Assembly Bill A11170A

                                BILL NUMBER:A11170

TITLE  OF BILL:  An act to amend the public health law, in relation to
state  reimbursement  for   public   health   services   provided   by
municipalities

PURPOSE  OR  GENERAL  IDEA OF BILL: To ensure that counties which have
been providing  home  health  and  hospices  services  pursuant  to  a
state-approved  public  health  plan  are not subject to the arbitrary
abdication of state aid  by  administrative  action,  which  has  been
proposed in circumvention of the Legislature.

SUMMARY  OF  SPECIFIC  PROVISIONS: This bill amends section 605 of the
public  health  law  to  prevent  the  Commissioner  of  Health   from
eliminating  through  regulation  or administrative action funding for
home  health,  hospice  and  other  public  health  services  that   a
municipality has been provided under an approved plan.

JUSTIFICATION:  The  state  Department  of  Health  has  submitted two
proposed rules in the May 5, 2010 New York State Registry -- one would
eliminate Article 6 funding for home health agency services  delivered
by  municipalities  when  there  is  another home care provider in the
county, and the other that  would  eliminate  Article  6  funding  for
hospice and various other services.

Last  year  when the Department made a similar proposal legislatively,
              

it was soundly rejected by the Legislature,  for  the  reasons  stated
below.  Now  the  Department has moved to circumvent the intent of and
involvement of the Legislature by using the regulatory  process  in  a
manner  that  would  abdicate the state's commitment to counties under
Article 6 of the public health law.

Not only  does  this  action  seek  to  contradict  the  will  of  the
Legislature,  but it would be irreparably damaging to the local public
health  infrastructure  in  the  state.  There  is  reason   why   the
Legislature  through  Article  6 has made, and maintained, the state's
commitment to public health.

For many areas of the state, county-sponsored home care  agencies  are
the  safety  net  of  the  service  delivery  system.  Even when these
agencies are not the sole community provider in the county,  they  are
the  safety  net-  assuring  that  the  home  care  needs  of the most
difficult and chronic cases in the community arc met.

In addition to providing crucial  rehabilitative  and  life-sustaining
care  at  home to the elderly and disabled in these communities, these
agencies are the source of viral  public  health  services,  including
urgent  responses  to  epidemics  such  as  the  H1N1,  flu  and other
immunization needs,  preventive  health  screening  and  intervention,
maternal   and  child  health  care,  emergency  response  in  natural
disasters, and other services.

These agencies arc pivotal to the functioning  of  the  entire  health
system  in their communities, providing safe and appropriate care upon
hospital discharge, permitting more appropriate and cost-effective use
of hospital and nursing home  services,  enabling  patients  to  avoid
premature  or  unnecessary  nursing  home placement, reducing rates of


hospitalization  and  rehospitalization  among  the  post  acute   and
chronically  ill,  and  providing  and  coordinating  home care in all
corners  of  their  region,  undeterred   by,   mountainous   terrain,
navigating  to homes situation on islands or other geographic barriers
or distances. Without these agencies  supporting  the  functioning  of
their  entire health care system, the system would freeze and costs to
the state and other payors would  increase.    A  financial  condition
study of the home care system in New York State, published in January,
showed  that the compounding pressures of Medicaid underpayment, state
budget cuts, the behavior of managed care plans, unfunded mandates and
other system issues have taken an enormous  toll  on  county-sponsored
home  care  services  -  which  are  already  challenged  by  resource
limitations, staffing and geographic conditions.

Even before the enactment of a cumulative $300 million in state budget
cuts to home care since April 2008, these factors were causing over 75
percent of county home health agencies to experience operating losses,
and the trend is worsening, compounded by the onset  of  these  recent
cuts.  The loss of Article 6 aid will likely cause the closure of many
certified home health agencies  and/or  long  term  home  health  care
programs  and  adversely affect the entire health care delivery system
in these communities.

This legislation is necessary to  prevent  the  circumvention  of  the
Legislature  and  the  irreparable  harm  to  New York's public health
system.

PRIOR LEGISLATIVE HISTORY: New bill.

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE: The bill would take effect April 1, 2010.