What's happening
This bill authorizes demonstration projects for managed long-term care plans to enroll and manage nursing home residents in rural New York.
Why it matters
Aims to test if managed long-term care plans can better support nursing home residents in rural areas. , especially by helping those permanently placed in nursing homes transition back to community living when possible.
Targets rural communities, which often face unique challenges such as limited healthcare options, provider shortages, and transportation barriers. the demonstration could highlight solutions or gaps specific to these areas.
May provide evidence for broader reforms in how long-term care is delivered and funded in New York. , especially if the demonstration projects show improved health outcomes, cost savings, or increased resident satisfaction.
Does not change existing patient protections or plan requirements. the demonstration must operate within current regulatory frameworks, ensuring that residents’ rights and benefits remain intact during the pilot.
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Who cares
Managed long-term care plans
Department-approved plans could enroll permanently placed nursing home residents and manage their nursing home benefits in rural demonstration projects, subject to existing statutory requirements.
Permanently placed nursing home residents in rural areas
The projects would study whether managed care models help them return to community-based settings.
Rural nursing homes
The projects would allow managed long-term care plans to manage nursing home benefits for enrolled permanent residents.
New York State Department of Health
The bill would require the department to authorize one or more demonstration projects and approve participating plans to operate in rural areas.
Headline styles
Test Managed Care in Nursing Homes
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to health
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Rural Nursing Home Care Pilot
In Assembly Committee · Health · Sponsor Billy Jones
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
2933
2019-2020 Regular Sessions
IN SENATE
January 30, 2019
Introduced by Sen. LITTLE -- 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 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
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Paragraph (b) of subdivision 7 of section 4403-f of the public health law is amended by adding a new subparagraph (v-e) to read as follows:
(v-e) Notwithstanding clause thirteen of subparagraph (v) of this paragraph, the department shall authorize 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, as such term is defined in section twenty-nine hundred fifty-one of this chapter. Such plan shall be approved by the department to operate under this subparagraph in one or more such rural areas, in order to study the effectiveness of managed care models in assisting permanently-placed nursing home residents to return to community-based settings. Nothing in this subparagraph shall modify or alter any requirements of this section for plans authorized to enroll persons under this subparagraph.
§ 2. This act shall take effect immediately; provided, however, that the amendments to paragraph (b) of subdivision 7 of section 4403-f of the public health law made by section one of this act shall not affect the expiration of such paragraph pursuant to subdivision (i) of section 111 of part H of chapter 59 of the laws of 2011, as amended, and shall be deemed to expire therewith; provided, further, that the amendments to section 4403-f of the public health law made by section one of this act shall not affect the repeal of such section pursuant to chapter 659 of the laws of 1997, as amended, and shall be deemed repealed therewith.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03243-01-9
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
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 transitioning 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 risk of permanent placement to continue partnering to do so and will allow 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 of more than three months.
Individuals interested in living in the community should have the oppor- tunity 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
2017-18: S.8488/A.10688 - Senate & Assembly Health Committees
Fiscal implications
None.
Effective date
This act shall take effect immediately.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.