. . . from the Assembly Committee on Aging

Sheldon Silver, Speaker · Steve Englebright, Chair · January 2005

Assemblyman Steve Englebright
Message from the Chair...

Dear Friends,

I am pleased to provide you with the "Committee on Aging Newsletter" that summarizes our accomplishments for the year.

Most notable was the passage into law of the Assisted Living Reform Act. After five years of difficult negotiations, this important new law will provide much needed oversight and inspections of the non-regulated (look-alike) assisted living industry in New York State.

We were also successful in blocking the Governor's proposed changes to Medicaid long-term care. While we need to reduce state and county Medicaid costs, the Governor's proposals would likely have actually increased Medicaid costs by pushing seniors, prematurely, into institutions to receive the care they need. This almost inevitable outcome violates the Olmstead Supreme Court Decision. Providing cost-effective community services is the common-sense approach to safely maintaining senior independence while holding down Medicaid costs.

Community-based services such as EISEP, social model adult day care, transportation and nutrition programs are cost effective and have a proven track record of delaying and preventing more costly care in hospitals and nursing homes. They are also critical in ensuring that older adults being discharged from hospitals, nursing homes and rehabilitation facilities have the support services they need to safely regain their independence as they recover at home.

As we look to the future, the Committee on Aging will continue to work on initiatives that help solve today's problems and anticipate those of tomorrow. As our state's senior population will double in the next decade, we must ensure that older New Yorkers have quality of life, not just quantity of life.

Steve Englebright
Chair, Assembly Committee on Aging

Room 824 LOB · Albany, New York 12248 · 518.455.4804
149 Main Street · East Setauket, New York 11733 · 631.751.3094

2004 Enacted Legislation

Assisted Living Reform Act
(Chap 2; A.11820, Rules/Englebright)

This year, the greatest achievement of the Aging Committee was securing the passage of the assisted living bill on the last day of session. Unregulated assisted living facilities have been growing rapidly throughout New York State, causing much concern about the quality of care being provided in them. This new legislation will require all assisted living facilities to be licensed and regulated by the Department of Health to ensure the health and safety of residents.

The Assisted Living Reform Act establishes a uniform licensing procedure for all assisted living facilities. It further requires important consumer disclosures and sets forth a clear set of consumer rights, protections and safeguards, so residents and their families can be sure they're getting quality care. The legislation also does the following:

  • Clearly defines "assisted living residences;"

  • Clearly defines "aging in place;"

  • Requires that residences advertising or marketing themselves as serving individuals with dementia and cognitive impairments submit special needs plans outlining their ability to serve such vulnerable individuals;

  • Requires each facility to conspicuously post residents' rights;

  • Requires the execution of a written residency agreement with each resident;

  • Sets guidelines regarding the management of a resident's money and personal property;

  • Requires facilities to assist in the development and operation of resident and family councils;

  • Sets uniform guidelines for the admission, discharge and transfer of residents; and

  • Creates a task force to update and revise the requirements and regulations that are applicable to adult care facilities and assisted living facilities and to develop and implement recommendations to further improve safety and service provision in these facilities.

Nursing Facility Transition and Diversion Medicaid Waiver
(Chapter 615; A.11350-A, Rules/Cahill)

This historic legislation directs the Department of Health to apply for a Medicaid waiver from the federal government in order to identify individuals of all ages with disabilities in nursing homes who do not need to be there and to transition them back into the community. The waiver would finance this transition and provide community-based support services to enable persons of all ages to live in the most integrated setting. This bill is an important step in rebalancing the long-term care system and complying with the Olmstead Supreme Court Decision of 1999.

Senior Citizens Bill of Rights
(A. 9587-C, Englebright)

This bill establishes in statute a senior citizens bill of rights and directs the State to report on these rights in its policy development and implementation, focusing on the independence, dignity and contributions that older New Yorkers provide to New York.

Elder Law
(Chapter 642; A. 9708, Englebright)

This legislation establishes a new chapter of the Consolidated Law to be called Elder Law. Creating a New York Elder Law will provide a new level of focus on issues affecting the State's seniors. This legislation is just the first step in establishing a new section of law devoted to aging policy and programs.

Displaying Long-Term Care Ombudsman Posters
(Chapter 363; A.2350-A, Englebright)

This legislation requires adult homes to display a long-term care ombudsman poster in a prominent public area and to distribute long-term care ombudsman brochures to residents upon request.

Intergenerational Day Care Program
(Chapter 308; A.10876, Rules/Englebright)

This legislation extends the provisions of the combined senior citizen services center/residential health care facility/child day care community grants program from December 31, 2004 until December 31, 2006.

2004-05 Budget Highlights

Funding for Community-Based Services for the Elderly

The Legislature restored about $1 million in funding for the following programs:

  • Community Services for the Elderly Program (CSE provides a flexible funding stream to local communities to provide a variety of supportive services designed to help seniors maintain their independence and support caregivers.) The proposed cut of $202,215 was restored;

  • Expanded In-home Services for the Elderly Program (EISEP provides older, frail non-Medicaid eligible seniors with non-medical in-home support services that keep them living at home - services include help with personal care, homemaker and chore, case management, respite, etc.) The proposed cut of $528,030 was restored;

  • Long Term Care Ombudsman Program (provides training to volunteers who go into long-term care facilities and help the administration and the residents work out differences, complaints and other problems.) The proposed cut of $58,400 was restored; and

  • Respite Services (provides caregivers with time to take a break from the rigors of being a caregiver.) The proposed cut of $175,000 was restored.

