Section 367-S. Long term care demonstration program  


Latest version.
  • 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