Page 1/
Re:
MEMORANDUM IN SUPPORT
A5074 –C (McDonald)/S3651 – D (Ortt)
An act to amend the social services law, the insurance law and the public health law, in relation to preserving access to quality complex rehabilitation technology for patients with complex medical needs
Center for Independence of the Disabled, New York (CIDNY) is a non-profit organization founded in 1978. CIDNY’s goal is to ensure full integration, independence and equal opportunity for all people with disabilities by removing barriers to full participation in the community. CIDNY helps consumers understand, enroll in and use private and public health programs, including commercial health insurance.
CIDNY supports Assembly Bill 5074 - C/Senate Bill 3651 - Dwhich would maintain access to quality complex rehabilitation equipment for patients with specific diagnoses and physical conditions who requireindividually configured equipment and technology to sustain independence and avoid institutionalization.
The bill seeks to preserve the guidelines and practices developed by the New York State Health Department for prior authorization and regulation for those accessing high cost, individually configured equipment through fee for service Medicaid. Individuals with complex needs and chronic disabling conditions cannot remain mobile, safe and healthy without equipment that addresses their specific disability. The continuing practices include using suppliers who have at least one storefront in New York State, have certified technicians on staff and that are able to service and repair the complex rehabilitation equipment.
These guidelines and practices must be maintained when the individuals who need complex rehabilitation equipment are transitioned into Medicaid Managed Care. Over 130,000 dual eligibles thatrequire more than 120 days of long term care have been enrolled in Managed Long Term Care (MLTC) plans and now get their durable medical equipment through their Plan. Enrollment of thousands more dual eligbles into FIDA plans is now underway. When CIDNY’s benefit counselors help people enroll in an MLTC, they have a difficult time getting the information they need from the Plan about how complex rehabilitation equipment is secured. We ask what the procedures are for getting complex rehabilitation equipment assessed and fitted. We ask if they work with a specific wheelchair seating clinic. If not, do they have their own pt/ot team who will work with their vendor to evaluate and fit the consumer?
Patients with complex medical conditions and with disabilities rely upon mobility devices not only to stay in the community, but also to prevent pressure sores, facilitate breathing, and relieve joint pain. People who do not have reliable equipment need more home care than they otherwise would need. The people CIDNY serves wouldprefer to maintain their privacy and independence, over more attendant hours to help them accomplish the things they needto get done.
CIDNY urges the Assembly Health Committee to vote in favor of A.5074.-C/S3651 DFor further information, please contact Heidi Siegfried, CIDNY’s Health Policy Director, at 646-442-4147 or