Senate Bill S4918A

Vetoed By Governor

2011-2012 Legislative Session

Provides for the payment of capitated rates for services provided by assisted living programs, whether freestanding or not

download bill text pdf

Archive: Last Bill Status Via A8248 - Vetoed by Governor

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Vetoed By Governor
Signed By Governor

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Actions

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Sep 23, 2011	tabled vetoed memo.67
Sep 12, 2011	delivered to governor
Jun 20, 2011	returned to assembly passed senate 3rd reading cal.1387 substituted for s4918a
Jun 20, 2011	substituted by a8248 ordered to third reading cal.1387 committee discharged and committed to rules
Jun 09, 2011	print number 4918a
Jun 09, 2011	amend and recommit to finance
May 17, 2011	reported and committed to finance
Apr 29, 2011	referred to health

Votes

- Jun 20, 2011 - Floor Vote
  A8248
  
  Aye
  
  53
  
  Nay
  
  9
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  
  0
  - - Floor Vote: Jun 20, 2011
      
      aye (53)
      
      Alesi
      
      Ball
      
      Bonacic
      
      Breslin
      
      Carlucci
      
      DeFrancisco
      
      Diaz
      
      Dilan
      
      Duane
      
      Espaillat
      
      Farley
      
      Flanagan
      
      Fuschillo
      
      Gallivan
      
      Golden
      
      Griffo
      
      Grisanti
      
      Hannon
      
      Huntley
      
      Johnson
      
      Klein
      
      Krueger
      
      Kruger
      
      LaValle
      
      Lanza
      
      Larkin
      
      Libous
      
      Little
      
      Marcellino
      
      Martins
      
      Maziarz
      
      McDonald
      
      Montgomery
      
      Nozzolio
      
      O'Mara
      
      Oppenheimer
      
      Parker
      
      Perkins
      
      Ranzenhofer
      
      Ritchie
      
      Robach
      
      Saland
      
      Sampson
      
      Savino
      
      Serrano
      
      Seward
      
      Skelos
      
      Smith
      
      Squadron
      
      Stewart-Cousins
      
      Valesky
      
      Young
      
      Zeldin
      
      nay (9)
      
      Adams
      
      Addabbo Jr.
      
      Avella
      
      Gianaris
      
      Hassell-Thompson
      
      Kennedy
      
      Peralta
      
      Rivera
      
      Stavisky
  Jun 20, 2011 - Rules Committee Vote
  S4918A
  
  Aye
  
  22
  
  Nay
  
  1
  
  Aye with Reservations
  
  1
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  
  0
  - - Rules Committee Vote: Jun 20, 2011
      
      aye (22)
      
      Alesi
      
      Breslin
      
      Dilan
      
      Duane
      
      Farley
      
      Hannon
      
      Hassell-Thompson
      
      Johnson
      
      Krueger
      
      LaValle
      
      Larkin
      
      Libous
      
      Marcellino
      
      Maziarz
      
      Nozzolio
      
      Perkins
      
      Saland
      
      Sampson
      
      Seward
      
      Skelos
      
      Smith
      
      Stewart-Cousins
      
      nay (1)
      
      Parker
      
      aye wr (1)
      
      Montgomery
  May 17, 2011 - Health Committee Vote
  S4918A
  
  Aye
  
  14
  
  Nay
  
  0
  
  Aye with Reservations
  
  2
  
  Absent
  
  0
  
  Excused
  
  1
  
  Abstained
  
  0
  - - Health Committee Vote: May 17, 2011
      
      aye (14)
      
      Adams
      
      Ball
      
      Duane
      
      Farley
      
      Fuschillo
      
      Golden
      
      Hannon
      
      Larkin
      
      McDonald
      
      Rivera
      
      Seward
      
      Smith
      
      Stewart-Cousins
      
      Young
      
      aye wr (2)
      
      Gianaris
      
      Kruger
      
      excused (1)
      
      Montgomery

Bill Amendments

Original

A (Active)

2011-S4918 - Details

See Assembly Version of this Bill:: A8248
Law Section:: Public Health Law
Laws Affected:: Amd §3614, Pub Health L

2011-S4918 - Summary

Provides for the payment of capitated rates for services provided by assisted living programs, whether free-standing or not.

2011-S4918 - Sponsor Memo

                                BILL NUMBER:S4918

TITLE OF BILL:

An act
to amend the public health law, in relation to capitated rates of
payment for services provided by assisted living programs

PURPOSE:

This bill will expand the criteria for ALPs to obtain Medicaid
reimbursement for real property capital construction costs.

