4015 - Pilot program for all-inclusive care for children.

§  4015.  Pilot  program  for  all-inclusive care for children. 1. The  commissioner is hereby authorized  to  establish  a  pilot  program  for  all-inclusive  care for children. Such program, subject to the rules and  regulations of the commissioner, shall consist of comprehensive  hospice  and  palliative  care services for children with life-limiting illnesses  that addresses the medical, psychosocial and spiritual aspects  of  care  and  allows  such  children  to  be  cared for at home rather than in an  institutional setting. Such services shall be provided  by  a  licensed,  certified  hospice  working jointly with a certified home health agency,  or a certified home health  agency  working  jointly  with  a  licensed,  certified  hospice  to  assure  the  provision  of services which are an  enhancement of either the certified home health agency or hospice alone,  and shall  include  hospice  services  as  well  as  related  expressive  therapies  such as art, play or music therapy in addition to services of  a child life specialist, and opportunities for respite care.    2. "A child with a  life  threatening  illness"  shall  mean  a  child  eligible  for  medical  assistance  under  article  five  of  the social  services law, who under the age of eighteen is diagnosed with an illness  that places the child at substantial risk of dying  before  the  age  of  twenty-one  where  the child can, with appropriate services be cared for  at an alternative to institutional care.    3. Qualified agencies providing services under this section to a child  shall be reimbursed under medical assistance under article five  of  the  social  services  law,  at  a  per  diem  rate for each day the child is  enrolled in a program. To ensure the alienability of needed services  to  these  children,  reimbursement shall be provided only to those agencies  having satisfied conditions of  the  department  including  satisfactory  training in pediatric palliative care.    4.  Certified hospice programs shall be allowed to waive the admission  criteria requiring certification of "a terminal illness  with  prognosis  of  six months or less" as well as the requirement for families to forgo  curative treatment for children qualifying for  this  program  receiving  care from an approved site.    5.  All  home  care and other medical assistance under article five of  the social services  law  otherwise  authorized  for  the  child,  shall  continue  without interruption. The pilot program for all-inclusive care  for children is not intended to supersede any program already in place.    6. The  locations  of  the  providers  under  the  pilot  program  for  all-inclusive  care  shall  be  geographically  disbursed throughout the  state and approved by the commissioner.    7. The commissioner  shall  require  each  provider  under  the  pilot  program  for all-inclusive care for children to submit an annual report,  which shall include data analyzing  the  cost  and  efficiency  of  care  provided  under  such  program.  On or before December thirty-first, two  thousand eight, the commissioner shall submit a report to the  governor,  the  temporary  president  of the senate and the speaker of the assembly  analyzing the cost and efficiency of the pilot program.