S T A T E O F N E W Y O R K
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10189
I N A S S E M B L Y
May 10, 2024
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Introduced by COMMITTEE ON RULES -- (at request of M. of A. Gunther) --
read once and referred to the Committee on Health
AN ACT to amend the public health law, in relation to establishing an
advanced residential health care for aging adults with medical fragil-
ity demonstration program
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. The public health law is amended by adding a new section
2808-f to read as follows:
§ 2808-F. ADVANCED RESIDENTIAL HEALTH CARE FOR AGING ADULTS MEDICAL
FRAGILITY DEMONSTRATION PROGRAM. 1. NOTWITHSTANDING ANY LAW, RULE, OR
REGULATION TO THE CONTRARY, THE COMMISSIONER SHALL, WITHIN AMOUNTS
APPROPRIATED AND SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL
PARTICIPATION, ESTABLISH A DEMONSTRATION PROGRAM FOR ELIGIBLE ADULT
RESIDENTIAL HEALTH CARE FACILITIES, AS DEFINED IN PARAGRAPH (C) OF
SUBDIVISION TWO OF THIS SECTION, TO CONSTRUCT A NEW FACILITY OR REPUR-
POSE PART OF AN EXISTING FACILITY TO OPERATE AS AN ADULT RESIDENTIAL
HEALTH CARE FACILITY FOR THE PURPOSE OF IMPROVING THE QUALITY OF CARE
FOR AGING ADULTS WITH MEDICAL FRAGILITY.
2. FOR PURPOSES OF THIS SECTION:
(A) "AGING ADULTS WITH MEDICAL FRAGILITY" SHALL MEAN ADULTS FROM AGE
THIRTY-FIVE TO END OF LIFE WHO HAVE A CHRONIC DEBILITATING CONDITION OR
CONDITIONS, ARE AT RISK OF HOSPITALIZATION, ARE TECHNOLOGY-DEPENDENT FOR
LIFE OR HEALTH SUSTAINING FUNCTIONS, REQUIRE COMPLEX MEDICATION REGIMENS
OR MEDICAL INTERVENTIONS TO MAINTAIN OR TO IMPROVE THEIR HEALTH STATUS,
AND/OR ARE IN NEED OF ONGOING ASSESSMENT OR INTERVENTION TO PREVENT
SERIOUS DETERIORATION OF THEIR HEALTH STATUS OR MEDICAL COMPLICATIONS
THAT PLACE THEIR LIFE, HEALTH OR DEVELOPMENT AT RISK.
(B) "ADULT RESIDENTIAL HEALTH CARE FACILITY" SHALL MEAN A RESIDENTIAL
HEALTH CARE FACILITY OR DISCRETE UNIT OF A RESIDENTIAL HEALTH CARE
FACILITY PROVIDING SERVICES TO ADULTS OVER THE AGE OF THIRTY-FIVE.
(C) "ELIGIBLE ADULT RESIDENTIAL HEALTH CARE FACILITIES" SHALL MEAN
ADULT HEALTH CARE FACILITIES THAT MEET THE FOLLOWING ELIGIBILITY CRITE-
RIA FOR THE DEMONSTRATION PROGRAM SET FORTH IN SUBDIVISION ONE OF THIS
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD15463-01-4
A. 10189 2
SECTION: (I) HAS OVER ONE HUNDRED TEN ADULT BEDS LICENSED UNDER ARTICLE
SIXTEEN OF THIS CHAPTER; OR (II) IS CURRENTLY LICENSED FOR ADULT BEDS
PURSUANT TO ARTICLE SIXTEEN OF THIS CHAPTER, IS LICENSED TO PROVIDE
DIAGNOSTIC AND TREATMENT SERVICES PURSUANT TO THIS ARTICLE, AND QUALI-
FIES FOR FUNDS PURSUANT TO A VITAL ACCESS PROVIDER ASSURANCE PROGRAM OR
A VALUE BASED PAYMENT INCENTIVE PROGRAM, AS ADMINISTERED BY THE DEPART-
MENT IN ACCORDANCE WITH ALL REQUIREMENTS SET FORTH IN THE STATE'S FEDER-
AL 1115 MEDICAID WAIVER STANDARD TERMS AND CONDITIONS.