SUMMARY OF PROVISIONS:

This bill amends subdivision 6 of section 3614 of the public health
law, by amending paragraph (b) to broaden the criteria for
eligibility for capital reimbursement.

JUSTIFICATION:

Currently, there is a very small capital component in the Medicaid ALP
rate, which does not reflect current true capital costs. At the time
that the ALP program was developed, it was envisioned that adult care
facilities would convert already-licensed facilities to include ALP
programs, thereby limiting the capital costs. Much has changed since

that time, however, and changes are necessary to reflect the present
day needs and practices.

Current state policy is encouraging a transition from nursing home
beds to ALP beds to "rightsize" the system of care. This initiative
will help save Medicaid dollars by enabling low-income seniors to
reside in ALPs at half the cost of the nursing home rate. It also
enables seniors to live in a more home-like, community-oriented
setting. Rightsizing projects are impossible without capital funding,
however.

In addition, many of the original ALP programs (or adult care
facilities seeking ALP licensure) are housed in aging buildings that
require significant capital improvements to update physical plants to
meet the needs of more frail residents who might otherwise need
nursing home care. Funding is needed for resident safety and quality
of life, as well as to meet increasing structural requirements
imposed by the Department of Health.

This bill amends existing legislation allowing Medicaid reimbursement
for real property capital construction costs for certain ALPs, to
include more entities. While this incurs a new cost to the state, it
is a necessary investment to ultimately save significant Medicaid
funds by diverting nursing home placement and transitioning people
out of nursing homes to the ALP.
Providing a capital component in the ALP rate will enable true
rightsizing of
long term care. The viability of the ALP is essential because
Medicaid eligible individuals who need ALP services will go to a
nursing home at a greater cost if there is no ALP bed available in


their community. The ALP is the only assisted living option for
Medicaid-eligible individuals.

LEGISLATIVE HISTORY:

This is a new bill.

FISCAL IMPLICATIONS:

While this incurs a new cost to the state, it will ultimately save
significant Medicaid funds by diverting nursing home placement and
transitioning people out of nursing homes to the ALP.

EFFECTIVE DATE:

This shall take effect immediately.

2011-S4918 - Bill Text download pdf

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

                                  4918

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             April 29, 2011
                               ___________

Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the public health law, in relation to capitated rates of
  payment for services provided by assisted living programs

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1. Paragraphs (a) and (b) of subdivision 6 of section 3614 of
the public health law, paragraph (a) as amended by section 17 of part  D
of  chapter 58 of the laws of 2009 and paragraph (b) as added by chapter
645 of the laws of 2003, is amended to read as follows:
  (a) The commissioner shall, subject  to  the  approval  of  the  state
director  of  the  budget,  establish  capitated  rates  of  payment for
services provided by assisted living programs as  defined  by  paragraph
(a) of subdivision one of section four hundred sixty-one-l of the social
services  law.  Such rates of payment shall be related to costs incurred
by residential health care facilities. The rates shall reflect the  wage
equalization  factor  established  by  the  commissioner for residential
health care facilities in  the  region  in  which  the  assisted  living
program  is provided, and real property capital construction costs asso-
ciated with the construction of [a  free-standing]  AN  assisted  living
program  [such]  AND THE rate FOR REAL PROPERTY CONSTRUCTION COSTS shall
include a payment equal to the cost of interest  owed  and  depreciation
costs  of  such construction. The rates shall also reflect the efficient
provision of a quality and quantity of  services  to  patients  in  such
residential  health  care facilities, with needs comparable to the needs
of residents served in such assisted  living  programs.  Such  rates  of
payment  shall  be equal to fifty percent of the amounts which otherwise
would have been expended, based upon the mean prices for  the  first  of
July,  nineteen  hundred  ninety-two (utilizing nineteen hundred eighty-
three costs) for freestanding, low  intensity  residential  health  care
facilities  with  less than three hundred beds, and for years subsequent

