Bill Text: NY A06329 | 2021-2022 | General Assembly | Amended


Bill Title: Enacts provisions to provide minimum wages for home care aides; requires at least 150% of minimum wage or other set minimum; directs the commissioner of health to set regional minimum rates of reimbursement for home care aides under medicaid and managed care plans.

Spectrum: Strong Partisan Bill (Democrat 92-10)

Status: (Introduced - Dead) 2022-01-05 - referred to ways and means [A06329 Detail]

Download: New_York-2021-A06329-Amended.html



                STATE OF NEW YORK
        ________________________________________________________________________

                                         6329--A

                               2021-2022 Regular Sessions

                   IN ASSEMBLY

                                     March 16, 2021
                                       ___________

        Introduced by M. of A. GOTTFRIED, REYES, DINOWITZ, FRONTUS, GONZALEZ-RO-
          JAS,  BURGOS, CARROLL, KIM, BURDICK, JACOBSON, SIMON, GUNTHER, ABINAN-
          TI, CYMBROWITZ, BRABENEC, GALEF,  EPSTEIN,  KELLES,  MAMDANI,  PAULIN,
          QUART,  MITAYNES,  LUPARDO,  BICHOTTE HERMELYN,  STECK,  L. ROSENTHAL,
          TAGUE, ENGLEBRIGHT, SOLAGES, FALL,  RAMOS,  HUNTER,  CRUZ,  GALLAGHER,
          CAHILL,  FORREST,  M. MILLER,  JONES,  JEAN-PIERRE,  SEPTIMO,  BARRON,
          STERN,  DICKENS,  O'DONNELL,  CLARK,  FERNANDEZ,  LUNSFORD,   BRONSON,
          SEAWRIGHT, MEEKS, JOYNER, HYNDMAN, DARLING, McDONOUGH, HEVESI, STIRPE,
          DURSO,  SILLITTI,  McDONALD,  SMITH,  CUSICK,  PERRY,  WOERNER,  OTIS,
          ZEBROWSKI, PRETLOW, DE LA ROSA, SAYEGH,  J. A. GIGLIO,  PHEFFER AMATO,
          TAPIA,  BUTTENSCHON, FAHY, ANDERSON, PEOPLES-STOKES, RAJKUMAR, LAVINE,
          J. D. RIVERA, NIOU -- read once  and  referred  to  the  Committee  on
          Health  -- reported and referred to the Committee on Ways and Means --
          committee discharged, bill amended, ordered reprinted as  amended  and
          recommitted to said committee

        AN  ACT to amend the public health law, the state finance law and part H
          of chapter 59 of the laws of 2011, amending the public health law  and
          other  laws relating to known and projected department of health state
          fund Medicaid expenditures, in relation to  fair  pay  for  home  care
          aides

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. The public health law is amended by adding  a  new  section
     2  3614-f to read as follows:
     3    §  3614-f. Fair pay for home care. 1. For the purpose of this section,
     4  "home care aide" shall have the same meaning defined in section  thirty-
     5  six hundred fourteen-c of this article.
     6    2.  Beginning  January  first,  two thousand twenty-three, the minimum
     7  wage for a home care aide shall be no less than one  hundred  and  fifty
     8  percent  of  the  higher  of:  (a) the otherwise applicable minimum wage
     9  under section six hundred fifty-two of the labor law, or (b) any  other-

