Regular Session - April 21, 1993

                                                                 
2608

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         9                       ALBANY, NEW YORK

        10                       April 21, 1993

        11                         12:10 p.m.

        12

        13

        14                       REGULAR SESSION

        15

        16

        17

        18       SENATOR HUGH T. FARLEY, Acting President

        19       STEPHEN F. SLOAN, Secretary

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        21

        22

        23











                                                             
2609

         1                      P R O C E E D I N G S

         2                      ACTING PRESIDENT FARLEY:  Senate

         3       will come to order.  Senators will find their

         4       seats.

         5                      If you will please rise with me

         6       for the Pledge of Allegiance to the Flag.

         7                      (Whereupon, the Senate joined in

         8       the Pledge of Allegiance to the Flag. )

         9                      Today, in the absence of clergy,

        10       we will bow our heads for a moment of silent

        11       prayer.

        12                      (Whereupon, there was a moment of

        13       silence. )

        14                      Secretary will begin by reading

        15       the Journal.

        16                      THE SECRETARY:  In Senate,

        17       Tuesday, April 20.  The Senate met pursuant to

        18       adjournment.  Senator Farley in the chair upon

        19       designation of the Temporary President.  The

        20       Journal of Monday, April 19, was read and

        21       approved.  On motion, Senate adjourned.

        22                      ACTING PRESIDENT FARLEY:  Hearing

        23       no objection, the Journal will stand approved as











                                                             
2610

         1       read.

         2                      The order of business:

         3                      Presentation of petitions.

         4                      Messages from the Assembly.

         5                      Messages from the Governor.

         6                      Reports of standing committees.

         7                      Reports of select committees.

         8                      Communications and reports from

         9       state officers.

        10                      Motions and resolutions.

        11                      Senator Present.

        12                      SENATOR PRESENT:  Mr. President,

        13       would you recognize Senator Holland, please.

        14                      ACTING PRESIDENT FARLEY:  Senator

        15       Holland.

        16                      SENATOR HOLLAND:  Mr. President,

        17       I have two privileged resolutions at the desk.

        18       I would like to have the titles of both read and

        19       move for immediate adoption.

        20                      ACTING PRESIDENT FARLEY:

        21       Secretary will read the titles to Senator

        22       Holland's resolutions.

        23                      THE SECRETARY:  Legislative











                                                             
2611

         1       Resolution, by Senator Holland, recognizing the

         2       week of April 18th through the 24th, 1993, as

         3       National Volunteer Weak in the state of New

         4       York.

         5                      Also, Legislative Resolution, by

         6       Senator Holland, commemorating Big Brothers Big

         7       Sisters Volunteer Appreciation Week, April the

         8       18th through the 24th, 1993.

         9                      ACTING PRESIDENT FARLEY:  On both

        10       resolutions.  All those in favor, aye.

        11                      (Response of "Aye.")

        12                      Those opposed, nay.

        13                      (There was no response. )

        14                      The resolutions are adopted.

        15                      Senator Present, we have a

        16       substitution.  What's your pleasure?

        17                      SENATOR PRESENT:  On the

        18       substitution.

        19                      ACTING PRESIDENT FARLEY:  The

        20       Secretary will make the substitution.

        21                      THE SECRETARY:  On page 7 of

        22       today's calendar, Senator Johnson moves to

        23       discharge the Committee on Environmental











                                                             
2612

         1       Conservation from Assembly Bill Number 4009 and

         2       substitute the identical Calendar Number 438.

         3                      ACTING PRESIDENT FARLEY:

         4       Substitution is ordered.

         5                      Senator Volker.

         6                      SENATOR VOLKER:  Mr. President,

         7       on page 12, Calendar Number 55, Senate Print

         8       Number 1141A, could you please star that bill.

         9       Page 12, Calendar 55, 1141A, please star it.

        10                      ACTING PRESIDENT FARLEY:  The

        11       bill is starred at the request of the sponsor.

        12                      Senator Present, what's your

        13       pleasure?

        14                      SENATOR PRESENT:  Let's take up

        15       the non-controversial calendar, please.

        16                      ACTING PRESIDENT FARLEY:

        17       Non-controversial.

        18                      Secretary will read.

        19                      THE SECRETARY:  On page 12,

        20       Calendar Number 79, by Senator Spano, Senate

        21       Bill Number 1411, an act to amend the Mental

        22       Hygiene Law, in relation to prohibiting the

        23       Office of Mental Health and the Office of Mental











                                                             
2613

         1       Retardation from requesting certain redundant

         2       information.

         3                      ACTING PRESIDENT FARLEY:  Read

         4       the last section.

         5                      THE SECRETARY:  Section 2.  This

         6       act shall take effect immediately.

         7                      ACTING PRESIDENT FARLEY:  Call

         8       the roll.

         9                      (The Secretary called the roll. )

        10                      THE SECRETARY:  Ayes 32.

        11                      ACTING PRESIDENT FARLEY:  The

        12       bill is passed.

        13                      THE SECRETARY:  Calendar Number

        14       93, by Senator Daly, Senate Bill Number 1106A.

        15                      SENATOR STACHOWSKI:  Lay it

        16       aside.

        17                      ACTING PRESIDENT FARLEY:  Lay it

        18       aside.

        19                      THE SECRETARY:  Calendar Number

        20       108, by Senator Holland.

        21                      SENATOR STACHOWSKI:  Lay it

        22       aside.

        23                      ACTING PRESIDENT FARLEY:  Lay











                                                             
2614

         1       that bill aside.

         2                      THE SECRETARY:  Calendar Number

         3       139, by Senator Lack, Senate Bill Number 2179,

         4       an act to amend the Workers' Compensation Law.

         5                      ACTING PRESIDENT FARLEY:  Read

         6       the last section.

         7                      THE SECRETARY:  Section 6.  This

         8       act shall take effect immediately.

         9                      ACTING PRESIDENT FARLEY:  Call

        10       the roll.

        11                      (The Secretary called the roll. )

        12                      THE SECRETARY:  Ayes 32.

        13                      ACTING PRESIDENT FARLEY:  The

        14       bill is passed.

        15                      THE SECRETARY:  Calendar Number

        16       178, by Senator Sears.

        17                      SENATOR PRESENT:  Lay it aside

        18       for the day.

        19                      ACTING PRESIDENT FARLEY:  Lay it

        20       aside for the day.

        21                      THE SECRETARY:  Calendar Number

        22       335, by Senator Kuhl, Senate Bill Number 2530,

        23       an act to amend the General Business Law, in











                                                             
2615

         1       relation to automobile auctioneers.

         2                      ACTING PRESIDENT FARLEY:  Read

         3       the last section.

         4                      THE SECRETARY:  Section 2.  This

         5       act shall take effect immediately.

         6                      ACTING PRESIDENT FARLEY:  Call

         7       the roll.

         8                      (The Secretary called the roll. )

         9                      THE SECRETARY:  Ayes 33.

        10                      ACTING PRESIDENT FARLEY:  The

        11       bill is passed.

        12                      THE SECRETARY:  Calendar Number

        13       342, by Senator Lack, Senate Bill Number 3744,

        14       an act to amend the Workers' Compensation Law.

        15                      ACTING PRESIDENT FARLEY:  Read

        16       the last section.

        17                      THE SECRETARY:  Section 2.  This

        18       act shall take effect immediately.

