Common use of PROGRAM DESCRIPTION AND OBJECTIVES Clause in Contracts

PROGRAM DESCRIPTION AND OBJECTIVES. This demonstration had its origins in an earlier demonstration, the Partnership Plan that sought to improve the economy, efficiency, and quality of care by requiring families and children to enroll in managed care entities to receive services. This mandatory managed care is known as Mandatory Mainstream Managed Care (MMMC). The Partnership Plan demonstration is ongoing, but MMMC enrollees in 14 counties are now included instead in this demonstration. New York also has authority under this demonstration to expand MMMC to elderly and disabled populations. In 2004, the state was presented with significant reform opportunities including the aging of New York’s population, the continued shift in care from institutional to outpatient settings, and the quality and efficiency advantages that are available through health information technology. The state created the Health Care Efficiency and Affordability Law for New Yorkers (HEAL NY) capital grant program in that year to invest an anticipated $1 billion over a four-year period, to effectively reform and reconfigure New York’s health care delivery system to achieve improvements in patient care and increased efficiency of operation. In 2005, the state asked the federal government to partner with its HEAL NY initiative to implement reform projects that would improve the quality of care and result in long-term savings for both the state and federal government. This demonstration was approved for an initial 5-year period beginning October 1, 2006; under that demonstration authority, the state committed to pursue the following reform initiatives: • Rightsizing Acute Care Infrastructure. New York’s acute care infrastructure is outdated and oversized, while the facilities are highly leveraged with debt. The inexorable migration of health care services to the outpatient setting has added to the significant excess capacity that exists in the state, estimated at over 19,000 beds. As a result, state law was enacted in 2005 establishing the Commission on Health Care Facilities in the 21st Century (Commission) which is charged with recommending reconfiguration measures, including downsizing, restructuring, and/or facility closures. Such measures will reduce future Medicaid inpatient hospital costs.

PROGRAM DESCRIPTION AND OBJECTIVES. This demonstration Demonstration had its origins in an earlier demonstration, the Partnership Plan that sought to improve the economy, efficiency, and quality of care by requiring families and children to enroll in managed care entities to receive services. This mandatory managed care is known as Mandatory Mainstream Managed Care (MMMC). The Partnership Plan demonstration is ongoing, but MMMC enrollees in 14 counties are now included instead in this demonstrationDemonstration. New York also has authority under this demonstration Demonstration to expand MMMC to elderly and disabled populations. In 2004, the state was presented with significant reform opportunities including the aging of New York’s population, the continued shift in care from institutional to outpatient settings, and the quality and efficiency advantages that are available through health information technology. The state created the Health Care Efficiency and Affordability Law for New Yorkers (HEAL NY) capital grant program in that year to invest an anticipated $1 billion over a four-year period, to effectively reform and reconfigure New York’s health care delivery system to achieve improvements in patient care and increased efficiency of operation. In 2005, the state asked the federal government to partner with its HEAL NY initiative to implement reform projects that would improve the quality of care and result in long-term savings for both the state and federal government. This demonstration Demonstration was approved for an initial 5-year period beginning October 1, 2006; under that demonstration authority, the state committed to pursue the following reform initiatives: • Rightsizing Acute Care Infrastructure. New York’s acute care infrastructure is outdated and oversized, while the facilities are highly leveraged with debt. The inexorable migration of health care services to the outpatient setting has added to the significant excess capacity that exists in the state, estimated at over 19,000 beds. As a result, state law was enacted in 2005 establishing the Commission on Health Care Facilities in the 21st Century (Commission) which is charged with recommending reconfiguration measures, including downsizing, restructuring, and/or facility closures. Such measures will reduce future Medicaid inpatient hospital costs.

PROGRAM DESCRIPTION AND OBJECTIVES. This demonstration Demonstration had its origins in an earlier demonstration, the Partnership Plan that sought to improve the economy, efficiency, and quality of care by requiring families and children to enroll in managed care entities to receive services. This mandatory managed care is known as Mandatory Mainstream Managed Care (MMMC). The Partnership Plan demonstration is ongoing, but MMMC enrollees in 14 counties are now included instead in this demonstrationDemonstration. New York also has authority under this demonstration Demonstration to expand MMMC to elderly and disabled populations. In 2004, the state was presented with significant reform opportunities including including, the aging of New York’s population, the continued shift in care from institutional to outpatient settings, and the quality and efficiency advantages that are available through health information technology. The state created the Health Care Efficiency and Affordability Law for New Yorkers (HEAL NY) capital grant program in that year to invest an anticipated $1 billion over a four-year period, to effectively reform and reconfigure New York’s health care delivery system to achieve improvements in patient care and increased efficiency of operation. In 2005, the state asked the federal government to partner with its HEAL NY initiative to implement reform projects that would improve the quality of care and result in long-term savings for both the state and federal government. This demonstration was approved for an initial 5-year period beginning October 1, 2006; under that demonstration authority, the state committed to pursue the following reform initiatives: • Rightsizing Acute Care Infrastructure. New York’s acute care infrastructure is outdated and oversized, while the facilities are highly leveraged with debt. The inexorable migration of health care services to the outpatient setting has added to the significant excess capacity that exists in the state, estimated at over 19,000 beds. As a result, state law was enacted in 2005 establishing the Commission on Health Care Facilities in the 21st Century (Commission) which is charged with recommending reconfiguration measures, including downsizing, restructuring, and/or restructuringand/or facility closures. Such measures will reduce future Medicaid inpatient hospital costs. Reforming Long-Term Care. The growth of non-institutional alternatives for long-term care services such as assisted living, advances in medical technology, overall improvement in the health of potential consumers and caregivers, and increasing preference for less restrictive alternatives is generating less demand for nursing facility services. New York will pursue the rightsizing of its long-term care system; implementation of a locally-based, but state-wide point of entry (▇▇▇) system to help ensure appropriate services are rendered to recipients; a home modification program to enable recipients to stay at home; and a tele-home care program to help individuals stay healthy and at home.