3. UPON RECEIPT OF A CERTIFICATE OF NEED APPLICATION FROM AN ELIGIBLE
ADULT RESIDENTIAL HEALTH CARE FACILITY SELECTED BY THE COMMISSIONER FOR
THE DEMONSTRATION PROGRAM AUTHORIZED UNDER THIS SECTION, THE COMMISSION-
ER IS AUTHORIZED TO APPROVE, WITH THE WRITTEN APPROVAL OF THE PUBLIC
HEALTH AND HEALTH PLANNING COUNCIL PURSUANT TO SECTION TWENTY-EIGHT
HUNDRED TWO OF THIS ARTICLE, THE CONSTRUCTION OF A NEW RESIDENTIAL
HEALTH CARE FACILITY TO BE CONSTRUCTED AND OPERATED ON A PARCEL OF LAND
WITHIN THE SAME COUNTY AS THAT OF AN ELIGIBLE ADULT RESIDENTIAL HEALTH
CARE FACILITY THAT IS PROPOSING SUCH NEW FACILITY AND OVER WHICH IT WILL
HAVE SITE CONTROL, OR THE REPURPOSING OF A PORTION OF A RESIDENTIAL
HEALTH CARE FACILITY THAT IS CURRENTLY SERVING GERIATRIC RESIDENTS OR
THOSE WITH SIMILAR NEEDS FOR THE PROVISION OF NURSING, MEDICAL, PSYCHO-
LOGICAL AND COUNSELING SUPPORT SERVICES APPROPRIATE TO THE NEEDS OF
NURSING HOME-ELIGIBLE ADULTS WITH MEDICAL FRAGILITY, REFERRED TO HEREIN
BELOW AS AN AGING ADULT FACILITY, PROVIDED THAT THE ESTABLISHED OPERATOR
OF SUCH ELIGIBLE ADULT RESIDENTIAL HEALTH CARE FACILITY PROPOSING THE
AGING ADULT FACILITY IS IN GOOD STANDING AND POSSESSES AT LEAST FORTY
YEARS' PRIOR EXPERIENCE OPERATING AS AN ADULT RESIDENTIAL HEALTH CARE
FACILITY IN THE STATE OR MORE THAN FORTY YEARS' EXPERIENCE SERVING
MEDICALLY FRAGILE ADULT PATIENTS, AND PROVIDED FURTHER THAT SUCH FACILI-
TY QUALIFIES FOR THE DEMONSTRATION PROGRAM SET FORTH IN SUBDIVISION ONE
OF THIS SECTION.
4. AN AGING ADULT FACILITY ESTABLISHED PURSUANT TO SUBDIVISION THREE
OF THIS SECTION MAY ADMIT, FROM THE COMMUNITY-AT-LARGE OR UPON REFERRAL
FROM AN UNRELATED FACILITY, AGING ADULTS WITH MEDICAL FRAGILITY WHO,
PRIOR TO REACHING AGE THIRTY-FIVE, WERE YOUNG ADULTS WITH MEDICAL
FRAGILITY, AND WHO ARE ELIGIBLE FOR NURSING HOME CARE AND IN NEED OF
EXTENSIVE NURSING, MEDICAL, PSYCHOLOGICAL AND COUNSELING SUPPORT
SERVICES, PROVIDED THAT THE AGING ADULT FACILITY, TO PROMOTE CONTINUITY
OF CARE, UNDERTAKES TO PROVIDE PRIORITY ADMISSION TO AGING ADULTS WITH
MEDICAL FRAGILITY TRANSITIONING FROM THE PEDIATRIC RESIDENTIAL HEALTH
CARE FACILITY OR UNIT OPERATED BY THE ENTITY THAT PROPOSED THE AGING
ADULT FACILITY AND ENSURE SUFFICIENT CAPACITY TO ADMIT SUCH ADULTS AS
THEY ATTAIN THIRTY-FIVE YEARS OF AGE.
