§ 2958. Rural health care access development program. 1. To the extent
of funds available therefor, the sum of ten million dollars shall
annually be made available for periods prior to January first, two
thousand three, and up to nine million three hundred twenty thousand
dollars for the period January first, two thousand three through
December thirty-first, two thousand three, up to nine million three
hundred twenty thousand dollars for the period January first, two
thousand four through December thirty-first, two thousand four, up to
twelve million eighty-eight thousand dollars for the period January
first, two thousand five through December thirty-first, two thousand
five, up to twelve million eighty-eight thousand dollars for the period
January first, two thousand six through December thirty-first, two
thousand six, up to eleven million eighty-eight thousand dollars
annually for the period January first, two thousand seven through
December thirty-first, two thousand ten, up to two million seven hundred
seventy-two thousand dollars for the period January first, two thousand
eleven through March thirty-first, two thousand eleven, and within
amounts appropriated for each state fiscal year on and after April
first, two thousand eleven, shall be available to the commissioner from
funds pursuant to section twenty-eight hundred seven-l of this chapter
to provide assistance to general hospitals classified as a rural
hospital for purposes of determining payment for inpatient services
provided to beneficiaries of title XVIII of the federal social security
act (Medicare) or under state regulations, in recognition of the unique
costs incurred by these facilities to provide hospital services in
remote or sparsely populated areas pursuant to subdivision two of this
section.

2. a. The commissioner shall provide assistance to all rural hospitals
as defined in this section by distributing all amounts made available
pursuant to section twenty-eight hundred seven-l of this chapter.

b. For the purposes of this subdivision, the commissioner shall devise
a distribution methodology that takes into account the need for rural
hospitals to improve operational efficiencies, reduce the duplication of
services, and develop affiliations with community based health care
providers and which recognizes whether a hospital is a federally
designated sole community hospital, rural referral center, rural
hospital, state designated rural hospital, or a hospital that is at
substantial financial risk of failure and whose service area is
threatened with reduced access to essential health services. In no event
shall the size of the rural hospital be the sole contributing factor in
such distribution methodology. Such methodology shall provide assistance
at graduated levels from highest to lowest, in accordance with the
following criteria:

(i) The hospital shall be at substantial risk of financial failure,
using a combination of generally accepted standard measures of financial
viability and which is:

A. a federally designated sole community hospital or a rural referral
center and is both a federally designated rural hospital and is
classified as a state rural hospital;

B. a federally designated sole community hospital or a rural referral
center and is a federally designated rural hospital;

C. both a federally designated rural hospital and is classified as a
state rural hospital, but is not a sole community hospital or a rural
referral center;

D. either a federally designated rural hospital or is classified as a
state rural hospital; or

E. the hospital is either a federally defined sole community hospital
or rural referral center.

(ii) The hospital is a sole community hospital or a rural referral
center and is both a federally designated rural hospital and is
classified as a state rural hospital;

(iii) The hospital is a sole community hospital or a rural referral
center and is a federally designated rural hospital, but is not
classified as a state rural hospital;

(iv) The hospital is both a federally designated rural hospital and is
classified as a state rural hospital but is not a sole community
hospital or a rural referral center;

(v) The hospital is either a federally designated rural hospital or is
classified as a state rural hospital; or

(vi) The hospital is either a federally defined sole community
hospital or a rural referral center.

c. The commissioner may include in regulation a factor to enhance the
distribution to those hospitals that have taken actions in accordance
with the goals specified in paragraph b of this subdivision to be
applied effective January first, two thousand one, except, however, in
no event shall the distribution of the funds be delayed because of the
development of the factor pursuant to this paragraph.

3. The commissioner shall cause reports to be prepared and submitted
by rural hospitals at such times and in such manner as are consistent
with the purposes of this section.