        19                      ACTING PRESIDENT FARLEY:  Call

        20       the roll.

        21                      (The Secretary called the roll. )

        22                      THE SECRETARY:  Ayes 33.

        23                      ACTING PRESIDENT FARLEY:  That











                                                             
2616

         1       bill is passed.

         2                      THE SECRETARY:  Calendar Number

         3       348, by Senator Present, Senate Bill Number

         4       1655A, an act to amend the Education Law, in

         5       relation to the transportation of pupils.

         6                      ACTING PRESIDENT FARLEY:  There

         7       is a local fiscal impact note here at the desk.

         8                      Read the last section.

         9                      THE SECRETARY:  Section 2.  This

        10       act shall take effect immediately.

        11                      ACTING PRESIDENT FARLEY:  Call

        12       the roll.

        13                      (The Secretary called the roll. )

        14                      THE SECRETARY:  Ayes 33.

        15                      ACTING PRESIDENT FARLEY:  That

        16       bill is passed.

        17                      THE SECRETARY:  Calendar Number

        18       three-fifty... -

        19                      SENATOR STACHOWSKI:  Lay it

        20       aside.

        21                      ACTING PRESIDENT FARLEY:  Lay it

        22       aside.

        23                      THE SECRETARY:  Calendar Number











                                                             
2617

         1       378, by Senator Daly, Senate Bill Number 3204.

         2                      SENATOR STACHOWSKI:  Lay it

         3       aside.

         4                      ACTING PRESIDENT FARLEY:  Lay it

         5       aside.

         6                      THE SECRETARY:  Calendar Number

         7       388, by Senator Levy, Senate Bill Number 3515A,

         8       an act to amend the Education Law, terms of

         9       members of the Board of Regents.

        10                      ACTING PRESIDENT FARLEY:  Read

        11       the last section.

        12                      THE SECRETARY:  Section 2.  This

        13       act shall take effect immediately.

        14                      ACTING PRESIDENT FARLEY:  Call

        15       the roll.

        16                      (The Secretary called the roll. )

        17                      THE SECRETARY:  Ayes 34.

        18                      ACTING PRESIDENT FARLEY:  The

        19       bill is passed.

        20                      THE SECRETARY:  Calendar Number

        21       464.

        22                      SENATOR PRESENT:  Lay it aside.

        23                      ACTING PRESIDENT FARLEY:  Lay it











                                                             
2618

         1       aside.

         2                      Senator Present, that's the first

         3       time through.

         4                      SENATOR PRESENT:  Let's take up

         5       the controversial calendar, please.

         6                      ACTING PRESIDENT FARLEY:

         7       Controversial.  The Secretary will read

         8       controversial.

         9                      THE SECRETARY:  On page 13,

        10       Calendar Number 93, by Senator Daly, Senate Bill

        11       Number 1106A, Social Services Law, in relation

        12       to direct payment of shelter allowances.

        13                      ACTING PRESIDENT FARLEY:  Read

        14       the last section.

        15                      Senator Stachowski, you asked for

        16       an explanation.  Senator Daly.

        17                      SENATOR DALY:  Mr. President.

        18       One of the major contributors to the lack of

        19       adequate housing for those who are on welfare is

        20       the unwillingness of property owners to rent

        21       apartments to people on welfare.  Why? Because

        22       all too many of them have been burned by the

        23       process.  And certainly, in many instances, the











                                                             
2619

         1       tenants leave the apartment owing several months

         2       back rent.  And the purpose of this bill is to

         3       enable landlords, tenants, or district

         4       commissioners to have the shelter allowance of

         5       home relief recipients paid to the landlords in

         6       the form of a direct voucher at the request of

         7       either of the aforementioned.

         8                      The bill also provides that once

         9       home relief is received in the form of a direct

        10       payment at the request of either the landlord or

        11       the tenant, it cannot again be issued as an

        12       unrestricted payment at a later date.

        13                      ACTING PRESIDENT FARLEY:  Read

        14       the last section.

        15                      THE SECRETARY:  Section 2.  This

        16       act shall take effect immediately.

        17                      ACTING PRESIDENT FARLEY:  Call

        18       the roll.

        19                      (The Secretary called the roll. )

        20                      THE SECRETARY:  Ayes 34.

        21                      ACTING PRESIDENT FARLEY:  The

        22       bill is passed.

        23                      THE SECRETARY:  Calendar Number











                                                             
2620

         1       108, by Senator Holland, Senate Bill Number 263,

         2       an act to amend the Public Health Law, in

         3       relation to Medicare-distinct parts in nursing

         4       facilities.

         5                      SENATOR STACHOWSKI:  Could you

         6       lay it aside temporarily?

         7                      ACTING PRESIDENT FARLEY:  Lay it

         8       aside temporarily.  Is that all right, Senator

         9       Present?

        10                      SENATOR PRESENT:  Yes.

        11                      THE SECRETARY:  Calendar Number

        12       356, by Senator Larkin, Senate Bill Number 3144,

        13       an act to amend the Real Property Tax Law and

        14       the Public Service Law, in relation to the

        15       definition of special franchise property.

        16                      SENATOR STACHOWSKI:  Can we have

        17       this laid aside temporarily also for Senator

        18       Oppenheimer?

        19                      ACTING PRESIDENT FARLEY:  What's

        20       the sponsor's pleasure?

        21                      SENATOR PRESENT:  Temporarily lay

        22       it aside.

        23                      ACTING PRESIDENT FARLEY:  Lay it











                                                             
2621

         1       aside, temporarily.

         2                      THE SECRETARY:  Calendar Number

         3       378, by Senator Daly, Senate Bill Number 3204.

         4                      SENATOR STACHOWSKI:  Explanation.

         5                      ACTING PRESIDENT FARLEY:

         6       Explanation.  Senator Daly.

         7                      SENATOR DALY:  Mr. President.

         8       This bill strengthens the sanctions on home

         9       relief recipients who do not comply with the

        10       training and employment requirements, and it

        11       clarifies that the burden of proof for failure

        12       by public assistance recipients to comply with

        13       education, training and employment rests with

        14       the recipient, and it makes clear that anyone

        15       who voluntarily quits his or her job is

        16       ineligible for home relief or aid to dependent

        17       children benefits for 75 days.

        18                      Basically also, Mr. President,

        19       what it does, it makes the work relief and jobs

        20       program uniform with mandatory job search for

        21       home relief requests.

        22                      We do add -- I should clarify

        23       that with one other point.  We do add or change











                                                             
2622

         1       the fourth sanction.  So that one is issued

         2       permanently, not 180 days under the present law.

         3                      ACTING PRESIDENT FARLEY:  Read

         4       the last section.

         5                      Senator Gold.

         6                      SENATOR GOLD:  Yes, very

         7       briefly.  Last year we debated this, and Senator

         8       Connor and myself and Senator Halperin,

         9       Markowitz, Montgomery, Ohrenstein, Paterson,

        10       Smith, Stavisky and Waldon voted in the

        11       negative.

        12                      I just want to make one comment.

        13       I mentioned yesterday on a completely different

        14       subject how, you know, sometimes unless you see

        15       something with your own eyes, we all know what's

        16       out there, but it doesn't crystallize.

