Relates to allowing residential health care facilities meeting certain requirements located in Essex county reimbursement at rate of forty percent above the rate set forth in 10 NYCRR section 86-2.10.

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S825-2011 Actions

• Jan 4, 2012: REFERRED TO HEALTH
• Jan 5, 2011: REFERRED TO HEALTH

S825-2011 Memo

BILL NUMBER:S825

TITLE OF BILL:
An act
to amend the social services law, in relation to payments for
residential health care facilities in Essex county

PURPOSE:
To ensure the provisions of the long term
care services for
frail and impoverished elderly patients, and to prevent future
closures of nursing homes.

SUMMARY OF 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: 75% or more Medicaid payer mix,
hospital affiliation, not-for-profit status, the creation or
retention of at least 150 jobs at the facility, location in a
non-metropolitan statistical area and in a county where more than 15%
of the population is aged 65 and located in Essex County.

Section 2 Effective date.

JUSTIFICATION:
Essex County 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
$50 to $60 below cost, per Medicaid patient, per day, resulting in
losses that have exceeded $1,500,000 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 down and
layoff workers.

In the past year, two hospital based Long Term Care Units have closed
in the North Country. In Rouses Point, one facility has closed in the
past 48 months, resulting in the loss of over fifty jobs. In the
Adirondack Park, where any single health care facility is 50 miles
away from the next. The loss of one 156 bed nursing home would
sharply curtail the hospital's ability to discharge patients, thereby
escalating Medicaid cost while the hospital patient awaits nursing
home placement.

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. In Essex County, 14.7% of the
individuals are at or below the poverty level.

LEGISLATIVE HISTORY:
04/09/10  S.7431  Reported to Health
06/15/10  A.10678 Reported to Ways & Means

FISCAL IMPLICATIONS:
To be determined.


EFFECTIVE DATE:
This act shall take effect immediately, with provisions.

S825-2011 Text

                      S T A T E   O F   N E W   Y O R K
  ________________________________________________________________________

      S. 825                                                    A. 519

                         2011-2012 Regular Sessions

                        SENATE - ASSEMBLY

                                 (PREFILED)

                               January 5, 2011
                                 ___________

  IN  SENATE -- Introduced by Sen. LITTLE -- read twice and ordered print-
    ed, and when printed to be committed to the Committee on Health

  IN ASSEMBLY -- Introduced by M. of A. SAYWARD -- read once and  referred
    to the Committee on Social Services

  AN  ACT  to  amend  the social services law, in relation to payments for
    residential health care facilities in Essex 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-x to read as follows:

    S 367-X. PAYMENT FOR RESIDENTIAL HEALTH CARE FACILITIES IN ESSEX COUN-
  TY. 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 A RURAL AREA;
    (B) THE FACILITY IS A HOSPITAL AFFILIATED FACILITY;
    (C) THE FACILITY IS IN A RURAL AREA AND IN A COUNTY  WHERE  MORE  THAN
  FIFTEEN PERCENT OF THE TOTAL POPULATION IS OVER THE AGE OF SIXTY-FIVE;
    (D) THE FACILITY HAS OVER SEVENTY-FIVE PERCENT OF MEDICAID PAYOR MIX;
    (E)  THERE  IS  JOB RETENTION AND/OR CREATION FOR AT LEAST ONE HUNDRED
  FIFTY PEOPLE PER FACILITY; AND
    (F) THE FACILITY IS LOCATED IN ESSEX COUNTY;
  SHALL BE REIMBURSED AT A RATE 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

   EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                        [ ] is old law to be omitted.
                                                             LBD01293-01-1

 S. 825                              2                             A. 519

  SECURITY ACT, PROVIDED THAT SUCH FACILITY POSSESSES  A  VALID  OPERATING
  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 date.