GOVERNOR PATERSON AND LEGISLATIVE LEADERS ANNOUNCE AGREEMENT ON LEGISLATION TO HELP SERIOUSLY ILL CHILDREN REMAIN AT HOME

Bill Will Allow More Children to Avoid Institutionalization Under the Care at Home Medicaid Waiver Program

Governor David A. Paterson today announced that he has reached agreement with legislative leaders on a bill that will increase the number of children served by the Care at Home I/II Medicaid waiver program. The legislation will make the program available to additional children who are medically fragile but do not qualify for services under the existing financial eligibility standard.

“This patient-centered legislation will allow for families to care for their medically fragile children at home, rather than in an institution. By equipping homes with services such as respite care and case management, this legislation will bring an enhanced level of care to children and families that need it most,” said Governor Paterson. “I want to thank the Legislature for agreeing to an approach to patient care that is not only the right thing to do for children and families, but also a more cost effective approach to care.”

The Care at Home Medicaid waiver program serves children under 18 years of age who have physical disabilities and require a level of care that would otherwise be provided in a nursing facility or hospital. This includes children who are dependent on ventilators to breathe, are fed through a gastrostomy tube, or require other complex medical interventions or continuous monitoring. The program avoids unnecessary institutionalization by providing services such as case management, home and vehicle adaptations, and respite services.

The legislation will change the financial eligibility requirements used for a child to qualify for the Care at Home program. Previously, a seriously ill child whose individual cost of care was too high was not eligible to qualify for home care. By changing the eligibility requirement to an aggregate standard, those children will now have the opportunity to qualify for Care at Home.

New York provides the Care at Home program under a home and community based waiver approved by the federal government, which makes federal funding available under the Medicaid program for individuals who are otherwise eligible for services but whose income is too high to qualify for Medicaid. The waiver also permits certain services to be provided that are ordinarily not covered under Medicaid.

The change to an aggregate financial eligibility standard that will be accomplished by the legislation announced today is consistent with other waiver programs in New York, including the new program for children in foster care (Bridges to Health), the adult Nursing Home Transition and Diversion waiver, into which children in Care at Home may transition at age 18, and the Traumatic Brain Injury waiver.

Senate Majority Leader Joseph L. Bruno said: “This is critically important legislation for seriously ill children and their families because it will ensure that these children get the care they need at home. I applaud Senator Hannon and Senator Golden for working with the Governor and Assembly to achieve a positive result on this important health care issue.”

Assembly Speaker Sheldon Silver said: “This legislation will allow many more children with physical disabilities the chance to receive extended benefits. By changing the eligibility standards, seriously ill children across the state can now receive the level of care they require while being at home with their families. This measure will build on other efforts of the Assembly by ensuring that our children receive the enhanced care they need. I applaud Governor Paterson for making this key issue a priority while benefiting our children in need.”

Senate Minority Leader Malcolm A. Smith said: "Governor Paterson has always taken the lead when it comes to issues affecting the health and safety of our children. He should be commended along with my state colleagues for passing this legislation that will allow our most medically fragile children to receive special home care that their families might not be able to afford otherwise. This wavier program will expand the pool of those who are financially eligible and will save the state money in the long run by allowing children under eighteen with physical disabilities the home care they need without institutionalization."

Senator Kemp Hannon, Chair of the Senate Health Committee, said: "The best way to treat patients is where they are most comfortable, which is often in their own home surrounded by family. This is especially true for children. I am pleased to have come to this agreement with the Governor and Assembly to take in-patient care and bring it to the homes of those who need it most. Now, those under 18 who are medically dependent to eat or breathe, or need round-the-clock monitoring will be able to be treated at home regardless of their financial situation."

Assemblyman Richard N. Gottfried, Chair of the Assembly Health Committee, said: “These technical changes will assure that we continue to provide needed services to disabled and medically fragile children in their homes.”

Senator John Sampson, Ranking Member on the Senate Health Committee, said: “This legislation allows families the opportunity to provide care, attention and support for their children in a familiar environment. While institutions provide responsible and dedicated services, the availability of this important service will significantly impact the lives of families.”

Senator Martin Golden said: "This measure will not only help to ensure a high quality of care for thousands of children across New York, it will also help to save taxpayer dollars by avoiding more costly institutional care. It represents a compassionate, positive step forward for our children, for families, and for taxpayers throughout our State."

New York State Health Commissioner Richard F. Daines, M.D., said: "Parents of children who are disabled know their children's best chance at a fuller life comes from care in the home, with interaction with parents and siblings, and quality long-term care at home. I thank Governor Paterson, Senator Bruno, and Speaker Silver for unity on this bill, for which parents of disabled children have urged for so long. Care must meet a patient's needs first."

Melinda Dutton, Counsel and Project Director for Coalition for Medically Fragile Children, said: "The Coalition for Medically Fragile Children strongly supports this legislation that will improve the Care at Home program through the establishment of cost targets on an aggregate basis, rather than on an individual child by child basis. With this and other recent reforms to the Care at Home program, New York State is making it easier for parents of medically fragile children to get the support they need to care for children at home, surrounded by their families, rather than in a costly institution. This reform will help ease administrative burdens in the Care at Home program that otherwise can stand in the way of doing what is right for these children and their families, while still maintaining cost effectiveness for the State's Medicaid program."