        17                      There is an opportunity opening

        18       up on my staff in New York, and I have already

        19       interviewed four gentlemen, each one of whom is

        20       totally qualified -- totally qualified -- each

        21       one of them could do that job.  Isn't even a

        22       question.  Each one of them goes to one or two

        23       interviews a day, a week, or whatever, and is











                                                             
2623

         1       trying to get a job.

         2                      And you start to understand that

         3       in this economic time we are not talking about

         4       bums, we are not talking about criminals, we are

         5       not talking about sleaze.  We are talking about

         6       men and women just like us who want to work

         7       immediately if you get them a job.

         8                      Now, I understand what you want

         9       to do here, Senator Daly.  I understand it.  And

        10       what I'm talking about is a little bit of an

        11       angle from that.  All right? And you are going

        12       to tell me, I'm sure, one thing has nothing to

        13       do with the other, except for one thing.  Some

        14       of the legislation that we get here, from time

        15       to time the expression mean-spirited has been

        16       used.  I don't want to use words like that.  But

        17       the point is that for political reasons -- and

        18       this isn't Democrat/Republican political

        19       reasons, Senator Daly -- we somehow wind up

        20       picking on people who are at the lowest ends

        21       ever society, most of whom, the huge number of

        22       whom want to work, and for some reason our

        23       society has failed them.











                                                             
2624

         1                      I can't tell you -- I have a job

         2       to give, and I feel guilty that I don't have

         3       four jobs.  Because there's four men who want to

         4       work, and I can't give them a job.

         5                      I don't think bills like this are

         6       the answer.  I understand the kind of

         7       frustration, Senator Daly, that you have in

         8       putting in the bill, and I know you very well,

         9       and there's not a mean bone in your body.  But

        10       this kind of legislation, I think, is just the

        11       wrong way to go.

        12                      It would be wonderful if we could

        13       spend our time and if some of the Congressmen

        14       down there would stop acting like city

        15       councilmen and worry about the national picture

        16       and the international picture and we get people

        17       back to work.  If we could do that, I'm telling

        18       you a lot of the problems that we deal with day

        19       in and day out would fall by the wayside.

        20                      So I wanted to make those

        21       comments because I really have had a very

        22       difficult week meeting with these people because

        23       I think it would affect everybody in this











                                                             
2625

         1       chamber if you had had this same experience.

         2       There are wonderful people out there that want

         3       to work.  It's not a question of training them.

         4       They are qualified, and they can't get jobs.

         5                      SENATOR DALY:  Mr. President.

         6                      ACTING PRESIDENT FARLEY:  Senator

         7       Daly.

         8                      SENATOR DALY:  Really, I agree

         9       with everything Senator Gold said.  This bill is

        10       not out in any way to hurt those people.  This

        11       bill is aimed at those who are trying to beat

        12       the system.

        13                      I point out specifically,

        14       Senator, that we do not touch the good cause

        15       section of the rules and regulations, and there

        16       are 18 individual causes that are listed in the

        17       rules and regulations which will excuse someone

        18       from these sanctions, and we stayed away from

        19       those good causes on purpose because we did not

        20       want to have this legislation apply to anyone

        21       who was trying.  I would be the last one -- I

        22       would be the last one to try to -- I should say

        23       to change the law so that we create even greater











                                                             
2626

         1       sanctions on those people who are trying.  Only

         2       those people, really, who are trying to beat the

         3       system.

         4                      ACTING PRESIDENT FARLEY:  Read

         5       the last section.

         6                      THE SECRETARY:  Section 6.  This

         7       act shall take effect immediately.

         8                      ACTING PRESIDENT FARLEY:  Call

         9       the roll.

        10                      (The Secretary called the roll. )

        11                      SENATOR STAVISKY:  Mr. President.

        12                      ACTING PRESIDENT FARLEY:  Senator

        13       Stavisky.

        14                      SENATOR STAVISKY:  I rise for the

        15       purpose of explaining my vote.

        16                      It appears to me that the

        17       penalty, the initial penalty of 75 days, does

        18       not take into account the possibility that

        19       someone will comply with the requirement within

        20       five days or six days.  And yet if the 75 days

        21       is the penalty for being deprived of sustenance,

        22       I believe that that situation may not have been

        23       addressed by the sponsor of the bill.











                                                             
2627

         1       Accordingly, I wish to be recorded in the

         2       negative.

         3                      SENATOR DALY:  Mr. President, if

         4       I may explain my vote.  I mentioned, although I

         5       didn't go into depth in my explanation, the fact

         6       that really what we're doing is creating the

         7       same sanctions in most cases, the first three

         8       sanctions, the 75 days that the Senator

         9       mentioned, are the same sanctions that we have

        10       in all other employment, training and education

        11       programs.  So this is not something that stands

        12       by itself.  In this particular case, we have

        13       brought them up together.

        14                      ACTING PRESIDENT FARLEY:

        15       Results.

        16                      THE SECRETARY:  Those recorded in

        17       the negative on Calendar Number 378 are Senators

        18       Connor, Espada, Gold, Leichter, Markowitz,

        19       Mendez, Nolan, Ohrenstein, Smith, and Stavisky.

        20                      Ayes 35, nays 11.

        21                      ACTING PRESIDENT FARLEY:  The

        22       bill is passed.

        23                      SENATOR STAVISKY:  Mr. President.











                                                             
2628

         1                      ACTING PRESIDENT FARLEY:  Senator

         2       Stavisky.

         3                      SENATOR STAVISKY:  Mr.

         4       President.  Yesterday, I arrived in the chamber

         5       just moments after the adjournment.  If I had

         6       been in the chamber on Calendar Number 384, I

         7       would have asked to be recorded in the negative.

         8                      ACTING PRESIDENT FARLEY:  The

         9       record will so state.

        10                      SENATOR STAVISKY:  I'm sorry.

        11       Forgive me, sir.  385.  It was 385, not 384.

        12                      ACTING PRESIDENT FARLEY:  385.

        13       The record will state.

        14                      SENATOR LEICHTER:  Mr. President.

        15                      ACTING PRESIDENT FARLEY:  Senator

        16       Leichter.

        17                      SENATOR LEICHTER:  Yes.  May I be

        18       recorded in the negative on Calendar 93.  Was

        19       that laid aside or did that pass?

        20                      ACTING PRESIDENT FARLEY:  Which

        21       one are you talking about?

        22                      SENATOR LEICHTER:  Calendar 93

        23       today.











                                                             
2629

         1                      ACTING PRESIDENT FARLEY:  It was

         2       passed.

         3                      SENATOR LEICHTER:  It was

         4       passed?

         5                      ACTING PRESIDENT FARLEY:  Yes,

         6       sir.

         7                      SENATOR LEICHTER:  May I be

         8       recorded in the negative?

         9                      ACTING PRESIDENT FARLEY:  Without

        10       objection.

        11                      Senator Santiago.

        12                      SENATOR SANTIAGO:  I need to be

        13       recorded in the negative for 378.

        14                      ACTING PRESIDENT FARLEY:  378,

        15       without objection.

        16                      Senator Galiber.

        17                      SENATOR GALIBER:  Record me in

        18       the negative.

        19                      ACTING PRESIDENT FARLEY:  378?

        20                      SENATOR GALIBER:  That's correct.

        21                      ACTING PRESIDENT FARLEY:  Without

        22       objection.

        23                      Secretary will continue.











                                                             
2630

         1                      THE SECRETARY:  Calendar Number

         2       464, by Senator Nozzolio, Senate Bill Number

         3       4195A, an act to amend the Election Law.

