Senate Bill S9464

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9464
 
                             I N  S E N A T E
 
                              March 13, 2026
                                ___________
 
 Introduced  by  Sen.  CLEARE -- 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 rates  of  payment
   for adult day health care services
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. Subdivision 23 of section 2808 of the public health law, as
 added by section 29 of part C of  chapter  109  of  the  laws  of  2006,
 subparagraph (ii) of paragraph (a) as amended by chapter 591 of the laws
 of  2007,  and subparagraph (iii) of paragraph (a) as amended by section
 20 of part D of chapter 58 of the laws of 2009, is amended  to  read  as
 follows:
   23. Notwithstanding any inconsistent provision of law or regulation to
 the contrary:
   (a)  (i)  For  adult  day health care services provided by residential
 health care facilities, effective April first, two thousand  seven  [and
 thereafter]  UNTIL  APRIL  FIRST, TWO THOUSAND TWENTY-SIX, the operating
 component of the rate of payment established pursuant  to  this  article
 for  an  adult  day  health care program which has achieved an occupancy
 percentage of ninety percent or greater for a  calendar  year  prior  to
 April first, two thousand seven, shall be calculated utilizing allowable
 costs reported in the two thousand four, two thousand five, or two thou-
 sand  six  calendar  year  residential  health care facility cost report
 filed by the sponsoring residential health care facility,  whichever  is
 the earliest of such calendar year cost reports in which the program has
 achieved  an  occupancy  percentage of ninety percent or greater, except
 that programs receiving rates of payment based on allowable costs for  a
 period  prior  to  April  first,  two  thousand  seven shall continue to
 receive rates of payment based on such period.
   (ii) For such programs which achieved an occupancy percentage of nine-
 ty percent or greater prior to calendar year two thousand four, so  long
 as  approved  capacity  in that year is the same as in calendar year two
 thousand four, but which did not maintain occupancy of ninety percent or
 greater in calendar years two thousand four, two thousand five,  or  two
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD15122-01-6
 S. 9464                             2
 
 thousand six, the operating component of the rate of payment established
 pursuant  to  this article shall be calculated utilizing allowable costs
 reported in the two thousand four calendar year cost report  divided  by
 visits imputed at ninety percent occupancy.
   (iii)  For such programs which have not achieved an occupancy percent-
 age of ninety percent or greater for a  calendar  year  prior  to  April
 first,  two  thousand  seven,  the  operating  component  of the rate of
 payment established pursuant to this article shall be calculated utiliz-
 ing allowable costs reported in the first calendar year after two  thou-
 sand  six  in  which  such a program achieves an occupancy percentage of
 ninety percent or greater effective January first of such calendar  year
 except  for  calendar year two thousand seven, effective no earlier than
 April first of such year,  provided,  however,  that  effective  January
 first,  two  thousand nine, for programs that have not achieved an occu-
 pancy percentage of ninety percent or greater for a calendar year  prior
 to January first, two thousand nine, the operating component of the rate
 of  payment  established  pursuant  to  this article shall be calculated
 utilizing allowable costs reported in the two thousand nine cost  report
 filed  by  the  sponsoring  residential  health care facility divided by
 visits imputed at actual  or  ninety  percent  occupancy,  whichever  is
 greater.  This  subparagraph shall also apply to programs which achieved
 an occupancy percentage of ninety percent or greater prior  to  calendar
 year  two  thousand  four but in such year had an approved capacity that
 was not the same as in calendar year two thousand four.
   (b) [For a residential health care facility  approved  to  operate  an
 adult  day  health  care  program  on or after April first, two thousand
 seven, rates of payment for such programs shall be computed  based  upon
 annual  budgeted allowable costs, as submitted by the residential health
 care facility, and total estimated annual visits  by  adult  day  health
 care  registrants of not less than ninety percent of licensed occupancy,
 and in accordance with the following:
   (i) Each program shall be required to  submit  an  individual  budget.
 Multiple  programs operated by the same residential health care facility
 shall submit a separate budget for each program. Multiple programs oper-
 ated by the same residential health care facility  shall  have  separate
 rates of payment.
   (ii)  Rates developed based upon budgets shall remain in effect for no
 longer than two calendar years from the earlier of:
   (A) the date the program commences operations; or
   (B) the date the sponsoring residential health care facility submits a
 full calendar year residential health care facility cost report in which
 the program has achieved ninety percent or greater occupancy. If a spon-
 soring residential health care facility submits such a cost report with-
 in two years of the date the program commences  operation,  rates  shall
 then be computed utilizing such cost report.
   (iii) If a program fails to achieve ninety percent or greater occupan-
 cy  within  two calendar years of the date of its commencing operations,
 rates shall be calculated utilizing allowable  costs  reported  in  such
 second  calendar year residential health care facility's cost report for
 the applicable sponsoring residential health care  facility  divided  by
 visits  imputed  at  ninety percent occupancy] NOTWITHSTANDING ANY OTHER
 PROVISION OF LAW, FOR ADULT DAY HEALTH CARE SERVICES PROVIDED  BY  RESI-
 DENTIAL  HEALTH  CARE  FACILITIES,  EFFECTIVE  APRIL FIRST, TWO THOUSAND
 TWENTY-SIX AND THEREAFTER, THE OPERATING COMPONENT OF RATES  OF  PAYMENT
 ESTABLISHED  PURSUANT  TO THIS ARTICLE SHALL EQUAL SIXTY-FIVE PERCENT OF
 THE  SPONSORING  RESIDENTIAL  HEALTH  CARE  FACILITY'S  INPATIENT  RATE,
 S. 9464                             3
 
