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Memo

BILL NUMBER:S4738A

TITLE OF BILL: An act to amend the public health law, in relation to continuing care retirement communities

PURPOSE OR GENERAL IDEA OF BILL: To allow life care CCRCs to enter into fee-for-service contracts under Article 46-A of the Public Health Law.

SUMMARY OF SPECIFIC PROVISIONS: Section one of the bill amends subdivision 2-b and adds a new subdivision 8-a of section 4601 of the Public Health Law of to allow continuing care retirement communities to offer either a life care contract or a fee-for-service contract on a per diem or agreed upon rate.

JUSTIFICATION: Effective January 1, 2005 providers could apply to develop a fee-for-service CCRC that would provide the same services as a life care or modified CCRC, but charge for them on a fee-for-service basis as needed by individual residents. Because they are not being regulated by the Department of Insurance (DOI), reserve requirements for FFS CCRCs will be much lower than the requirements under DOI Regulation 140 for life care and modified CCRCs. The higher reserve requirements for life care and modified CCRCs will require much higher entrance and monthly fees, putting them at a distinct marketing disadvantage in relation to FFS CCRCs. Allowing life care CCRCs to enter into fee-for-service contracts will give them flexibility to respond to the needs of the seniors applying to reside in their community.

Additionally, seniors with long term care insurance would probably not utilize the life care contract, but could take advantage of the features of the CCRC through the fee-for-service contract. A fee-for-service option would allow seniors more flexibility within a CCRC setting.

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE: Immediately.

Text

STATE OF NEW YORK
________________________________________________________________________

4738--A

2011-2012 Regular Sessions

IN SENATE

April 18, 2011
___________

Introduced  by  Sen.  GOLDEN -- read twice and ordered printed, and when
  printed to be committed  to  the  Committee  on  Health  --  committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee

AN  ACT  to  amend the public health law, in relation to continuing care
  retirement communities

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  Subdivision 2-b of section 4601 of the public health law,
as added by chapter 659 of the laws of 1997, paragraph a as  amended  by
chapter 401 of the laws of 2003, is amended to read as follows:
  2-b.  "Continuing care retirement community" or "community" shall mean
a facility or facilities established to provide a  comprehensive,  cohe-
sive  living arrangement for the elderly, oriented to the enhancement of
the quality of life and which, pursuant to the terms of  the  continuing
care contract, at a minimum:
  a.  provides  independent  living units, and provides a meal plan. The
independent living unit can be made available either through a non-equi-
ty arrangement or through  an  equity  arrangement  including,  but  not
limited  to  a cooperative or condominium. For purposes of this article,
the purchase price of an independent living unit in an  equity  arrange-
ment,  regardless  of  the  form of the purchase agreement, shall not be
considered an entry fee for purposes of calculating reserve liabilities,
but shall be considered an entry fee for escrow purposes;
  b. provides a range of health care and  social  services,  subject  to
such  terms  as may be included within the contract, which shall include
[home health care, nursing care] ADULT  CARE  FACILITY  SERVICES  OF  AN
ON-SITE  OR AFFILIATED ADULT CARE FACILITY, and at a minimum, sixty days
of prepaid services of an on-site or  affiliated  nursing  facility  FOR
RESIDENTS NOT RECEIVING SERVICES UNDER A FEE-FOR-SERVICE CONTRACT;

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10823-03-1
S. 4738--A                          2

  c.  provides  access  to  health  services as defined in the contract,
prescription drugs, and rehabilitation services; [and]
  d. nothing in this article shall eliminate the obligation of a contin-
uing care retirement community to provide at least sixty days of prepaid
nursing  facility services to all residents, WITH THE EXCEPTION OF RESI-
DENTS RECEIVING SERVICES UNDER THE TERMS OF A FEE-FOR-SERVICE CONTINUING
CARE CONTRACT AS DEFINED IN THIS SECTION.  The prepaid days must include
the first sixty days  of  nursing  facility  services,  whether  or  not
consecutive,  not  covered by Title XVIII of the federal social security
act[.]; AND
  E.  COMMUNITIES  ESTABLISHED   UNDER   THIS   ARTICLE   AND   OFFERING
FEE-FOR-SERVICE  CONTINUING  CARE  CONTRACTS MUST OFFER, ALONG WITH SUCH
FEE-FOR-SERVICE CONTINUING CARE CONTRACTS, LIFE CARE  AND/OR  CONTINUING
CARE CONTRACTS AS DEFINED IN SUBDIVISION EIGHT-A OF THIS SECTION.
  S  2. Section 4601 of the public health law is amended by adding a new
subdivision 8-a to read as follows:
  8-A. "FEE-FOR-SERVICE CONTINUING CARE CONTRACT" SHALL  MEAN  A  SINGLE
CONTINUING  CARE  RETIREMENT  CONTRACT THAT PROVIDES LONG-TERM AND OTHER
SERVICES ON A PER DIEM, FEE-FOR-SERVICE OR MONTHLY RATE.
  S 3. This act shall take effect immediately.