         4                      SENATOR NOZZOLIO:  Mr.

         5       President.  Is there a message at the desk?

         6                      ACTING PRESIDENT FARLEY:  No,

         7       there is not, sir.

         8                      SENATOR NOZZOLIO:  Thank you, Mr.

         9       President.

        10                      ACTING PRESIDENT FARLEY:  Lay the

        11       bill aside.

        12                      SENATOR PRESENT:  Mr. President.

        13                      ACTING PRESIDENT FARLEY:  Senator

        14       Present.

        15                      SENATOR PRESENT:  Can we call up

        16       Calendar 356, Senator Larkin's bill that was

        17       laid aside temporarily?

        18                      ACTING PRESIDENT FARLEY:

        19       Secretary will call up 356, by Senator Larkin.

        20                      THE SECRETARY:  Calendar Number

        21       356, by Senator Larkin, Senate Bill Number 3144,

        22       an act to amend the Real Property Tax Law and

        23       the Public Service Law, in relation to the











                                                             
2631

         1       definition of special franchise property.

         2                      ACTING PRESIDENT FARLEY:  Read

         3       the last section.

         4                      SENATOR STACHOWSKI:  Explanation.

         5                      ACTING PRESIDENT FARLEY:

         6       Explanation.  Senator Larkin.

         7                      SENATOR LARKIN:  New York has

         8       exempt central office equipment of telephone

         9       companies from real property tax since the

        10       Legislature enacted the exemption back in 1987,

        11       Chapter 416, we have had some changes in the

        12       technology within the communication industry

        13       which calls for the relocation of some of the

        14       central office equipment using transformer fiber

        15       optic signals to impulses closer to the

        16       consumer.  This equipment which is located

        17       within the approximate distance of its consumers

        18       is entitled to the same benefit as if it was

        19       stored at their central office.  It's just

        20       moving the equipment from the central office to

        21       give a better response to the consumer.

        22                      And with regard to that, any

        23       savings in the real property tax that would be











                                                             
2632

         1       given to the telephone company on this, the

         2       Public Service Commission has deemed by this to

         3       ensure that any savings go back to the ratepayer

         4       and not to the telephone company.

         5                      ACTING PRESIDENT FARLEY:  Senator

         6       Oppenheimer.

         7                      SENATOR OPPENHEIMER:  Would the

         8       Senator yield for a question?

         9                      ACTING PRESIDENT FARLEY:  Senator

        10       Larkin, would you yield?

        11                      SENATOR LARKIN:  Yes.

        12                      SENATOR OPPENHEIMER:  Is this not

        13       going to be taking -- offering another tax

        14       break?

        15                      SENATOR LARKIN:  I can't hear

        16       you.

        17                      SENATOR OPPENHEIMER:  Is this not

        18       going to be taking the properties off of the tax

        19       rolls for the municipal government and offering

        20       the tax break at the expense of the municipal

        21       government?

        22                      SENATOR LARKIN:  The total tax

        23       cost across the state is $2.5 million.  I would











                                                             
2633

         1       remind the Senator that the 1987 bill that gave

         2       the same exemption to this equipment cost $200

         3       million.  This 2.5 million will be taken off the

         4       local rolls but will be given as a benefit to

         5       ratepayers in the telephone system.

         6                      SENATOR OPPENHEIMER:  Yeah, I

         7       understand.  Thank you, Senator.

         8                      On the bill.  It is true that

         9       this doesn't entail a great deal of money for

        10       many of our communities.  Some of my communities

        11       will have to bear a $40,000 reduction, and I

        12       feel that we have consistently in this Senate

        13       and in the Assembly put the burden on the lower

        14       levels of government consistently.  We are

        15       telling them what they must do.  We are not

        16       supplying money, and we are causing our property

        17       tax rolls to increase at an increasing rate

        18       every year.  I think that -- though this is not

        19       a major item, I think it's something that I can

        20       not support because it is just a continuation of

        21       the reductions which are causing municipal

        22       governments to increase the property taxation on

        23       local residents, and I think it's time we took a











                                                             
2634

         1       stand.

         2                      I vote no.

         3                      ACTING PRESIDENT FARLEY:  Read

         4       the last section.

         5                      THE SECRETARY:  Section 2.  This

         6       act shall take effect immediately.

         7                      ACTING PRESIDENT FARLEY:  Call

         8       the roll.

         9                      (The Secretary called the roll. )

        10                      THE SECRETARY:  Those recorded in

        11       the negative on Calendar Number 356 are Senators

        12       Cook, Farley, Johnson, Jones, Markowitz,

        13       Oppenheimer, Pataki, Seward and Stachowski.

        14       Ayes 39, nays 9.

        15                      ACTING PRESIDENT FARLEY:  The

        16       bill is passed.

        17                      SENATOR MARKOWITZ:  Mr.

        18       President.

        19                      ACTING PRESIDENT FARLEY:  Senator

        20       Markowitz.

        21                      SENATOR MARKOWITZ:  May I have

        22       unanimous approval to vote in the negative on

        23       Calendar Number 93, please?











                                                             
2635

         1                      ACTING PRESIDENT FARLEY:  Without

         2       objection, Senator Markowitz in the negative on

         3       Calendar 93.

         4                      Senator Present.

         5                      SENATOR PRESENT:  Mr. President,

         6       can we take up Calendar 108.

         7                      ACTING PRESIDENT FARLEY:  108.

         8       Secretary will read it.

         9                      THE SECRETARY:  Calendar Number

        10       108, by Senator Holland, Senate Bill Number 263,

        11       an act to amend the Public Health Law, in

        12       relation to Medicare-distinct parts in nursing

        13       facilities.

        14                      ACTING PRESIDENT FARLEY:

        15       Explanation.  Senator Holland.

        16                      SENATOR HOLLAND:  Yes, Mr.

        17       President.  In New York State today, all nursing

        18       home beds must be certified both Medicaid and

        19       Medicare.  This bill would allow nursing homes

        20       to set up separate units for Medicare, thereby

        21       allowing higher reimbursement from the federal

        22       government and less reimbursement by the state

        23       government saving us money.











                                                             
2636

         1                      ACTING PRESIDENT FARLEY:  Read

         2       the last section.

         3                      Senator Leichter.

         4                      SENATOR LEICHTER:  Senator

         5       Holland, if you would be so good as to yield?

         6                      SENATOR HOLLAND:  Yes, sir.

         7                      SENATOR LEICHTER:  Yes, I'm

         8       trying to understand how that's going to save

         9       money for the state.  I'm not challenging your

        10       conclusion, but I would like to understand it.

        11       Could you just run us through that, please?

        12                      SENATOR HOLLAND:  It would allow

        13       separate units to be set up within the

        14       facilities, and the accounting will just be

        15       Medicare rather than Medicaid; therefore, the

        16       federal government will pay for those units

        17       rather than the state government contributing.

        18                      SENATOR LEICHTER:  But, Senator,

        19       it's my understanding now that if somebody is

        20       Medicare-eligible irrespective of the unit that

        21       they are in, doesn't the federal government

        22       cover that by Medicare?

        23                      SENATOR HOLLAND:  To a degree you











                                                             
2637

         1       are correct, Senator, but it will bring more

         2       money into the state of New York.