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD10145-02-1

        A. 6329--A                          2

     1  wise  applicable  wage rule or order under article nineteen of the labor
     2  law.
     3    3.  Where  any  home  care  aide  is  paid  less than required by this
     4  section, the home care aide, or the  commissioner  of  labor  acting  on
     5  behalf  of  the home care aide, may bring an action under article six or
     6  nineteen of the labor law.
     7    4. (a) The commissioner shall establish a regional minimum hourly base
     8  reimbursement rate for all providers employing workers  subject  to  the
     9  minimum  wage provisions established in subdivision one of this section.
    10  The regional minimum hourly base reimbursement rate shall  be  based  on
    11  regions established by the commissioner, provided that for areas subject
    12  to section thirty-six hundred fourteen-c of this article, each area with
    13  a  different  prevailing  rate of total compensation, as defined in that
    14  section, shall be its own region.
    15    (b) For the purposes of this section, "regional  minimum  hourly  base
    16  reimbursement rate" means a reimbursement rate that reflects the average
    17  combined costs associated with the provision of direct service inclusive
    18  of, but not limited to, overtime costs; all benefits; all payroll taxes,
    19  including  but not limited to federal insurance contributions act, medi-
    20  care, federal unemployment tax act, state unemployment insurance,  disa-
    21  bility  insurance, workers' compensation, and the metropolitan transpor-
    22  tation authority tax; related increases  tied  to  base  wages  such  as
    23  compression;  reasonable  administrative costs as defined by the commis-
    24  sioner; allowances for capital  costs;  the  development  of  profit  or
    25  reserves as allowable by law or regulations of the commissioner; and any
    26  additional supplemental payments.
    27    5.  (a)  The  initial  regional minimum hourly base reimbursement rate
    28  shall be no less than the following:
    29    (i) thirty-eight dollars and fifty cents per hour in the  wage  parity
    30  region,  encompassing all counties subject to section thirty-six hundred
    31  fourteen of this article; and
    32    (ii) thirty-eight dollars and eighteen cents per hour for the counties
    33  in the remainder of the state.
    34    (b) For consumer directed personal assistance services provided  under
    35  section  three  hundred  sixty-five-f  of  the  social services law, the
    36  initial regional minimum hourly base reimbursement  rate  shall  reflect
    37  the  rates  established  in  paragraph (a) of this subdivision, provided
    38  that the commissioner may reduce such rates by no more than  twelve  and
    39  nine-tenths  percent.  In  the  event  that such reduction occurs, a per
    40  member, per month  increase  reflective  of  actual  administrative  and
    41  general  costs,  adjusted to reflect regional differences as regions are
    42  defined in this section, shall be made to fiscal intermediaries adminis-
    43  tering such programs. If the department or a managed  care  organization
    44  chooses  not  to  utilize  the per member, per month payment established
    45  pursuant to this paragraph, the regional minimum hourly base  reimburse-
    46  ment  rate for that region, as defined in paragraph (a) of this subdivi-
    47  sion, shall apply.
    48    6. No payment made to a provider who employs home care  aides  subject
    49  to  this  section  that  is  less  than the regional minimum hourly base
    50  reimbursement rate established by the  commissioner  for  a  region  for
    51  services  provided  under  authorization by a local department of social
    52  services, a managed care provider under  section  three  hundred  sixty-
    53  four-j  of the social services law, or a managed long-term care provider
    54  under section forty-four hundred-f  of  this  chapter  shall  be  deemed
    55  adequate.

