S T A T E O F N E W Y O R K
________________________________________________________________________
5020--A
2023-2024 Regular Sessions
I N S E N A T E
February 21, 2023
___________
Introduced by Sens. COMRIE, ADDABBO, BRESLIN, CLEARE, MARTINEZ, SALAZAR,
SANDERS, SCARCELLA-SPANTON, SEPULVEDA -- read twice and ordered print-
ed, and when printed to be committed to the Committee on Health --
committee discharged, bill amended, ordered reprinted as amended and
recommitted to said committee
AN ACT to amend the social services law, in relation to certain authori-
zations to fiscal intermediaries; and to repeal certain provisions of
such law relating thereto
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Paragraph (b) of subdivision 4-a of section 365-f of the
social services law, as amended by section 4 of part G of chapter 57 of
the laws of 2019, subparagraph (vi) as amended by section 1 of part LL
of chapter 57 of the laws of 2021, is amended to read as follows:
(b) [Notwithstanding any inconsistent provision of section one hundred
sixty-three of the state finance law, or section one hundred forty-two
of the economic development law the commissioner shall enter into
contracts under this subdivision with eligible contractors that submit
an offer for a contract, provided, however, that:
(i) the department shall post on its website:
(A) a description of the proposed services to be provided pursuant to
contracts in accordance with this subdivision;
(B) that the selection of contractors shall be based on criteria
reasonably related to the contractors' ability to provide fiscal inter-
mediary services including but not limited to: ability to appropriately
serve individuals participating in the program, geographic distribution
that would ensure access in rural and underserved areas, demonstrated
cultural and language competencies specific to the population of consum-
ers and those of the available workforce, ability to provide timely
consumer assistance, experience serving individuals with disabilities,
the availability of consumer peer support, and demonstrated compliance
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD09732-02-3
S. 5020--A 2
with all applicable federal and state laws and regulations, including
but not limited to those relating to wages and labor;
(C) the manner by which prospective contractors may seek such
selection, which may include submission by electronic means;
(ii) all reasonable and responsive offers that are received from
prospective contractors in timely fashion shall be reviewed by the
commissioner;
(iii) the commissioner shall award such contracts to the contractors
that best meet the criteria for selection and are best suited to serve
the purposes of this section and the needs of consumers;
(iv) all entities providing fiscal intermediary services on or before
April first, two thousand nineteen, shall submit an offer for a contract
under this section within sixty days after the commissioner publishes
the initial offer on the department's website. Such entities shall be
deemed authorized to provide such services unless: (A) the entity fails
to submit an offer for a contract under this section within the sixty
days; or (B) the entity's offer for a contract under this section is
denied;
(v) all decisions made and approaches taken pursuant to this paragraph
shall be documented in a procurement record as defined in section one
hundred sixty-three of the state finance law; and
(vi) the commissioner is authorized to either reoffer contracts or
utilize the previous offer, to ensure that all provisions of this
section are met.] THE COMMISSIONER SHALL PROVIDE AUTHORIZATIONS UNDER
THIS SUBDIVISION TO ALL FISCAL INTERMEDIARIES THAT TIMELY SUBMIT A
REQUEST FOR AUTHORIZATION PRIOR TO JANUARY FIRST, TWO THOUSAND TWENTY-
FOUR, AND MEET THE REQUIREMENTS OF THIS SECTION. NO ENTITY SHALL
PROVIDE, DIRECTLY OR THROUGH CONTRACT, FISCAL INTERMEDIARY SERVICES
WITHOUT HAVING RECEIVED AN AUTHORIZATION AS A FISCAL INTERMEDIARY ISSUED
BY THE COMMISSIONER IN ACCORDANCE WITH THIS SUBDIVISION, OR THAT HAS A
PENDING AUTHORIZATION TIMELY SUBMITTED AND CURRENTLY IN PROCESSING,
REVIEW, APPEAL, OR LEGAL CHALLENGE.