         3                      SENATOR LEICHTER:  That's what

         4       we're trying to understand and, you know, it's

         5       nice to have you say, "This is going to bring in

         6       more money," explanation is finished.  But how

         7       will it bring in more money?

         8                      I'm trying to understand how it

         9       will bring in more money.  Because Medicare

        10       eligibility and Medicare payments aren't deter

        11       mined by which part of a nursing home you're in

        12       or whether you call it this is the Medicare wing

        13       as distinguished from the Medicaid wing.

        14                      SENATOR HOLLAND:  I understand

        15       that the cost is just based on the Medicare

        16       patient; therefore, the federal government will

        17       be paying more money.

        18                      SENATOR LEICHTER:  If you'll be

        19       good enough to continue to yield, Senator

        20       Holland?

        21                      SENATOR HOLLAND:  Sure.

        22                      SENATOR LEICHTER:  So what you

        23       are telling us is that you can establish -











                                                             
2638

         1       within the same home, you can establish a

         2       Medicare rate and a Medicaid rate, and that the

         3       Medicare rate could conceivably be higher than

         4       the Medicaid rate?

         5                      SENATOR HOLLAND:  Yes, that's

         6       true, Senator.

         7                      SENATOR LEICHTER:  Now, one thing

         8       I -

         9                      SENATOR HOLLAND:  Go ahead.

        10                      SENATOR LEICHTER:  I just wanted

        11       to give your counsel a chance to speak to you

        12       about it.

        13                      One of the things that I'm

        14       concerned about is will there be different

        15       levels of care? Are we then saying, well, the

        16       federal government is paying for these people so

        17       we're going to try to get that rate up higher?

        18       We'll give more care.  We'll have more nurses.

        19       We'll give better food.  The others, Medicaid,

        20       will be receiving a different level care.  Is

        21       that a possibility as a result of this bill?

        22                      SENATOR HOLLAND:  No, Senator,

        23       that is not true.  They will both be receiving











                                                             
2639

         1       the same level of care.  And before any nursing

         2       home goes into this program, they must prepare

         3       and have the Commissioner approve a policy that

         4       outlines the level of care that they are to get,

         5       the transfer and discharge policies, and the

         6       patient's rights.  The level of care will be the

         7       same.

         8                      SENATOR LEICHTER:  Senator, I

         9       don't see anything in the bill which states that

        10       the level of care must be the same.  You say

        11       that they must submit a plan, but you don't say

        12       necessarily that it has to have the same level

        13       of care.  I think, inevitably, you are going to

        14       have to have a different level of care, and I

        15       will tell you why.  Because what you are really

        16       saying is that if you have a nursing home and

        17       you have homogenized rates for Medicaid and

        18       Medicare that the Medicaid rates, I assume,

        19       track the Medicare, or the other way about.  In

        20       any event, they are locked together.

        21                      Now, as I understand this bill,

        22       you are trying to unlock it.  And I want to just

        23       add here at this point that I have a lot of











                                                             
2640

         1       trouble understanding Medicare/Medicaid, and I

         2       haven't really looked into it.  Obviously, you

         3       are a chair of a committee.  I assume you have.

         4                      But it seems to me that what you

         5       are trying to do is to separate the two and get

         6       the fed's to set a separate rate.  Because,

         7       presently, you still have the fed's paying for

         8       people who are Medicare eligible.  Isn't that

         9       the case?

        10                      SENATOR HOLLAND:  Yes.

        11                      SENATOR LEICHTER:  So what you

        12       are doing is trying to get a separate rate so

        13       that in some way that presently, let's say for

        14       the sake of argument, in that home why, the

        15       reimbursement rate for both Medicare and

        16       Medicaid patients is $100.  Now, what you are

        17       trying to do is maybe get the fed's to pay 120

        18       whereas the state will be paying only $100 for

        19       the Medicaid people.  So isn't that -

        20       inevitably, isn't somebody in the fed's -- they

        21       are not all dopes.  I mean somebody is going to

        22       say, "Wait a second.  The state is paying 100.

        23       They want us to pay 120.  Let's go in there."











                                                             
2641

         1       If the level of care is the same, wouldn't the

         2       fed's at that point say, "Wait a second.  Why

         3       should we be paying more reimbursement than the

         4       state is paying under Medicaid if the level of

         5       care is the same?"

         6                      SENATOR HOLLAND:  I'm not sure

         7       that the level of care is always the same.  The

         8       need is always the same, Senator.

         9                      SENATOR LEICHTER:  Well, Senator,

        10       that was my point initially that this bill may

        11       very well lead to a differential in care.

        12                      SENATOR HOLLAND:  But if -- go

        13       ahead.  You've got the floor.

        14                      SENATOR LEICHTER:  That you are

        15       going to have different services for people who

        16       are Medicare eligible than people who are

        17       Medicaid eligible.

        18                      SENATOR HOLLAND:  O.K., but -

        19                      SENATOR LEICHTER:  You concede

        20       now that that is the case.

        21                      SENATOR HOLLAND:  I do.  But it

        22       depends upon the needs of the individuals.  They

        23       will receive the quality of care necessary











                                                             
2642

         1       depending upon their need.  And I'm sure that

         2       the federal government will not reimburse us and

         3       will still maintain -- still continue to check

         4       and see if those needs are met as we do.

         5                      SENATOR LEICHTER:  Well, all that

         6       you are saying, Senator, is that basic needs -

         7       obviously, you have to meet the basic

         8       requirements, but you will now have two levels

         9       of care and Medicare people will receive a

        10       better level of care.  I must tell you I am

        11       disturbed about that.  Has the Health Department

        12       commented on your bill, Senator?

        13                      SENATOR HOLLAND:  No.  No, they

        14       have not.

        15                      SENATOR LEICHTER:  All right.

        16                      SENATOR HOLLAND:  But I want to

        17       repeat that the Commissioner is required to

        18       approve a policy before any nursing home goes

        19       into this.

        20                      SENATOR LEICHTER:  I understand

        21       that.  Thank you, Senator, and I appreciate that

        22       you and I had an opportunity to discuss the

        23       bill, because it's certainly much clearer on my











                                                             
2643

         1       part, and while -- well, I think what it shows

         2       is essentially the statement that you initially

         3       made that it's going to save money for the state

         4       is just not so.  It may bring in more money to

         5       the nursing home, and it may -- not may -- but

         6       as you concede, it will lead to a

         7       differentiation in the level of care between

         8       Medicaid and Medicare because you conceded

         9       unless there was that differentiation the fed's

        10       are not going to pay more for the Medicare than

        11       we pay for the Medicaid.  So I must say,

        12       Senator, there are no savings that I see

        13       whatsoever for the state whatsoever in this

        14       plan.

        15                      And I know we're dealing in a

        16       very murky, complex, difficult area and you know

        17       much more about it than I do, but certainly as I

        18       understand the bill now and as you have

        19       explained it, that very nice statement you made

        20       which made us all feel good, "Hey, this bill is

        21       going to save money for the state," really

        22       doesn't show up on examination and you are

        23       leading to what I think is somewhat troublesome











                                                             
2644

         1       of whether we want to have two levels of care in

         2       nursing homes.

         3                      So I would respectfully suggest,

         4       Senator, that this bill may need more study.

         5                      ACTING PRESIDENT FARLEY:  Senator

         6       Cook.

         7                      SENATOR COOK:  Senator Holland,

         8       if you would yield and help me understand.

