2023 New York Laws › SOS - Social Services › Article 5 - Assistance and Care › Title 11 - Medical Assistance for Needy Persons › 367-S - Long Term Care Demonstration Program.

* §  367-s.  Long  term care demonstration program. 1. Notwithstanding
any inconsistent  provision  of  law,  the  commissioner  of  health  is
authorized  to  establish  a  long  term  care demonstration program for
persons eligible to receive services under this title, to operate in  up
to  four  social  services  districts,  for  the  purposes  of  creating
incentives for providers to  care  for  individuals  with  more  complex
medical  needs,  supporting  relatives  and  other  caregivers to assist
patients  needing   care   at   home   and   reducing   the   need   for
institutionalization.
2.  The  provisions  of  this section shall not take effect unless all
necessary approvals under federal law and regulation have been  obtained
to  receive  federal  financial participation in the costs of the health
care services provided pursuant to this section.
3. (a) The demonstration program established pursuant to this  section
may  include  a  program to improve the availability of care for persons
with clinically  complex  care  needs  who  are  being  discharged  from
hospitals  or residential health care facilities. In this regard, and in
accordance with paragraph (d)  of  this  subdivision,  the  commissioner
shall  adjust  the  rates  of  payment  to selected home health agencies
certified under article thirty-six of the public health law that provide
services to such persons.
(b) Eligible certified home health agencies shall:
(i) demonstrate they have the  experience  and  resources  to  provide
services to individuals who are discharged from hospitals or residential
health care facilities with clinically complex care needs, as determined
in accordance with criteria established by the commissioner.
(ii)   demonstrate  that  they  are  capable  of  meeting  such  other
conditions as may be established by the commissioner.
(c)  In  selecting  eligible  certified  home  health  agencies,   the
commissioner  shall consider the likelihood that the agency will provide
improved availability of care and may consider such other matters as the
commissioner deems appropriate.
(d) The adjusted Medicaid rate pursuant to this subdivision  shall  be
available  for  eligible  certified  home  health  agencies for services
provided to individuals, eligible for  medical  assistance  pursuant  to
this  title,  who  are  discharged from a hospital or residential health
care facility and have clinically complex care needs, as  determined  in
accordance  with  criteria  established  by  the commissioner. Such rate
shall be payable for services provided up to the first sixty days  after
discharge from a hospital or residential health care facility.
4.  One  or  more  demonstration  sites  established  pursuant to this
section may include the provision of  respite  care  through  innovative
models.   Subject to the approval of the director of the division of the
budget, the commissioner is authorized to  establish  payment  rates  or
fees for services provided pursuant to this subdivision.
5. One or more of the demonstration sites established pursuant to this
section  may  include  a  program  with  authority  to make payments for
personal care services that are provided by a consumer's family members.
* NB There are 2 § 367-s's