BILL NUMBER: S5060A

SPONSOR: VALESKY
 
TITLE OF BILL:  An act to amend the public health law, in relation to
home care aides

 
PURPOSE:

To extend the wage parity law to apply to workers who are employed under
the Consumer Directed Personal Assistance Program

 
SUMMARY OF PROVISIONS:

Section one of the bill amends paragraph d of subdivision 1 of section
3614-c of the public health law, as amended by chapter 56 of the laws of
2016 to provide that for purposes of this section, that nothing in this
paragraph shall be construed to exclude individuals who are employed
under the consumer directed personal assistance program.

 
JUSTIFICATION:
              

Most individuals receiving home care in the State through Medicaid are
signed up with a home care agency. The agency has licensed home care
staff that will go to the consumer's home to provide services. An
increasing number of Medicaid recipients now receive their homecare
services through another model, the Consumer Directed Personal Assist-
ance Program (CDPAP). In this model, Medicaid patients are expected to
hire home health aides directly, while using the assistance of a Fiscal
Intermediary (FI) that will take care of the paperwork for payroll and
billing. Consumers are allowed to hire blood relations as their home
health aides under this program.  Workers are exempted from licensing
requirements.

In 2011, the state passed the Wage Parity Law, which requires that
organizations providing aide services paid for by Medicaid in New York
City, Long Island, and Westchester to compensate home health aides using
the living wage of New York City in order to create wage parity with
home care attendants who provide services and supports to Medicaid
clients residing in these counties. This law specifically excludes aides
that are related by blood or adoption to the customer of services. The
law was silent on other individuals hired under the CDPAP model but in
2012 the Department of Health (DOH) declared that workers hired under
the CDPAP model were not covered by the Wage Parity Act. 2011 was also
the year when the Medicaid redesigned team's proposal that all long term
home care services be provided through a managed care system was insti-
tuted into law.

The fact that workers under the CDPAP system are exempted from the Wage
Parity Act has created a number of perverse outcomes. The workers them-
selves face low wages and often receive no benefits. The lower wages for
these workers have given managed care companies an incentive to push as
many people as possible to use the CDPAP model, even for consumers for
whom it might not be the best. It has also given managed care companies
an excuse to cut rates to CDPAP providers. The fact that neither workers
nor FI's need to be licensed has created a system in which the quality
of services and the integrity of the system are being challenged. For
this reason, the IDC believes that we must reverse DOH's action and
ensure that the provisions of the Wage Parity Act apply to home care
workers hired through CDPAP. The IDC will also examine steps to ensure
the quality of services and the integrity of the home care system by
supporting licensing of FI's.

 
LEGISLATIVE HISTORY:

New Bill

 
FISCAL IMPLICATIONS:

To be determined.

 
EFFECTIVE DATE:
This act shall take effect immediately.