N.Y. Social Services Law § 364-b: Residential and medical care placement demonstration projects

* § 364-b. Residential and medical care placement demonstration

projects. 1. Notwithstanding any inconsistent provisions of this

chapter or any other law to the contrary, social services districts are

hereby authorized to conduct or participate in time-limited

demonstration projects for the purpose of demonstrating the feasibility

of reducing medical assistance expenditures for care in residential

health facilities by utilizing medical assistance funds for: (a)

conducting initial assessments of, and performing case management

functions, for (i) persons financially eligible for medical assistance

pursuant to this title who request long term care services, and (ii)

persons whether or not otherwise financially eligible for medical

assistance who seek care in or discharge from a residential health care

facility or a congregate care facility as described in section two

hundred nine of this chapter, and (b) providing social services and

medical supplies determined to be necessary and appropriate as a result

of assessments conducted pursuant to paragraph (a) hereof, to those

persons participating in an approved project who are otherwise eligible

to receive medical assistance, whether or not such services or supplies

are authorized to be provided under this title; provided, however, that

no such additional services or supplies provided hereunder shall be

subject to state reimbursement unless prior approval to provide such

services or supplies to persons eligible for medical assistance has been

granted by the department. Such demonstration projects may be conducted

or participated in by a social services district only in accordance with

a plan submitted to the department on or before the thirtieth day of

June, nineteen hundred seventy-seven, and only to the extent and period

for which such plan has been approved or from time to time extended by

the commissioner.

2. Any plan submitted pursuant to this section shall provide that in

any case in which it is determined by an assessment conducted in

accordance with such a project that placement in a skilled nursing

facility or an intermediate care facility would be appropriate, such

placement shall be subject to review and approval by the department of

health provided, however, that the commissioner of health may delegate

preplacement assessment review function to such a project. In addition,

any plan submitted pursuant to this section shall include a description

of any assessment methodology utilized in determining the

appropriateness of placements in skilled nursing facilities or

intermediate care facilities and any such plan may be approved by the

commissioner only after such methodology has been submitted to the

department of health for its review and comment.

3. Notwithstanding any inconsistent provision of law to the contrary,

expenditures made in connection with an approved residential and medical

care placement demonstration project for assessments, case management

and social services and medical supplies authorized to be provided by

this title or approved by the department, shall be subject to state

reimbursement under section three hundred sixty-eight-a of the social

services law in accordance with a schedule of maximum reimbursable

amounts established by the department for such services and supplies.

4. Notwithstanding any inconsistent provision of this chapter or any

other law to the contrary, the commissioner may, subject to the approval

of the director of the budget, approve such demonstration projects and

apply for the appropriate waivers under federal law and regulation and

may waive: (a) any provision of this title or regulation of the

department as may be necessary to make medical assistance funds

available for initial assessment and performing case management

functions for persons participating in such approved projects without

regard to their eligibility to participate in the medical assistance

program and when appropriate, providing additional approved social

services and medical supplies, not otherwise authorized under this

title, to persons participating in such approved projects who are

otherwise eligible to participate in the medical assistance program; and

(b) such department regulations relating thereto as may be necessary to

enable a social services district to carry out such project.

5. The commissioner shall require that a final independent evaluation

be made of any demonstration project approved and conducted hereunder in

a form mutually agreed upon by him and the state commissioner of health,

and shall provide copies of such report to the governor and to the

legislature. In addition the commissioner shall submit annual interim

reports on the progress of each project to the governor and legislature

by the first day of February of each year.

* NB Expired September 30, 1986