Assisted Living Living Regulations Adopted!

On March 26th, the Department of Health adopted final regulations governing assisted living facilities in New York State. Click here to see a summary of the adopted regulations. Thanks to all who sent in letters and faxes letting our state policy makers know how important these regulations are.

One change that we are not pleased about is that the requirement that RNs be present for one shift a day for 7 days a week in facilities with enhanced and special needs certificates (as stated in the last version) has been changed to a requirement for a RN for one shift a day for only 5 days with LPNs for the remaining 2 days.  Although this is a lowering of the standard from the last version, it is a significant victory for all of us who fought for RNs for residents with enhanced and special needs. All in all, the regulations are very protective. 

It is important to note that it will take months for the first application for licensure to be approved by the Department and for such residences to be required to comply with the adopted regulations.

Once this happens, we must make sure that these regulations are enforced.

Click here to see the full adopted regulations and an assessment of public comment done by the Department of Health.

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LTCCC Releases White Paper:

How to Make Assisted Living Affordable

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View Media Advisory

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New NYC Law Enacts One of the White Paper Recommendations: Prohibits Landlords from Discriminating against Rent-Subsidy Vouchers

A new law, introduced by New York City Councilman Bill de Blasio, prohibits landlords from discriminating against tenants who intend to pay their rent with federal rent-subsidy vouchers or any other form of government assistance.  The new law, which goes into effect immediately, applies to buildings with six or more units.  One of the recommendations In LTCCC’s White Paper on Affordable Assisted Living pointed out that  New York City Councilman Bill De Blasio had recently introduced a bill in the City Council which would bar landlords from discriminating against potential tenants who receive government rent subsidies. We urged the state to review this bill, as well as the antidiscrimination rules in those cities and states that have them, for a possible blueprint for a statewide law.  We are very pleased that this bill has become law in New York City and hope state leaders enact a similar bill .

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NY Assisted Living Law:

In 2004, NY State passed a bill requiring licensure for all assisted living in the state. Prior to that time, a bifurcated system existed, in which there were licensed adult homes and enriched housing and unlicensed residences (often calling themselves assisted living) providing similar services but with little oversight or accountability. LTCCC, worked hard to ensure passage of a law with a good basis for consumer protection.

The new law, for which regulations have been published for public comment, requires licensure for all communities and has specific requirements for residences that wish to care for people with dementia or allow residents to "age in place" (stay in the home as they become more frail).

Follow the links below to learn more about the issue and our work to protect seniors in assisted living.

Find Out More

Speak Out On Assisted Living Applications in Your Community

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State Task Force on Assisted Living:

According to the Assisted Living law that passed in 2004, the State Task Force was created to update and revise the requirements and regulations applicable to adult care facilities and assisted living residences to better promote resident choice, autonomy and independence.  The task force has been charged to make recommendations (a) minimizing duplicative or unnecessary regulatory oversight; (b) ensuring  that  the indigent have adequate access to, and that there are a sufficient number of  enhanced  assisted  living  residences;  (c)  developing  affordable assisted living; (d) promoting resident choice and independence; (e) the evaluation tool as required by section 4657 of the  public  health  law;  and,  (f)  specific standards and criteria relating to the special needs certificates required by section 4655 of the public health law.

As of this date, the Task Force has accomplished (e) and (f) and is focusing on the other tasks.  Cynthia Rudder, director of special projects, is a member of this ten person Task Force.  She, with the help of the LTCCC's Assisted Living committee has proposed the changes to current adult home regulations to promote resident choice, autonomy and independence. Click here to see the recommended changes.

Assisted Living Guidebooks: Free Guides & Workshop For Seniors, Residents and Staff to Foster Greater Quality of Life in Assisted Living

Assisted living is the fastest growing type of senior housing, holding out the promise of giving people the opportunity to get care and help with daily living in a home-like environment. It represents a move away from the institutionalized care setting often found in nursing homes, toward an environment that allows for greater freedom and independence and a higher quality of life. Unfortunately, the promise of assisted living is not always fulfilled. Too often, assisted living provides an environment that is much more institutionalized than necessary.

Free Guides: To address this issue, LTCCC and CIAD (the Coalition of the Institutionalized Aged & Disabled) have jointly produced free guides to help achieve greater resident autonomy and quality of life in assisted living. The four guides - one each for potential residents, current residents, direct care staff and administrative staff - provide valuable tools and information on how to achieve the promise of assisted living. They are free and easy to use. Click on the picture above to find the guide that is best for you.

Free Training Workshop: With generous support from the Nash Family Foundation, LTCCC developed a training program for senior community leaders, geriatric care managers, long term care ombudsmen and others who work with older adults to introduce them to the guides and provide an easy way for them to take the benefits of the guides back to others. This workshop, in the form of a PowerPoint presentation, can be downloaded for free (along with the guides) by clicking on the picture above. Individuals and organizations can use the workshop to conduct staff trainings, community workshops or other programs that will help seniors use the guides effectively to achieve a high quality of life in assisted living.

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Health Department Approves a 40 Percent Increase in
Assisted Living Program (ALP) Beds

There are two types of assisted living beds in New York State: the assisted living program (ALP) and the assisted living residence (ALR).  The ALP provides supportive housing and home care services to people who are eligible for placement in a nursing home, but instead choose to live in a more homelike setting.  ALP residents receive home care services through Medicaid or private insurance, and residential services from federal Supplemental Security Income (SSI) or private resources.  Beds in assisted living residences are paid for by private funds at this time and must function under the new regulations that were adopted in March (see article top left).  The ALP program does not follow the new regulations.
 

The additional ALP beds were mandated by legislation passed last year. LTCCC and other organizations had argued against this expansion because we believe that expanding a program that is exempt from the new assisted living residence regulations consumer protection statutes would further a system of assisted living that serves low-income people who will be governed by an inferior set of rules, and one serving non-Medicaid assisted living residents who would benefit from the strong consumer protections; Medicaid funding should only go to those models of assisted living that comply with the new regulations, which emphasize aging in place, personal dignity, autonomy, independence, privacy, and freedom of choice; and by expanding the ALP beds that do not meet the new standards, the confusion among consumers about assisted living and what it provides will just continue.  We were disappointed that our arguments were not heeded and the bill was passed into law.

LTCCC and other organizations then urged the state to make sure that any beds approved only go to those adult homes or enriched housing programs that:

1. Do not discriminate on the basis of source of payment, disability, race, religion or sexual orientation;

2.  Provide a wide range of resident choice;

3.  Respect residents’ self-direction;

4. Encourage residents’ independence;

5. Promote and honor resident decision-making power;

6. Deliver care in a culturally competent manner;

7. Provides a setting that is in compliance with the Americans with Disabilities Act and allows people with disabilities to interact with people without disabilities to the fullest extent possible; and

8. Do not have a history of spending significantly less than it received in ALP reimbursement; inflating Medicaid payment levels; substantive disparities between level of need ratings and plans of care and between plans of care and actual services provided; and ignoring the need to give adequate disclosure on related party transactions on annual financial reports filed with the Department of Health.