Senate Bill S3055

2021-2022 Legislative Session

Relates to eligibility for medical assistance for personal care services for persons with traumatic brain injury, developmental disability, cognitive impairments, blindness or visual impairment

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Archive: Last Bill Status - In Senate Committee Health 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
Jan 05, 2022	referred to health
Apr 23, 2021	print number 3055a
Apr 23, 2021	amend and recommit to health
Jan 27, 2021	referred to health

Bill Amendments

Original

A (Active)

co-Sponsors

View additional co-sponsors

2021-S3055 - Details

Current Committee:: Senate Health
Law Section:: Social Services Law
Laws Affected:: Amd §§365-a & 365-f, Soc Serv L
Versions Introduced in Other Legislative Sessions:: 2019-2020: S8403
2023-2024: S5470
2025-2026: S1747

2021-S3055 - Summary

Provides eligibility for medical assistance for personal care services for persons with traumatic brain injury, developmental disability, cognitive impairments, blindness or visual impairment.

2021-S3055 - Sponsor Memo

                                
 
BILL NUMBER: S3055               Revised 1/29/2021

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the social services law, in relation to eligibility for
medical assistance for personal care services for persons with traumatic
brain injury, cognitive impairments, developmental disabilities, blind-
ness, or  visual impairment

 
PURPOSE OR GENERAL IDEA OF BILL:

to clarify that provisions protecting eligibility for personal care at
home, afforded to persons with dementia or Alzheimer's in recently
enacted legislation, extends as well to persons with traumatic brain
injury, cognitive impairments, developmental disabilities, blindness or
visual impairment.

 
SUMMARY OF SPECIFIC PROVISIONS:

The bill amends Social Services Law §§ 365-a and 365-f. The law, enacted

as part of the April 2020 budget, now says that a person may receive
Medicaid-funded personal care it the person requires "limited assistance
with physical maneuvering with  
THREE OR MORE activities of daily
living" (ADLs) but that if the person has dementia or Alzheimer's, the
person only requires assistance with two or more ADLs to qualify for
Medicaid personal care. This bill extends that provision to persons with
traumatic brain injury, cognitive impairments, developmental disabili-
ties, blindness, or visual impairment.

 
JUSTIFICATION:

"Activities of daily living" are understood to be eating, bathing,
getting dressed, toileting, mobility, transferring from a laying or
sitting position to standing, and continence care.  Until now, whenever
a Medicaid eligible person has been assessed as requiring assistance
with any of these routine functions, Medicaid provided at least "level-
one" personal care. The actual number of hours of this basic level of
service was determined by an individual assessment. It was often not
even a daily visit, usually 8 hours a week. However, this was enough
support to enable persons to stay in their homes and communities, avoid-
ing accidents, injury, deteriorated health conditions, and institution-
alization.

The hastily enacted 2020-21 budget limits access to Medicaid personal
care to only those who require physical assistance with 3 or more of
these ADLs. Only in the case of dementia or Alzheimer's, could an appli-
cant avoid the near certain diminishing of their health, safety, and
ability to remain at home before Medicaid would come to their aid.

The new law sensibly applies a lower threshold for people with dementia
or Alzheimer's. That lower threshold should similarly apply to patients
with traumatic brain injury, cognitive impairments, developmental disa-
bilities, blindness, or visual impairment.

 
PRIOR LEGISLATIVE HISTORY:

2020: A.10486 - reported to Ways and Means committee.

 
FISCAL IMPLICATIONS:

To be determined.

 
EFFECTIVE DATE:.
Immediately, or at the same time as the amendments to Social Services
Law which are modified by the legislation.

2021-S3055 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3055
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             January 27, 2021
                                ___________
 
 Introduced  by  Sens.  RIVERA,  BIAGGI, GAUGHRAN, HOYLMAN, JACKSON, LIU,
   MAY, MYRIE -- read twice and ordered printed, and when printed  to  be
   committed to the Committee on Health
 
 AN  ACT to amend the social services law, in relation to eligibility for
   medical assistance for personal care services for persons  with  trau-
   matic brain injury, cognitive impairments, developmental disabilities,
   blindness, or  visual impairment
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subparagraph (v) of  paragraph  (e)  of  subdivision  2  of
 section  365-a  of  the  social services law, as added by section 2-a of
 part MM of chapter 56 of the  laws  of  2020,  is  amended  to  read  as
 follows:
   (v)  subject  to  the availability of federal financial participation,
 personal care services other than personal emergency  response  services
 available pursuant to this paragraph shall be available only to individ-
 uals  assessed  as  needing  at  least  limited assistance with physical
 maneuvering with more than two activities of daily living, or for  indi-
 viduals  with a dementia or Alzheimer's diagnosis, TRAUMATIC BRAIN INJU-
 RY, COGNITIVE IMPAIRMENT, DEVELOPMENTAL DISABILITY, BLINDNESS, OR VISUAL
 IMPAIRMENT, assessed as needing at least supervision with more than  one
 activity  of  daily  living,  as  defined  and  determined  by  using an
 evidenced based validated assessment instrument approved by the  commis-
 sioner  and  in  accordance  with  regulations of the department and any
 applicable state and  federal  laws  by  an  independent  assessor.  The
 provisions  of  this  subparagraph  shall  only apply to individuals who
 receive an initial authorization for such services on or  after  October
 first, two thousand twenty;
   §  2.  Paragraph  (c)  of subdivision 2 of section 365-f of the social
 services law, as amended by section 3 of part MM of chapter  56  of  the
 laws of 2020, is amended to read as follows:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD07223-01-1

