Legislation Introduced in the 2019 State Legislative Session

2019 State Legislative Session Priority Bills Introduced Â

Payment and Rate Stabilization What: A.7798/S.5915 does two things. First it would result in the development and posting of voluntary benchmark rates that payors (managed care plans, commercial insurance, etc.) would consider to help stabilize rate levels. Secondly, it would provide a 10% trend increase (like a COLA adjustment) to a minority portion of home care rates that are still directly set and reimbursed to providers by the state Medicaid program.

Home Care Rate & Benchmarking Bill

A.7798 (Richard Gottfried) S.5915 (Gustavo Rivera)

Why: Home care rate stabilization is critical at a time when the majority of agencies are operating at a loss, due to lagging reimbursement, with agencies reporting dramatic underpayments at 50% to 70% below costs in some payor categories. The voluntary benchmark rates developed and posted under A.7798/S.5915 would help stabilize, across payor sources, the rate levels for the majority of services that vulnerable New Yorkers rely upon.

This measure would also provide a long overdue trend increase to the portion of Medicaid payments for Certified Home Health Agencies (CHHAs) under the fee-for-service and episodic payment systems (EPS). CHHAs have not had a fee-for-service trend increase in over ten years. Such an increase will support EPS/FFS lines of service for medically intense care that is directly provided by CHHAs, as well as for CHHA care of pediatric patients under age 18.

Workforce

Home Health Aide and Personal Care Aide In-service Training and Tracking

A. 7854 (Richard Gottfried) S.5605 (Gustavo Rivera)

What: Requires trainers to submit to the existing Home Care Registry a record of each in-service training and the hours completed by workers toward the fulfillment of annual in-service training requirements.

Why: This bill, strongly recommended by HCA’s members, supports compliance with in-service training regulations, which are vital to the integrity of patient care. It gives home care employers an efficient and reliable source for determining whether a new hire has fulfilled these requirements, eliminating the administrative burden of tracking down this information from a prior employer. It also avoids unnecessary duplication of administrative and oversight efforts when an aide works for more than one agency at a time, as is often the case in home care.

2019 State Legislative Session Priority Bills Introduced

Home Care/Hospice Worker Shortage Areas and Disciplines

Labor and Market Study for Home Care/Hospice

What: Addresses major geographic and discipline shortages around the state that impact access to home care and hospice services; would allow providers to use funds to address key worker support needs.

A.6768 (Harry Bronson) S.1420 (Susan Serino)

A.6902 (Harry Bronson) S.1359 (Susan Serino)

Why: The urgent labor shortages in home care and hospice jeopardize access to care and are costly to a system where patients need cost-effective home care alternatives to institutions (such as hospitals or ER use) but face delays in admission or start of care because the workforce supply is lacking. Indeed, 38.95 percent of a provider’s case admissions, on average, are delayed or hindered by aide and nurse shortages, with wide variation across the state – a gap that this bill would help address.

What: Authorizes the state Commissioner of Labor to conduct a competitive labor market study assessing and making recommendations for home care and hospice capability to compete in the labor market for recruitment and retention of direct-care staff to meet patient and health system needs. The bill also establishes an interagency state task force to promote the value of home care and hospice occupations and strategies to encourage entrance into the field.

Why: We know anecdotally, as well as from our own polling/surveys, that home care shortages are acute; however, a comprehensive, statistical analysis is crucial for better understanding the labor and shortage patterns that exist in the various regions of the state, as well as the solutions needed to address those shortages, both in terms of wage and non-wage supports.

Promotion of Public Health Improvement, Savings & Reinvestment Home Care Integration in NY's Public Health Prevention Strategies

What: Supports the incorporation of home care in the state's public health, prevention and primary care strategies.

A.3836 (John McDonald) S.1816 (Gustavo Rivera)

Why: This legislation supports home care’s role and promising outcomes as part of the state’s planning and investment in core public health priority areas like asthma, diabetes and cardiac health. In line with state policy goals, the legislation would help position home care more strongly in term of its roles and partnerships, yielding system savings for reinvestment in workforce and infrastructure needs.

2019 State Legislative Session Priority Bills Introduced

What: Creates a new Article 36 section devoted to home care sepsis intervention that would authorize the state Department of Health to provide support for statewide home care sepsis efforts in numerous ways.

Sepsis Prevention

A.3839 (John McDonald) S.1817 (Gustavo Rivera)

Why: This legislation enables home care providers to draw upon existing strengths and assets for battling sepsis, a life-threatening condition which is the cause of a hospitalization every 20 seconds and a top cause of hospital readmissions. New York’s home care system has already pioneered a voluntary sepsis screening tool and algorithm that is now being used by home care nurses in nearly every county of New York State. It is saving lives and health care costs, but more can be done at the state level to foster this program and help support integration of protocols, data and screening encounters.

What: Amends the Geriatric Demonstration Program. Enables Commissioners of OMH and DOH to waive rules and regulations in order to address barriers to collaboration between mental health providers and providers of home care services under the Program.

Mental Health/Home Care Collaboration

A.6566-A (Aileen Gunther) S.3872-A (David Carlucci)

Why: Beyond its medical, therapeutic and community-based support role, home care is especially equipped to address the psychosocial needs of the elder care population by collaborating with mental health providers, combining individual areas of expertise and practice for patients through the geriatric program model that already exists under OMH. HCA has been working closely with OMH on this promising initiative that builds on a series of other collaboration statutes already in motion to strengthen our care for patients struggling not only with medical and supportive needs, but also the critical mental health supports necessary for successful outcomes across all disciplines of care.

What: Addresses health care disparities under the Hospital-Home Care-Physician Collaborative Program.

Health Care Disparities

A.6772 (Crystal PeoplesStokes) S.4742 (James Sanders)

Why: This proposal promotes health, and can save untold health care dollars. Disparities in health are a multibillion-dollar problem, and a condition that the late Rev. Martin Luther King described as “the greatest injustice.”

As a community-based field of practice, home care has unparalleled reach to provide vital medical, social, therapeutic and assistive supports to patients who may not otherwise access the health care system, have unmet needs, receive fragmented or uneven care, or who find themselves accessing the health care system in times of crisis or emergency. Many of the systematic disparities in treatment of hypertension, cancer care, diabetes and numerous other chronic conditions are rooted in cultural, racial, geographic and other demographic factors that home care providers are uniquely equipped to overcome, given their routine access to patients at home and their knowledge of the environmental or social conditions that directly influence care outcomes in the home and neighborhood-level settings.