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD11023-02-1

S. 4918                             2

to nineteen hundred ninety-two, adjusted  for  inflation  in  accordance
with  the  provisions of subdivision ten of section twenty-eight hundred
seven-c of this chapter, to provide the appropriate level  of  care  for
such  residents  in residential health care facilities in the applicable
wage equalization  factor  regions  plus  an  amount  equal  to  capital
construction  costs  associated  with  the  construction  of an assisted
living program facility as provided for in this subdivision.
  (b)  For  purposes  of  this  subdivision,   real   property   capital
construction  costs  shall  only  be  included  in  rates of payment for
assisted living programs if: (i) the facility is operated by a  not-for-
profit  corporation;  AND  (ii)  [the facility commenced operation after
nineteen hundred ninety-eight and at least ninety-five  percent  of  the
certified approved beds are provided to residents who are subject to the
assisted  living  program; and (iii) the assisted living program is in a
county with a population of no less than  two  hundred  eighty  thousand
persons] SUCH PAYMENT FOR REAL PROPERTY CAPITAL CONSTRUCTION COSTS WOULD
BE  NO LESS THAN THE CAPITAL CONSTRUCTION COST PAYMENT THAT WOULD OTHER-
WISE BE CALCULATED PURSUANT TO PARAGRAPH (A) OF  THIS  SUBDIVISION.  The
methodology  used  to  calculate  the rate for such capital construction
costs shall be the  same  methodology  used  to  calculate  the  capital
construction costs at residential health care facilities for such costs.
  S 2. This act shall take effect immediately.

co-Sponsors

2011-S4918A (ACTIVE) - Details

See Assembly Version of this Bill:: A8248
Law Section:: Public Health Law
Laws Affected:: Amd §3614, Pub Health L

2011-S4918A (ACTIVE) - Summary

Provides for the payment of capitated rates for services provided by assisted living programs, whether free-standing or not.

2011-S4918A (ACTIVE) - Sponsor Memo

                                BILL NUMBER:S4918A

TITLE OF BILL:
An act
to amend the public health law, in relation to capitated rates of
payment for services provided by assisted living programs

PURPOSE:
This bill will give the Commissioner authority to expand the
criteria for ALPs to obtain Medicaid reimbursement for real property
capital construction costs.

SUMMARY OF SPECIFIC PROVISIONS:
Section one of the bill amends subdivision 6 of section 3614 of the
public health law, by amending paragraphs (a) and (b) to broaden the
criteria for eligibility for capital reimbursement.

Section two provides for an immediate effective date.

JUSTIFICATION:
Currently, there is a very small capital component in
the Medicaid ALP rate, which does not reflect current true capital
costs. Current state policy is encouraging a transition from nursing
home beds to ALP beds to "rightsize" the system of care. This
initiative will help save Medicaid dollars by enabling low-income
seniors and other individuals in need of care to reside in ALPs at

half the cost of the nursing home rate. It also enables residents to
live in a more home-like, community-oriented setting. Rightsizing
projects are impossible without capital funding, however.

In addition, many of the original ALP programs (or adult care
facilities seeking ALP licensure) are housed in aging buildings that
require significant capital improvements to update physical plants to
meet the needs of more frail residents who might otherwise need
nursing home care. Funding is needed for resident safety and quality
of life, as well as to meet increasing structural requirements
imposed by the Department of Health.

This bill amends existing law by allowing Medicaid reimbursement for
real property capital construction costs for certain ALPs. Providing
a capital component in the ALP rate for these facilities will enable
true rightsizing of long term care. The viability of the ALP program
is essential because Medicaid eligible individuals who need ALP
services will go to a nursing home at a greater cost if there is no
ALP bed available in their community. The ALP is the only assisted
living option for Medicaid-eligible individuals, whether they are
seniors or individuals suffering from HIV/AIDS and related
complications, who need care but at a level less intensive than
skilled nursing care. Finally, this bill specifically requires that
the capital component will only be available for facilities that are
able to establish with the Department of Health that the conversion
will result in net fiscal savings to the state, thereby ensuring the
cost-effectiveness of this legislation.

PRIOR LEGISLATIVE HISTORY:
New Bill.


FISCAL IMPLICATIONS:
None to the State as Commissioner must determine
that it will result in a net fiscal savings to the state.

EFFECTIVE DATE:
Immediately.

2011-S4918A (ACTIVE) - Bill Text download pdf

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

                                 4918--A

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             April 29, 2011
                               ___________

Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health -- reported favora-
  bly from said committee and committed to the Committee on  Finance  --
  committee  discharged,  bill amended, ordered reprinted as amended and
  recommitted to said committee

AN ACT to amend the public health law, in relation to capitated rates of
  payment for services provided by assisted living programs