 S. 3055                             2
 
   (c)  has  been determined by the social services district, pursuant to
 an assessment of the person's appropriateness for the program, conducted
 with an appropriate long term home health care program, a certified home
 health agency, or an AIDS home care program or pursuant to the  personal
 care  program,  as  being  in need of home care services or private duty
 nursing and as needing at least limited assistance with physical  maneu-
 vering  with  more  than  two activities of daily living, or for persons
 with a dementia or Alzheimer's diagnosis, TRAUMATIC BRAIN INJURY, COGNI-
 TIVE IMPAIRMENT, DEVELOPMENTAL DISABILITY, BLINDNESS, OR VISUAL  IMPAIR-
 MENT, ASSESSED as needing at least supervision with more than one activ-
 ity  of daily living, provided that the provisions related to activities
 of daily living in this  paragraph  shall  only  apply  to  persons  who
 initially  seek  eligibility  for the program on or after October first,
 two thousand twenty, and who is able and willing  or  has  a  designated
 representative,  including  a  legal  guardian  able and willing to make
 informed choices, or a designated relative or other adult  who  is  able
 and  willing  to  assist  in making informed choices, as to the type and
 quality of services, including but not limited to such services as nurs-
 ing care, personal care, transportation and respite services; and
   § 3. This act shall take effect October 1, 2021.

co-Sponsors

View additional co-sponsors

2021-S3055A (ACTIVE) - Details

Current Committee:: Senate Health
Law Section:: Social Services Law
Laws Affected:: Amd §§365-a & 365-f, Soc Serv L
Versions Introduced in Other Legislative Sessions:: 2019-2020: S8403
2023-2024: S5470
2025-2026: S1747

2021-S3055A (ACTIVE) - Summary

Provides eligibility for medical assistance for personal care services for persons with traumatic brain injury, developmental disability, cognitive impairments, blindness or visual impairment.

2021-S3055A (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S3055A

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the social services law, in relation to eligibility for
medical assistance for personal care services for persons with traumatic
brain injury, cognitive impairments, developmental disabilities, blind-
ness, or  visual impairment

 
PURPOSE OR GENERAL IDEA OF BILL:

to clarify that provisions protecting eligibility for personal care at
home, afforded to persons with dementia or Alzheimer's in recently
enacted legislation, extends as well to persons with traumatic brain
injury, cognitive impairments, developmental disabilities, blindness or
visual impairment.

 
SUMMARY OF SPECIFIC PROVISIONS:

The bill amends Social Services Law §§ 365-a and 365-f. The law, enacted

as part of the April 2020 budget, now says that a person may receive
Medicaid-funded personal care it the person requires "limited assistance
with physical maneuvering with three or more activities of daily living"
(ADLs) but that if the person has dementia or Alzheimer's, the person
only requires assistance with two or more ADLs to qualify for Medicaid
personal care. This bill extends that provision to persons with traumat-
ic brain injury, cognitive impairments, developmental disabilities,
blindness, or visual impairment.

 
JUSTIFICATION:

"Activities of daily living" are understood to be eating, bathing,
getting dressed, toileting, mobility, transferring from a laying or
sitting position to standing, and continence care. Until now, whenever a
Medicaid eligible person has been assessed as requiring assistance with
any of these routine functions, Medicaid provided at least "levelone"
personal care. The actual number of hours of this basic level of service
was determined by an individual.assessment. It was often not even a
daily visit, usually 8 hours a week. However, this was enough support to
enable persons to stay in their homes and communities, avoiding acci-
dents, injury, deteriorated health conditions, and institutionalization.

The hastily enacted 2020-21 budget limits access to Medicaid personal
care to only those who require physical assistance with 3 or more of
these ADLs. Only in the case of dementia or Alzheimer's, could an appli-
cant avoid the near certain diminishing of their health, safety, and
ability to remain at home before Medicaid would come to their aid. The
new law sensibly applies a lower threshold for people with dementia or
Alzheimer's. That lower threshold should similarly apply to patients
with traumatic brain injury, cognitive impairments, developmental disa-
bilities, blindness, or visual impairment.

