NY State Senate Bill 2019-S9107

Archive: Last Bill Status - In Senate Committee Rules Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Nov 30, 2020	referred to rules

2019-S9107 (ACTIVE) - Details

Current Committee:: Senate Rules
Law Section:: Public Health Law
Laws Affected:: Add §2959-b, amd §2803-c, Pub Health L

2019-S9107 (ACTIVE) - Summary

Establishes a residential care home for people with advanced needs pilot program in the counties of Albany, Schenectady, Saratoga and such other counties as approved by the department; provides that such program shall provide medical, social and residential care to persons afflicted by dementia, significant cognitive disease and/or behavior disturbances as defined by the Diagnostic and Statistical Manual 5 (DSM-5) and other standards as approved by the commissioner.

2019-S9107 (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S9107

SPONSOR: RIVERA
 
PURPOSE OR GENERAL IDEA OF BILL:

To amend the Public Health Law to address the needs of individuals with
behavioral conditions residing at hospitals or those that are unable to
be placed within current long term care facilities, by establishing
physician supervised and live-in registered nurse staffed Residential
Care Homes (RCHs) to care for people with advanced needs.

 
SUMMARY OF PROVISIONS:

Section One: adds a new section 2959-b to Public Health Law to establish
a residential care home pilot program for people with advanced needs in
the counties of Albany, Schenectady, Saratoga and such other counties as
approved by the department. Such pilot program shall provide medical,
social and residential care to persons afflicted by dementia, signif-
icant cognitive disease and/or behavior disturbances as defined by the
Diagnostic and Statistical Manual 5 (DSM-5) other standards as approved
by the commissioner. Such pilot shall:

   *be limited to person with private pay resources absent the avail-
ability and approval by the department of Medicaid funding for such
pilot;
   *demonstrate the ability to improve health care outcomes of persons
through palliative care and the coordination of health care services;
   *provide medical, nursing and residential services;
   *demonstrate the ability to assist residents with severe cognitive
and behavioral dysfunction consistent with their diagnosis;
   *be limited to no more than ten residents per site together with two
flexible adult daycare persons;
   *have an operator who shall be responsible for the care and safety of
persons in such pilot program;
   *have a physician who shall be responsible for oversight and super-
vision of the operator of each site, staff and persons residing at such
site; home; and
   *have entered into a memorandum of understanding with regional
hospital(s) and skilled nursing facilities for patient transfer and
care;

Paragraph 2 authorizes the Commissioner to approve, inspect and super-
vise facilities eligible to participate in the pilot program.

Paragraph 3 provides authority for the Commissioner to enable medical
assistance as payment for the pilot model and to seek federal financial
participation for such assistance.

Paragraph 4 provides authority for the Commissioner to waive, modify or
suspend provisions of rules and regulations promulgated if necessary for
the successful implementation of the program.

Paragraph 5 provides for annual reporting requirements of the program to
both the Governor and the Legislature.

Section Two: amends Section 2803-c of public health law to provide for
patient care rights and responsibilities for those involved in the pilot
program.

Section Three: This act shall be effective immediately and shall expire
and be deemed repealed December 31, 2024.

 
JUSTIFICATION:

This legislation recognizes the new paradigm of healthcare that is crit-
ically needed for our communities and our State. This new model of care
establishing Residential Care Homes (RCH), will serve as a safety net
for this new class of seniors who lack suitable living options for the
care they need. There exists a critical gap in New York State's long
term care system for the terminally ill patients afflicted by dementia
with behavior disturbances. The severity of this gap is reflected in the
many dementia patients who are retained in hospitals statewide -as
hospital residents- due to inability to be placed in any assisted living
facilities, private homes, or nursing homes.

Seniors afflicted with dementia (Alzheimer's, Lewy body, frontotemporal,
or vascular) frequently experience a phase in their disease in which
undesirable behaviors are exhibited such as hyper sexuality, disrobing,
agitation, elopement, or aggression (verbal or physical); all due to the
confusion, delusions and hallucinations from the degenerating neurons.
When patients manifest these behaviors, they are prohibited from being
admitted or retained in assisted living facilities. Although legally
allowed, it is challenging for nursing homes to accept these individ-
uals. This is due to the labor intensive need of a dedicated staff (1:1
staff to resident), the use of antipsychotic medications for management,
and the confusing effect an institutional setting can have at this stage
in dementia.

