§ 4015 — Pilot program for all-inclusive care for children

§ 4015. Pilot program for all-inclusive care for children. 1. The\ncommissioner is hereby authorized to establish a pilot program for\nall-inclusive care for children. Such program, subject to the rules and\nregulations of the commissioner, shall consist of comprehensive hospice\nand palliative care services for children with life-limiting illnesses\nthat addresses the medical, psychosocial and spiritual aspects of care\nand allows such children to be cared for at home rather than in an\ninstitutional setting. Such services shall be provided by a licensed,\ncertified hospice working jointly with a certified home health agency,\nor a certified home health agency working jointly with a licensed,\ncertified hospice to assure the provision of services which are an\nenhancement of either the certified home health agency or hospice alone,\nand shall include hospice services as well as related expressive\ntherapies such as art, play or music therapy in addition to services of\na child life specialist, and opportunities for respite care.\n 2. "A child with a life threatening illness" shall mean a child\neligible for medical assistance under article five of the social\nservices law, who under the age of eighteen is diagnosed with an illness\nthat places the child at substantial risk of dying before the age of\ntwenty-one where the child can, with appropriate services be cared for\nat an alternative to institutional care.\n 3. Qualified agencies providing services under this section to a child\nshall be reimbursed under medical assistance under article five of the\nsocial services law, at a per diem rate for each day the child is\nenrolled in a program. To ensure the alienability of needed services to\nthese children, reimbursement shall be provided only to those agencies\nhaving satisfied conditions of the department including satisfactory\ntraining in pediatric palliative care.\n 4. Certified hospice programs shall be allowed to waive the admission\ncriteria requiring certification of "a terminal illness with prognosis\nof six months or less" as well as the requirement for families to forgo\ncurative treatment for children qualifying for this program receiving\ncare from an approved site.\n 5. All home care and other medical assistance under article five of\nthe social services law otherwise authorized for the child, shall\ncontinue without interruption. The pilot program for all-inclusive care\nfor children is not intended to supersede any program already in place.\n 6. The locations of the providers under the pilot program for\nall-inclusive care shall be geographically disbursed throughout the\nstate and approved by the commissioner.\n 7. The commissioner shall require each provider under the pilot\nprogram for all-inclusive care for children to submit an annual report,\nwhich shall include data analyzing the cost and efficiency of care\nprovided under such program. On or before December thirty-first, two\nthousand eight, the commissioner shall submit a report to the governor,\nthe temporary president of the senate and the speaker of the assembly\nanalyzing the cost and efficiency of the pilot program.\n