Grants for long term care demonstration projects

§ 2807-x. Grants for long term care demonstration projects. 1. The
commissioner shall establish three demonstration projects to develop,
evaluate and implement programs to test new models for the organization
and delivery of long term care services to encourage community based
programs and smaller residential health care models in order to promote
consumer choice, improve the efficiency and appropriateness of the use
of state and federal resources and ensure the recruitment, retention and
training of health care staff to adequately meet the needs of a
community and residential long term care system. Notwithstanding the
provisions of section one hundred twelve of the state finance law or any
other inconsistent provision of the state finance law or any other law,
funds available for distribution pursuant to this section may be
allocated and distributed by the commissioner without a competitive bid
or request for proposal process.

(a) The following factors shall be considered in approving each
demonstration project respectively:

(i) Residential health care demonstration project. (A) the extent to
which there is a reduction in the need for skilled nursing beds for a
facility that is eligible to replace its existing skilled nursing
facility; (B) the potential to design and develop more appropriate
smaller residential health care facilities as an alternative to
replacing an existing skilled nursing facility; (C) the extent to which
the quality, efficiency and continuity of care will be promoted and
provided for by the development of integrated long-term care services in
the community; (D) the extent to which the project will provide training
to health care workers to appropriately staff new community based models
of long term care; (E) demonstrate the involvement and support of
workforce in the program redesign; (F) the development of a new
long-term care reimbursement methodology that encourages care in the
least restrictive setting and adequately reflects the resources needed
to serve consumers in each level of long term care; (G) and the
incorporation of a research component designed to evaluate the project.

(ii) Community based care demonstration project. (A) the extent to
which there is a reduction in the need for skilled nursing facility beds
on a countywide basis; (B) the development of a new system to inform
recently admitted residents of skilled nursing facilities of the
availability of community long-term care options; (C) the extent to
which the discharge planning program from skilled nursing facilities
will inform, assist and maximize freedom of choice to consumers who
choose to move back to the community; (D) the extent to which the
project will develop community based long term care services, including
funding for the recruitment and retention of direct care health care
workers necessary to increase community based services; (E) the extent
to which the project will provide training to health care staff; and (F)
the incorporation of a research component designed to evaluate the
projects.

(iii) Managed long term care project. (A) the extent to which a
current operator of skilled nursing facilities possesses the necessary
authorizations through a related entity to assume risk and receive
capitated payments, pursuant to titles 18 and 19 of the federal social
security act, for the purpose of providing and arranging for the care of
individuals eligible for admission to a skilled nursing facility, (B)
the extent to which such services to individuals eligible for benefits
pursuant to both titles 18 and 19 of the federal social security act
will be provided through the capitated rate, (C) the extent to which the
quality, efficiency and continuity of care will be promoted and provided
for by the development of integrated long-term care services in the
community, (D) the extent to which the project sponsor will directly or
indirectly in association with a joint labor management program, provide
for training of health care workers to appropriately staff community
based models of long-term care; and (E) the incorporation of a research
component designed to evaluate the project, with specific reference to
the determination of cost savings to the state, the quality of and
satisfaction with services provided to consumers and their families and
the satisfaction of direct care workers, with a report of the project's
progress and findings submitted annually to the commissioner.

2. The commissioner is authorized to waive, modify or suspend the
respective provisions of rules and regulations promulgated pursuant to
this chapter if the commissioner determines that such waiver is
necessary or appropriate for the successful implementation of a
demonstration project and when the health, safety, and general welfare
of persons receiving services under such demonstration project will not
be impaired as a result of such waiver, modification or suspension,
provided however, that for the managed long term care project pursuant
to subparagraph (iii) of paragraph (a) of subdivision one of this
section, the method for setting the capitated rate of payment under
title 19 of the federal social security act shall be consistent with the
method used for all managed long term care plans authorized under
subdivision eight of section forty-four hundred three-f of the public
health law.

3. The commissioner is authorized to seek federal waivers pursuant to
titles XVIII and XIX of the federal social security act when such
waivers are necessary to develop cost-effective long term care
demonstration projects.