 PROVIDED  HOWEVER,  THAT  NO RATE OF PAYMENT SHALL INCREASE BY MORE THAN
 FIFTY PERCENT WHEN COMPARED WITH THE RATE OF PAYMENT  IN  THE  PRECEDING
 CALENDAR  YEAR, PROVIDED FURTHER HOWEVER, THAT NOTWITHSTANDING PARAGRAPH
 (A)  OF  THIS  SUBDIVISION,  WHERE  SIXTY-FIVE PERCENT OF THE SPONSORING
 RESIDENTIAL HEALTH FACILITY'S INPATIENT RATE IS LESS  THAN  ONE  HUNDRED
 FIFTY  DOLLARS IN NEW YORK CITY, OR NASSAU, SUFFOLK OR WESTCHESTER COUN-
 TIES, THE RATE SHALL BE ONE HUNDRED FIFTY DOLLARS AND FOR  THE  REST  OF
 THE  STATE WHERE THE SPONSORING RESIDENTIAL HEALTH CARE FACILITY'S INPA-
 TIENT RATE IS LESS THAN ONE HUNDRED THIRTY DOLLARS, THE  RATE  SHALL  BE
 ONE HUNDRED THIRTY DOLLARS.
   (c) Effective January first, two thousand eight, [allowable costs] THE
 OPERATING  COMPONENT  OF  RATES  OF  PAYMENT  FOR  ADULT DAY HEALTH CARE
 SERVICES shall not include the costs of transportation.
   (d) [All rates of payment established pursuant to this subdivision are
 subject to the maximum daily rate provided by law.  Such  maximum  daily
 rate  of payment for adult day health care programs operated by residen-
 tial health care facilities that undergo a change  of  ownership  subse-
 quent  to  nineteen  hundred ninety shall be determined by utilizing the
 inpatient rate of payment of the prior operator as in effect on  January
 first,  nineteen  hundred ninety. In the event a residential health care
 facility establishes an off-site adult day health care  program  outside
 the  regional  input price adjustment region in which it is located, the
 computation of the maximum daily rate of payment for such program  shall
 utilize  the  weighted  average  of  the inpatient rates of payments for
 residential health care facilities in the region in which the program is
 located, as in effect on January  first,  nineteen  hundred  ninety,  in
 place  of  the  sponsoring  residential health care facility's inpatient
 rate of payment.
   (e)] Notwithstanding any inconsistent provision of the state  adminis-
 trative  procedure  act  or any other law or regulation to the contrary,
 the commissioner shall adopt or amend on an emergency  basis  any  regu-
 lations  the  commissioner  shall  determine  necessary to implement any
 provision of this subdivision.
   § 2. This act shall take effect immediately.