§ 367-v. County long-term care financing demonstration program. 1.
Notwithstanding any inconsistent provision of law, the commissioner is
authorized to establish a long-term care financing demonstration
program, to operate in up to five counties, for the purpose of creating
incentives and funding for the transformation of county nursing home
beds into other long-term care settings.

2. (a) The demonstration program established pursuant to this section
shall permit a participating county to reduce its county nursing home
bed capacity, or to close a county nursing home, and to invest any
resulting demonstrated savings in programs or services that will, to the
extent feasible, encourage the use of community-based long-term care
alternatives to institutional care.

(b) Such programs or services may include, but are not limited to:

(i) expansion of community-based services such as the program for
all-inclusive care for the elderly (PACE), the long term home health
care program, the managed long term care program, adult day care
services, and caregiver support services;

(ii) expansion of senior housing;

(iii) assisted living program;

(iv) payment of subsidies to encourage assisted living programs, adult
care facilities, and non-public nursing homes to accept hard-to-serve
residents; and

(v) contracts with non-public nursing homes to guarantee beds for
those hard-to-serve persons who choose nursing home care or for whom
other community-based options are not feasible or are unavailable.

3. A county wishing to participate in the demonstration program
established pursuant to this section shall develop a plan and submit an
application for participation to the commissioner of health detailing
such plan at a time and in a manner to be determined by such
commissioner. The commissioner is authorized to approve or disapprove
any such application and to certify the amount of demonstrated savings.

4. Notwithstanding the cap on social services district shares of
medical assistance expenditures established pursuant to section one of
part C of chapter fifty-eight of the laws of two thousand five, the
director of the division of the budget is authorized, in his or her sole
discretion, to adjust a district's cap amount to account for changes in
the non-federal share of medical assistance resulting from any approved
demonstration plan.

5. The commissioner of health is authorized to submit any amendments
to the state plan for medical assistance and any waivers of the federal
social security act that such commissioner determines to be necessary to
obtain federal financial participation in the costs of services provided
pursuant to this section.

6. The commissioner of health shall submit a report to the governor,
temporary president of the senate and speaker of the assembly by the
first day of November, two thousand fifteen, on the implementation of
this section. Such report shall include identification of the counties
approved to participate in the demonstration, a description of such
counties' approved demonstration plans, an analysis of the impact of the
demonstration on long-term care costs and service delivery, any
recommendations for legislative action, and such other matters as may be
pertinent.