Section 364-B. Residential and medical care placement demonstration projects  


Latest version.
  • 1.   Notwithstanding any  inconsistent  provisions  of  this
      chapter  or any other law to the contrary, social services districts are
      hereby  authorized   to   conduct   or   participate   in   time-limited
      demonstration  projects for the purpose of demonstrating the feasibility
      of reducing medical assistance  expenditures  for  care  in  residential
      health  facilities  by  utilizing  medical  assistance  funds for:   (a)
      conducting  initial  assessments  of,  and  performing  case  management
      functions,  for  (i) persons financially eligible for medical assistance
      pursuant to this title who request long term  care  services,  and  (ii)
      persons  whether  or  not  otherwise  financially  eligible  for medical
      assistance who seek care in or discharge from a residential health  care
      facility  or  a  congregate  care  facility  as described in section two
      hundred nine of this chapter, and  (b)  providing  social  services  and
      medical  supplies determined to be necessary and appropriate as a result
      of assessments conducted pursuant to  paragraph  (a)  hereof,  to  those
      persons  participating in an approved project who are otherwise eligible
      to receive medical assistance, whether or not such services or  supplies
      are  authorized to be provided under this title; provided, however, that
      no such additional services or  supplies  provided  hereunder  shall  be
      subject  to  state  reimbursement  unless prior approval to provide such
      services or supplies to persons eligible for medical assistance has been
      granted by the department.  Such demonstration projects may be conducted
      or participated in by a social services district only in accordance with
      a plan submitted to the department on or before  the  thirtieth  day  of
      June,  nineteen hundred seventy-seven, and only to the extent and period
      for which such plan has been approved or from time to time  extended  by
      the commissioner.
        2.   Any plan submitted pursuant to this section shall provide that in
      any case in which  it  is  determined  by  an  assessment  conducted  in
      accordance  with  such  a  project  that  placement in a skilled nursing
      facility or an intermediate care facility  would  be  appropriate,  such
      placement  shall  be subject to review and approval by the department of
      health provided, however, that the commissioner of health  may  delegate
      preplacement assessment review function to such a project.  In addition,
      any  plan submitted pursuant to this section shall include a description
      of   any   assessment   methodology   utilized   in   determining    the
      appropriateness   of   placements   in  skilled  nursing  facilities  or
      intermediate care facilities and any such plan may be  approved  by  the
      commissioner  only  after  such  methodology  has  been submitted to the
      department of health for its review and comment.
        3.  Notwithstanding any inconsistent provision of law to the contrary,
      expenditures made in connection with an approved residential and medical
      care placement demonstration project for  assessments,  case  management
      and  social  services  and medical supplies authorized to be provided by
      this title or approved by the department,  shall  be  subject  to  state
      reimbursement  under  section  three hundred sixty-eight-a of the social
      services law in accordance  with  a  schedule  of  maximum  reimbursable
      amounts established by the department for such services and supplies.
        4.   Notwithstanding any inconsistent provision of this chapter or any
      other law to the contrary, the commissioner may, subject to the approval
      of the director of the budget, approve such demonstration  projects  and
      apply  for  the appropriate waivers under federal law and regulation and
      may waive:   (a) any provision  of  this  title  or  regulation  of  the
      department  as  may  be  necessary  to  make  medical  assistance  funds
      available  for  initial  assessment  and  performing   case   management
      functions  for  persons  participating in such approved projects without
      regard to their eligibility to participate  in  the  medical  assistance
    
      program  and  when  appropriate,  providing  additional  approved social
      services and medical  supplies,  not  otherwise  authorized  under  this
      title,  to  persons  participating  in  such  approved  projects who are
      otherwise eligible to participate in the medical assistance program; and
      (b)  such department regulations relating thereto as may be necessary to
      enable a social services district to carry out such project.
        5.  The commissioner shall require that a final independent evaluation
      be made of any demonstration project approved and conducted hereunder in
      a form mutually agreed upon by him and the state commissioner of health,
      and shall provide copies of such report  to  the  governor  and  to  the
      legislature.    In addition the commissioner shall submit annual interim
      reports on the progress of each project to the governor and  legislature
      by the first day of February of each year.
        * NB Expired September 30, 1986