Relates to authorizing assisted living programs to admit or retain certain residents

BILL NUMBER:S5096 REVISED MEMO 05/14/13

Title of bill

An act to amend the social services law, in relation to authorizing an assisted living program to admit or retain residents who are chairfast under certain circumstances

Purpose or general idea of the bill

This bill would authorize an assisted living program to admit or retain a resident who is chairfast if such facility is equipped and staffed to meet the needs of the resident and the resident's physician approves the placement.

Summary of provisions

Section 1 amends Social Services Law § 461-1(d) to add persons who are chronically chairfast to the definition of "eligible person" in an assisted living program (ALP). Section 2 provides for an immediate effective date.

Existing law

Social Services Law section 461-1(d) currently provides that the following persons are ineligible for admission or retention to an ALP: (1) anyone in need of continual nursing or medical care; (2) a person who is chronically bedfast or chairfast; or (3) anyone who is cognitively, physically or medically impaired to such a degree that his or her safety would be endangered.

Justification

The ALP is the only Medicaid-funded "assisted living" level of care in New York, and the State's only alternative to nursing homes for lower-income seniors on Medicaid. Allowing ALPs to admit and retain individuals who are chronically chairfast will both save the State money under Medicaid and allow such individuals to reside in a more home-like setting. The ALP reimbursement rate under Medicaid is by law 50% of the nursing home rate in the region, thereby providing the State a much less expensive alternative for lower-income seniors. In addition to saving the State money, the ALP allows Medicaid-eligible New Yorkers to maintain autonomy and dignity by providing the services they need in a home-like setting. An individual who is chronically chairfast and unable to transfer without the assistance of one or more persons -- but does not need continual nursing or medical care -- should not be prematurely forced into a nursing home. This bill would authorize an ALP to admit or retain such an individual, and provide one or two person assistance with transfers so long as the facility is staffed to meet the needs of the resident and the individual's physician approves the placement. Consistent with current law, the chairfast individual could only be admitted to the ALP if he or she: (1) has a "stable medical condition" and is not in need of continual nursing or medical care; and (2) could be "appropriately cared for" in the ALP and is not "impaired to such a degree that his or her safety would be endangered?' To implement these expanded admission and retention standards, a current ALP would only have to notify the Department of Health of its intention and capability to admit and/or retain such residents prior to doing so.

Legislative history

New bill.

Fiscal implications

To be determined, but there will be a savings, as care in an ALP is about half as expensive as care in a nursing home.

Effective date

Immediate.