(I) AN APPLICATION FOR AUTHORIZATION AS A FISCAL INTERMEDIARY SHALL BE
FILED WITH THE COMMISSIONER, TOGETHER WITH SUCH OTHER FORMS AND INFORMA-
TION AS SHALL BE PRESCRIBED BY, OR ACCEPTABLE TO THE COMMISSIONER. SUCH
INFORMATION SHALL CONSIST OF THE FOLLOWING:
(A) THE NAME AND EMPLOYER IDENTIFICATION NUMBER, OF THE ENTITY,
INCLUDING ANY SUBSIDIARY CORPORATIONS, IF APPLICABLE, AND ANY NAME
UNDER WHICH THE ENTITY DOES BUSINESS;
(B) ALL ADDRESSES AT WHICH THE ORGANIZATION OPERATES;
(C) THE NAMES, TITLES AND CONTACT INFORMATION OF ALL OFFICERS AND
DIRECTORS IN A NOT-FOR-PROFIT COMPANY OR BUSINESS, OR MANAGERS IN A
LIMITED LIABILITY COMPANY, AS WELL AS THE NAME AND EMPLOYMENT HISTORY OF
THE INDIVIDUAL ULTIMATELY ACCOUNTABLE FOR OPERATION OF THE FISCAL INTER-
MEDIARY; AND FOR A NOT-FOR-PROFIT ENTITY, THE NUMBER OF DIRECTOR POSI-
TIONS SET BY THE COMPANY'S BY-LAWS, AND HOW MANY ARE CURRENTLY FILLED;
(D) A HISTORY OF THE ORGANIZATION, ALONG WITH AN OVERVIEW OF THE
ORGANIZATION AND ALL SERVICES IT OFFERS, INCLUDING ANY RELATIONSHIPS
WITH OUTSIDE AGENCIES THAT MAY INFLUENCE IN ANY WAY THE ABILITY OF THE
ORGANIZATION TO PROVIDE FISCAL INTERMEDIARY SERVICES CONSISTENT WITH THE
MANNER DESCRIBED IN ITS APPLICATION;
(E) ALL POLICIES AND PROCEDURES OF THE FISCAL INTERMEDIARY, INCLUDING
ANY CONTRACTS OR OTHER DOCUMENTS USED IN COMMUNICATIONS WITH CONSUMERS;
(F) PLANS TO SOLICIT AND CONSIDER INPUT FROM THE FISCAL INTERMEDIARY'S
CONSUMERS, STAFF, PERSONAL ASSISTANTS AND OTHER INTERESTED PARTIES WHICH
MAY BE CHARGED WITH ROLES INCLUDING, BUT NOT LIMITED TO, QUALITY ASSUR-
S. 5020--A 3
ANCE REVIEW, REFERRAL, PROGRAM MONITORING OR DEVELOPMENT OR ESTABLISHING
AND RESPONDING TO COMMUNITY NEEDS; SUCH INPUT MAY BE IN THE FORM OF A
BOARD OF DIRECTORS, COMMITTEE, SURVEY, OR OTHER MECHANISM, PROVIDED THAT
THE MAJORITY OF INPUT OBTAINED AS PART OF THIS PROCESS MUST BE FROM
INDIVIDUAL CONSUMERS AND CONSUMER ADVOCATES OF THE FISCAL INTERMEDIARY;
(G) THE ORGANIZATION'S PLAN TO ADDRESS THE NEEDS OF CONSUMERS AND
THEIR PERSONAL ASSISTANTS IN A TIMELY MANNER, REGARDLESS OF WHERE THEY
LIVE, INCLUDING, BUT NOT LIMITED TO, INPUT FROM CONSUMERS, OBTAINING
PHYSICALS AND OTHER HEALTH INFORMATION FROM PERSONAL ASSISTANTS, OBTAIN-
ING TIME RECORDS FOR PAYROLL, AND TIMELY PROCESSING OF PAYROLL; AND
(H) A WRITTEN SWORN STATEMENT BY AN OFFICER OF THE ENTITY DISCLOSING
ANY PENDING LITIGATION, UNSATISFIED JUDGMENTS OR PENALTIES, CONVICTIONS
FOR FRAUD OR SANCTIONS IMPOSED BY GOVERNMENT AUTHORITIES.
