Senate Bill S8635

                                 
BILL NUMBER: S8635

SPONSOR: FERNANDEZ
 
TITLE OF BILL:

An act to amend the social services law and the public health law, in
relation to a special needs assisted living demonstration program

 
PURPOSE OR GENERAL IDEA OF BILL:

This legislation will create a demonstration project to explore the
benefit of introducing a model that would expand Assisted Living Program
(ALP) eligibility to include persons with special needs, including
dementia and/or cognitive impairment.

 
SUMMARY OF PROVISIONS:

Section 1: Amends Subdivision 3 of section 461-1 of the social services
law to add a new paragraph (o) that states that the commissioner shall
establish a special needs assisted living demonstration program to allow
up to three assisted living programs throughout the state to serve indi-
viduals with dementia or cognitive impairments. The assisted living
              

programs will analyze feasibility, efficiency and potential for cost
savings and the commissioner will submit a report analyzing the program.

Section 2: Amends subdivision 6 of section 3614 of the public health law
to add a new paragraph (d) that medical assistance rates of payment will
be adjusted for services provided by the assisted living programs
participating in a demonstration program.

Section 3 sets the effective date

 
JUSTIFICATION:

The Medicaid funded Assisted Living Program (also known as the "ALP")
serves individuals who are medically eligible for nursing home care in a
more independent, lower cost setting. This program provides room, board,
personal care and therapy to thousands of low-income New Yorkers, allow-
ing them to maintain their independence.

The scope and reimbursement structure of the ALP does not currently
contemplate the provision of specialized services to individuals with
Alzheimer's and dementia. As such, many seniors who rely on Medicaid,
and who develop these types of conditions, end up being forced to trans-
fer to a nursing home - whether they need that level of care or not - at
a much higher cost to the state.

Alzheimer's dementia prevalence continues to increase in the United
States, with cost of care exceeding $350 billion dollars 
1. In New York
State alone, over 426,000 individuals aged 65 and older currently have
Alzheimer's. The need for specialized settings to care for this popu-
lation, including for Medicaid beneficiaries, will continue to grow over
time as our population ages - as will the cost of caring for them.

This legislation would authorize the Department of Health to allow up to
three ALP providers to serve individuals with special needs as part of a
demonstration, to test the feasibility of the model and the potential
for cost savings to the state resulting from caring for individuals in a
lower cost setting.
(1) Alzheimer's Association. 2025 Alzheimer's Disease Facts and Figures.
https://wvvw.alz.org/getmedia/ef8f48f9-ad36-
48ea-87f9-b74034635c1e/alzhei mers-facts-and-figu res.pdf

 
PRIOR LEGISLATIVE HISTORY:

New Bill

 
FISCAL IMPLICATIONS:

TBD

 
EFFECTIVE DATE:
This act shall take effect immediately