NY State Senate Bill 2025-S5145

Current Bill Status - In Senate Committee Health Committee

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

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Feb 19, 2025	referred to health

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2025-S5145 (ACTIVE) - Details

See Assembly Version of this Bill:: A5703
Current Committee:: Senate Health
Law Section:: Social Services Law
Laws Affected:: Amd §365-f, Soc Serv L
Versions Introduced in 2023-2024 Legislative Session:: S5020, A5281

2025-S5145 (ACTIVE) - Summary

Directs the commissioner of health to provide authorizations to all fiscal intermediaries that timely submit a request for authorization prior to January 1, 2026; details information required for such authorizations; makes related provisions.

2025-S5145 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S5145

SPONSOR: COMRIE
 
TITLE OF BILL:

An act to amend the social services law, in relation to certain authori-
zations to fiscal intermediaries

 
PURPOSE:

The Department of Health's attempt to drastically out the number of FIs
creates issues of network adequacy, resulting in palpable harms includ-
ing closing long-standing highly reputable Fis, and leaving many parts
of the state without a familiar FI, especially underserved and poverty
stricken areas left without local agencies.

 
SUMMARY OF SPECIFIC PROVISIONS:

This alternative proposal to the executive's 365-F the following key
areas: (1) clarity around the authorization process is detailed in the
statute; 2) FIs have a right to receive an authorization if they meet
the requirements; (3) FIs have an avenue to appeal if the DOH denies;

and (4) they can remain in business when this process is pending. The
authorization process proposed herein is very similar to the process
detailed in the version of 365-f that was in effect prior to March 31,
2019 (at which time it was replaced with an RFO process). Similar to
Governor Hochul's proposal, this proposal replaces the current RFO proc-
ess.

 
JUSTIFICATION:

During the current stage of the Coronavirus pandemic it is important to
not disrupt a major program that provides personal care service in the
home to people who would otherwise be forced into nursing home care. In
addition, current FIs performed on an outstanding :eve:  throughout the
pandemic. Equity requires that current FIs be given the opportunity to
continue providing services, instead of small minority owned agencies
being unfairly targeted and forced out of business.

During the COVID epidemic, for quality of healthcare, CDPAP has far
outperformed both Nursing Homes and LHCSAS in providing safe, reliable,
well managed services to the elderly and vulnerable patient population.
By keeping vulnerable patients out of a congregant setting, CDPAP is
preferable to Nursing Homes. By having one aide who is often a member of
the patient's household or family, instead of multiple aides visiting
multiple patients, CDPAP is preferable for many over EHCSA services,
especially in light of the Coronavirus pandemic and continued fears of
exposure.

In addition, the decentralized administration of current CDPAP organiza-
tions has been a strength when large offices were closed due to COVID
throughout NY State. Note that NYS offices and even the legislature were
closed to citizens due to COVID. This proposal add to the strength in
decentralized home care management during a large scale health crisis
like a pandemic. The Department of Health's attempt to drastically out
the number of FIs creates issues of network adequacy, resulting in
palpable harms including closing long-standing highly reputable Flo, and
leaving many parts of the state without a familiar FI, especially
under-served and poverty stricken areas left without local agencies. In
the case of new immigrants, the DOH attempts to eliminate agencies,
often those who are smaller in nature and formed to support a specific
culture, and ethnic population, will cause tremendous harm. These agen-
cies are often the only ones able to serve these populations with impor-
tant language and cultural proficiency. In addition, the DOH's consol-
idation effort provides inadequate network availability for small
disability populations like the Deaf and Deaf/Blind community.

Under this proposed bill, Els would be able to continue their work while
DOH holds an enhanced authorization process that makes sure that all
parts of the state will be served by experienced Els that can meet the
needs of diverse groups of patients.

 
PRIOR LEGISLATIVE HISTORY:

2023-2024: S5020A Comrie/ A5281A Sayegh

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
This act shall take effect immediately.

2025-S5145 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5145
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                             February 19, 2025
                                ___________
 
 Introduced by Sens. COMRIE, ADDABBO, CLEARE, FERNANDEZ, MARTINEZ, MYRIE,
   SALAZAR,  SANDERS,  SEPULVEDA  --  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 certain authori-
   zations to fiscal intermediaries

   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 2 of part HH of chapter 57 of
 the laws of 2024, is amended to read as follows:
   (b) [Notwithstanding section one  hundred  sixty-three  of  the  state
 finance  law,  section  one  hundred twelve of the state finance law, or
 section one hundred  forty-two  of  the  economic  development  law  the
 commissioner  shall enter into a contract under this subdivision with an
 eligible contractor that submits an  offer  for  a  contract,  provided,
 however, that:
   (i) the department shall post on its website:
   (A)  a  description  of  the  proposed  statewide  fiscal intermediary
 services to be provided pursuant to a contract in accordance  with  this
 subdivision;
   (B)  the  criteria for selection of the statewide fiscal intermediary,
 which shall include at a minimum that the eligible contractor is capable
 of performing statewide fiscal intermediary services  with  demonstrated
 cultural and language competencies specific to the population of consum-
 ers  and  those of the available workforce, has experience serving indi-
 viduals with disabilities, and as of April first, two  thousand  twenty-
 four is providing services as a fiscal intermediary on a statewide basis
 with at least one other state;
   (C)  the  manner  by  which  prospective  contractors  may  seek  such
 selection, which may include submission by electronic means;

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05945-01-5
 S. 5145                             2

   (ii) all offers that are received from prospective  contractors  in  a
 timely  fashion  and  that  meet the criteria set forth in clause (B) of
 subparagraph (i) of this paragraph shall be reviewed by the  commission-
 er; and
   (iii)  the  commissioner  shall  award such contract to the contractor
 that meets the criteria for selection and  offers  the  best  value  for
 providing  the  services required pursuant to this section and the needs
 of consumers.] 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-SIX,  AND
 MEET THE REQUIREMENTS OF THIS SECTION.  NO ENTITY SHALL PROVIDE, DIRECT-
 LY  OR  THROUGH  CONTRACT,  FISCAL  INTERMEDIARY SERVICES WITHOUT HAVING
 RECEIVED AN AUTHORIZATION AS A FISCAL INTERMEDIARY ISSUED BY THE COMMIS-
 SIONER 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-
 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.
 S. 5145                             3

   (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  1  of
 part  HH  of  chapter  57  of  the  laws of 2024, are amended to read as
 follows:
   (i) "Statewide fiscal intermediary"  means  an  entity  that  provides
 fiscal  intermediary  services  and  has  a  contract for providing such
 services with [the department of health  and  is  selected  through  the
 procurement process described in paragraph (b) of this subdivision.]:
   (A)  A  LOCAL  DEPARTMENT 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
 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 the  consum-
 er's 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;
 S. 5145                             4
 
   (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.  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.
   § 4. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2025.

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Senate Bill S5145

Sponsored By

Current Bill Status - In Senate Committee Health Committee

co-Sponsors

2025-S5145 (ACTIVE) - Details

2025-S5145 (ACTIVE) - Summary

2025-S5145 (ACTIVE) - Sponsor Memo

2025-S5145 (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S5145

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Sponsored By

Current Bill Status - In Senate Committee Health Committee

co-Sponsors

2025-S5145 (ACTIVE) - Details

2025-S5145 (ACTIVE) - Summary

2025-S5145 (ACTIVE) - Sponsor Memo

2025-S5145 (ACTIVE) - Bill Text download pdf

Comments