Senate Bill S7916B

                                 BILL NUMBER:  S7916

 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 are 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 vital public health services, including
urgent responses to epidemics such as the HINI, 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 are 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 re-hospitalization 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.

                                BILL NUMBER:S7916A

TITLE OF BILL:  An act to amend the public health law, in relation to
state reimbursement for public health services provided by munici-
palities and to the incorporation of home health and hospices services
within municipal public health services plans

PURPOSE OR GENERAL IDEA OF BILL:  To explicitly reference home health
and hospice services among the services in article 6 of the public
health law, so as to continue for counties their qualification for state
reimbursement pursuant to state-approved municipal public health plans.

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.

This bill amends also section 602 of the public health law to add home
health and hospice services provided by a municipality that is a Certi-
fied Home Health Agency, a Long Term Home Health Care Program or a
Hospice, to the list of services in municipal public health plans quali-
fying for article 6 reimbursement upon state approval of the municipal
plan.

JUSTIFICATION:  For many areas of the state, county-sponsored home care
              

agencies are the safety net of the service delivery system - assuring
that the home care needs of the most difficult and chronic cases in the
community are 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 vital 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 are 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 prema-
ture or unnecessary nursing home placement, reducing rates of hospitali-
zation 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 situated on
islands or other geographic barriers or distances. Without these agen-
cies 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.

A discontinuation of these services under Article 6 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 deliv-
ery system in these communities. This legislation is necessary to ensure
that continuation.

PRIOR LEGISLATIVE HISTORY:  New bill.

FISCAL IMPLICATIONS:  No additional State expense.

Funding for article 6 services is provided in the State health appropri-
ations bill (S.6604-E/A,9704-C) passed in June. This legislation would
move county-sponsored home health and hospice services from the regula-
tory definition, the amendments to which would discontinue them under
article 6, to the statutory list of municipal public health services
qualifying for reimbursement. As such, counties would continue to quali-
fy for article 6 home health and hospice reimbursement under the exist-
ing appropriation.

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