Authorizes the establishment of a long term care community in Columbia county known as Camphill Ghent, Inc. to provide integrated services to certain persons.
TITLE OF BILL:
An act relating to authorizing the establishment of a long term care community in Columbia county known as Camphill Ghent, Inc. to provide integrated services to certain persons
This bill will allow residents of the adult home and assisted living program at Camphill Ghent to age in place without the need for transfer to a nursing home or other institution, and would provide a mechanism to support the additional services necessary to serve persons with developmental disabilities in such program.
SUMMARY OF PROVISIONS:
Section one clarifies the legislative intent of the bill, which is to remove existing barriers preventing individuals residing in the adult home or assisted living program at Camphill Ghent from aging in place, and preventing support for the additional services necessary to serve persons with developmental disability in such program.
Section two describes the services to be provided by Camphill Ghent, Inc.
Section three provides that persons residing in the adult home or assisted living program at Camphill Ghent may remain in such program even where they would otherwise require discharge, provided that the program provides any additional services necessary to care for such persons.
Section four provides that the Office for People with Developmental Disabilities shall provide a supplemental payment to the assisted living program at Camphill Ghent to provide additional services necessary to serve persons with developmental disabilities residing in such program.
Section five exempts the adult home and assisted living program at Camphill Ghent from existing provisions of law requiring persons to be discharged from an adult home or assisted living program under certain circumstances, and prohibiting residents from performing volunteer work.
Section six provides that the bill would take effect immediately.
The Camphill Movement came to North America from Great Britain 50 years ago with the intention and founding ideal to build communities where the individuality and spiritual integrity of every human being is recognized, upheld and lovingly nourished. A Camphill community was started in Copake, New York, in 1961 at the urging of a group of concerned people that included parents of young adults with
developmental disabilities who wished to live and work in a fully integrated environment offering interesting and challenging work options and a healthy outdoor lifestyle. Today, Camphill Village in Copake comprises 600 acres of hills, woods and pastures, 24 houses of different sizes, crafts workshops, farm buildings, a medical care center, a culture and arts center, and a bakery co-op, cafe and gift shop. A total of 240 people live and work there together in dedication to the founding ideals.
As members of the Camphill Village community have aged over the years and required increasingly sophisticated health care services, Camphill has found that in many cases it has no choice but to defer those persons to nursing homes or other institutional settings. This not only results in a difficult and often traumatic transition for those persons from a very integrated to a much less integrated setting. It also results in unnecessary costs, which are frequently borne by the state through the Medicaid program. Such costs could be avoided if Camphill residents had access to more integrated long term health services.
In an effort to develop such services in a setting consistent with Camphill ideals, Camphill Village is in the process of establishing a long term care community that includes unlicensed senior housing, an adult home, a licensed home care services agency and an assisted living program. Such a community will serve persons with and without developmental disabilities both from Camphill Village and from elsewhere in Columbia County. The community has received significant support from New York State through the award of a $9.6 million grant under the Healthcare Efficiency and Affordability Law for New Yorkers (HEAL-NY) and the Federal State Health Reform Partnership (F-SHRP) and is awaiting final certification of need approval.
Unfortunately, there are barriers under current law that prevent Camphill Ghent from fully realizing its goals for the new community. First, under current law, an adult home or assisted living program must discharge individuals who need a higher level of care than the standard level offered by such programs. This bill would address that by allowing persons exceeding those discharge standards to remain at Camphill Ghent provided that the program provides the additional services necessary to adequately care for such persons. Second, there is currently no mechanism to support the additional services necessary to adequately care for individuals with developmental disabilities in an assisted living program. This bill would provide for a supplemental payment from the Office for Persons with Developmental Disability to support the additional services necessary to ensure such persons can be adequately served in such a setting.
As a result, individuals who would normally be referred to a more expensive institutional setting will be cared for in a less expensive, fully integrated community setting. Such setting would offer groundbreaking services for both persons with and persons without developmental disabilities, allowing them to age in place and maintain a high quality of life for as long as possible.
