NY Pub Health L § 2808-E (2021)
2021 New York Laws PBH - Public Health Article 28 - Hospitals 2808-E - Residential Health Care for Children With Medical Fragility in Transition to Young Adults and Young Adults With Medical Fragility Demonstration Program.

* §   2808-e.  Residential  health  care  for  children  with  medical fragility in transition to young adults and young  adults  with  medical fragility  demonstration  program.  1. Notwithstanding any law, rule, or regulation to the  contrary,  the  commissioner  shall,  within  amounts appropriated  and  subject  to  the  availability  of  federal financial participation,  establish  a  demonstration  program  for  two  eligible pediatric  residential  health  care facilities, as defined in paragraph (d) of subdivision two of this section, to construct a new  facility  or repurpose  part  of  an  existing  facility  to operate as a young adult residential health care  facility  for  the  purpose  of  improving  the quality of care for young adults with medical fragility.   2. For purposes of this section:  (a)  "children  with  medical  fragility"  shall  mean  children up to twenty-one years of age who have a  chronic  debilitating  condition  or conditions, are at risk of hospitalization, are technology-dependent for life or health sustaining functions, require complex medication regimens or  medical interventions to maintain or to improve their health status, and/or are in need of ongoing  assessment  or  intervention  to  prevent serious  deterioration  of  their health status or medical complications that place their life, health or development at risk.  (b) "young adults with medical fragility" shall mean  individuals  who meet the definition of children with medical fragility, but for the fact such individuals are aged between eighteen and thirty-five years old.  (c)   "pediatric  residential  health  care  facility"  shall  mean  a residential health care facility  or  discrete  unit  of  a  residential health  care  facility  providing  services to children under the age of twenty-one.  (d) "eligible pediatric residential health care facilities" shall mean pediatric health care facilities that  meet  the  following  eligibility criteria  for  the demonstration program set forth in subdivision one of this section: (i) has over one  hundred  and  sixty  licensed  pediatric beds;  or (ii) is currently licensed for pediatric beds pursuant to this article, is co-operated by a system of hospitals  licensed  pursuant  to this  article,  and such hospitals qualify for funds pursuant to a vital access provider assurance program or a  value  based  payment  incentive program,  as  administered  by  the  department  in  accordance with all requirements set forth in  the  state's  federal  1115  Medicaid  waiver standard terms and conditions.   3.  Notwithstanding  any law, rule, or regulation to the contrary, any child with medical  fragility  who  has  resided  for  at  least  thirty consecutive  days  in  an  eligible  pediatric  residential  health care facility and who has reached the age of twenty-one while a resident, may continue residing at such eligible  pediatric  residential  health  care facility  and  receiving  such services from the facility, provided that such young adult with medical fragility  remains  eligible  for  nursing home  care, and provided further that the eligible pediatric residential health care facility has prepared, applied for,  and  submitted  to  the commissioner,  a proposal for a new residential health care facility for the  provision  of  extensive  nursing,   medical,   psychological   and counseling  support  services  to young adults with medical fragility in accordance with subdivision four of this section.  A  young  adult  with medical  fragility  may  remain  in  such eligible pediatric residential health care facility until such time that the young adult  with  medical fragility  attains  the  age  of  thirty-five  years  or the young adult residential health care facility is constructed and becomes operational, whichever is sooner.   4. Upon receipt of a certificate of need application from an  eligible pediatric  residential health care facility selected by the commissioner  for  the  demonstration  program  authorized  under  this  section,  the commissioner  is authorized to approve, with the written approval of the public  health  and  health  planning  council   pursuant   to   section twenty-eight  hundred  two  of  this  article, the construction of a new residential health care facility to be constructed  and  operated  on  a parcel  of  land  within  the  same county as that of eligible pediatric residential health care facility that is proposing such new facility and over which it will have site control, or the repurposing of a portion of a residential health care facility that is currently  serving  geriatric residents  or  those  with  similar  needs for the provision of nursing, medical, psychological and counseling support  services  appropriate  to the  needs of nursing home-eligible young adults with medical fragility, referred to herein below as a young adult facility,  provided  that  the established  operator of such eligible pediatric residential health care facility proposing the young adult facility  is  in  good  standing  and possesses  at  least  thirty  years'  prior  experience  operating  as a pediatric residential health care facility in the  state  or  more  than thirty  years'  experience serving medically fragile pediatric patients, and provided further that such facility qualifies for the  demonstration program set forth in subdivision one of this section.   5.  A young adult facility established pursuant to subdivision four of this section may admit, from the  community-at-large  or  upon  referral from  an  unrelated  facility,  young  adults with medical fragility who prior to reaching age twenty-one were children with  medical  fragility, and  who  are  eligible  for  nursing home care and in need of extensive nursing,  medical,  psychological  and  counseling   support   services, provided  that  the young adult facility, to promote continuity of care, undertakes to provide priority admission to young  adults  with  medical fragility  transitioning  from  the  pediatric  residential  health care facility or unit operated by the entity that proposed  the  young  adult facility  and  ensure  sufficient capacity to admit such young adults as they approach or attain twenty-one years of age.   6. (a) For inpatient  services  provided  to  any  young  adults  with medical  fragility  eligible  for  medical  assistance pursuant to title eleven of article five of  the  social  services  law  residing  at  any eligible  pediatric  residential  health  care facility as authorized in subdivision three of this section, the commissioner shall establish  the operating  component  of  rates  of  reimbursement appropriate for young adults with medical fragility residing at a pediatric residential health care facility, to apply to such young adults twenty-one years of age  or older.  Such methodology shall take into account the methodology used to establish the operating component  of  the  rates  pursuant  to  section twenty  eight  hundred  eight  of this article for pediatric residential health care facilities  with  an  increase  or  decrease  adjustment  as appropriate  to account for any discrete expenses associated with caring for young adults with  medical  fragility,  including  addressing  their distinct  needs as young adults for psychological and counseling support services.  (b) For inpatient services provided to any young adults  with  medical fragility  eligible  for  medical assistance pursuant to title eleven of article five of the social services law at any young adult  facility  as authorized  in  subdivision four of this section, the commissioner shall establish the operating component of rates of reimbursement  appropriate for  young  adults  with  medical fragility. Such methodology shall take into account the methodology used to establish the  operating  component of  the  rates  pursuant  to  section twenty eight hundred eight of this article  for  pediatric  residential  health  care  facilities  with  an increase  or  decrease  adjustment  as  appropriate  to  account for any  discrete expenses associated with caring for young adults  with  medical fragility, including addressing their distinct needs as young adults for psychological and counseling support services.   7.  The  commissioner  shall  have  authority  to  waive  any  rule or regulation to effectuate the demonstration program  authorized  pursuant to subdivision one of this section.   * NB Repealed August 17, 2023   * NB There are 2 § 2808-e's