         9       Correct me if I'm incorrect on what I'm going to

        10       say because I think I know what I'm talking

        11       about, but I stand to be corrected.

        12                      Senator Leichter, I believe the

        13       situation is this, that in the nursing home the

        14       needs of the population are considered relative

        15       to the needs of the residents of the home.  I

        16       think that's what the RUGS rate basically is.

        17       It's according to the needs of the residents of

        18       the home.

        19                      What this proposes to do, I

        20       believe, is to differentiate that population of

        21       the given home into two segments.  There will be

        22       a Medicare segment and a Medicaid segment, and

        23       rates will be established separately according











                                                             
2645

         1       to the two.  The assumption is that the needs

         2       level, the RUGS rate for the federal government

         3       would be higher because the level of care needed

         4       for those people would be higher.  The average

         5       level of care needed for the non-Medicare

         6       population would be somewhat lower.  That would

         7       permit the Medicaid rate to go down.

         8                      You don't end up with any

         9       differential in total income for the nursing

        10       home.  What you do, however, is you have the

        11       federal government paying for the higher level

        12       of care that is necessary for the Medicare

        13       population as opposed to the Medicaid

        14       population.

        15                      SENATOR LEICHTER:  Mr.

        16       President.

        17                      ACTING PRESIDENT FARLEY:  Senator

        18       Leichter.

        19                      SENATOR LEICHTER:  Will Senator

        20       Cook yield?

        21                      SENATOR COOK:  Yes.

        22                      SENATOR LEICHTER:  But, Senator,

        23       the level of care is not determined whether you











                                                             
2646

         1       are on Medicare or whether you are on Medicaid.

         2       The level of care is determined by how sick you

         3       are, how infirm you are.

         4                      SENATOR COOK:  Mr. President.

         5       Senator, I think you are looking at it backwards

         6       because you don't begin with the rate at the top

         7       and go down.  You start with each patient, and

         8       you, in effect, survey what the care needs are

         9       for the patient in a nursing home.  Not all

        10       nursing homes would get the same RUGS rate

        11       depending -- of wherever they are.  It depends

        12       on the level of service they need.

        13                      So that's where you start.  You

        14       provide the level of service needed, level of

        15       care needed by the patient, and that's where the

        16       rate is established.  It's based on the severity

        17       of the cases within that nursing home.

        18                      So, Senator, it could be

        19       conceivable in some cases, I guess, where the

        20       Medicare rate could actually be lower and the

        21       Medicaid rate higher because it's based upon -

        22       on a survey of the actual patients.  It's not an

        23       assumption that you are going to give less care











                                                             
2647

         1       to somebody.  It's based on an actual survey

         2       that less care is actually needed by those

         3       patients that are there, and that's why you end

         4       up with a lower rate.

         5                      Am I basically correct?

         6                      SENATOR HOLLAND:  Yes.

         7                      SENATOR LEICHTER:  But, again,

         8       Senator Cook, the fact is that if you determine

         9        -- if you end up that all of the Medicaid

        10       patients require greater care than the Medicare

        11       patients, which may often be the case because

        12       they by and large tend to be a poorer

        13       population, then under no circumstance will

        14       there be any saving even for the home.  So it's

        15       hard to understand.

        16                      I think essentially as I -- I

        17       think as this bill becomes clearer, I think you

        18       are making a distinction between Medicare and

        19       Medicaid which I think may be unfortunate, and

        20       you are also I think in a sense going to

        21       stigmatize people who are on Medicaid.  Then

        22       what happens if somebody who is on Medicare may

        23       lose that Medicare eligibility? And then, what,











                                                             
2648

         1       move to Medicaid? I think you are setting up a

         2       double standard here.  And certainly one thing

         3       is clear.  There is no saving to the state.

         4                      SENATOR COOK:  Mr. President.

         5                      ACTING PRESIDENT FARLEY:  Senator

         6       Cook.

         7                      SENATOR COOK:  Try one more

         8       time.  Let's assume we are all in a nursing

         9       home, the 61 of us.  Everybody on that side of

        10       the aisle needs a catheter that has to be

        11       changed all the time.  Okay.  Nobody on this

        12       side does.  When you determine the RUGS rate,

        13       currently, you take all of those costs of all of

        14       these patients and you mix them all together and

        15       you say the average cost of caring for a patient

        16       in this nursing home is a certain level

        17       depending on whether they need the catheter or

        18       they don't need it, because it's based on an

        19       average level of care in the facility.

        20                      What this attempts to do is say

        21       all the people on that side of the room happen

        22       to be Medicare eligible.  So you are going to

        23       compute their rate separately from the people on











                                                             
2649

         1       this side of the aisle who are not Medicaid

         2       eligible.  However, what happens is because you

         3       now all need catheters and we don't and

         4       therefore the rate is higher on your side, you

         5       still get your catheters.  You get reimbursed

         6       for a higher rate, and you happen to be in

         7       Medicare because the federal government is

         8       paying it.  All of us on this side who don't

         9       have the catheters are getting reimbursed

        10       Medicaid rates which will be lower.  So let's

        11       say it's $100.  You are paying an average of

        12       $100 a day for everybody in the room.  You may

        13       end up with a Medicare rate now being 125, the

        14       Medicaid rate being 75, because of the different

        15       level of care required for those patients.  But

        16       when you average it all up, it's still $100 per

        17       patient for the whole nursing home.

        18                      SENATOR GOLD:  Mr. President.

        19                      ACTING PRESIDENT FARLEY:  Senator

        20       Gold.

        21                      SENATOR GOLD:  Senator Cook, I

        22       think I followed you, but you are talking about

        23       catheters which are a supply.  Would it be the











                                                             
2650

         1       same, for example, let's say everybody on that

         2       side of the aisle needed deep psychiatric care

         3       and the people on this side -

         4                      (Laughter.)

         5                      SENATOR COOK:  Same principle.

         6       Same principle.

         7                      ACTING PRESIDENT FARLEY:  Same

         8       principle.

         9                      Senator Onorato.

        10                      SENATOR ONORATO:  I don't know

        11       who wants to tackle this, Senator Holland or

        12       Senator Cook.  What happens eventually -- we

        13       know when we're dealing with nursing homes that

        14       the mix is Medicare and Medicaid.  What happens

        15       is eventually most Medicare patients do become

        16       Medicaid somewhere down the line when their

        17       funds are exhausted.  How does that now affect

        18       the rates when they start -- originally, you

        19       went into the nursing home, you had 50 Medicare

        20       and 100 Medicaid.  Now you got 140 Medicaid and

        21       10 Medicare.  Do you have to constantly readjust

        22       the rates for the nursing home or not?

        23                      ACTING PRESIDENT FARLEY:  Senator











                                                             
2651

         1       Cook.

         2                      SENATOR COOK:  Mr. President.

         3       You click over onto whatever your eligibility

         4       is.  I believe that the surveys are done

         5       periodically.  The RUGS rate is established.

         6       I'm not sure how often the survey is done, but

         7       periodically the patients within the nursing

         8       home are surveyed.  So the next year when they

         9       came around and surveyed all the patients who

        10       are in the Medicaid section, that person who had

        11       moved into Medicaid would be apart of that

        12       survey for establishing the Medicaid rate rather

        13       than the part of the group that was used in

        14       surveying for the Medicare rate.

