2006 New York Code - Consumer Directed Personal Assistance Program.



 
    §  365-f.  Consumer  directed personal assistance program. 1.  Purpose
  and  intent.  The  consumer  directed  personal  assistance  program  is
  intended   to   permit   chronically   ill  and/or  physically  disabled
  individuals receiving home care services under  the  medical  assistance
  program  greater  flexibility  and  freedom  of choice in obtaining such
  services. The department  shall,  upon  request  of  a  social  services
  district  or  group  of districts, provide technical assistance and such
  other assistance as  may  be  necessary  to  assist  such  districts  in
  assuring access to the program.
    2.  Eligibility. All eligible individuals receiving home care shall be
  provided notice of the availability of the program and  shall  have  the
  opportunity  to  apply  for  participation in the program.  On or before
  October first, nineteen hundred ninety-six each social services district
  shall  file  an  implementation  plan  with  the  commissioner  of   the
  department  of  health.  An  "eligible individual", for purposes of this
  section is a person who:
    (a) is eligible  for  long  term  care  and  services  provided  by  a
  certified home health agency, long term home health care program or AIDS
  home  care  program  authorized  pursuant  to  article thirty-six of the
  public health law, or is eligible for personal  care  services  provided
  pursuant to this article;
    (b) is eligible for medical assistance;
    (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 is able and willing or has a legal guardian able and willing
  to make informed choices, or has designated a 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
    (d)  meets  such  other  criteria,  as  may  be  established  by   the
  commissioner,   which   are   necessary  to  effectively  implement  the
  objectives of this section.
    3. Division of responsibilities. Eligible  individuals  who  elect  to
  participate  in the program assume the responsibility for services under
  such program as mutually  agreed  to  by  the  eligible  individual  and
  provider  and  as  documented  in the eligible individual's record. Such
  individuals shall be assisted  as  appropriate  with  service  coverage,
  supervision,  advocacy and management. Providers shall not be liable for
  fulfillment of responsibilities agreed to be undertaken by the  eligible
  individual.      This  subdivision,  however,  shall  not  diminish  the
  participating provider's liability for failure  to  exercise  reasonable
  care  in  properly carrying out its responsibilities under this program,
  which shall include monitoring such individual's continuing  ability  to
  fulfill those responsibilities documented in his or her records. Failure
  of the individual to carry out his or her agreed to responsibilities may
  be considered in determining such individual's continued appropriateness
  for the program.
    4.  Participating providers.  All agencies or individuals who meet the
  qualifications to provide home health, personal care or nursing services
  and who elect to provide such  services  to  persons  receiving  medical
  assistance  may  participate  in the program.  Any agency or individuals
  providing services under a patient managed home care program  authorized
  under  the  former  section  thirty-six hundred twenty-two of the public
  health law or the former sections three  hundred  sixty-five-f  of  this
  chapter may continue to provide such services under this section.
    5. Waivers, regulation and effectiveness.
    (a)  The  commissioner may, subject to the approval of the director of
  the budget, file for such federal waivers  as  may  be  needed  for  the
  implementation of the program.
    (b)  Notwithstanding  any  other provision of law, the commissioner is
  authorized to waive any provision of section three hundred sixty-seven-b
  of  this  title  related  to  payment  and  may  promulgate  regulations
  necessary to carry out the objectives of the program, and which describe
  the responsibilities of the eligible individuals in arranging and paying
  for  services  and  the protections assured such individuals if they are
  unable or no longer desire to continue in the program.
    6. This section shall be effective if, to the extent that, and as long
  as,  federal  financial  participation  is  available  for  expenditures
  incurred under this section.

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