BILL NUMBER: S547
SPONSOR: STEC
 
TITLE OF BILL:
An act to amend the public health law, in relation to authorizing one or
more demonstration projects that permit a managed long-term care plan to
enroll persons that are permanently placed in a nursing home and to
manage the nursing home benefit in one or more rural areas
 
PURPOSE:
The bill creates a demonstration program that would allow one or more
managed long term care plans that operate in rural counties and that
have demonstrated success in transition individuals in need of a nursing
home level of care from the nursing home to the community, to enroll and
manage the care of permanently-placed nursing home residents for periods
longer than three months
 
SUMMARY OF PROVISIONS:
The bill adds sub-paragraph (v-e) to paragraph b of subdivision 7 of
section 4403-f of public health law to authorize the Commissioner of
Health to allow one or more managed long term care plans to enroll Medi-
caid beneficiaries, and retain existing enrollees, who are permanently
placed in a nursing home, on a demonstration basis. Such a demonstration
or demonstrations would operate in one or more rural areas as defined in
section 2951 of public health law.
 
JUSTIFICATION:
Beginning in mid-2018, permanently placed nursing home residents who
have resided in a nursing home for longer than three consecutive months
are excluded from managed long-term care (MLTC) enrollment. While this
approach may be appropriate for urban areas, in rural areas, the coordi-
nation of services to facilitate the return of an individual with inten-
sive care needs to the community from a nursing home may require addi-
tional time.
This bill will allow those plans and providers most able and interested
in serving members who are permanently placed or are at greatest riskof
permanent placement to continue partnering to do so and will allow '4,"'
interested individuals to continue to receive coordinated care tailored
to their geographic realities. The bill relies on the definition of
rural area provided in section 2951 of Public Health Law.
It is beneficial for the health care system to allow a managed long term
care plan serving rural communities that has invested time, money,
effort and expertise in developing systems and forging provider partner-
ships to manage the care for individuals in need, or at greatest risk,
of long term nursing home care to continue enrolling and serving such
members. This would maximize the possibility that these members will be
able to return to the community even after a potentially permanent nurs-
ing home placement for more than three months. Individuals interested in
living in the community should have the opportunity to do so and this
measure will serve to broaden that opportunity. Avoiding or delaying
permanent placement for individuals wishing to live in the community
will not only improve the quality of life for these individuals, it will
also serve to save Medicaid dollars.
 
LEGISLATIVE HISTORY:
2023-2024: S496 referred to Health; A2437 referred to Health
2022/2021: S5345referred to Health; A882 referred to Health
2020/2019: S2933referred to Health; A2996 referred to Health
2018: S8488 referred to Health; A10688 referred to Health
 
FISCAL IMPLICATIONS:
None.
 
EFFECTIVE DATE:
This act shall take effect immediately.

Statutes affected:
S547: 4403-f public health law, 4403-f(7) public health law