Memorandum of Support for A.196C and S.1576C
A.196C – Gottfried
S.1576C – Rivera
AARP New York
ARISE (Onondaga, Oswego, Madison & Cayuga counties)
Bronx Independent Living Services
Brooklyn Center for Independence of the Disabled
CaringKind, The Heart of Alzheimer’s Caregiving
Center for Elder Law and Justice (Western New York)
Center for Independence of the Disabled, NY
Coalition of Institutionalized Aged & Disabled
Disability Rights New York
Elder Justice Committee of Metro Justice of Rochester
Empire Justice Center
Family Service League (Long Island)
Gray Panthers NYC
Harlem Independent Living Center
Independent Living Center of the Hudson Valley, Inc.
Lifespan of Greater Rochester
Long Island Center for Independent Living
Long Term Care Community Coalition
Medicaid Matters New York
Mental Health Association in New York State
Mobilization for Justice, Inc. (NYC)
National Alliance on Mental Illness New York State
New York Association of Psychiatric Rehabilitation Services, Inc.
New York Association on Independent Living
New York Lawyers for the Public Interest
NY StateWide Senior Action Council
Schuyler Center for Analysis & Advocacy
Staten Island Center for Independent Living
50,000 seniors and people with disabilities live in New York’s adult care facilities (ACFs). One in four of them receive SSI and/or the state supplement (SSP). These numbers are expected to grow as New York expands Medicaid-funded assisted living programs in new and existing ACFs. As more New Yorkers move into these facilities, it is important to improve the transparency and accountability these facilities are held to.
We support A.196C / S.1576C because it provides important consumer protections to residents and their families and because it deters the worst abuses in facilities that put residents’ health and safety at risk.
Protecting Residents’ Health and Safety
New York’s seniors and people with disabilities deserve to live in home-like settings that treat them with dignity and protect them from physical or financial abuse. While many of New York’s 500+ ACFs respect residents’ rights and foster their health and safety, others have been allowed to consistently fall short. Too many homes— particularly “transitional adult homes” with large numbers of residents with mental health disabilities—have long histories of serious regulatory violations that undermine resident safety or substantially interfere with residents’ quality of life. These chronic conditions continue even after being cited because there is no penalty for serious violations if a facility “rectifies” the violation within 30 days of a citation.
This bill adds three situations to the definitions of harm and endangerment in which the Department of Health can fine facilities for regulatory violations.
- If a facility’s violation results in a resident’s physical injury
- If a facility abuses a resident financially, such as preventing a resident from accessing her statutory Personal Needs Allowance
- If a facility operator, administrator, or other manager purposefully violates a resident’s rights
These changes are narrowly-tailored to improve conditions in the worst facilities to ensure seniors are not mistreated. A few examples show the need for these modest changes to ACF regulatory enforcement:
Financial abuse: ACF residents who receive SSI/state supplement program income are entitled to a monthly Personal Needs Allowance (PNA) that, by law, cannot be comingled with facility funds, withheld from residents, or used to pay the facility’s monthly fee. Nevertheless, this has been a frequent practice by some adult homes. In a recent example, a facility in Brooklyn illegally collected funds from many residents’ Personal Needs Allowance. Six months after a complaint, the DOH issued a citation and required the facility to refund the residents’ money, without interest. Although this is not a problem in most homes, similar cases have been cited in homes from Long Island to the Adirondacks. A facility in Monroe County was cited for violations related to resident funds 15 times in four years. This bill would allow a fine in addition to a refund, to deter facilities’ incentive to steal.
Manager’s purposeful violation of resident rights: Quality of life is directly improved when residents’ rights aren’t purposefully violated. Managerial staff set a tone for all staff, so a purposeful violation of a resident’s rights affects the culture of a home. Even sending and receiving mail can be a problem in some homes. In the summer of 2018, for example, ten facilities were cited when the administration intercepted federal court notices about residents’ rights mailed by the DOH. This bill would protect residents from managers’ unacceptable conduct.
The bill also raises the maximum fine from $1,000 (set in 1977) to $2,000 per violation per day. This amount was proposed by the industry, and most violations are set at a fraction of the maximum. We agree with the industry that it’s time to adjust the maximum fines.
Consumer Protections for Seniors, People with Disabilities, and Their Families
A.196C / S.1576C improves the information prospective residents and families have when deciding on a home, and shares critical information about facilities with residents and referral sources. Right now, the Department of Health’s do-not-refer list isn’t sent to hospitals and nursing homes, the main referral sources for ACFs. This bill would change that. It would also make DOH complaint investigation reports more accessible to residents and prospective residents and would allow prospective residents to read their admission agreement before signing. The bill also would require facilities to post their admission agreement on their website, to allow prospective residents and families to more easily compare homes.
These are common sense changes to make hard-to-access information more easily available to prospective consumers, current residents, and other facilities that help families choose a home.
We urge you to support A.196C / S.1576C.
rev. May 18, 2022
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