§ 2807-X — Grants for long term care demonstration projects

§ 2807-x. Grants for long term care demonstration projects. 1. The\ncommissioner shall establish three demonstration projects to develop,\nevaluate and implement programs to test new models for the organization\nand delivery of long term care services to encourage community based\nprograms and smaller residential health care models in order to promote\nconsumer choice, improve the efficiency and appropriateness of the use\nof state and federal resources and ensure the recruitment, retention and\ntraining of health care staff to adequately meet the needs of a\ncommunity and residential long term care system. Notwithstanding the\nprovisions of section one hundred twelve of the state finance law or any\nother inconsistent provision of the state finance law or any other law,\nfunds available for distribution pursuant to this section may be\nallocated and distributed by the commissioner without a competitive bid\nor request for proposal process.\n (a) The following factors shall be considered in approving each\ndemonstration project respectively:\n (i) Residential health care demonstration project. (A) the extent to\nwhich there is a reduction in the need for skilled nursing beds for a\nfacility that is eligible to replace its existing skilled nursing\nfacility; (B) the potential to design and develop more appropriate\nsmaller residential health care facilities as an alternative to\nreplacing an existing skilled nursing facility; (C) the extent to which\nthe quality, efficiency and continuity of care will be promoted and\nprovided for by the development of integrated long-term care services in\nthe community; (D) the extent to which the project will provide training\nto health care workers to appropriately staff new community based models\nof long term care; (E) demonstrate the involvement and support of\nworkforce in the program redesign; (F) the development of a new\nlong-term care reimbursement methodology that encourages care in the\nleast restrictive setting and adequately reflects the resources needed\nto serve consumers in each level of long term care; (G) and the\nincorporation of a research component designed to evaluate the project.\n (ii) Community based care demonstration project. (A) the extent to\nwhich there is a reduction in the need for skilled nursing facility beds\non a countywide basis; (B) the development of a new system to inform\nrecently admitted residents of skilled nursing facilities of the\navailability of community long-term care options; (C) the extent to\nwhich the discharge planning program from skilled nursing facilities\nwill inform, assist and maximize freedom of choice to consumers who\nchoose to move back to the community; (D) the extent to which the\nproject will develop community based long term care services, including\nfunding for the recruitment and retention of direct care health care\nworkers necessary to increase community based services; (E) the extent\nto which the project will provide training to health care staff; and (F)\nthe incorporation of a research component designed to evaluate the\nprojects.\n (iii) Managed long term care project. (A) the extent to which a\ncurrent operator of skilled nursing facilities possesses the necessary\nauthorizations through a related entity to assume risk and receive\ncapitated payments, pursuant to titles 18 and 19 of the federal social\nsecurity act, for the purpose of providing and arranging for the care of\nindividuals eligible for admission to a skilled nursing facility, (B)\nthe extent to which such services to individuals eligible for benefits\npursuant to both titles 18 and 19 of the federal social security act\nwill be provided through the capitated rate, (C) the extent to which the\nquality, efficiency and continuity of care will be promoted and provided\nfor by the development of integrated long-term care services in the\ncommunity, (D) the extent to which the project sponsor will directly or\nindirectly in association with a joint labor management program, provide\nfor training of health care workers to appropriately staff community\nbased models of long-term care; and (E) the incorporation of a research\ncomponent designed to evaluate the project, with specific reference to\nthe determination of cost savings to the state, the quality of and\nsatisfaction with services provided to consumers and their families and\nthe satisfaction of direct care workers, with a report of the project's\nprogress and findings submitted annually to the commissioner.\n 2. The commissioner is authorized to waive, modify or suspend the\nrespective provisions of rules and regulations promulgated pursuant to\nthis chapter if the commissioner determines that such waiver is\nnecessary or appropriate for the successful implementation of a\ndemonstration project and when the health, safety, and general welfare\nof persons receiving services under such demonstration project will not\nbe impaired as a result of such waiver, modification or suspension,\nprovided however, that for the managed long term care project pursuant\nto subparagraph (iii) of paragraph (a) of subdivision one of this\nsection, the method for setting the capitated rate of payment under\ntitle 19 of the federal social security act shall be consistent with the\nmethod used for all managed long term care plans authorized under\nsubdivision eight of section forty-four hundred three-f of the public\nhealth law.\n 3. The commissioner is authorized to seek federal waivers pursuant to\ntitles XVIII and XIX of the federal social security act when such\nwaivers are necessary to develop cost-effective long term care\ndemonstration projects.\n