41.36 - Community residential facilities.

§ 41.36 Community residential facilities.    (a) As used in this section:    1. "Community  residential  facility"  means  any  facility subject to  licensure by the office for people with developmental disabilities which  provides a supervised residence  or  residential  respite  services  for  individuals  with mental disabilities. Such term does not include family  care homes.    2. "Reimbursable services" means  services,  other  than  intermediate  care  services, comprehensive medicaid case management and personal care  services for which funding is available under Title XIX of  the  federal  social  security  act,  provided  at  a  community  residential facility  described  by  regulations  of   the   commissioner   of   developmental  disabilities  for  which  fees  or  rates  may  be paid to a provider of  services pursuant to this section.    3. "Income"  means  revenues  received  by  a  provider  of   services  incidental  to  the  operation  of  a community residential facility and  includes:    (i) revenues received from other units  of  state,  local  or  federal  government  in  consideration  for  the  provision of care to a mentally  disabled person, excluding that portion  of  such  revenue  specifically  intended  to  offset  capital  costs  and  that  portion of such revenue  received pursuant to Title XIX of the federal  social  security  act  as  payment  for  personal  care  services  or  comprehensive  medicaid case  management services;    (ii) charges received from residents or on  their  behalf  from  third  party insurers or medical assistance programs; and    (iii)   other  funds  received  in  the  operation  of  the  community  residential facility.    4. "Provider of services" means a local government,  voluntary  agency  or  other  entity  or  person  that  provides reimbursable services at a  community residential facility.    5. "Commissioner"   means   the    commissioner    of    developmental  disabilities.    (b)  The  commissioner  shall  establish,  by  rules  or  regulations,  descriptive listings of reimbursable services at  community  residential  facilities for which payments may be made pursuant to this section. Such  services  shall include direct care and support staff services, housing,  administrative services and other than personal services.    (c) The commissioner shall establish  standards  for  programs  funded  under  this  section  and  shall  by  rule or regulation, subject to the  approval of the director of the budget, establish fees or rates at least  annually for each reimbursable  service  to  be  paid  to  providers  of  services. Fees or rates may be varied for geographic or other reasons.    (d)  Each  local  governmental  unit shall include in its annual local  plan a review of existing  community  residential  facilities  providing  reimbursable  services and a recommendation of anticipated needs for the  development of  such  facilities,  consistent  with  the  needs  of  the  mentally  retarded  and developmentally disabled within the jurisdiction  of the local governmental unit.    (e) Notwithstanding any inconsistent provision of  this  chapter,  the  commissioner  may, from monies appropriated by the legislature for state  aid for services provided pursuant to this article, grant state aid  for  the operation of a community residential facility through the payment of  fees or rates for reimbursable services provided at such facility.    (f)  Providers  of  services may apply to the commissioner pursuant to  this section to receive payment of fees or rates for  the  provision  of  reimbursable services at community residential facilities.(g)  The commissioner may, after consideration of the service needs of  the area in which a community residential facility is  to  operate,  the  capacity  of  the  facility  to  meet  those  needs, the availability of  services in the  area,  the  annual  comprehensive  plan  of  the  local  governmental  unit,  the  recommendations of the local governmental unit  and the availability  or  resources  therefor,  grant  state  aid  to  a  provider  of  services for the payment of fees or rates for reimbursable  services, subject to the provisions of subdivision (h) of this section.    (h) Payments for reimbursable services  shall  be  made  monthly.  The  commissioner  shall each month advance to providers of services an equal  monthly proration of fees or rates which may be  paid  for  reimbursable  services  estimated  to  be provided during the fee or rate period, from  which shall be deducted income received during the preceding months  and  rent  charged  clients.  At  the  end  of  each  fee  or rate period, an  adjustment shall  be  made  so  that  payments  of  fees  or  rates  for  reimbursable services provided during the fee or rate period shall equal  fees  or rates for reimbursable services provided during the fee or rate  period less income received and the rent charged clients as required  in  this subdivision.    (i)  No  client  shall be denied services because of inability to pay.  Voluntary agencies and local governments  may  charge  clients  for  the  provision  of  reimbursable services and shall charge rent in accordance  with the client's ability to pay and the availability to the  client  of  health insurance or other third party reimbursement for the provision of  such  services.  Charge  and  rental schedules shall be developed by the  commissioner and approved by the director of the budget. Providers shall  bill third party insurers and other state or local agencies directly  if  payments  are available from such parties and report to the commissioner  claims made against them and any  billings  of  clients  for  whom  such  reimbursement  is not available. Providers shall make reasonable efforts  to collect such billings.  In  the  event  payment  of  charges  is  not  received  after such efforts, the provider shall assign the commissioner  the right to enforce the claim and receive payment. Every  effort  shall  be made to assure that the process of collection of charges from clients  does not interfere with the therapeutic program.    (j)  Providers  of  service  shall  be reimbursed for capital costs in  accordance with the provisions of this section.    (k) Payments pursuant to this section shall be made in lieu  of  state  aid  for operating costs payable pursuant to any other provision of this  article.    (l) The operator of a community residential facility may appeal to the  commissioner  or  his  designee  for  reconsideration  of  his  decision  regarding authorization of payments to the facility and establishment of  fees  or  rates  for reimbursable services provided at the facility. The  commissioner,  after  hearing  such  appeal  or  consideration  of   the  recommendations of his designee, may amend such decision, subject to the  approval of the director of the budget.    (m) The commissioner shall issue regulations as necessary to implement  the  provisions  of this section. Public hearings shall be held prior to  final issuance of such regulations.    (n) The commissioner shall  establish  a  procedure,  subject  to  the  approval  of  the state comptroller, whereby payments in addition to the  client's personal allowance may be made to providers of services for one  or more of the following needs of clients residing in  such  facilities,  limited  to  two  hundred  fifty  dollars  per  client per year and paid  semi-annually in the manner specified by such procedures:    1. Replacement of necessary clothing;    2. Personal requirements and incidental needs of clients;3. Recreational and cultural activities of clients. Such payments  may  be  made  from  monies appropriated to the office for this purpose. Such  payments shall be audited by  the  office  pursuant  to  an  audit  plan  approved by the comptroller.    (o)  Notwithstanding  any  inconsistent provision of this article, the  commissioner may reimburse voluntary agencies for the reasonable cost of  rental of a community residential facility less any income received from  a state or federal agency or third party insurer which  is  specifically  intended  to  offset  the  cost  of  rental of the facility or housing a  client at the facility, subject to the  availability  of  appropriations  therefor  and  the commissioner's certification of the reasonableness of  the rental cost, with the approval of the director of the budget.