Relates to allowing residential health care facilities meeting certain requirements located in Erie county and Niagara county reimbursement at rate of forty percent above the rate set forth in 10 NYCRR section 86-2.10.
TITLE OF BILL: An act to amend the social services law, in relation to payments for residential health care facilities in Erie county and Niagara county
PURPOSE: To ensure the provision of long term care services for frail and impoverished elderly patients, and to prevent future closures of nursing homes.
SUMMARY OF SPECIFIC PROVISIONS: Section 1: This legislation will create a special Medicaid reimbursement rate 40% higher than what is called for in previous regulations. The rate will apply to facilities that meet five of the six criteria: 80% or more Medicaid payor mix, hospital affiliation, not-for-profit status, the creation or retention of at least 120 jobs at the facility, location in a metropolitan statistical area where more than 15.5% of the population is over the age 65, and location in either Erie or Niagara Counties.
Section II: Effective date.
JUSTIFICATION: Western New York is at a disadvantage because the rate at which Medicaid reimburses nursing homes has been significantly below the cost to provide care. In many cases, the reimbursement has been $35 to $50 below cost, per Medicaid patient, per day, resulting in losses that have exceeded $1,000,000 a year for some nursing homes. This has caused a situation where the nursing homes that have high percentages of patients on Medicaid are being forced to shut clown and layoff workers. Most of the workers who are laid off are minorities.
In the past several years, eight nursing homes have closed in western New York. In the City of Buffalo, three facilities have closed in the past 24 months, resulting in the loss of over 700 jobs. A fourth nursing home in Buffalo recently received approval for closure, and several more are on the brink of bankruptcy. In this urban area, where there were once 14 nursing homes, there has been a 36% drop in the number of facilities, a figure that will increase if no action is taken to address the problem. As such, this legislation is necessary to avoid significant loss of jobs and closure of facilities where the percentage of residents on Medicaid is very high, and where rates of poverty are substantially higher than the statewide average.
PRIOR LEGISLATIVE HISTORY: 03/18/10 Referred to Health
FISCAL IMPLICATIONS: To be determined.
EFFECTIVE DATE: This act shall take effect immediately.
STATE OF NEW YORK ________________________________________________________________________ 2879 2011-2012 Regular Sessions IN SENATE February 2, 2011 ___________Introduced by Sens. GRISANTI, MAZIARZ, KENNEDY -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the social services law, in relation to payments for residential health care facilities in Erie county and Niagara county THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. The social services law is amended by adding a new section 367-y to read as follows: S 367-Y. PAYMENT FOR RESIDENTIAL HEALTH CARE FACILITIES IN ERIE COUNTY AND NIAGARA COUNTY. 1. NOTWITHSTANDING ANY LAW, RULE OR REGULATION TO THE CONTRARY, RESIDENTIAL HEALTH CARE FACILITIES MEETING FIVE OF THE FOLLOWING SIX CATEGORIES: (A) THE FACILITY IS A NOT-FOR-PROFIT FACILITY LOCATED IN AN URBAN AREA; (B) THE FACILITY IS A HOSPITAL AFFILIATED FACILITY; (C) THE FACILITY IS IN A METROPOLITAN STATISTICAL AREA WHERE MORE THAN FIFTEEN AND ONE-HALF PERCENT OF THE TOTAL POPULATION IS OVER THE AGE OF SIXTY-FIVE; (D) THE FACILITY HAS OVER EIGHTY PERCENT OF MEDICAID PAYOR MIX; (E) THERE IS JOB RETENTION AND/OR CREATION FOR AT LEAST ONE HUNDRED TWENTY PEOPLE PER FACILITY; AND (F) THE FACILITY IS LOCATED IN ERIE COUNTY OR NIAGARA COUNTY; SHALL BE REIMBURSED AT A MEDICAID RATE (LESS CAPITAL) OF FORTY PERCENT ABOVE THE RATE SET FORTH IN 10 NYCRR SECTION 86-2.10 FOR ALL CARE PROVIDED AT SUCH FACILITY. 2. THE TERM "RESIDENTIAL HEALTH CARE FACILITIES" SHALL MEAN ALL FACIL- ITIES OR ORGANIZATIONS COVERED BY THE TERM "NURSING HOME" AS DEFINED IN SUBDIVISION TWO OF SECTION TWENTY-EIGHT HUNDRED ONE OF THE PUBLIC HEALTH LAW, INCLUDING HOSPITAL-BASED RESIDENTIAL HEALTH CARE FACILITIES, AND NURSING FACILITIES AS DEFINED IN SECTION 1919 OF THE FEDERAL SOCIAL SECURITY ACT, PROVIDED THAT SUCH FACILITY POSSESSES A VALID OPERATINGEXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06861-01-1 S. 2879 2
CERTIFICATE ISSUED BY THE STATE COMMISSIONER OF HEALTH AND, WHERE REQUIRED, HAS BEEN ESTABLISHED BY THE PUBLIC HEALTH COUNCIL. 3. THE COMMISSIONER OF HEALTH IS HEREBY AUTHORIZED AND DIRECTED TO ADOPT RULES AND REGULATIONS TO IMPLEMENT THE PROVISIONS OF THIS SECTION. S 2. This act shall take effect immediately, provided, however, that the commissioner of health shall promulgate any rules and regulations necessary for the implementation of this act on or before such effective date.