2023 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, 2025
* NB There are 2 § 2808-e's