What's happening
This bill removes certain restrictions on eligibility for home care services, making it easier for individuals to access such care.
Why it matters
Broader home care access removes past barriers. By repealing restrictions like the need to show difficulty with multiple activities of daily living, the bill opens eligibility to a wider range of people, including those with less severe disabilities or different care needs.
Potentially faster and more flexible support. With fewer eligibility hurdles, individuals and families could access needed in-home services more quickly, possibly reducing the risk of deterioration or unnecessary institutionalization.
Empowers personal choice and independence. The changes emphasize that recipients (or their representatives) can make informed decisions about the type and quality of care, supporting autonomy and potentially improving satisfaction with care arrangements.
Could impact Medicaid costs and workforce demand. Easier access may increase demand for home care services, affecting state budgets and potentially creating more jobs in the home care sector, but also posing challenges if workforce supply is limited.
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Who cares
Headline styles
Expand Medicaid Home Care Access
Plain English, a few words. Used as the page title.
Sponsors
History
- Referred to health
- Reported and committed to finance
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Expand Medicaid Home Care Access
In Assembly Committee · Health · Sponsor Amy Paulin
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
358
2025-2026 Regular Sessions
IN SENATE (Prefiled)
January 8, 2025
Introduced by Sens. RIVERA, ADDABBO, BRISPORT, CLEARE, COONEY, GONZALEZ, HINCHEY, HOYLMAN-SIGAL, JACKSON, MARTINS, MAY, MYRIE, RAMOS, RHOADS, ROLISON, SALAZAR, SEPULVEDA, WEBB -- 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 removing certain restrictions on access to home care services; and to repeal certain provisions of such law relating thereto
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subparagraph (i) of paragraph (e) of subdivision 2 of section 365-a of the social services law, as amended by section 2 of part MM of chapter 56 of the laws of 2020, is amended to read as follows:
(i) personal care services, including personal emergency response services, shared aide and an individual aide, subject to the provisions of subparagraphs (ii), (iii), (iv)[, (v)] and (vi) of this paragraph, furnished to an individual who is not an inpatient or resident of a hospital, nursing facility, intermediate care facility for individuals with intellectual disabilities, or institution for mental disease, as determined to meet the recipient's needs for assistance when cost effective and appropriate, and when prescribed by a qualified independent physician selected or approved by the department of health, in accordance with the recipient's plan of treatment and provided by individuals who are qualified to provide such services, who are supervised by a registered nurse and who are not members of the recipient's family, and furnished in the recipient's home or other location;
§ 2. Subparagraph (v) of paragraph (e) of subdivision 2 of section 365-a of the social services law is REPEALED.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00585-01-5
§ 3. Paragraph (c) of subdivision 2 of section 365-f of the social services law, as amended by section 3 of part MM of chapter 56 of the laws of 2020, is amended to read as follows:
(c) has been determined by the social services district, pursuant to an assessment of the person's appropriateness for the program, conducted with an appropriate long term home health care program, a certified home health agency, or an AIDS home care program or pursuant to the personal care program, as being in need of home care services or private duty nursing and [as needing at least limited assistance with physical maneuvering with more than two activities of daily living, or for persons with a dementia or Alzheimer's diagnosis, as needing at least supervision with more than one activity of daily living, provided that the provisions related to activities of daily living in this paragraph shall only apply to persons who initially seek eligibility for the program on or after October first, two thousand twenty, and] who is able and willing or has a designated representative, including a legal guardian able and willing to make informed choices, or a designated relative or other adult who is able and willing to assist in making informed choices, as to the type and quality of services, including but not limited to such services as nursing care, personal care, transportation and respite services; and
§ 4. This act shall take effect immediately.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the social services law, in relation to removing certain restrictions on access to home care services; and to repeal certain provisions of such law relating thereto
Purpose of bill
To repeal limitations on certain eligibility requirements for an indi- vidual to receive personal care and private duty nursing services under Medicaid.
Summary of provisions
The bill amends Social Services Law § 365-a and § 365-f to eliminate the requirement that applicants for Medicaid services in the home have to be assessed as needing at least limited assistance with physical maneuver- ing with activities of daily living.
The current law qualifies individuals who need assistance with three or more activities of daily living, or for persons with a dementia or Alzheimer's diagnosis, who need assistance with two or more activities of daily living.
Justification
Activities of daily living include tasks such as dressing, using the bathroom, moving about one's home, housekeeping, and meals. Assisting persons who are elderly or with disabilities so that they may remain in their homes prevents the higher cost of them entering institutional care. This bill will restore eligibility criteria for home care services and consumer directed personal assistance (CDPA) to the form it existed before the 2020 legislation. This bill will ensure that New York contin- ues to comply with federal requirements under the Olmstead Decision and Community First Choice (CFC). Eligibility criteria for home care services must remain less stringent than that of nursing homes to ensure that services in the least restrictive setting are prioritized as set forth by Olmstead. Additionally, for the State to remain in compliance with CFC, avoid lawsuits, and retain the additional federal funding from the CFC program, we must eliminate any difference in services offered based on the type of disability.
The goal of this legislation is to allow individuals to continue to receive these needed services in their homes. For most people, home is the safest, healthiest, and preferred option. Congregate settings should be the last resort and are typically much more costly than home care services. This bill will help minimize institutionalization.
Legislative history
2023-24 - S328 Rivera / A6346 Paulin
2021-22 - S5028-A Rivera / A5367-A Gottfried
Fiscal implications
To be determined. In 2020, the Division of Budget estimated that this proposal would cost $277 million.
Effective date
Immediately.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.