(II) THE ENTITY SHALL REASONABLY PROMPTLY NOTIFY THE DEPARTMENT OF ANY
CHANGE IN THE INFORMATION SUBMITTED TO THE DEPARTMENT FOR AUTHORIZATION
UNDER THIS SUBDIVISION.
(III) THE COMMISSIONER SHALL NOT WITHHOLD APPROVAL OF ANY APPLICATION
FOR AUTHORIZATION THAT DEMONSTRATES THE FISCAL INTERMEDIARY'S ABILITY TO
PROVIDE FISCAL INTERMEDIARY SERVICES, IN ACCORDANCE WITH THE MANNER
REQUIRED BY THIS SUBDIVISION AND THE RULES AND REGULATIONS HEREUNDER.
ALL SUCH APPLICATIONS SHALL BE APPROVED BY THE COMMISSIONER.
(IV) IF THE COMMISSIONER DENIES AN APPLICATION FOR AUTHORIZATION, HE
OR SHE SHALL INCLUDE A NARRATIVE EXPLANATION OF THE REASON OR REASONS
FOR ITS DENIAL AND PROVIDE THE FISCAL INTERMEDIARY WITH SIXTY DAYS TO
SUBMIT ADDITIONAL INFORMATION FOR RECONSIDERATION BY THE COMMISSIONER.
(V) THE COMMISSIONER SHALL CONSIDER AND EVALUATE ANY RESPONSE RECEIVED
BY THE FISCAL INTERMEDIARY BEFORE REACHING A FINAL DETERMINATION, WHICH
LIKEWISE SHALL BE ACCOMPANIED BY A NARRATIVE EXPLANATION, IF THE APPLI-
CATION IS STILL DENIED.
(VI) ALL ORDERS OR DETERMINATIONS UNDER THIS SUBDIVISION SHALL BE
SUBJECT TO REVIEW AS PROVIDED IN ARTICLE SEVENTY-EIGHT OF THE CIVIL
PRACTICE LAW AND RULES.
§ 2. Subparagraphs (i) and (ii) of paragraph (a) of subdivision 4-a of
section 365-f of the social services law, as amended by section 3 of
part G of chapter 57 of the laws of 2019, the opening paragraph of
subparagraph (i) as amended by section 2 of part PP of chapter 57 of the
laws of 2022, are amended to read as follows:
(i) "Fiscal intermediary" means an entity that provides fiscal inter-
mediary services and has a contract for providing such services with
[the department of health and is selected through the procurement proc-
ess described in paragraphs (b), (b-1), (b-2) and (b-3) of this subdivi-
sion. Eligible applicants for contracts shall be entities that are capa-
ble of appropriately providing fiscal intermediary services, performing
the responsibilities of a fiscal intermediary, and complying with this
section, including but not limited to entities that]:
(A) [are a service center for independent living under section one
thousand one hundred twenty-one of the education law; or
(B) have been established as fiscal intermediaries prior to January
first, two thousand twelve and have been continuously providing such
services for eligible individuals under this section.] A LOCAL DEPART-
MENT OF SOCIAL SERVICES; AN ORGANIZATION LICENSED UNDER ARTICLE FORTY-
FOUR OF THE PUBLIC HEALTH LAW; OR
(B) AN ACCOUNTABLE CARE ORGANIZATION CERTIFIED UNDER ARTICLE TWENTY-
NINE-E OF THE PUBLIC HEALTH LAW OR AN INTEGRATED DELIVERY SYSTEM
COMPOSED PRIMARILY OF HEALTH CARE PROVIDERS RECOGNIZED BY THE DEPARTMENT
S. 5020--A 4
AS A PERFORMING PROVIDER SYSTEM UNDER THE DELIVERY SYSTEM REFORM INCEN-
TIVE PAYMENT PROGRAM.
