARY OF SPECIFIC PROVISIONS:
The bill amends Social Services Law § 365-a and § 365-f to eliminate the
requirement that applicants for Medicaid services in the home have to be
assessed as needing at least limited assistance with physical maneuver-
ing with activities of daily living.
The current law requires an individual to need assistance with three or
more activities of daily living, or for persons with dementia or
Alzheimer's diagnosis, as needing assistance with two or more activities
of daily living.
 
JUSTIFICATION:
Activities of daily living include such tasks as dressing, using the
bathroom, moving about one's home, housekeeping, and meals. Assisting
persons who are elderly or with disabilities so that they may remain in
their homes prevents the higher cost of them entering institutional
care. This bill will restore eligibility criteria for home care services
and consumer directed personal assistance (CDPA) to the form in which it
existed prior to the 2020 legislation. This bill will ensure that New
York continues to comply with federal requirements under the Olmstead
Decision and Community First Choice (CFC). Eligibility criteria for home
care services must remain less stringent than that of nursing homes to
ensure that services in the least restrictive setting are prioritized as
set forth by Olmstead. Additionally, for the State to remain in compli-
ance with CFC, avoid lawsuits, and retain the additional federal funding
from the CFC program, we must eliminate any difference in services
offered based on type of disability.
Though enacted in the SFY 2020-21 budget, the provisions of the statute
were delayed due to requirements under federal COVID aid that prevented
New York from restricting or reducing the Medicaid benefit to enrollees
as a condition of receiving funding. The goal of this legislation is to
allow individuals to continue to receive these needed services in their
homes. For most people, home is the safest, healthiest, and preferred
option. Congregate settings should be the last resort and are typically
much more costly than home care services. This bill will help minimize
institutionalization.
 
PRIOR LEGISLATIVE HISTORY:
2022 - S5028A (Rivera) - Referred to Health
2021 - S5028A (Rivera) - Referred to Health
 
FISCAL IMPLICATIONS:
To be determined. In 2020, the Division of Budget estimated that this
proposal would cost $277 million.
 
EFFECTIVE DATE:
Immediately

Statutes affected:
S328: 365-a social services law, 365-a(2) social services law, 365-f social services law, 365-f(2) social services law