        A. 6329--A                          3

     1    (a)  The  commissioner shall submit any and all necessary applications
     2  for approvals and/or waivers to the federal  centers  for  medicare  and
     3  medicaid  services  to  secure approval to establish minimum hourly base
     4  reimbursement rates and make state-directed payments  to  providers  for
     5  the purposes of supporting wage increases.
     6    (b)  Directed  payments  shall  be  made to such providers of medicaid
     7  services through contracts with managed care organizations where  appli-
     8  cable,  provided  that  the  commissioner  ensures  that  such  directed
     9  payments are in accordance with the terms of this section.
    10    (c) The commissioner shall ensure  that  managed  care  capitation  is
    11  adjusted to ensure rate adequacy for the managed care organizations.
    12    7.  Nothing  in  this  section shall preclude providers employing home
    13  care aides covered under this section or  payers  from  contracting  for
    14  services   at  rates  higher  than  the  regional  minimum  hourly  base
    15  reimbursement rate if the parties agree to such terms.
    16    8. The commissioner shall publish and  post  regional  minimum  hourly
    17  base  reimbursement rates annually and shall take all necessary steps to
    18  advise commercial and government programs payers of home  care  services
    19  of  the  regional  minimum  hourly  base reimbursement rates and require
    20  other state authorized  payers  to  reimburse  providers  of  home  care
    21  services at the minimum hourly base reimbursement rate.
    22    9.  Following  the  initial  established  regional minimum hourly base
    23  reimbursement rate established  under  this  section,  the  commissioner
    24  shall  annually  adjust  the regional hourly base reimbursement rate for
    25  each region to reflect costs or other increases in wages,  benefits,  or
    26  other  requirements.  The  commissioner  shall develop a methodology for
    27  annual increases,  taking  into  consideration  relevant  data  sources,
    28  including but not limited to information from certified cost reports and
    29  statistical  reports  submitted to the department by providers employing
    30  individuals subject to this section for the prior calendar year, consum-
    31  er price index increases; subsequent pandemic  or  other  public  health
    32  emergencies;  and  other relevant economic factors.  Prior to finalizing
    33  such methodology, the commissioner shall establish  a  public  workgroup
    34  that  shall  include  provider, consumer, managed care organization, and
    35  labor representatives from each geographical region in which there is an
    36  established regional minimum hourly base reimbursement  rate;  statewide
    37  associations;  and other stakeholders to inform the process. The commis-
    38  sioner shall publish and take public input on the  proposed  methodology
    39  to be used to update regional minimum hourly base reimbursement rates.
    40    10. Annual increases to the regional minimum hourly base reimbursement
    41  rates  shall be issued and posted by the department by September thirti-
    42  eth of the prior calendar year to when such rates shall take effect.
    43    11. For years in which rate adjustments to the regional minimum hourly
    44  base reimbursement rate have not been calculated prior to the  start  of
    45  the  calendar year, the previous year's rate shall remain in place until
    46  the new rate is calculated. If it is determined  that  retroactive  rate
    47  adjustments  are necessary, payment adjustments will be made as a direct
    48  pass through to providers within sixty days of the adjusted rate.
    49    § 2. Section 3614-d of the public health law, as added by  section  49
    50  of  part  B  of  chapter  57  of the laws of 2015, is amended to read as
    51  follows:
    52    § 3614-d. Universal  standards  for  coding  of  payment  for  medical
    53  assistance claims for long term care. Claims for payment submitted under
    54  contracts  or  agreements  with  insurers  under  the medical assistance
    55  program for home and community-based long-term  care  services  provided
    56  under  this  article,  by  fiscal  intermediaries  operating pursuant to

        A. 6329--A                          4

     1  section three hundred sixty-five-f of the social services  law,  and  by
     2  residential  health  care facilities operating pursuant to article twen-
     3  ty-eight of this chapter shall have standard billing codes. Such  insur-
     4  ers  shall include but not be limited to Medicaid managed care plans and
     5  managed long term care plans. Such payments shall be based on  universal
     6  billing  codes  approved  by  the  department or a nationally accredited
     7  organization as approved by  the  department;  provided,  however,  such
     8  coding  shall  be  consistent  with  any  codes developed as part of the
     9  uniform assessment system for long term care established by the  depart-
    10  ment  and shall include, for any entity operating pursuant to this arti-
    11  cle or section three hundred sixty-five-f of  the  social  services  law
    12  that  is  unable to control the cumulative hours worked by an individual
    13  in a given payroll period, a code that is specific to the hourly cost of
    14  services at an overtime rate.
    15    § 3. The state finance law is amended by adding a new section 91-h  to
    16  read as follows:
    17    § 91-h. Fair pay for home care fund. 1. There is hereby established in
    18  the  joint  custody  of the commissioner of taxation and finance and the
    19  comptroller, a special fund to be known as the "fair pay for  home  care
    20  fund".
    21    2. The fund shall consist of, but not be limited to:
    22    a.  revenues  and federal medical assistance percentage reimbursements
    23  in excess of the standard reimbursement received by  the  department  of
    24  health pursuant to section thirty-seven of part B of chapter fifty-seven
    25  of the laws of two thousand fifteen;
    26    b.  an amount equal to savings from the permanent conversion or decer-
    27  tification of residential health  care  facility  beds,  as  defined  in
    28  section  twenty-eight  hundred  one  or  twenty-eight hundred two of the
    29  public health law;
    30    c. any unspent monies from the New  York  works  economic  development
    31  funds  or  a  life sciences initiative created by section one of chapter
    32  fifty-four of the laws of two thousand seventeen which  were  originally
    33  appropriated  prior to the two thousand nineteen state fiscal year which
    34  have not been bound by a contract as of April first two  thousand  twen-
    35  ty-one and which are not otherwise legally required to be spent on capi-
    36  tal  projects under bonding requirements through the dormitory authority
    37  of New York state or other bonding entity; and
    38    d. any grants, gifts  or  bequests  received  by  the  state  for  the
    39  purposes of the fund under this section.
    40    3.  Monies  of  the  fund  shall be distributed to the commissioner of
    41  health, or the commissioner's designee, for the  purpose  of  increasing
    42  medical  assistance reimbursements under title eleven of article five of
    43  the social services law to entities subject to minimum wage requirements
    44  for home care aides under section thirty-six hundred fourteen-f  of  the
    45  public  health  law,  provided  that  the  monies  of this fund shall be
    46  utilized to offset general fund expenses related to  implementation  and
    47  ongoing  costs  of  section  thirty-six hundred fourteen-f of the public
    48  health law and shall not be the sole source of funds made  available  to
    49  meet the requirements established by such section.
    50    § 4. Paragraph (c) of subdivision 1 of section 92 of part H of chapter
    51  59  of  the  laws  of 2011 amending the public health law and other laws
    52  relating to known and projected department of health state fund Medicaid
    53  expenditures, as amended by section 1 of part CCC of chapter 56  of  the
    54  laws of 2020, is amended to read as follows:
    55    (c)  Projections  may  be  adjusted  by  the director of the budget to
    56  account for any changes in the New York state federal medical assistance