About 70 percent of American nursing homes are for profit. The most
lucrative patients are those on short-term rehabilitation stints paid
for by private insurers or Medicare, the federal program that insures
seniors and people with disabilities. Poor people on longer-term stays
are covered by Medicaid, which reimburses nursing homes at a much lower
rate than Medicare. The financial incentive to have more Medicare or
privately insured patients, and fewer on Medicaid, becomes more
pronounced when the Medicaid patients have illnesses, like dementia,
that require extra care from staff. Disruptive behavior symptoms occur
at the moderate to advanced stages of dementia. These behaviors occur
due to miscuing of daily events by the degenerating brain. Instead of
placement in a proper setting, these residents are sent out to the local
emergency rooms and many times prohibited from returning to their previ-
ous residence. . This creates havoc for the dying patients, distressed
families and financial ruin for families and hospitals. Ambulance trans-
port and chaotic emergency rooms only add further confusion and
agitation to these patients.

Facing placement challenges in New York, hospital case managers typical-
ly end up placing patients out of New York State to the neighboring
states such as Vermont, Massachusetts, Connecticut, Pennsylvania, etc,
to receive care under a different set of department of health regu-
lations. This practice of turfing patients out of New York State for
long term care creates further trauma and anguish to the dying patients
and their families. The mere fact that this is occurring on a daily
basis is a direct reflection of flaws in New York's long term care
system. With the projected increase in the number of seniors with demen-
tia such as Alzheimer's disease and other degenerative neurological
diseases such as Parkinson's, the crisis will only worsen.
 
PRIOR LEGISLATIVE HISTORY:

This is a new bill

 
FISCAL IMPACT:

None.

 
EFFECTIVE DATE:
This act shall take effect immediately and shall expire and be deemed
repealed December 31, 2024.

2019-S9107 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9107
 
                             I N  S E N A T E
 
                             November 30, 2020
                                ___________
 
 Introduced  by  Sen.  RIVERA -- read twice and ordered printed, and when
   printed to be committed to the Committee on Rules
 
 AN ACT to amend the public health law, in  relation  to  establishing  a
   residential  care  home  for people with advanced needs pilot program;
   and providing for the repeal of such provisions  upon  the  expiration
   thereof

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. The public health law is amended by adding  a  new  section
 2959-b to read as follows:
   §  2959-B.  RESIDENTIAL CARE HOME FOR PEOPLE WITH ADVANCED NEEDS PILOT
 PROGRAM. 1. THE COMMISSIONER SHALL ESTABLISH  A  RESIDENTIAL  CARE  HOME
 PILOT  PROGRAM FOR PEOPLE WITH ADVANCED NEEDS IN THE COUNTIES OF ALBANY,
 SCHENECTADY, SARATOGA AND SUCH OTHER COUNTIES AS APPROVED BY THE DEPART-
 MENT. SUCH PILOT PROGRAM SHALL PROVIDE MEDICAL, SOCIAL  AND  RESIDENTIAL
 CARE  TO  PERSONS  AFFLICTED  BY DEMENTIA, SIGNIFICANT COGNITIVE DISEASE
 AND/OR BEHAVIOR DISTURBANCES AS DEFINED BY THE  DIAGNOSTIC  AND  STATIS-
 TICAL  MANUAL  5  (DSM-5) AND OTHER STANDARDS AS APPROVED BY THE COMMIS-
 SIONER. SUCH PILOT PROGRAM SHALL:
   (A) BE LIMITED TO PERSONS WITH PRIVATE PAY RESOURCES ABSENT THE AVAIL-
 ABILITY AND APPROVAL BY THE DEPARTMENT  OF  MEDICAID  FUNDING  FOR  SUCH
 PILOT PROGRAM;
   (B) DEMONSTRATE THE ABILITY TO IMPROVE HEALTH CARE OUTCOMES OF PERSONS
 THROUGH PALLIATIVE CARE AND THE COORDINATION OF HEALTH CARE SERVICES;
   (C) PROVIDE MEDICAL, NURSING AND RESIDENTIAL SERVICES;
   (D)  DEMONSTRATE THE ABILITY TO ASSIST RESIDENTS WITH SEVERE COGNITIVE
 AND BEHAVIORAL DYSFUNCTION CONSISTENT WITH THEIR DIAGNOSIS;
   (E) BE LIMITED TO NO MORE THAN TEN RESIDENTS PER  SITE  TOGETHER  WITH
 TWO FLEXIBLE ADULT DAYCARE PERSONS;
   (F)  HAVE AN OPERATOR WHO SHALL BE RESPONSIBLE FOR THE CARE AND SAFETY
 OF PERSONS IN SUCH PILOT PROGRAM;
   (G) HAVE A PHYSICIAN WHO SHALL BE RESPONSIBLE FOR OVERSIGHT AND SUPER-
 VISION OF THE OPERATOR OF EACH SITE, STAFF AND PERSONS RESIDING AT  SUCH
 SITE; AND
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets

