2010 New York Code
PBH - Public Health
Article 28 - (2800 - 2822) HOSPITALS
2807-X - Grants for long term care demonstration projects.

§  2807-x.  Grants  for  long term care demonstration projects. 1. The
  commissioner shall establish three demonstration  projects  to  develop,
  evaluate  and implement programs to test new models for the organization
  and delivery of long term care services  to  encourage  community  based
  programs  and smaller residential health care models in order to promote
  consumer choice, improve the efficiency and appropriateness of  the  use
  of state and federal resources and ensure the recruitment, retention and
  training  of  health  care  staff  to  adequately  meet  the  needs of a
  community and residential long term  care  system.  Notwithstanding  the
  provisions of section one hundred twelve of the state finance law or any
  other  inconsistent provision of the state finance law or any other law,
  funds available  for  distribution  pursuant  to  this  section  may  be
  allocated  and distributed by the commissioner without a competitive bid
  or request for proposal process.
    (a) The following  factors  shall  be  considered  in  approving  each
  demonstration project respectively:
    (i)  Residential  health care demonstration project. (A) the extent to
  which there is a reduction in the need for skilled nursing  beds  for  a
  facility  that  is  eligible  to  replace  its  existing skilled nursing
  facility; (B) the potential  to  design  and  develop  more  appropriate
  smaller   residential  health  care  facilities  as  an  alternative  to
  replacing an existing skilled nursing facility; (C) the extent to  which
  the  quality,  efficiency  and  continuity  of care will be promoted and
  provided for by the development of integrated long-term care services in
  the community; (D) the extent to which the project will provide training
  to health care workers to appropriately staff new community based models
  of long term care;  (E)  demonstrate  the  involvement  and  support  of
  workforce  in  the  program  redesign;  (F)  the  development  of  a new
  long-term care reimbursement methodology that  encourages  care  in  the
  least  restrictive  setting and adequately reflects the resources needed
  to serve consumers in  each  level  of  long  term  care;  (G)  and  the
  incorporation of a research component designed to evaluate the project.
    (ii)  Community  based  care  demonstration project. (A) the extent to
  which there is a reduction in the need for skilled nursing facility beds
  on a countywide basis; (B) the development of a  new  system  to  inform
  recently  admitted  residents  of  skilled  nursing  facilities  of  the
  availability of community long-term care  options;  (C)  the  extent  to
  which  the  discharge  planning  program from skilled nursing facilities
  will inform, assist and maximize freedom  of  choice  to  consumers  who
  choose  to  move  back  to  the  community;  (D) the extent to which the
  project will develop community based long term care services,  including
  funding  for  the  recruitment  and retention of direct care health care
  workers necessary to increase community based services; (E)  the  extent
  to which the project will provide training to health care staff; and (F)
  the  incorporation  of  a  research  component  designed to evaluate the
  projects.
    (iii) Managed long term care  project.  (A)  the  extent  to  which  a
  current  operator  of skilled nursing facilities possesses the necessary
  authorizations through a related  entity  to  assume  risk  and  receive
  capitated  payments,  pursuant to titles 18 and 19 of the federal social
  security act, for the purpose of providing and arranging for the care of
  individuals eligible for admission to a skilled  nursing  facility,  (B)
  the  extent  to which such services to individuals eligible for benefits
  pursuant to both titles 18 and 19 of the  federal  social  security  act
  will be provided through the capitated rate, (C) the extent to which the
  quality, efficiency and continuity of care will be promoted and provided
  for  by  the  development  of  integrated long-term care services in the
  community, (D) the extent to which the project sponsor will directly  or

indirectly in association with a joint labor management program, provide
  for  training  of  health  care workers to appropriately staff community
  based models of long-term care; and (E) the incorporation of a  research
  component  designed  to evaluate the project, with specific reference to
  the determination of cost savings to  the  state,  the  quality  of  and
  satisfaction  with services provided to consumers and their families and
  the satisfaction of direct care workers, with a report of the  project's
  progress and findings submitted annually to the commissioner.
    2.  The  commissioner  is  authorized  to waive, modify or suspend the
  respective provisions of rules and regulations promulgated  pursuant  to
  this  chapter  if  the  commissioner  determines  that  such  waiver  is
  necessary  or  appropriate  for  the  successful  implementation  of   a
  demonstration  project  and when the health, safety, and general welfare
  of persons receiving services under such demonstration project will  not
  be  impaired  as  a  result  of such waiver, modification or suspension,
  provided however, that for the managed long term care  project  pursuant
  to  subparagraph  (iii)  of  paragraph  (a)  of  subdivision one of this
  section, the method for setting the  capitated  rate  of  payment  under
  title 19 of the federal social security act shall be consistent with the
  method  used  for  all  managed  long  term  care plans authorized under
  subdivision eight of section forty-four hundred three-f  of  the  public
  health law.
    3.  The commissioner is authorized to seek federal waivers pursuant to
  titles XVIII and XIX of  the  federal  social  security  act  when  such
  waivers   are   necessary  to  develop  cost-effective  long  term  care
  demonstration projects.