Senate Bill S8779

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8779
 
                             I N  S E N A T E
 
                               July 15, 2020
                                ___________
 
 Introduced  by  Sen.  STEWART-COUSINS -- read twice and ordered printed,
   and when printed to be committed to the Committee on Rules
 
 AN ACT to amend the public health law, in  relation  to  aiding  in  the
   transition  to adulthood for children with medical fragility living in
   pediatric nursing homes and other settings
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  The  public health law is amended by adding a new section
 2808-e to read as follows:
   § 2808-E. RESIDENTIAL HEALTH CARE FOR CHILDREN WITH MEDICAL  FRAGILITY
 IN  TRANSITION  TO YOUNG ADULTS AND YOUNG ADULTS WITH MEDICAL FRAGILITY.
 1. FOR PURPOSES OF THIS SECTION:
   (A) "CHILDREN WITH MEDICAL FRAGILITY" SHALL MEAN CHILDREN UP TO  TWEN-
 TY-ONE  YEARS OF AGE WHO HAVE A CHRONIC DEBILITATING CONDITION OR CONDI-
 TIONS, ARE AT RISK OF HOSPITALIZATION, ARE TECHNOLOGY-DEPENDENT FOR LIFE
 OR HEALTH SUSTAINING FUNCTIONS, REQUIRE COMPLEX MEDICATION  REGIMENS  OR
 MEDICAL  INTERVENTIONS  TO  MAINTAIN  OR TO IMPROVE THEIR HEALTH STATUS,
 AND/OR ARE IN NEED OF ONGOING  ASSESSMENT  OR  INTERVENTION  TO  PREVENT
 SERIOUS  DETERIORATION  OF  THEIR HEALTH STATUS OR MEDICAL COMPLICATIONS
 THAT PLACE THEIR LIFE, HEALTH OR DEVELOPMENT AT RISK.
   (B) "YOUNG ADULTS WITH MEDICAL FRAGILITY" SHALL MEAN  INDIVIDUALS  WHO
 MEET THE DEFINITION OF CHILDREN WITH MEDICAL FRAGILITY, BUT FOR THE FACT
 SUCH INDIVIDUALS ARE AGED TWENTY-ONE YEARS OR OLDER.
   (C)  "PEDIATRIC  RESIDENTIAL  HEALTH CARE FACILITY" SHALL MEAN A FREE-
 STANDING FACILITY OR DISCRETE UNIT WITHIN A FACILITY AUTHORIZED  BY  THE
 COMMISSIONER  TO  PROVIDE  EXTENSIVE NURSING, MEDICAL, PSYCHOLOGICAL AND
 COUNSELING SUPPORT SERVICES SOLELY TO CHILDREN.
   2. NOTWITHSTANDING ANY LAW, RULE OR REGULATION TO  THE  CONTRARY,  ANY
 CHILD WITH MEDICAL FRAGILITY WHO HAS RESIDED FOR AT LEAST THIRTY CONSEC-
 UTIVE  DAYS  IN A PEDIATRIC RESIDENTIAL HEALTH CARE FACILITY AND WHO HAS
 REACHED THE AGE OF TWENTY-ONE WHILE A RESIDENT, MAY CONTINUE RESIDING AT
 SUCH PEDIATRIC FACILITY AND RECEIVING SUCH SERVICES FROM  THE  FACILITY,
 PROVIDED  THAT  SUCH YOUNG ADULT WITH MEDICAL FRAGILITY REMAINS ELIGIBLE
 FOR NURSING HOME CARE.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD15856-01-0

