A battle is raging right now in New York State as people with disabilities defend their right to choose. According to a recent bill proposed by Governor Andrew Cuomo, those with disabilities would have access to a new category of caregiver called an “advanced home health aide.” While New York’s Nurse Practice Act prohibits in-home caregivers from providing certain critical therapies or treatments, the new legislation would give said caregivers much wider professional freedom in meeting client needs.

This, in turn, would give New York’s disabled citizens greater flexibility when seeking or receiving vital care. In particular, this bill would free in-home caregivers to perform certain care procedures that, to this point, could only be received in a hospital, nursing home or other inpatient facility. The legislation would at once diminish the burden on the state’s senior care system and would help countless seniors and disabled Americans continue living on their own terms.

The Community First Choice Option

Unfortunately, the New York State Assembly is dragging its feet on passing the bill. According to an article in the Times Union, the state has been awarded $350 million in federal funds under the terms of the Community First Choice Option. This nationwide legislation would create much greater latitude for the disabled when it comes to Medicare and Medicaid coverage. The bill proposes far-reaching new categories of in-home care that would be eligible for reimbursement.

However, as a protest in the state capital highlighted in mid-June, New York’s State Assembly appeared content to leave the allotted federal funds on the table. Disabled rights advocacy groups, led by the American Disabled for Attendant Programs Today, stormed the Assembly Chamber during its sessions and demanded a vote.

Standing Up for the Rights of the Disabled

Advocacy groups for disabled rights see the legislation as an opportunity to expand their freedom to choose the caregiving scenario that works best for them. Expanding the legal capacity of in-home caregivers could allow countless seniors and disabled New York residents to receive the care they need without disrupting their lives through hospitalization.

This is a potentially invaluable new provision that could substantially reduce the need for hospitalization among seniors and, consequently, could reduce the potentially negative health drawbacks that can come with hospitalization. For many, even a hospital stay of modest length can have a deleterious impact on mobility and other functions. Giving seniors a way to receive a higher level of care at home could mean fewer negative health effects and higher quality of life for many.

The Opposition

At present, resistance to passing the bill as it stands today stems from concerns over providing effective oversight to the new category of caregiver. A representative for the Nurses Association argued that the bill was too broad in its current form and that it could open the door for exploitation by profit-driven companies. Some Assembly members have also expressed concern that the legislation could create a new path for poorly regulated and low-quality care.

Advocates of the legislation rejected these claims.

So said Sue Hoger, chairwoman of the New York Association for Independent Living who observed “there seems to be a perception that once you’ve designated a professional licensure to do one thing, that is all they can do. With that narrow mind-set we’re going to force people with disabilities to continue living in institutional settings when they could easily come out into the community.”

The hope is that a compromise can be reached to ensure that seniors and disabled residents of New York can access the highest quality of care no matter where they receive it.


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