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HEALTH BENEFITS AND MEDICAL CARE

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Sponsors: Assemblywomen Loretta D. Weinberg (D37) and Bonnie Watson Coleman (D15)

Bill No. S580

Sponsors: Senators Richard J. Codey (D27) and Joseph F. Vitale (D19)

Bill Title: Dignity in Home Care Act

Summary: Provides for increases in Medicaid reimbursement to home health care agencies for direct care worker salaries; appropriates $10 million in State funds and $10 million in federal funds.

Comments: This bill proposes an increase in reimbursement to home health care agencies paid by the State Department of Health and Senior Services and the State Department of Human Services through the Medicaid program at the rate of $1.50 per hour per direct care worker. The bill further provides that $1.00 per hour of this increase is to be used to increase the wages of direct care employees and the balance of the increase is to be used for pension and health benefits of direct care employees. The current bill retains language originally introduced in 2000, making the first increase effective July 1, 2001, and providing additional increases of $1.00 per hour per employee effective July 1, 2002 and July 1, 2003, respectively.

Current Status: Assembly Health and Human Services Committee

Legislative Activity: 1/08/02 Introduced and referred to Assembly Health and Human Services Committee

Last Session: A3601

Current Status: Assembly Health and Human Services Committee

Legislative Activity: 1/08/02 Introduced and referred to Senate Health, Human Services and Senior Citizens Committee

Last Session: S2427

Sponsor: Assemblyman John E. Rooney (R39)

Sponsors: Senators Gerald Cardinale (R39) and Anthony R. Bucco (R25)

Summary: Amends "Family Support Act" to provide reimbursement to families for certain documented costs incurred in connection with the care of an individual with disabilities before the individual is determined eligible for services made available under the Act; appropriates $100,000

Comments: At present, the "Family Support Act," N.J.S.A.30:6D-33 et. seq., provides various services to a family once a family member is determined eligible for the program. However, costs the family incurs prior to the family member becoming eligible for the program are not reimbursable. Such costs can be significant and can pose a dire financial burden to the family. This bill appropriates $100,000 to expand the services provided under the "Family Support Act." Under the proposed amendment, the Act would authorize reimbursements for documented unreimbursed medical and other costs incurred before a family member is declared eligible for the program.

Current Status: Assembly Family, Women and Children's Services Committee

Legislative Activity: 3/4/02 Introduced and referred to Assembly Family, Women and Children's Services Committee

Current Status: Senate Health, Human Services and Senior Citizens Committee

Legislative Activity: 2/21/02 Introduced and referred to Senate Health, Human Services and Senior Citizens Committee.

Last Session: S2583

Sponsors: Assemblywoman Loretta D. Weinberg (D37) and Assemblyman Matt Ahearn (D38)

Sponsor: Senator Diane Allen (R7)

Summary: Provides in-network benefits to patient with disability for services provided by out-of-network provider under certain circumstance

Comments: This bill proposes to impose certain coverage requirements on managed care plans that provide both in-network and out-of-network benefits. As introduced, the bill would permit a patient with a physical disability to receive benefits at the in-network level for medically necessary health care services provided by an out-of-network health care provider under certain circumstances. The in-network benefit level would apply when there is no in-network provider who is: (1) located at a reasonable distance from the covered person's place of residence, (2) qualified by area of professional specialty or practice to provide the needed health care services; and (3) has physical accommodations that afford "reasonably convenient access" to the insured. The Assembly Health and Human Services Committee amended the bill to require, among other things, that the benefit be available if there is no in-network provider with significant experience in treating the particular physical disability. The amendments define such experience as having treated at least 24 other patients with the insured's medical condition in each of the two preceding years. The Assembly amendments also specify that the benefit be available if there is no qualified in-network provider located within 20 miles from the insured's home. The Council recognizes that the bill would increase medical benefits for some people with disabilities but is concerned that it does not provide protection for people required to obtain out-of-network treatment for developmental disabilities or psychological disabilities not covered by the proposed legislation.

Current Status: Assembly Appropriations Committee

Legislative Activity:
9/19/02 Introduced and referred to Assembly Health and Human Services Committee

10/21/02 Reported out of committee with committee amendments, referred to Assembly Appropriations Committee

3/10/03 Reported out of committee, 2nd reading in Assembly

5/15/03 Passed in Assembly 77-0-0

5/19/03 Received in Senate and referred to Senate Health, Human Services and Senior Citizens Committee

Current Status: Senate Health, Human Services and Senior Citizens Committee

Legislative Activity: 9/30/02 Introduced and referred to Senate Health, Human Services and Senior Citizens Committee

Sponsors: Assemblywomen Nilsa Cruz-Perez (D5) and Charlotte Vandervalk (R39)

Summary: Creates the Medical Care for Persons with Developmental Disabilities Commission

Comment: This bill proposes to establish a 24-member Medical Care for Persons with Developmental Disabilities Commission. The bill names certain State agencies, providers and advocacy groups as members of the commission. Significantly, the Commission would include a member of the Developmental Disabilities Council. The purpose of the Commission would be to assess the need for and availability of medical care provided to people with developmental disabilities in New Jersey and to identify sources of available government and private funding for such care. The bill also directs the Commission to consider these issues with particular attention to the expansion of managed care services. The proposed legislation would require the Commission to submit a report to the Governor and Legislature within six months, at which time the Commission would cease to exit.

Current Status: Senate Health, Human Services and Senior Citizens Committee

Legislative Activity:
1/8/02 Introduced and referred to Assembly Health and Human Services Committee

2/21/02 Reported out of committee, 2nd reading in Assembly

3/25/02 Passed in Assembly 78-0-0

3/25/02 Received in Senate and referred to Senate Health, Human

Services and Senior Citizens Committee

Last Session: A385

Sponsors: Assemblymen Craig A. Stanley (D28), Jeff Van Drew (D1), Alfred E. Steele (D35), Ronald S. Dancer (R30)

Sponsor: Senator Joseph A. Palaia (R11)

Summary: Establishes "New Jersey Task Force on Long-Term Care Quality and Financing."

Comments: This bill establishes a 13-member "New Jersey Task Force on Long-Term Care Quality and Financing." The bill directs the task force to study alternatives to the current public funding mechanisms for long-term care. The bill also requires the task force to present a report of its findings and recommendations to the Governor and Legislature no later than 12 months after the date of its initial meeting. The task force would dissolve 30 days after the issuance of the report.
The members of the task force would include a representative of the State Treasurer, the Department of Health and Senior Services, and the Department of Banking and Insurance, along with the Hospital Association, the health insurance industry, direct care providers and AARP. The bill does not provide for representation by agencies that address the needs of people with developmental disabilities.

Action Taken: Council staff corresponded with the Co-Chairs of the Senate Health, Human Services, and Senior Citizens Committee, Senators John J. Matheussen and Joseph F. Vitale, and with the sponsors of the legislation, Senator Joseph A. Palaia and Assemblyman Craig Stanley, regarding our concern.

Current Status: Assembly Senior Issues Committee

Legislative Activity:
1/14/2003 Introduced and referred to Assembly Senior Issues Committee

1/16/03 Reported out of committee, 2nd reading in Assembly

2/10/03 Amended on Assembly floor, 2nd reading in Assembly

2/24/03 Passed in Assembly 77-0-0

2/27/03 Received in Senate and referred to Senate Health, Human Services and Senior Citizens Committee

Current Status: Senate Health, Human Services and Senior Citizens Committee

Legislative Activity: 1/27/03 Introduced and referred to Senate Health, Human Services and Senior Citizens Committee