Relates to requirements for continuing care retirement communities.
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.
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.