        A. 6329--A                          5

     1  percentage amount established pursuant to the  federal  social  security
     2  act,  changes  in provider revenues, reductions to local social services
     3  district medical  assistance  administration,  minimum  wage  increases,
     4  increases  to  the mandatory base wage for home care workers pursuant to
     5  article 36 of the public health law, and beginning  April  1,  2012  the
     6  operational costs of the New York state medical indemnity fund and state
     7  costs  or  savings  from the basic health plan.  Such projections may be
     8  adjusted by the director of the budget to account for increased or expe-
     9  dited department of health state funds medicaid expenditures as a result
    10  of a natural or other type of disaster, including a governmental  decla-
    11  ration of emergency.
    12    §  5.   Paragraph (a) of subdivision 3 of section 3614-c of the public
    13  health law is amended by adding  a  new  subparagraph  (v)  to  read  as
    14  follows:
    15    (v)  for  all  periods on or after January first, two thousand twenty-
    16  three, the cash portion of the minimum rate  of  home  care  aide  total
    17  compensation shall be the minimum wage for home care aides in the appli-
    18  cable  region,  as  defined  in section thirty-six hundred fourteen-f of
    19  this article. The benefit portion of the minimum rate of home care  aide
    20  total compensation shall be four dollars and eighty-four cents.
    21    §  6.  Subparagraph  (iv) of paragraph (b) of subdivision 3 of section
    22  3614-c of the public health law, as amended by section 1 of part  OO  of
    23  chapter 56 of the laws of 2020, is amended and a new subparagraph (v) is
    24  added to read as follows:
    25    (iv)  for  all  periods on or after March first, two thousand sixteen,
    26  the cash portion of the minimum rate of home  care  aide  total  compen-
    27  sation shall be ten dollars or the minimum wage as laid out in paragraph
    28  (b)  of  subdivision  one  of section six hundred fifty-two of the labor
    29  law, whichever is higher. The benefit portion of  the  minimum  rate  of
    30  home  care aide total compensation shall be three dollars and twenty-two
    31  cents[.];
    32    (v) for all periods on or after January first,   two thousand  twenty-
    33  three,  the  cash  portion of the   minimum rate of home care aide total
    34  compensation shall be the minimum wage for  the  applicable  region,  as
    35  defined  in  section  thirty-six hundred fourteen-f of this chapter. The
    36  benefit portion of the minimum rate of home care aide total compensation
    37  shall be three dollars and eighty-nine cents.
    38    § 7. Severability. If any provision of this act, or any application of
    39  any provision of this act, is held to be invalid, or to  violate  or  be
    40  inconsistent  with  any federal law or regulation, that shall not affect
    41  the validity or effectiveness of any other provision of this act, or  of
    42  any  other  application  of any provision of this act which can be given
    43  effect without that provision or  application;  and  to  that  end,  the
    44  provisions and applications of this act are severable.
    45    § 8. This act shall take effect immediately.
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