(ii) Fiscal intermediary services shall include the following
services, performed on behalf of the consumer to facilitate his or her
role as the employer:
(A) wage and benefit processing for consumer directed personal assist-
ants;
(B) processing all income tax and other required wage withholdings;
(C) complying with workers' compensation, disability and unemployment
requirements;
(D) maintaining personnel records for each consumer directed personal
assistant, including time records and other documentation needed for
wages and benefit processing and a copy of the medical documentation
required pursuant to regulations established by the commissioner;
(E) ensuring that the health status of each consumer directed personal
assistant is assessed prior to service delivery pursuant to regulations
issued by the commissioner;
(F) maintaining records of service authorizations or reauthorizations;
(G) monitoring the consumer's or, if applicable, the designated repre-
sentative's continuing ability to fulfill the consumer's responsibil-
ities under the program and promptly notifying the authorizing entity of
any circumstance that may affect the consumer's or, if applicable, the
designated representative's ability to fulfill such responsibilities;
(H) complying with regulations established by the commissioner speci-
fying the responsibilities of fiscal intermediaries providing services
under this title; AND
(I) entering into a department approved memorandum of understanding
with the consumer that describes the parties' responsibilities under
this program[; and
(J) other related responsibilities which may include, as determined by
the commissioner, assisting consumers to perform the consumers' respon-
sibilities under this section and department regulations in a manner
that does not infringe upon the consumer's responsibilities and self-di-
rection].
§ 3. Paragraphs (b-1), (b-2) and (b-3) of subdivision 4-a of section
365-f of the social services law are REPEALED.
§ 4. Subdivision 4-b of section 365-f of the social services law, as
amended by section 8 of part G of chapter 57 of the laws of 2019, is
amended to read as follows:
4-b. Actions involving the authorization of a fiscal intermediary.
(a) [The department may terminate a fiscal intermediary's contract
under this section or suspend or limit the fiscal intermediary's rights
and privileges under the contract] A FISCAL INTERMEDIARY'S AUTHORIZATION
MAY BE REVOKED, SUSPENDED, LIMITED OR ANNULLED upon thirty [day's] DAYS'
written notice to the fiscal intermediary, if the commissioner finds
that the fiscal intermediary has failed to comply with the provisions of
this section or regulations promulgated hereunder. The written notice
shall include:
(i) A description of the conduct and the issues related thereto that
have been identified as failure of compliance; and
(ii) the time frame of the conduct that fails compliance.
(b) Notwithstanding the foregoing, upon determining that the public
health or safety would be imminently endangered by the continued opera-
tion or actions of the fiscal intermediary, the commissioner may [termi-
nate] REVOKE, SUSPEND, LIMIT OR ANNUL the fiscal intermediary's
[contract or suspend or limit the fiscal intermediary's rights and priv-
S. 5020--A 5
ileges under the contract] AUTHORIZATION immediately upon written
notice.
(c) All orders or determinations under this subdivision shall be
subject to review as provided in article seventy-eight of the civil
practice law and rules.
§ 5. Paragraph (c) of subdivision 4-d of section 365-f of the social
services law, as added by section 7 of part G of chapter 57 of the laws
of 2019, is amended to read as follows:
(c) Where a fiscal intermediary is suspending or ceasing operation
pursuant to an order under subdivision four-b of this section, [or has
failed to submit an offer for a contract, or has been denied a contract
under this section,] all the provisions of this subdivision shall apply
except subparagraph (i) of paragraph (a) of this subdivision, notice of
which to all parties shall be provided by the department as appropriate.
§ 6. Paragraph (d) of subdivision 4-d of section 365-f of the social
services law is REPEALED.
§ 7. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2023.