N.Y. Public Health Law § 2808-f: Advanced residential health care for aging adults medical fragility demonstration program

§ 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

repurpose 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 applicant" shall mean

adult health care facilities that meet the following eligibility

criteria for the demonstration program set forth in subdivision one of

this section: (i) is a nonprofit corporation that operates one hundred

ten adult beds licensed under article sixteen of the mental hygiene law;

or (ii) is licensed to provide diagnostic and treatment services

pursuant to this article.

3. Upon receipt of a certificate of need application from an eligible

adult residential health care applicant selected by the commissioner for

the demonstration program authorized under this section, the

commissioner 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 applicant that is proposing such new facility

and over which it will have site control, provided that such facility

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. For inpatient services provided to any aging adults with medical

fragility eligible for medical assistance as authorized in subdivision

three of this section, the commissioner shall establish the operating

component 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 fragility, including addressing their distinct needs

as aging adults for medical and psychological support services.