New York Laws
Article 28 - Hospitals
2808-E - Residential Health Care for Children With Medical Fragility in Transition to Young Adults and Young Adults With Medical Fragility Demonstration Program.

(a) "children with medical fragility" shall mean children up to
twenty-one years of age who have a chronic debilitating condition or
conditions, 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 between eighteen and thirty-five years old.
(c) "pediatric residential health care facility" shall mean a
residential health care facility or discrete unit of a residential
health care facility providing services to children under the age of
twenty-one.
(d) "eligible pediatric residential health care facilities" shall mean
pediatric health care facilities that meet the following eligibility
criteria for the demonstration program set forth in subdivision one of
this section: (i) has over one hundred and sixty licensed pediatric
beds; or (ii) is currently licensed for pediatric beds pursuant to this
article, is co-operated by a system of hospitals licensed pursuant to
this article, and such hospitals qualify for funds pursuant to a vital
access provider assurance program or a value based payment incentive
program, as administered by the department in accordance with all
requirements set forth in the state's federal 1115 Medicaid waiver
standard terms and conditions.
3. Notwithstanding any law, rule, or regulation to the contrary, any
child with medical fragility who has resided for at least thirty
consecutive days in an eligible pediatric residential health care
facility and who has reached the age of twenty-one while a resident, may
continue residing at such eligible pediatric residential health care
facility and receiving such services from the facility, provided that
such young adult with medical fragility remains eligible for nursing
home care, and provided further that the eligible pediatric residential
health care facility has prepared, applied for, and submitted to the
commissioner, a proposal for a new residential health care facility for
the provision of extensive nursing, medical, psychological and
counseling support services to young adults with medical fragility in
accordance with subdivision four of this section. A young adult with
medical fragility may remain in such eligible pediatric residential
health care facility until such time that the young adult with medical
fragility attains the age of thirty-five years or the young adult
residential health care facility is constructed and becomes operational,
whichever is sooner.
4. Upon receipt of a certificate of need application from an eligible
pediatric residential health care facility selected by the commissioner

for the demonstration program authorized under this section, the
commissioner is authorized to approve, with the written approval of the
public health and health planning council pursuant to section
twenty-eight hundred two of this article, the construction of a new
residential health care facility to be constructed and operated on a
parcel of land within the same county as that of eligible pediatric
residential health care facility that is proposing such new facility and
over which it will have site control, or the repurposing of a portion of
a residential health care facility that is currently serving geriatric
residents or those with similar needs 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, provided that the
established operator of such eligible pediatric residential health care
facility proposing the young adult facility is in good standing and
possesses at least thirty years' prior experience operating as a
pediatric residential health care facility in the state or more than
thirty years' experience serving medically fragile pediatric patients,
and provided further that such facility qualifies for the demonstration
program set forth in subdivision one of this section.
5. A young adult facility established pursuant to subdivision four 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 or unit 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.
6. (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
eligible pediatric residential health care facility as authorized in
subdivision three of this section, the commissioner shall establish the
operating component of rates of reimbursement appropriate for young
adults with medical fragility residing at a pediatric residential health
care facility, to apply to such young adults twenty-one years of age or
older. Such methodology shall take into account the methodology used to
establish the operating component of the rates pursuant to section
twenty eight hundred eight of this article for pediatric residential
health care facilities with an increase or decrease adjustment as
appropriate 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.
(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 four of this section, the commissioner shall
establish the operating component of rates of reimbursement appropriate
for young adults with medical fragility. Such methodology shall take
into account the methodology used to establish the operating component
of the rates pursuant to section twenty eight hundred eight of this
article for pediatric residential health care facilities with an
increase or decrease adjustment as appropriate 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.
7. The commissioner shall have authority to waive any rule or
regulation to effectuate the demonstration program authorized pursuant
to subdivision one of this section.
* NB Repealed August 17, 2025
* NB There are 2 § 2808-e's

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