A 1198: Removes certain restrictions on eligibility for personal and home care services under medicaid.

  
  STATE OF NEW YORK ________________________________________________________________________ 1198 2025-2026 Regular Sessions  IN ASSEMBLY January 9, 2025 ___________ Introduced by M. of A. PAULIN, SIMON, EPSTEIN, JACKSON, ANDERSON, FORREST, LUPARDO, STECK, BRABENEC, MITAYNES, MAMDANI, KELLES, ROSEN- THAL, McMAHON, SAYEGH, REYES, SHRESTHA, RAMOS, GALLAGHER, McDONOUGH, SEAWRIGHT, SANTABARBARA, LUNSFORD, GONZALEZ-ROJAS, DAVILA, GALLAHAN, RAGA, ANGELINO -- read once and referred 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 Assem- bly, do enact as follows: 1 Section 1. Subparagraph (i) of paragraph (e) of subdivision 2 of 2 section 365-a of the social services law, as amended by section 2 of 3 part MM of chapter 56 of the laws of 2020, is amended to read as 4 follows: 5 (i) personal care services, including personal emergency response 6 services, shared aide and an individual aide, subject to the provisions 7 of subparagraphs (ii), (iii), (iv)[, (v)] and (vi) of this paragraph, 8 furnished to an individual who is not an inpatient or resident of a 9 hospital, nursing facility, intermediate care facility for individuals 10 with intellectual disabilities, or institution for mental disease, as 11 determined to meet the recipient's needs for assistance when cost effec- 12 tive and appropriate, and when prescribed by a qualified independent 13 physician selected or approved by the department of health, in accord- 14 ance with the recipient's plan of treatment and provided by individuals 15 who are qualified to provide such services, who are supervised by a 16 registered nurse and who are not members of the recipient's family, and 17 furnished in the recipient's home or other location; 18 § 2. Subparagraph (v) of paragraph (e) of subdivision 2 of section 19 365-a of the social services law is REPEALED.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 
 A. 1198 2 1 § 3. Paragraph (c) of subdivision 2 of section 365-f of the social 2 services law, as amended by section 3 of part MM of chapter 56 of the 3 laws of 2020, is amended to read as follows: 4 (c) has been determined by the social services district, pursuant to 5 an assessment of the person's appropriateness for the program, conducted 6 with an appropriate long term home health care program, a certified home 7 health agency, or an AIDS home care program or pursuant to the personal 8 care program, as being in need of home care services or private duty 9 nursing and [as needing at least limited assistance with physical maneu- 10 vering with more than two activities of daily living, or for persons 11 with a dementia or Alzheimer's diagnosis, as needing at least super- 12 vision with more than one activity of daily living, provided that the 13 provisions related to activities of daily living in this paragraph shall 14 only apply to persons who initially seek eligibility for the program on 15 or after October first, two thousand twenty, and] who is able and will- 16 ing or has a designated representative, including a legal guardian able 17 and willing to make informed choices, or a designated relative or other 18 adult who is able and willing to assist in making informed choices, as 19 to the type and quality of services, including but not limited to such 20 services as nursing care, personal care, transportation and respite 21 services; and 22 § 4. This act shall take effect immediately.