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1. Paragraphs (a) and (b) of subdivision 6 of section 3614 of
the public health law, paragraph (a) as amended by section 17 of part  D
of  chapter 58 of the laws of 2009 and paragraph (b) as added by chapter
645 of the laws of 2003, is amended to read as follows:
  (a) The commissioner shall, subject  to  the  approval  of  the  state
director  of  the  budget,  establish  capitated  rates  of  payment for
services provided by assisted living programs as  defined  by  paragraph
(a) of subdivision one of section four hundred sixty-one-l of the social
services  law.  Such rates of payment shall be related to costs incurred
by residential health care facilities. The rates shall reflect  (I)  the
wage equalization factor established by the commissioner for residential
health  care  facilities  in  the  region  in  which the assisted living
program is provided, and  (II) real property capital construction  costs
associated  with the construction of (A) a free-standing assisted living
program, OR (B) OTHER ASSISTED LIVING PROGRAMS FOR WHICH THE COMMISSION-
ER DETERMINES THAT SUCH REAL PROPERTY CAPITAL CONSTRUCTION COST  ADJUST-
MENT  WOULD  PROVIDE  NET  FISCAL  SAVINGS TO THE STATE; such rate shall
include a payment equal to the cost of interest  owed  and  depreciation
costs  of  such construction. The rates shall also reflect the efficient
provision of a quality and quantity of  services  to  patients  in  such
residential  health  care facilities, with needs comparable to the needs
of residents served in such assisted  living  programs.  Such  rates  of

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD11023-03-1

S. 4918--A                          2

payment  shall  be equal to fifty percent of the amounts which otherwise
would have been expended, based upon the mean prices for  the  first  of
July,  nineteen  hundred  ninety-two (utilizing nineteen hundred eighty-
three  costs)  for  freestanding,  low intensity residential health care
facilities with less than three hundred beds, and for  years  subsequent
to  nineteen  hundred  ninety-two,  adjusted for inflation in accordance
with the provisions of subdivision ten of section  twenty-eight  hundred
seven-c  of  this  chapter, to provide the appropriate level of care for
such residents in residential health care facilities in  the  applicable
wage  equalization  factor  regions  plus  an  amount  equal  to capital
construction costs associated  with  the  construction  of  an  assisted
living program facility as provided for in this subdivision.
  (b)   For   purposes   of  this  subdivision,  real  property  capital
construction costs shall only  be  included  in  rates  of  payment  for
assisted  living programs if: (i) the facility is operated by a not-for-
profit corporation; (ii) the facility commenced operation after nineteen
hundred ninety-eight and at least ninety-five percent of  the  certified
approved  ADULT CARE FACILITY beds, AS APPLICABLE, are provided to resi-
dents who are subject to the assisted living  program;  and  (iii)  WITH
RESPECT  TO  AN ASSISTED LIVING PROGRAM UNDER CLAUSE (A) OF SUBPARAGRAPH
(II) OF PARAGRAPH (A) OF THIS SUBDIVISION, the assisted  living  program
is  in  a  county  with  a population of no less than two hundred eighty
thousand persons.  The methodology used to calculate the rate  for  such
capital  construction costs shall be the same methodology used to calcu-
late the capital construction costs at residential health  care  facili-
ties for such costs.
  S 2. This act shall take effect immediately.

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Senate Bill S4918A

Vetoed By Governor

Sponsored By

Archive: Last Bill Status Via A8248 - Vetoed by Governor

Actions

Votes

Jun 20, 2011 - Floor Vote

Floor Vote: Jun 20, 2011

Jun 20, 2011 - Rules Committee Vote

Rules Committee Vote: Jun 20, 2011

May 17, 2011 - Health Committee Vote

Health Committee Vote: May 17, 2011

Bill Amendments

2011-S4918 - Details

2011-S4918 - Summary

2011-S4918 - Sponsor Memo

2011-S4918 - Bill Text download pdf

co-Sponsors

2011-S4918A (ACTIVE) - Details

2011-S4918A (ACTIVE) - Summary

2011-S4918A (ACTIVE) - Sponsor Memo

2011-S4918A (ACTIVE) - Bill Text download pdf

Comments

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Senate Bill S4918A

Vetoed By Governor

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Sponsored By

Kemp Hannon

Archive: Last Bill Status Via A8248 - Vetoed by Governor

Actions

Votes

Bill Amendments

2011-S4918 - Details

2011-S4918 - Summary

2011-S4918 - Sponsor Memo

2011-S4918 - Bill Text download pdf

co-Sponsors

Thomas K. Duane

2011-S4918A (ACTIVE) - Details

2011-S4918A (ACTIVE) - Summary

2011-S4918A (ACTIVE) - Sponsor Memo

2011-S4918A (ACTIVE) - Bill Text download pdf

Comments