Relates to payments under managed long term care plans for home care services; requires certain funds to pass through directly to subcontracting agency and requires payments to reflect increased transportation costs.

---

S7141-2011 Actions

• May 1, 2012: REFERRED TO HEALTH

S7141-2011 Memo

BILL NUMBER:S7141

TITLE OF BILL:
An act to amend the public health law, in relation to payments under
managed long term care plans for home care services

PURPOSE:
To ensure that monies paid by managed long term care programs (insurers
providing long term care) include adequate reimbursement to ensure
compliance with State wage mandates, adjustments for increased fuel
costs, and provide for the pass through of worker recruitment and
retention monies in payments to agencies that employ direct care workers
in the home care industry.

SUMMARY OF PROVISIONS:
Section one of the bill adds a new subdivision 12 to section 4403-f of
the public health law to ensure adequacy of payment for compliance with
State wage mandates, pass through for escalating fuel costs, and worker
recruitment and retention monies to agencies certified and licensed
under article thirty six of the public health law providing direct care
services to disabled, elderly and other populations.

Section 2 of the bill is the effective date.

STATEMENT IN SUPPORT:
Home care providers are in severe financial distress. Recent cuts and
unfunded mandates have hampered agencies' ability to continue delivering
care to New York's elderly, disabled and chronically-ill and have put
home care jobs at risk.

At the same time, recent changes in State law have resulted in a shift
from fee-for-service to managed care for the provision of home and
community-based services. As a result, rather than working directly with
the State to obtain reimbursement, home care providers are now working
with managed care and managed long term plans. Similar to other health
insurance companies, it is critical that the State monitor and ensure
adequate reimbursement to providers from managed care and managed long
term care plans to ensure high quality care is provided to the State's
elderly, disabled and other populations. Absent such actions, New York's
home care industry, which has lead the nation in providing high quality
and cost-effective care to the state's elderly, disabled and other popu-
lations for several decades, is at risk.

This legislation seeks to ensure that agencies have the necessary
resources to meet State and local wage mandates. In addition, the legis-
lation seeks to ensure that worker recruitment and retention monies are
passed through from insurance plans to the agencies that directly employ
the workers and deliver the care.

In addition, agencies and workers must receive an adjustment in
reimbursement for the ever-increasing costs of transportation, whether

this involves increased MTA fares, bus fares in suburban and urban
areas, as well as the ever-escalating cost of gasoline for workers that
drive sometimes hundreds of miles a day to deliver care.  While overall
driving costs increased over 3% according to the AAA in 2011, the costs
of gasoline have risen almost $2 per gallon since 2009.

Rates of payments to agencies and their workers must incorporate monies
to ensure compliance with State and local wage mandates, ensure State
recruitment and retention funds get to the workers, and recognize the
escalating costs of transportation.

FISCAL IMPLICATIONS:
None.

LEGISLATIVE HISTORY:
This is a new bill.

EFFECTIVE DATE:
Immediately.

S7141-2011 Text

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

                                    7141

                              I N  SENATE

                                 May 1, 2012
                                 ___________

  Introduced  by  Sen. MAZIARZ -- 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  payments  under
    managed long term care plans for home care services

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


    Section 1. Section 4403-f of the  public  health  law  is  amended  by
  adding a new subdivision 12 to read as follows:

    12.  PAYMENTS  TO  THOSE  AGENCIES  CERTIFIED AND LICENSED PURSUANT TO
  ARTICLE THIRTY-SIX OF THIS CHAPTER PROVIDING DIRECT CARE SERVICES TO THE
  ENROLLED POPULATION SHALL BE REASONABLY RELATED TO THE COST OF PROVIDING
  EFFICIENT, CONSISTENT AND HIGH QUALITY SERVICES REQUIRED BY THE PLAN  OF
  CARE  AND  SHALL, IN ADDITION, INCORPORATE THE AMOUNT OF ANY LABOR COSTS
  ATTRIBUTABLE TO SECTION THIRTY-SIX HUNDRED FOURTEEN-C  OF  THIS  CHAPTER
  AND  ANY  RECRUITMENT  AND  RETENTION  FUNDS  MADE AVAILABLE PURSUANT TO
  SECTION THIRTY-SIX HUNDRED FOURTEEN OF THIS CHAPTER;  PROVIDED  FURTHER,
  SUCH  AMOUNTS  SHALL  BE PASSED DIRECTLY THROUGH TO THE AGENCY PROVIDING
  SUCH DIRECT CARE SERVICES IF SUCH SERVICES ARE SUBCONTRACTED.  IN  ADDI-
  TION,  SUCH PAYMENTS SHALL REFLECT AND ADJUST ANNUALLY FOR ANY INCREASED
  COSTS OF THE TRANSPORTATION OF DIRECT CARE WORKERS TO AND FROM PATIENTS'
  RESIDENCES RELATED TO INCREASED  FUEL  COSTS  AND/OR  TRANSPORTATION  AS
  REPORTED BY THE NEW YORK STATE ENERGY RESEARCH AND DEVELOPMENT AUTHORITY
  AND THE METROPOLITAN TRANSPORTATION AUTHORITY.
    S  2. This act shall take effect immediately; provided that the amend-
  ments to 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 expire
  and be deemed repealed therewith.



   EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                        [ ] is old law to be omitted.
                                                             LBD15589-01-2