Relates to payments under managed long term care plans for home care services

BILL NUMBER:S7141

Title of bill

An act to amend the public health law, in relation to payments under managed long term care plans for home care services

Purpose

To ensure that monies paid by managed long term care programs (insurers providing long term care) include adequate reimbursement to ensure compliance with State wage mandates, adjustments for increased fuel costs, and provide for the pass through of worker recruitment and retention monies in payments to agencies that employ direct care workers in the home care industry.

Summary of provisions

Section one of the bill adds a new subdivision 12 to section 4403-f of the public health law to ensure adequacy of payment for compliance with State wage mandates, pass through for escalating fuel costs, and worker recruitment and retention monies to agencies certified and licensed under article thirty six of the public health law providing direct care services to disabled, elderly and other populations.

Section 2 of the bill is the effective date.

Statement in support

Home care providers are in severe financial distress. Recent cuts and unfunded mandates have hampered agencies' ability to continue delivering care to New York's elderly, disabled and chronically-ill and have put home care jobs at risk.

At the same time, recent changes in State law have resulted in a shift from fee-for-service to managed care for the provision of home and community-based services. As a result, rather than working directly with the State to obtain reimbursement, home care providers are now working with managed care and managed long term plans. Similar to other health insurance companies, it is critical that the State monitor and ensure adequate reimbursement to providers from managed care and managed long term care plans to ensure high quality care is provided to the State's elderly, disabled and other populations. Absent such actions, New York's home care industry, which has lead the nation in providing high quality and cost-effective care to the state's elderly, disabled and other popu- lations for several decades, is at risk.

This legislation seeks to ensure that agencies have the necessary resources to meet State and local wage mandates. In addition, the legis- lation seeks to ensure that worker recruitment and retention monies are passed through from insurance plans to the agencies that directly employ the workers and deliver the care.

In addition, agencies and workers must receive an adjustment in reimbursement for the ever-increasing costs of transportation, whether

this involves increased MTA fares, bus fares in suburban and urban areas, as well as the ever-escalating cost of gasoline for workers that drive sometimes hundreds of miles a day to deliver care. While overall driving costs increased over 3% according to the AAA in 2011, the costs of gasoline have risen almost $2 per gallon since 2009.

Rates of payments to agencies and their workers must incorporate monies to ensure compliance with State and local wage mandates, ensure State recruitment and retention funds get to the workers, and recognize the escalating costs of transportation.

Fiscal implications

None.

Legislative history

This is a new bill.

Effective date

Immediately.