NY Pub Health L § 2807-X (2021)
2021 New York Laws PBH - Public Health Article 28 - Hospitals 2807-X - Grants for Long Term Care Demonstration Projects.

§  2807-x.  Grants  for  long term care demonstration projects. 1. The commissioner shall establish three demonstration  projects  to  develop, evaluate  and implement programs to test new models for the organization and delivery of long term care services  to  encourage  community  based programs  and smaller residential health care models in order to promote consumer choice, improve the efficiency and appropriateness of  the  use of state and federal resources and ensure the recruitment, retention and training  of  health  care  staff  to  adequately  meet  the  needs of a community and residential long term  care  system.  Notwithstanding  the provisions of section one hundred twelve of the state finance law or any other  inconsistent provision of the state finance law or any other law, funds available  for  distribution  pursuant  to  this  section  may  be allocated  and distributed by the commissioner without a competitive bid or request for proposal process.  (a) The following  factors  shall  be  considered  in  approving  each demonstration project respectively:  (i)  Residential  health care demonstration project. (A) the extent to which there is a reduction in the need for skilled nursing  beds  for  a facility  that  is  eligible  to  replace  its  existing skilled nursing facility; (B) the potential  to  design  and  develop  more  appropriate smaller   residential  health  care  facilities  as  an  alternative  to replacing an existing skilled nursing facility; (C) the extent to  which the  quality,  efficiency  and  continuity  of care will be promoted and provided for by the development of integrated long-term care services in the community; (D) the extent to which the project will provide training to health care workers to appropriately staff new community based models of long term care;  (E)  demonstrate  the  involvement  and  support  of workforce  in  the  program  redesign;  (F)  the  development  of  a new long-term care reimbursement methodology that  encourages  care  in  the least  restrictive  setting and adequately reflects the resources needed to serve consumers in  each  level  of  long  term  care;  (G)  and  the incorporation of a research component designed to evaluate the project.  (ii)  Community  based  care  demonstration project. (A) the extent to which there is a reduction in the need for skilled nursing facility beds on a countywide basis; (B) the development of a  new  system  to  inform recently  admitted  residents  of  skilled  nursing  facilities  of  the availability of community long-term care  options;  (C)  the  extent  to which  the  discharge  planning  program from skilled nursing facilities will inform, assist and maximize freedom  of  choice  to  consumers  who choose  to  move  back  to  the  community;  (D) the extent to which the project will develop community based long term care services,  including funding  for  the  recruitment  and retention of direct care health care workers necessary to increase community based services; (E)  the  extent to which the project will provide training to health care staff; and (F) the  incorporation  of  a  research  component  designed to evaluate the projects.  (iii) Managed long term care  project.  (A)  the  extent  to  which  a current  operator  of skilled nursing facilities possesses the necessary authorizations through a related  entity  to  assume  risk  and  receive capitated  payments,  pursuant to titles 18 and 19 of the federal social security act, for the purpose of providing and arranging for the care of individuals eligible for admission to a skilled  nursing  facility,  (B) the  extent  to which such services to individuals eligible for benefits pursuant to both titles 18 and 19 of the  federal  social  security  act will be provided through the capitated rate, (C) the extent to which the quality, efficiency and continuity of care will be promoted and provided for  by  the  development  of  integrated long-term care services in the community, (D) the extent to which the project sponsor will directly  or  indirectly in association with a joint labor management program, provide for  training  of  health  care workers to appropriately staff community based models of long-term care; and (E) the incorporation of a  research component  designed  to evaluate the project, with specific reference to the determination of cost savings to  the  state,  the  quality  of  and satisfaction  with services provided to consumers and their families and the satisfaction of direct care workers, with a report of the  project's progress and findings submitted annually to the commissioner.   2.  The  commissioner  is  authorized  to waive, modify or suspend the respective provisions of rules and regulations promulgated  pursuant  to this  chapter  if  the  commissioner  determines  that  such  waiver  is necessary  or  appropriate  for  the  successful  implementation  of   a demonstration  project  and when the health, safety, and general welfare of persons receiving services under such demonstration project will  not be  impaired  as  a  result  of such waiver, modification or suspension, provided however, that for the managed long term care  project  pursuant to  subparagraph  (iii)  of  paragraph  (a)  of  subdivision one of this section, the method for setting the  capitated  rate  of  payment  under title 19 of the federal social security act shall be consistent with the method  used  for  all  managed  long  term  care plans authorized under subdivision eight of section forty-four hundred three-f  of  the  public health law.   3.  The commissioner is authorized to seek federal waivers pursuant to titles XVIII and XIX of  the  federal  social  security  act  when  such waivers   are   necessary  to  develop  cost-effective  long  term  care demonstration projects.