                       [ ] is old law to be omitted.
                                                            LBD17656-01-0

 S. 9107                             2
 
   (H)  HAVE  ENTERED  INTO  A  MEMORANDUM OF UNDERSTANDING WITH REGIONAL
 HOSPITALS AND SKILLED NURSING FACILITIES FOR PATIENT TRANSFER AND CARE.
   2.  THE  COMMISSIONER  SHALL BE RESPONSIBLE FOR APPROVING, INSPECTING,
 AND SUPERVISING FACILITIES UNDER THIS SECTION.
   3. THE COMMISSIONER SHALL, TO THE EXTENT NECESSARY FOR THE PURPOSE  OF
 THIS  SECTION,  SUBMIT  THE  APPROPRIATE WAIVERS AND OTHER APPLICATIONS,
 INCLUDING, BUT NOT LIMITED TO, THOSE  AUTHORIZED  PURSUANT  TO  SECTIONS
 ELEVEN  HUNDRED  FIFTEEN  AND  NINETEEN  HUNDRED  FIFTEEN OF THE FEDERAL
 SOCIAL SECURITY ACT, OR SUCCESSOR PROVISIONS, AND ANY OTHER  WAIVERS  OR
 APPLICATIONS  NECESSARY  TO  ACHIEVE THE PURPOSES OF HIGH QUALITY, INTE-
 GRATED, AND COST EFFECTIVE CARE  AND  INTEGRATED  FINANCIAL  ELIGIBILITY
 POLICIES  UNDER  MEDICAID,  FAMILY  HEALTH PLUS AND CHILD HEALTH PLUS OR
 MEDICARE. COPIES OF SUCH ORIGINAL WAIVER AND OTHER APPLICATIONS SHALL BE
 PROVIDED TO THE CHAIRMAN OF THE SENATE FINANCE COMMITTEE AND THE  CHAIR-
 MAN  OF  THE ASSEMBLY WAYS AND MEANS COMMITTEE SIMULTANEOUSLY WITH THEIR
 SUBMISSION TO THE FEDERAL GOVERNMENT.
   4. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW TO THE  CONTRARY,
 THE   COMMISSIONER  IS  AUTHORIZED  TO  WAIVE,  MODIFY  OR  SUSPEND  THE
 PROVISIONS OF RULES AND  REGULATIONS  PROMULGATED  PURSUANT  TO  ARTICLE
 TWENTY-EIGHT  OF  THIS  CHAPTER IF THE COMMISSIONER DETERMINES THAT SUCH
 WAIVER, MODIFICATION OR  SUSPENSION  IS  NECESSARY  FOR  THE  SUCCESSFUL
 IMPLEMENTING OF THE RESIDENTIAL CARE HOME FOR PEOPLE WITH ADVANCED NEEDS
 PILOT  PROGRAM AUTHORIZED PURSUANT TO THIS SECTION AND PROVIDED THAT THE
 COMMISSIONER DETERMINES THAT THE HEALTH, SAFETY AND GENERAL  WELFARE  OF
 PEOPLE  RECEIVING  HEALTH  CARE  UNDER  SUCH  PILOT  PROGRAM WILL NOT BE
 IMPAIRED AS A RESULT OF SUCH WAIVER, MODIFICATION, OR SUSPENSION.
   5. TWELVE MONTHS AFTER THE APPROVAL OF THE RESIDENTIAL CARE  HOME  FOR
 PEOPLE  WITH  ADVANCED NEEDS PILOT PROGRAM, AND ANNUALLY THEREAFTER, THE
 PROGRAM SHALL REPORT TO THE COMMISSIONER ON THE PROGRESS OF THE PROGRAM.
 THE COMMISSIONER SHALL EVALUATE THE FINDINGS OF THE STUDY AND REPORT  TO
 THE  GOVERNOR, THE TEMPORARY PRESIDENT OF THE SENATE, THE SPEAKER OF THE
 ASSEMBLY, THE CHAIR OF THE SENATE STANDING COMMITTEE ON HEALTH  AND  THE
 CHAIR OF THE ASSEMBLY HEALTH COMMITTEE.
   §  2. Subdivision 2 and paragraph l of subdivision 3 of section 2803-c
