§ 367-S — Long term care demonstration program

* § 367-s. Long term care demonstration program. 1. Notwithstanding\nany inconsistent provision of law, the commissioner of health is\nauthorized to establish a long term care demonstration program for\npersons eligible to receive services under this title, to operate in up\nto four social services districts, for the purposes of creating\nincentives for providers to care for individuals with more complex\nmedical needs, supporting relatives and other caregivers to assist\npatients needing care at home and reducing the need for\ninstitutionalization.\n 2. The provisions of this section shall not take effect unless all\nnecessary approvals under federal law and regulation have been obtained\nto receive federal financial participation in the costs of the health\ncare services provided pursuant to this section.\n 3. (a) The demonstration program established pursuant to this section\nmay include a program to improve the availability of care for persons\nwith clinically complex care needs who are being discharged from\nhospitals or residential health care facilities. In this regard, and in\naccordance with paragraph (d) of this subdivision, the commissioner\nshall adjust the rates of payment to selected home health agencies\ncertified under article thirty-six of the public health law that provide\nservices to such persons.\n (b) Eligible certified home health agencies shall:\n (i) demonstrate they have the experience and resources to provide\nservices to individuals who are discharged from hospitals or residential\nhealth care facilities with clinically complex care needs, as determined\nin accordance with criteria established by the commissioner.\n (ii) demonstrate that they are capable of meeting such other\nconditions as may be established by the commissioner.\n (c) In selecting eligible certified home health agencies, the\ncommissioner shall consider the likelihood that the agency will provide\nimproved availability of care and may consider such other matters as the\ncommissioner deems appropriate.\n (d) The adjusted Medicaid rate pursuant to this subdivision shall be\navailable for eligible certified home health agencies for services\nprovided to individuals, eligible for medical assistance pursuant to\nthis title, who are discharged from a hospital or residential health\ncare facility and have clinically complex care needs, as determined in\naccordance with criteria established by the commissioner. Such rate\nshall be payable for services provided up to the first sixty days after\ndischarge from a hospital or residential health care facility.\n 4. One or more demonstration sites established pursuant to this\nsection may include the provision of respite care through innovative\nmodels. Subject to the approval of the director of the division of the\nbudget, the commissioner is authorized to establish payment rates or\nfees for services provided pursuant to this subdivision.\n 5. One or more of the demonstration sites established pursuant to this\nsection may include a program with authority to make payments for\npersonal care services that are provided by a consumer's family members.\n * NB There are 2 § 367-s's\n