        15                      ACTING PRESIDENT FARLEY:  You can

        16       read the last section.

        17                      I'm sorry.  Somebody? Oh, I'm

        18       sorry, Senator Montgomery.

        19                      SENATOR MONTGOMERY:  Thank you,

        20       Mr. President.  Would Senator Holland yield for

        21       a question?

        22                      ACTING PRESIDENT FARLEY:  Senator

        23       Holland.











                                                             
2652

         1                      SENATOR MONTGOMERY:  Thank you,

         2       Senator Holland, I'm a little bit confused.  The

         3       way that you and Senator Cook have been

         4       discussing what happens when you separate out

         5       the Medicare and the Medicaid is that it's

         6       primarily a fiscal action that is required, and

         7       so it's basically paper that we're talking about

         8       that we need to establish which beds are

         9       Medicare and which are Medicaid.

        10                      So your bill seems to establish

        11       segregated units, however, and force the

        12       facility to respond by physically segregating

        13       the beds themselves.  And I'm just wondering why

        14       you feel it necessary to establish this kind of

        15       segregation among the patients in the nursing

        16       home.

        17                      SENATOR HOLLAND:  They do have to

        18       be separated, Senator, as you say.  We feel it

        19       would be a savings for the nursing home and,

        20       overall, for the state as well.  That's our

        21       thrust.

        22                      SENATOR MONTGOMERY:  If they are

        23       required to physically segregate the beds?











                                                             
2653

         1                      SENATOR HOLLAND:  They are

         2       required.

         3                      SENATOR MONTGOMERY:  In other

         4       words, we can't get the differential in

         5       reimbursement unless the beds are physically

         6       segregated?

         7                      SENATOR HOLLAND:  That is true,

         8       Senator, and that is the reason or one of the

         9       reasons that the facility has to have a plan

        10       approved by the Commissioner with regard to

        11       transfers if this proposal is accepted.  It has

        12       to be agreeable to the Commissioner.

        13                      SENATOR MONTGOMERY:  Mr.

        14       President, if I may pursue that?

        15                      ACTING PRESIDENT FARLEY:  Senator

        16       Montgomery.

        17                      SENATOR MONTGOMERY:  In order to

        18       get the reimbursement at a higher rate, it is

        19       not simply that one bed, A, because it's a

        20       Medicare patient receives a different rate of

        21       reimbursement than bed B because that patient is

        22       a Medicaid patient? Is that not the case?

        23                      SENATOR HOLLAND:  They have to be











                                                             
2654

         1       physically separated.  If could be the next room

         2       or the next aisle, but they have to be

         3       physically separated.

         4                      SENATOR MONTGOMERY:  Mr.

         5       President.  If Senator Holland would allow me I

         6       would like to ask, then, why do you establish

         7       units? Why is it necessary to establish units?

         8                      SENATOR HOLLAND:  Federal

         9       regulations, Senator.  But just indicating the

        10       separate areas, that's all it means.

        11                      SENATOR MONTGOMERY:  The Medicare

        12       rate indicates a higher level of service?

        13                      SENATOR HOLLAND:  Yes.

        14                      SENATOR MONTGOMERY:  For that

        15       patient?

        16                      SENATOR HOLLAND:  Yes.

        17                      SENATOR MONTGOMERY:  But it also

        18       requires that patient to be in a different

        19       room?

        20                      SENATOR HOLLAND:  Yes.

        21                      SENATOR MONTGOMERY:  And a

        22       different wing of -

        23                      SENATOR HOLLAND:  Not necessarily











                                                             
2655

         1       a different wing.  It could be the next bed.

         2       They could just move the bed to a separate area,

         3       a distinct unit, a distinct area.

         4                      SENATOR MONTGOMERY:  Mr.

         5       President, if Senator Holland would yield?

         6                      I would like to ask you if the

         7       facility -- if you anticipate based on this

         8       legislation that the facility would then begin

         9       to diminish the number of Medicaid beds because

        10       of the higher rate of reimbursement to Medicare

        11       and, therefore, we may lose a number of Medicaid

        12       beds in the state?

        13                      SENATOR HOLLAND:  Hasn't been the

        14       case, Senator.  I don't see that.  It really

        15       depends upon the census.  Eighty percent of

        16       clients in nursing homes are Medicaid today and

        17       historically.

        18                      SENATOR MONTGOMERY:  They are

        19       today?

        20                      SENATOR HOLLAND:  Yes.

        21                      SENATOR MONTGOMERY:  But assuming

        22       that the nursing home is interested in balancing

        23       its books, do you anticipate that it may be -











                                                             
2656

         1       they may see it in their interest to reduce the

         2       number of Medicaid beds, make smaller units for

         3       Medicaid beds and larger units for Medicare? Is

         4       that conceivable?

         5                      SENATOR HOLLAND:  It is

         6       conceivable, I guess, Senator.

         7                      SENATOR MONTGOMERY:  Okay.  Thank

         8       you, Senator Holland.

         9                      Mr. President, just on the bill

        10       briefly.

        11                      ACTING PRESIDENT FARLEY:  Senator

        12       Montgomery on the bill.

        13                      SENATOR MONTGOMERY:  I think

        14       based that on the debate on the floor and

        15       certainly Senator Holland's own acknowledgement

        16       that we may lose, in fact, Medicaid beds and

        17       that we're now asking nursing homes to have

        18       separate units, and it's conceivable that we may

        19       have two units dedicated to Medicare and one

        20       unit dedicated to Medicaid, because there's more

        21       income based on the Medicare, the number of

        22       Medicare beds, and so I would urge, Senator

        23       Holland, to think very carefully about the











                                                             
2657

         1       possible consequences of this.

         2                      Because, one, we're segregating

         3       patients within the same facility and, two,

         4       there is a possibility that we're going to lose

         5       the mix of nursing home beds that we currently

         6       have because nursing homes will see it in their

         7       interest not to serve Medicaid patients as equal

         8       priority to Medicare patients.

         9                      So I hope that Senator Holland

        10       will rethink this and that we're able to come up

        11       with a solution that does not require us to

        12       segregate patients in any nursing home in the

        13       state.

        14                      (Whereupon, Senator Mega was in

        15       the chair. )

        16                      ACTING PRESIDENT MEGA:  Senator

        17       Espada.

        18                      SENATOR ESPADA:  Yes, Mr.

        19       President.  Would Senator Holland yield for a

        20       question, please?

        21                      ACTING PRESIDENT MEGA:  Senator

        22       Holland, will you yield?

        23                      SENATOR HOLLAND:  Yes, I will.











                                                             
2658

         1                      ACTING PRESIDENT MEGA:  Senator

         2       yields.

         3                      Senator Espada.

         4                      SENATOR ESPADA:  Senator Holland,

         5       I'm advised that RUGS 3 will probably answer

         6       some of the questions with respect to these

         7       distinctions.  They are due to take effect this

         8       summer.  Why not wait that out and see the full

         9       implementation of the new federal initiative

        10       there?

        11                      SENATOR HOLLAND:  It's a

        12       probability what you say, that RUGS 3 will

        13       assist.  But they have been slow in implementing

        14       RUGS 3 and we just wanted to move ahead.

        15                      SENATOR ESPADA:  Mr. President,

        16       if I might follow up.