 of the public health law, subdivision 2 as amended by chapter 186 of the
 laws of 1979 and paragraph 1 of subdivision 3 as amended by chapter  270
 of the laws of 2011, is amended to read as follows:
   2. The commissioner shall require that every nursing home and facility
 providing  health  related  service,  as  defined in subdivision two and
 paragraph (b) of subdivision four of section twenty-eight hundred one of
 this article OR ANY PILOT PROGRAM  APPROVED  UNDER  SECTION  TWENTY-NINE
 HUNDRED  FIFTY-NINE-B  OF  THIS  CHAPTER,  shall adopt and make public a
 statement of the rights and responsibilities of  the  patients  who  are
 receiving  care  in  such  facilities,  and shall treat such patients in
 accordance with the provisions of such statement.
   l. Pursuant to regulations promulgated by the commissioner, no facili-
 ty or individual and no  general  hospital  providing  medical  care  to
 persons  having  been  admitted  from such facilities or from adult care
 facilities covered by the provisions of section four hundred sixty-one-b
 of the social services law, or to applicants  for  readmission  to  such
 facilities  or  to  adult  care  facilities covered by the provisions of
 section four hundred sixty-one-b of the social services law OR  INDIVID-
 UALS  ADMITTED TO A RESIDENTIAL CARE HOME FOR PEOPLE WITH ADVANCED NEEDS
 APPROVED UNDER SECTION TWENTY-NINE HUNDRED FIFTY-NINE-B OF THIS CHAPTER,
 shall restrict or prohibit the access to the facility or general  hospi-
 tal nor interfere with the performance of the official duties, including

 S. 9107                             3

 confidential  visits  with residents, of duly designated persons partic-
 ipating in the long term care  ombudsman  program  as  provided  for  in
 section two hundred eighteen of the elder law.
   §  3.  This act shall be effective immediately and shall expire and be
 deemed repealed December 31, 2024.

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Senate Bill S9107

Sponsored By

Archive: Last Bill Status - In Senate Committee Rules Committee

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2019-S9107 (ACTIVE) - Details

2019-S9107 (ACTIVE) - Summary

2019-S9107 (ACTIVE) - Sponsor Memo

2019-S9107 (ACTIVE) - Bill Text download pdf

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Sponsored By

Gustavo Rivera

Archive: Last Bill Status - In Senate Committee Rules Committee

Actions

2019-S9107 (ACTIVE) - Details

2019-S9107 (ACTIVE) - Summary

2019-S9107 (ACTIVE) - Sponsor Memo

2019-S9107 (ACTIVE) - Bill Text download pdf

Comments