 
PRIOR LEGISLATIVE HISTORY:

2020: A.10486 - reported to Ways and Means committee.

 
FISCAL IMPLICATIONS:

To be determined.

 
EFFECTIVE DATE:.
Immediately.

2021-S3055A (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  3055--A
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             January 27, 2021
                                ___________
 
 Introduced  by  Sens.  RIVERA,  BIAGGI, GAUGHRAN, HOYLMAN, JACKSON, LIU,
   MAY, MYRIE -- read twice and ordered printed, and when printed  to  be
   committed  to  the  Committee  on Health -- committee discharged, bill
   amended, ordered reprinted as amended and recommitted to said  commit-
   tee

 AN  ACT to amend the social services law, in relation to eligibility for
   medical assistance for personal care services for persons  with  trau-
   matic brain injury, cognitive impairments, developmental disabilities,
   blindness, or  visual impairment
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subparagraph (v) of  paragraph  (e)  of  subdivision  2  of
 section  365-a  of  the  social services law, as added by section 2-a of
 part MM of chapter 56 of the  laws  of  2020,  is  amended  to  read  as
 follows:
   (v)  subject  to  the availability of federal financial participation,
 personal care services other than personal emergency  response  services
 available pursuant to this paragraph shall be available only to individ-
 uals  assessed  as  needing  at  least  limited assistance with physical
 maneuvering with more than two activities of daily living, or for  indi-
 viduals  with a dementia or Alzheimer's diagnosis, TRAUMATIC BRAIN INJU-
 RY, COGNITIVE IMPAIRMENT, DEVELOPMENTAL DISABILITY, BLINDNESS, OR VISUAL
 IMPAIRMENT, assessed as needing at least supervision with more than  one
 activity  of  daily  living,  as  defined  and  determined  by  using an
 evidenced based validated assessment instrument approved by the  commis-
 sioner  and  in  accordance  with  regulations of the department and any
 applicable state and  federal  laws  by  an  independent  assessor.  The
 provisions  of  this  subparagraph  shall  only apply to individuals who
 receive an initial authorization for such services on or  after  October
 first, two thousand twenty;

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD07223-03-1

 S. 3055--A                          2
 
   §  2.  Paragraph  (c)  of subdivision 2 of section 365-f of the social
 services law, as amended by section 3 of part MM of chapter  56  of  the
 laws of 2020, is amended to read as follows:
   (c)  has  been determined by the social services district, pursuant to
 an assessment of the person's appropriateness for the program, conducted
 with an appropriate long term home health care program, a certified home
 health agency, or an AIDS home care program or pursuant to the  personal
 care  program,  as  being  in need of home care services or private duty
 nursing and as needing at least limited assistance with physical  maneu-
 vering  with  more  than  two activities of daily living, or for persons
 with a dementia or Alzheimer's diagnosis, TRAUMATIC BRAIN INJURY, COGNI-
 TIVE IMPAIRMENT, DEVELOPMENTAL DISABILITY, BLINDNESS, OR VISUAL  IMPAIR-
 MENT, ASSESSED as needing at least supervision with more than one activ-
 ity  of daily living, provided that the provisions related to activities
 of daily living in this  paragraph  shall  only  apply  to  persons  who
 initially  seek  eligibility  for the program on or after October first,
 two thousand twenty, and who is able and willing  or  has  a  designated
 representative,  including  a  legal  guardian  able and willing to make
 informed choices, or a designated relative or other adult  who  is  able
 and  willing  to  assist  in making informed choices, as to the type and
 quality of services, including but not limited to such services as nurs-
 ing care, personal care, transportation and respite services; and
   § 3. This act shall take effect immediately.

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Senate Bill S3055

Sponsored By

Archive: Last Bill Status - In Senate Committee Health Committee

Actions

Bill Amendments

co-Sponsors

2021-S3055 - Details

2021-S3055 - Summary

2021-S3055 - Sponsor Memo

2021-S3055 - Bill Text download pdf

co-Sponsors

2021-S3055A (ACTIVE) - Details

2021-S3055A (ACTIVE) - Summary

2021-S3055A (ACTIVE) - Sponsor Memo

2021-S3055A (ACTIVE) - Bill Text download pdf

Comments

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Sponsored By

Archive: Last Bill Status - In Senate Committee Health Committee

Actions

Bill Amendments

co-Sponsors

2021-S3055 - Details

2021-S3055 - Summary

2021-S3055 - Sponsor Memo

2021-S3055 - Bill Text download pdf

co-Sponsors

2021-S3055A (ACTIVE) - Details

2021-S3055A (ACTIVE) - Summary

2021-S3055A (ACTIVE) - Sponsor Memo

2021-S3055A (ACTIVE) - Bill Text download pdf

Comments