These cost-effective, community-based support programs help seniors remain independent with dignity and keep older New Yorkers from needing to apply for Medicaid. These programs also save the State money by reducing the number of hospitalizations and nursing home placements. They should be expanded, not cut.

Unfortunately, the Governor vetoed these restorations.

EPIC and Medicaid Pharmacy Reimbursement Rates

The Governor proposed to reduce the amount of money that the State would reimburse pharmacies under the Medicaid and EPIC programs. While pharmacy expenses for the state continue to rise, going after community pharmacies is the wrong strategy. New York should be developing and implementing strategies to use its size and clout to bulk purchase on behalf of its residents. A recent study by the Boston University School of Public Health found that New York and New Yorkers could save $4.7 billion annually if it received rates equivalent with the federal supply schedule.

The legislature restored 75 percent of the Governor's proposed cuts.

Medicaid Long-Term Care Changes Rejected

The Governor proposed to change the eligibility requirements for Medicaid long-term care. The theory backing these proposals centered around wealthy individuals who hide their assets to qualify for Medicaid. While we wholeheartedly agree that individuals with means should contribute to their long-term care costs, the proposals to change Medicaid long-term care would not have solved the problem, and the impact of the proposed changes would have significantly hurt low and moderate income seniors.

The Governor's proposed changes in eligibility for Medicaid long-term care included:

  • Eliminating the right of spousal refusal;

  • Increasing the look-back period for asset transfers from 36 to 60 months;

  • Instituting a look-back period of 60 months for home care; and

  • Commencing the penalty period for an asset transfer or gift to the time the individual needs care rather than when the transfer was actually made.

While we are all looking for ways to reduce state and county Medicaid costs, these proposals will not meet these goals.

Indeed, we believe they will actually increase Medicaid costs by pushing seniors, prematurely, into institutions to receive the care they need. This almost inevitable outcome violates the Olmstead Supreme Court Decision. Providing cost effective community services is the best way to lower state and local Medicaid costs, while remaining compliant with the Olmstead decision.

Long-Term Care Insurance

The SFY 2004-05 Enacted Budget includes the following initiatives to promote the purchase of long-term care insurance:

  • Increases the percentage of the long-term care insurance tax credit from 10 percent to 20 percent, starting with taxes paid in 2004;

  • Reduces the minimum benefit requirements for insurance policies offered under the New York State Partnership for Long-Term Care; and

  • Creates the Long-Term Care Insurance Education and Outreach program (with an appropriation of $5 million) to provide educational materials, workshops, media campaigns and a toll-free hotline and establish resource centers at each area agency on aging to educate and inform the public about long-term care insurance.

Adult Home Initiatives

The Legislature provided $10 million for the following adult home initiatives:

  • $3 million to increase the Supplemental Security Income (SSI) rate for adult home residents by $3 per day by January 1, 2005 and up to $7 per day by January 1, 2006. This measure was vetoed by the Governor;

  • $3.5 million for the Adult Care Facility Quality Incentive Payment Program (QUIP). The language directing this appropriation was vetoed by the Governor;

  • $3 million to provide supplemental case management services for mentally-ill residents living in impacted adult homes. The language directing this appropriation was vetoed by the Governor; and

  • $500,000 for a housing assistance program for adult home residents who need to relocate to another adult home or want to find a more independent living environment. The language directing this appropriation was vetoed by the Governor.

Adult Home Reforms

In the SFY 2004-05 Enacted Budget, the Legislature provides for a series of reforms to foster quality of life improvements for adult care facility residents. These reforms include: mandating the posting of a Do Not Refer list on the Department of Health's website; prohibiting referrals by social service districts, mental hygiene facilities, correctional facilities and hospitals to adult care facilities on the Do Not Refer list; prohibiting an adult home operator whose license has been suspended or revoked from applying to be the operator of another facility; and establishing an Adult Home Quality Enhancement Fund to be funded with fines imposed against adult homes in violation of New York State laws and regulations.

Passed Assembly 2004

A.1131 (Sidikman) requires local governments to notify their residents of the availability of the senior citizen real property tax exemption 30 days prior to the filing deadline and allows seniors to apply for this exemption 60 days after the filing deadline if they have received this exemption before.

A.1432-A (Lentol) authorizes the State Office for the Aging (SOFA) to establish one or more senior pet companionship programs.

A.2345 (Englebright) authorizes SOFA to establish the Senior Vision Services program.

A.2560 (Gianaris) allows localities to exclude all medical and prescription drug expenses not reimbursed or paid for by insurance when determining income eligibility for the Senior Citizen Rent Increase Exemption program (SCRIE).

A.4847 (Pretlow) allows localities to exclude up to $15,000 of income earned from a disability pension or benefit when determining income eligibility for the Senior Citizen Real Property Tax Exemption program.

A.6929 (Carrozza) allows municipalities to adopt a 14 tiered sliding scale SCRIE benefit.

A.8473-A Rules (Bing) allows local governments to exclude 100 percent of Social Security income when determining income eligibility for the SCRIE program.

A.9519 (Gunther, A) allows localities to provide a five day extension to pay real property taxes for seniors who are receiving an enhanced STAR exemption.

A.10540-A (Grannis) ensures that residents of nursing homes who are enrolled in the Elderly Pharmaceutical Insurance Coverage program (EPIC) can continue to access their prescription drug coverage under this program.

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