BILL NUMBER:A9944

TITLE OF BILL:  An act to amend the public health law, in relation to
rates of payment for residential health care facilities

PURPOSE OR GENERAL IDEA OF BILL: The purpose of this legislation is to
ensure continuation of a consistent Medicaid nursing home reimbursement
rate for a specialty nursing home that treats neurologically impaired
children who cannot be appropriately discharged into the community when
they age.

SUMMARY OF SPECIFIC PROVISIONS: This legislation provides that a resi-
dential health care facility with fewer than sixty beds as of July 1,
2007, which provides services primarily to neurologically impaired indi-
viduals and is located in a county with of population between 290,000 -
310,000- as of July 1, 2007, shall receive one Medicaid reimbursement
rate, which shall be based solely on the methodology to establish rates
for a specialty children's nursing home.

JUSTIFICATION:  Prior to the enactment of Chapter 414 of the Laws of
2007, the facility received two different Medicaid rates under the
Health Departments rate setting -one for individuals under 16 and one
for individuals 16 and over, despite the fact that virtually the same
services were provided. Because of the differences in the way the two
rates were calculated, the rate for those 16 and over was considerably
less than that for those under 16. The rate for those over 16 .did not
              

cover the cost of care for these vulnerable individuals. Chapter 414 of
the laws of 2007 mandated that the facility receive one rate of payment
based solely on the methodology used to establish rates for facilities
which provide extensive nursing, medical, psychological and counseling
support services solely to children.

However, the facility has now received certificate of need approval to
add 36 beds, which will result in a facility with more than 60 beds.
Without a change in the law, the facility would no longer receive one
rate as it would no longer meet the qualification of having less than 60
beds (when chapter 414 of the Laws of 2007 was enacted, the facility did
not envision increasing its number of beds) - even though the rationale
that resulted in the enactment of chapter 414 of the Laws of 2007 still
applies. The beds being added are pediatric beds, not beds for the young
adult neurologically impaired population aged 16 and over, which will
remain at 20 beds (therefore, there is no change in the number of beds
the higher rate applies to).

PRIOR LEGISLATIVE HISTORY: New Bill

FISCAL IMPLICATIONS: Since this amendment simply allows for the contin-
uation of establishing one, rather than two, rates for the facility,
there would be no increase in Medicaid expenditures - the status quo
would be continued.

EFFECTIVE DATE: Immediately