STATE OF NEW YORK
________________________________________________________________________
9464
IN SENATE
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:
1 Section 1. Subdivision 23 of section 2808 of the public health law, as
2 added by section 29 of part C of chapter 109 of the laws of 2006,
3 subparagraph (ii) of paragraph (a) as amended by chapter 591 of the laws
4 of 2007, and subparagraph (iii) of paragraph (a) as amended by section
5 20 of part D of chapter 58 of the laws of 2009, is amended to read as
6 follows:
7 23. Notwithstanding any inconsistent provision of law or regulation to
8 the contrary:
9 (a) (i) For adult day health care services provided by residential
10 health care facilities, effective April first, two thousand seven [and
11 thereafter] until April first, two thousand twenty-six, the operating
12 component of the rate of payment established pursuant to this article
13 for an adult day health care program which has achieved an occupancy
14 percentage of ninety percent or greater for a calendar year prior to
15 April first, two thousand seven, shall be calculated utilizing allowable
16 costs reported in the two thousand four, two thousand five, or two thou-
17 sand six calendar year residential health care facility cost report
18 filed by the sponsoring residential health care facility, whichever is
19 the earliest of such calendar year cost reports in which the program has
20 achieved an occupancy percentage of ninety percent or greater, except
21 that programs receiving rates of payment based on allowable costs for a
22 period prior to April first, two thousand seven shall continue to
23 receive rates of payment based on such period.
24 (ii) For such programs which achieved an occupancy percentage of nine-
25 ty percent or greater prior to calendar year two thousand four, so long
26 as approved capacity in that year is the same as in calendar year two
27 thousand four, but which did not maintain occupancy of ninety percent or
28 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
1 thousand six, the operating component of the rate of payment established
2 pursuant to this article shall be calculated utilizing allowable costs
3 reported in the two thousand four calendar year cost report divided by
4 visits imputed at ninety percent occupancy.
5 (iii) For such programs which have not achieved an occupancy percent-
6 age of ninety percent or greater for a calendar year prior to April
7 first, two thousand seven, the operating component of the rate of
8 payment established pursuant to this article shall be calculated utiliz-
9 ing allowable costs reported in the first calendar year after two thou-
10 sand six in which such a program achieves an occupancy percentage of
11 ninety percent or greater effective January first of such calendar year
12 except for calendar year two thousand seven, effective no earlier than
13 April first of such year, provided, however, that effective January
14 first, two thousand nine, for programs that have not achieved an occu-
15 pancy percentage of ninety percent or greater for a calendar year prior
16 to January first, two thousand nine, the operating component of the rate
17 of payment established pursuant to this article shall be calculated
18 utilizing allowable costs reported in the two thousand nine cost report
19 filed by the sponsoring residential health care facility divided by
20 visits imputed at actual or ninety percent occupancy, whichever is
21 greater. This subparagraph shall also apply to programs which achieved
22 an occupancy percentage of ninety percent or greater prior to calendar
23 year two thousand four but in such year had an approved capacity that
24 was not the same as in calendar year two thousand four.
25 (b) [For a residential health care facility approved to operate an
26 adult day health care program on or after April first, two thousand
27 seven, rates of payment for such programs shall be computed based upon
28 annual budgeted allowable costs, as submitted by the residential health
29 care facility, and total estimated annual visits by adult day health
30 care registrants of not less than ninety percent of licensed occupancy,
31 and in accordance with the following:
32 (i) Each program shall be required to submit an individual budget.
33 Multiple programs operated by the same residential health care facility
34 shall submit a separate budget for each program. Multiple programs oper-
35 ated by the same residential health care facility shall have separate
36 rates of payment.
37 (ii) Rates developed based upon budgets shall remain in effect for no
38 longer than two calendar years from the earlier of:
39 (A) the date the program commences operations; or
40 (B) the date the sponsoring residential health care facility submits a
41 full calendar year residential health care facility cost report in which
42 the program has achieved ninety percent or greater occupancy. If a spon-
43 soring residential health care facility submits such a cost report with-
44 in two years of the date the program commences operation, rates shall
45 then be computed utilizing such cost report.
46 (iii) If a program fails to achieve ninety percent or greater occupan-
47 cy within two calendar years of the date of its commencing operations,
48 rates shall be calculated utilizing allowable costs reported in such
49 second calendar year residential health care facility's cost report for
50 the applicable sponsoring residential health care facility divided by
51 visits imputed at ninety percent occupancy] Notwithstanding any other
52 provision of law, for adult day health care services provided by resi-
53 dential health care facilities, effective April first, two thousand
54 twenty-six and thereafter, the operating component of rates of payment
55 established pursuant to this article shall equal sixty-five percent of
56 the sponsoring residential health care facility's inpatient rate,
S. 9464 3
1 provided however, that no rate of payment shall increase by more than
2 fifty percent when compared with the rate of payment in the preceding
3 calendar year, provided further however, that notwithstanding paragraph
4 (a) of this subdivision, where sixty-five percent of the sponsoring
5 residential health facility's inpatient rate is less than one hundred
6 fifty dollars in New York City, or Nassau, Suffolk or Westchester coun-
7 ties, the rate shall be one hundred fifty dollars and for the rest of
8 the state where the sponsoring residential health care facility's inpa-
9 tient rate is less than one hundred thirty dollars, the rate shall be
10 one hundred thirty dollars.
11 (c) Effective January first, two thousand eight, [allowable costs] the
12 operating component of rates of payment for adult day health care
13 services shall not include the costs of transportation.
14 (d) [All rates of payment established pursuant to this subdivision are
15 subject to the maximum daily rate provided by law. Such maximum daily
16 rate of payment for adult day health care programs operated by residen-
17 tial health care facilities that undergo a change of ownership subse-
18 quent to nineteen hundred ninety shall be determined by utilizing the
19 inpatient rate of payment of the prior operator as in effect on January
20 first, nineteen hundred ninety. In the event a residential health care
21 facility establishes an off-site adult day health care program outside
22 the regional input price adjustment region in which it is located, the
23 computation of the maximum daily rate of payment for such program shall
24 utilize the weighted average of the inpatient rates of payments for
25 residential health care facilities in the region in which the program is
26 located, as in effect on January first, nineteen hundred ninety, in
27 place of the sponsoring residential health care facility's inpatient
28 rate of payment.
29 (e)] Notwithstanding any inconsistent provision of the state adminis-
30 trative procedure act or any other law or regulation to the contrary,
31 the commissioner shall adopt or amend on an emergency basis any regu-
32 lations the commissioner shall determine necessary to implement any
33 provision of this subdivision.
34 § 2. This act shall take effect immediately.
