Relates to state reimbursement for public health services provided by municipalities and to the incorporation of home health and hospices services within municipal public health services plans

Summary of specific provisions

This bill amends section 602 of the public health law to add home health and hospice services provided by a municipality that is a Certified Home Health Agency, a Long Term Home Health Care Program or a Hospice, to the list of services in municipal public health plans qualifying for article 6 reimbursement upon state approval of the municipal plan.

Justification

This legislation ensures the Legislature's jurisdiction over the components of article 6, and as such, the Legislature's design that counties who are home health agencies and hospices continue to qualify for article 6 reimbursement.

The State Department of Health's recent regulatory action undermines the long-standing provision of home health services by counties. Last year when the Department made a similar proposal legislatively, it was soundly rejected by the Legislature.

For many areas of the state, county-sponsored home care agencies are the safety net of the service delivery system - assuring that the home care needs of the most difficult and chronic cases in the community are met.

In addition to providing crucial rehabilitative and life-sustaining care at home to the elderly and disabled in these communities, these agencies are the source of vital public health services, including urgent responses to epidemics such as the H1N1, flu and other immunization needs, preventive health screening and intervention, maternal and child health care, emergency response in natural disasters, and other services.

These agencies are pivotal to the functioning of the entire health system in their communities, providing safe and appropriate care upon hospital discharge, permitting more appropriate and cost-effective use of hospital and nursing home services, enabling patients to avoid premature or unnecessary nursing home placement, reducing rates of hospitalization and re-hospitalization among the post acute and chronically ill, and providing and coordinating home care in all corners of their region.

A financial condition study of the home care system in New York State, published in January, showed that the compounding pressures of Medicaid underpayment, state budget cuts, the behavior of managed care plans, unfunded mandates and other system issues have taken an enormous toll on county-sponsored home care services - which are

already challenged by resource limitations, staffing and geographic conditions.

A discontinuation of these services under Article 6 will likely cause the closure of many certified home health agencies and/or long term home health care programs and adversely affect the entire health care delivery system in these communities. This legislation is necessary to ensure that continuation.

Prior legislative history

New bill.

Fiscal implications

No additional State expense. Funding for article 6 services is provided in the State health appropriations bill (S.6604-B/A.9704-C) passed in June. This legislation would move county-sponsored home health and hospice services from the regulatory definition, the amendments to which would discontinue them under article 6, to the statutory list of municipal public health services qualifying for reimbursement. As such, counties would continue to qualify for article 6 home health and hospice reimbursement under the existing appropriation.

Effective date

The bill shall take effect immediately and shall be deemed to have been in full force and effect on or after July 1, 2010.