§ 461-s. Enhancing the quality of adult living program for adult care
facilities. 1. (a) The commissioner of health shall establish the
enhanced quality of adult living program (referred to in this section as
the "EQUAL program" or the "program") for adult care facilities. The
program shall be targeted at improving the quality of life for adult
care facility residents by means of grants to facilities for the
purposes set forth in subparagraphs (i) and (ii) of the paragraph. The
department of health, subject to the approval of the director of the
budget, shall develop an allocation methodology taking into account the
financial status and size of the facility, resident needs and the
population of residents who receive supplemental security income, state
supplemental payments, Medicaid (with respect to residents in an
assisted living program), or safety net assistance. On or before June
first of each year, the department shall make available the application
for EQUAL program funds. Grants may be used to support the following
purposes:

(i) to improve the quality of life for adult care facility residents
by funding projects including, but not limited to, clothing allowances,
resident training to support independent living skills, improvements in
food quality, outdoor leisure projects, and culturally recreational and
other leisure events; and resident quality of life, pursuant to this
subparagraph, and

(ii) to improve the quality of life for adult care facility residents
by financing capital improvement projects that will enhance the physical
environment of the facility and promote a higher quality of life for
residents. Any capital related expense generated by such capital
expenditure must receive approval by the department of health, provided
however, that such expenditures shall not be used to supplant the
obligations of the facility operator to provide a safe, comfortable
environment for residents in a good state of repair and sanitation.

(b) On or before June first of each year, the department shall make
available the application for EQUAL program funds to eligible adult care
facilities, as set forth in this section.

2. No payment shall be made under the program to a facility that has
received official written notice from the department of a proposed
revocation, suspension, limitation or denial of the operator's operating
certificate.

3. Prior to applying for EQUAL program funds, a facility shall receive
approval of its expenditure plan from the residents' council for the
facility. The residents' council shall adopt a process to identify the
priorities of the residents for the use of the program funds and
document residents' top preferences by means that may include a vote or
survey. The plan shall detail how program funds will be used to improve
resident quality of life, pursuant to subparagraph (i) of paragraph (a)
of subdivision one of this section, and support sustainable enhancements
to the physical environment of the facility pursuant to subparagraph
(ii) of paragraph (a) of this subdivision. The facility's application
for EQUAL program funds shall include a signed attestation from the
president or chair-person of the residents' council or, in the absence
of a residents' council, at least three residents of the facility,
stating that the application reflects the priorities of the residents of
the facility. The department shall investigate reports of resident abuse
and retaliation related to program applications and expenditures.

4. EQUAL program funds shall not be expended for a facility's daily
operating expenses, including employee salaries or benefits, or for
expenses incurred retrospectively, except that expenditures may be
incurred prior to the approval of the facility's application for such
fiscal year, provided that: (a) consistent with subdivision three of
this section, the residents' council approves such expenditure prior to
the expenditure being incurred, and the facility provides with its
application documentation of such approval and the date thereof; and (b)
the expenditure meets all applicable requirements pursuant to this
section and is subsequently approved by the department. EQUAL program
funds may be used for expenditures related to corrective action as
required by an inspection report, provided such expenditure is
consistent with subdivision three of this section.