5. (A) FOR INPATIENT SERVICES PROVIDED TO ANY AGING ADULTS WITH
MEDICAL FRAGILITY ELIGIBLE FOR MEDICAL ASSISTANCE PURSUANT TO TITLE
ELEVEN OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW RESIDING AT ANY ELIGI-
BLE RESIDENTIAL HEALTH CARE FACILITY AS AUTHORIZED IN SUBDIVISION THREE
OF THIS SECTION, THE COMMISSIONER SHALL ESTABLISH THE OPERATING COMPO-
NENT OF RATES OF REIMBURSEMENT APPROPRIATE FOR AGING ADULTS WITH MEDICAL
FRAGILITY RESIDING AT AN ADULT RESIDENTIAL HEALTH CARE FACILITY, TO
APPLY TO SUCH ADULTS THIRTY-FIVE YEARS OF AGE OR OLDER. SUCH METHODOLOGY
SHALL TAKE INTO ACCOUNT THE METHODOLOGY USED TO ESTABLISH THE OPERATING
COMPONENT OF THE RATES PURSUANT TO SECTION TWENTY-EIGHT HUNDRED EIGHT OF
THIS ARTICLE FOR ADULT RESIDENTIAL HEALTH CARE FACILITIES WITH AN
INCREASE OR DECREASE ADJUSTMENT AS APPROPRIATE TO ACCOUNT FOR ANY
DISCRETE EXPENSES ASSOCIATED WITH CARING FOR AGING ADULTS WITH MEDICAL
A. 10189 3
FRAGILITY, INCLUDING ADDRESSING THEIR DISTINCT NEEDS AS AGING ADULTS FOR
MEDICAL AND PSYCHOLOGICAL SUPPORT SERVICES.
(B) FOR INPATIENT SERVICES PROVIDED TO ANY AGING ADULTS WITH MEDICAL
FRAGILITY ELIGIBLE FOR MEDICAL ASSISTANCE PURSUANT TO TITLE ELEVEN OF
ARTICLE FIVE OF THE SOCIAL SERVICES LAW AT ANY YOUNG ADULT FACILITY AS
AUTHORIZED IN SECTION TWENTY-EIGHT HUNDRED EIGHT-E OF THIS ARTICLE, THE
COMMISSIONER SHALL ESTABLISH THE OPERATING COMPONENT OF RATES OF
REIMBURSEMENT APPROPRIATE FOR ADULTS WITH MEDICAL FRAGILITY. SUCH METH-
ODOLOGY SHALL TAKE INTO ACCOUNT THE METHODOLOGY USED TO ESTABLISH THE
OPERATING COMPONENT OF THE RATES PURSUANT TO SECTION TWENTY-EIGHT
HUNDRED EIGHT OF THIS ARTICLE FOR YOUNG ADULT RESIDENTIAL HEALTH CARE
FACILITIES WITH AN INCREASE OR DECREASE ADJUSTMENT AS APPROPRIATE TO
ACCOUNT FOR ANY DISCRETE EXPENSES ASSOCIATED WITH CARING FOR AGING
ADULTS WITH MEDICAL FRAGILITY, INCLUDING ADDRESSING THEIR DISTINCT NEEDS
AS AGING ADULTS FOR MEDICAL AND PSYCHOLOGICAL SERVICES.
6. THE COMMISSIONER SHALL HAVE AUTHORITY TO WAIVE ANY RULE OR REGU-
LATION TO EFFECTUATE THE DEMONSTRATION PROGRAM AUTHORIZED PURSUANT TO
SUBDIVISION ONE OF THIS SECTION.
§ 2. This act shall take effect immediately.