 S. 8779                             2
 
   3. THE COMMISSIONER IS  AUTHORIZED  TO  ESTABLISH,  WITH  THE  WRITTEN
 APPROVAL  OF  THE  PUBLIC HEALTH AND HEALTH PLANNING COUNCIL PURSUANT TO
 SECTION TWENTY-EIGHT HUNDRED ONE-A OF THIS  ARTICLE,  ONE  OR  MORE  NEW
 RESIDENTIAL  HEALTH  CARE  FACILITIES  FOR  THE  PROVISION  OF  NURSING,
 MEDICAL,  PSYCHOLOGICAL  AND  COUNSELING SUPPORT SERVICES APPROPRIATE TO
 THE NEEDS OF NURSING HOME-ELIGIBLE YOUNG ADULTS WITH MEDICAL  FRAGILITY,
 REFERRED  TO  HEREIN  BELOW  AS A YOUNG ADULT FACILITY, WHICH SUCH YOUNG
 ADULT FACILITY MAY BE PROPOSED BY AN ESTABLISHED OR PROPOSED OPERATOR OF
 A PEDIATRIC RESIDENTIAL HEALTH CARE FACILITY OR A DISCRETE  UNIT  WITHIN
 AN ESTABLISHED NURSING HOME IN GOOD STANDING.
   4. A YOUNG ADULT FACILITY ESTABLISHED PURSUANT TO SUBDIVISION THREE OF
 THIS  SECTION  MAY  ADMIT,  FROM THE COMMUNITY-AT-LARGE OR UPON REFERRAL
 FROM AN UNRELATED FACILITY, YOUNG  ADULTS  WITH  MEDICAL  FRAGILITY  WHO
 PRIOR  TO  REACHING AGE TWENTY-ONE WERE CHILDREN WITH MEDICAL FRAGILITY,
 AND WHO ARE ELIGIBLE FOR NURSING HOME CARE  AND  IN  NEED  OF  EXTENSIVE
 NURSING,   MEDICAL,   PSYCHOLOGICAL  AND  COUNSELING  SUPPORT  SERVICES,
 PROVIDED THAT THE YOUNG ADULT FACILITY, TO PROMOTE CONTINUITY  OF  CARE,
 UNDERTAKES  TO  PROVIDE  PRIORITY ADMISSION TO YOUNG ADULTS WITH MEDICAL
 FRAGILITY TRANSITIONING  FROM  THE  PEDIATRIC  RESIDENTIAL  HEALTH  CARE
 FACILITY  OPERATED  BY THE ENTITY THAT PROPOSED THE YOUNG ADULT FACILITY
 AND ENSURE SUFFICIENT CAPACITY  TO  ADMIT  SUCH  YOUNG  ADULTS  AS  THEY
 APPROACH OR ATTAIN TWENTY-ONE YEARS OF AGE.
   5.  (A)  FOR  INPATIENT  SERVICES  PROVIDED  TO  ANY YOUNG ADULTS WITH
 MEDICAL FRAGILITY ELIGIBLE FOR  MEDICAL  ASSISTANCE  PURSUANT  TO  TITLE
 ELEVEN OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW RESIDING AT ANY PEDIA-
 TRIC  RESIDENTIAL  HEALTH CARE FACILITY AS AUTHORIZED IN SUBDIVISION TWO
 OF THIS SECTION, THE COMMISSIONER SHALL REIMBURSE SUCH PEDIATRIC FACILI-
 TY AT THE SAME RATES OF REIMBURSEMENT APPROVED BY THE  COMMISSIONER  FOR
 CHILDREN  WITH  MEDICAL FRAGILITY RESIDING AT SAID PEDIATRIC RESIDENTIAL
 HEALTH CARE FACILITY PURSUANT TO SECTION TWENTY-EIGHT HUNDRED  EIGHT  OF
 THIS ARTICLE.
   (B)  FOR  INPATIENT SERVICES PROVIDED TO ANY YOUNG ADULTS WITH MEDICAL
 FRAGILITY ELIGIBLE FOR MEDICAL ASSISTANCE PURSUANT TO  TITLE  ELEVEN  OF
 ARTICLE  FIVE  OF THE SOCIAL SERVICES LAW AT ANY YOUNG ADULT FACILITY AS
 AUTHORIZED IN SUBDIVISION THREE OF THIS SECTION, THE COMMISSIONER  SHALL
 ESTABLISH  THE  OPERATING  COMPONENT OF RATES OF REIMBURSEMENT UTILIZING
 THE SAME METHODOLOGY USED TO ESTABLISH THE OPERATING  COMPONENT  OF  THE
 RATES PURSUANT TO SECTION TWENTY-EIGHT HUNDRED EIGHT OF THIS ARTICLE FOR
 THE  FREE-STANDING  PEDIATRIC RESIDENTIAL HEALTH CARE FACILITY DESCRIBED
 IN SUBDIVISION THREE OF THIS SECTION, SUBJECT TO ADJUSTMENT AS APPROPRI-
 ATE TO ACCOUNT FOR ANY DISCRETE  EXPENSES  ASSOCIATED  WITH  CARING  FOR
 YOUNG ADULTS WITH MEDICAL FRAGILITY, INCLUDING ADDRESSING THEIR DISTINCT
 NEEDS AS YOUNG ADULTS FOR PSYCHOLOGICAL AND COUNSELING SUPPORT SERVICES.
   6. SUBJECT TO THE FOREGOING, ALL OTHER LAWS AND REGULATIONS THAT APPLY
 TO  PEDIATRIC  RESIDENTIAL  HEALTH CARE FACILITIES, INCLUDING EXEMPTIONS
 FROM LAWS AND REGULATIONS  OTHERWISE  APPLICABLE  TO  OTHER  RESIDENTIAL
 HEALTH  CARE  FACILITIES,  SHALL ALSO APPLY TO ANY PEDIATRIC RESIDENTIAL
 HEALTH CARE FACILITY AUTHORIZED IN SUBDIVISION TWO OF  THIS  SECTION  TO
 PROVIDE INPATIENT SERVICES TO YOUNG ADULTS WITH MEDICAL FRAGILITY AND TO
 ANY  YOUNG  ADULT  FACILITY ESTABLISHED PURSUANT TO SUBDIVISION THREE OF
 THIS SECTION, AND TO ANY INPATIENT  SERVICES  PROVIDED  BY  EITHER  SUCH
 FACILITY.
   § 2. This act shall take effect immediately.