        17                      SENATOR HOLLAND:  Yes.

        18                      ACTING PRESIDENT MEGA:  You may.

        19                      SENATOR ESPADA:  Having heard the

        20       possible ramifications that are not -- it is not

        21       the legislative intent of this sponsor, I'm

        22       sure.  But I tell you coming from a health care

        23       background, unfortunately what drives much of











                                                             
2659

         1       the treatment plans, the quality of the

         2       treatment plans, is the reimbursement, is the

         3       amount of money received at the other end of the

         4       treatment phase.  That's unfortunate, but it's a

         5       real truism in our industry.  And I would ask

         6       you to please take into account that perhaps in

         7       terms of balancing these equities, it may very

         8       well be worth our while to wait and see the full

         9       impact of RUGS 3.  I ask you to please consider

        10       that.

        11                      ACTING PRESIDENT MEGA:  Read the

        12       last section.

        13                      THE SECRETARY:  Section 2.  This

        14       act -

        15                      ACTING PRESIDENT MEGA:  Oh,

        16       Senator Jones.  I apologize.

        17                      SENATOR JONES:  That's okay.

        18                      ACTING PRESIDENT MEGA:  Senator

        19       Jones.

        20                      SENATOR JONES:  Will Senator

        21       Holland yield for another question?

        22                      ACTING PRESIDENT MEGA:  Senator

        23       Holland, do you yield?











                                                             
2660

         1                      Senator yields.

         2                      Senator Jones.

         3                      SENATOR JONES:  Thank you.  I'm

         4       still trying to get this straightened out in my

         5       mind, and I have to admit at this point my heart

         6       is also getting involved since I have a

         7       92-year-old mother, and I'm trying to picture

         8       these two sections here.  But is there not a

         9       problem today that the number of people -- there

        10       are many people in hospitals.  I believe that

        11       was a major concern during the budget process

        12       that there are people waiting for nursing home

        13       beds.  Is that not correct?

        14                      SENATOR HOLLAND:  That's true,

        15       yes, Senator.

        16                      SENATOR JONES:  Okay.  Now, my

        17       next question is, does the nursing home at some

        18       point make a distinction? I'm not sure whether

        19       it would be on the number of patients there or

        20       whatever.  We have, let's say, 30 Medicare beds,

        21       40 Medicaid beds.  Would it be something like

        22       that?

        23                      SENATOR HOLLAND:  I assume that











                                                             
2661

         1       would be in the policy that is approved by the

         2       Commissioner, yes, Senator.

         3                      SENATOR JONES:  Okay. Then I

         4       guess I'm wondering would that not then create

         5       an additional problem if these nursing homes

         6       then cut down on the number of Medicaid beds?

         7       What would then happen to the people awaiting

         8       these beds in hospitals?

         9                      SENATOR HOLLAND:  I wouldn't -- I

        10       wouldn't -- I want to go back to what Senator

        11       Montgomery said.  You know, it's just a

        12       possibility.  I don't think this is really going

        13       to happen.  And I also believe that if there was

        14       a necessity to change the number of beds, the

        15       Commissioner would be more than willing to

        16       change the number of beds.  I don't think we're

        17       going to leave any beds unoccupied if we can put

        18       people into them and help the people.

        19                      SENATOR JONES:  Okay.  Would the

        20       Senator just yield to one more question?

        21                      ACTING PRESIDENT MEGA:  Senator

        22       yields.

        23                      SENATOR JONES:  In other words,











                                                             
2662

         1       you're saying, then, that this decision can be

         2       changed at any point by a nursing home.  Say

         3       they needed to change the mix, 30/40, or

         4       whatever it could.  There would not be a time

         5       frame that this would have to happen.

         6                      SENATOR HOLLAND:  Yes.

         7                      SENATOR JONES:  Thank you,

         8       Senator.

         9                      ACTING PRESIDENT MEGA:  Are there

        10       any other questions or any comments on Senator

        11       Holland's bill?

        12                      If not, read the last section.

        13                      THE SECRETARY:  Section 3.  This

        14       act shall take effect immediately.

        15                      ACTING PRESIDENT MEGA:  Call the

        16       roll.

        17                      (The Secretary called the roll. )

        18                      ACTING PRESIDENT MEGA:  Senator

        19       Smith to explain her vote.

        20                      SENATOR SMITH:  Thank you, Mr.

        21       President.  As a former administrator in a

        22       nursing home, I'm greatly concerned about the

        23       segregation that this bill would create,











                                                             
2663

         1       especially since I have been privy to how

         2       skilled nursing facility beds and health-related

         3       beds have been traded off for the sake of

         4       finances.  And in communities such as those that

         5       I represent, the majority of the people are

         6       clearly Medicaid eligible and not Medicare

         7       eligible.  And I've even watched as people are

         8       accepted from hospitals into nursing homes and

         9       how the evaluations process can be skewed to

        10       take in only those that can be easily taken care

        11       of.  So this raises an even greater concern,

        12       and, therefore, I must vote in the negative.

        13       And I urge my colleagues to join me.

        14                      ACTING PRESIDENT MEGA:  Negatives

        15       please raise your hand.

        16                      Senator Santiago to explain her

        17       vote.

        18                      SENATOR SANTIAGO:  I would like

        19       to ask for unanimous consent to be excused from

        20       the vote, please.

        21                      ACTING PRESIDENT MEGA:  Without

        22       objection.

        23                      THE SECRETARY:  Those recorded in











                                                             
2664

         1       the negative on Calendar Number 108 are Senators

         2       Connor, Espada, Galiber, Jones, Leichter,

         3       Markowitz, Montgomery, Paterson and Smith.  Ayes

         4       42, nays 9.

         5                      ACTING PRESIDENT MEGA:  The bill

         6       is passed.

         7                      Senator Present, that concludes

         8       the calendar.

         9                      SENATOR PRESENT:  Mr. President,

        10       would you recognize Senator Paterson, please?

        11                      ACTING PRESIDENT MEGA:  Senator

        12       Paterson.

        13                      SENATOR PATERSON:  Thank you,

        14       Senator President -- Senator Present and Mr.

        15       President.  With unanimous consent, I would like

        16       to be recorded in the negative on Calendar

        17       Number 378.

        18                      ACTING PRESIDENT MEGA:  Without

        19       objection.

        20                      SENATOR PATERSON:  Thank you.

        21                      ACTING PRESIDENT MEGA:  Senator

        22       Montgomery.

        23                      SENATOR MONTGOMERY:  Yes, Mr.











                                                             
2665

         1       President.  I would like also unanimous consent

         2       to be recorded in the negative also on 378.

         3                      ACTING PRESIDENT MEGA:  Without

         4       objection.

         5                      SENATOR MONTGOMERY:  Thank you.

         6                      ACTING PRESIDENT MEGA:  Senator

         7       Present.  Stand at ease temporarily.

         8                      SENATOR PRESENT:  Mr. President.

         9                      ACTING PRESIDENT MEGA:  Senator

        10       Present.

        11                      SENATOR PRESENT:  There being no

        12       further business, I move we adjourn until

        13       Monday, April 26, at 2:30 p.m., intervening days

        14       to be legislative days.

        15                      ACTING PRESIDENT MEGA:  So

        16       ordered.

        17                      (Whereupon, at 1:06 p.m., the

        18       Senate adjourned. )

        19

        20

        21

        22