This bill should result in a net savings to the state of approximately $900,000 per year attributable to the reduced cost of caring for individuals who would otherwise be served in more expensive institutional settings.
STATE OF NEW YORK ________________________________________________________________________ 4851 2011-2012 Regular Sessions IN SENATE April 27, 2011 ___________Introduced by Sen. SALAND -- read twice and ordered printed, and when printed to be committed to the Committee on Aging AN ACT relating to authorizing the establishment of a long term care community in Columbia county known as Camphill Ghent, Inc. to provide integrated services to certain persons THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Legislative intent. New York state has long recognized the need to support a full continuum of long term care services for the aging that supports the ability of seniors to remain in integrated community settings for as long as possible. The state has offered simi- lar support to allow persons with developmental disabilities and their caregivers to live in community settings, but for the most part not in integrated housing arrangements. Further, the state does not currently support a service model that adequately supports the increasingly sophisticated long term health care needs of persons with developmental disabilities who are elderly in an integrated community setting that includes elderly persons with developmental disabilities and others. The Legislature finds that the Camphill movement has a long tradition of providing services to persons with developmental disabilities in fully integrated community settings through its worldwide network of planned, intentional communities serving persons with and without devel- opmental disabilities. Much more than providers of basic services for people with developmental disabilities, Camphill communities offer an environment where people of all ages and abilities share home, work and social activities and enjoy a rich artistic and cultural life with opportunities for spiritual expression and dignified work. Camphill communities rely on both paid and volunteer workers to ensure that persons with developmental disabilities can realize their full potential through constructive and productive interactions as fully participatory members of their communities.EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD11097-01-1 S. 4851 2
The Legislature further finds that members of such communities must frequently leave those communities when they develop long term health care needs that cannot be addressed in those settings. In such cases, they are often admitted to less integrated settings that negatively impact their quality of life and generate costs to those individuals and to the state that would not be necessary if a more appropriate alterna- tive were available. In recognition of this fact, Camphill Village USA, Inc., which currently operates a Camphill community in Copake, New York, is in the process of developing a community in Ghent, New York, under the auspices of Camphill Ghent, Inc., ("Camphill Ghent"), that would provide an array of long term care services, including assisted living, to persons with and without developmental disabilities in the Camphill tradition. The Legislature further finds that the Camphill Ghent project is consistent with the goal of both the department of health and the office for people with developmental disabilities to provide cost effective services in the most integrated setting appropriate to the needs of residents. In fact, Camphill Ghent has already received support from the state in the form of a $9.6 million grant under the Healthcare Efficien- cy and Affordability Law for New Yorkers and the Federal-State Health Reform Partnership, pursuant to which it is subject to state oversight and regulation. However, there are currently legislative barriers to the full realiza- tion of the Camphill Ghent goal, including barriers against allowing residents to age in place, barriers against full funding for the services necessary for persons living in a fully integrated setting who have both developmental disabilities and significant long term health care needs, and barriers against the use of volunteer services provided by the potential residents of the new community. In the past, the Legis- lature has enacted legislation to support a Camphill-related facility in New York state by removing such barriers. Moreover, Camphill Village has a proven track record of providing services at substantially lower cost than comparable providers. Accordingly, the Legislature finds that it is in the best interests of the state to establish Camphill Ghent as a unique program to provide long term care services to persons with developmental disabilities and others in an integrated community setting in a manner that allows such individuals to age in place with all appro- priate state supports, and without the barriers that will prevent such persons from becoming fully participatory members of their community. S 2. The Legislature hereby authorizes the establishment of a communi- ty in Columbia county known as Camphill Ghent, Inc. (hereinafter "Camp- hill Ghent"), that is specifically designed to provide long term care and other services to persons with developmental disabilities and others. Such community shall: (a) include, at a minimum, an assisted living program as defined in section 461-l of the social services law, other adult home beds as defined in subdivision 25 of section 2 of the social services law, and unlicensed housing targeted to seniors aged 55 and over comprised of self-contained studio, one bedroom and two bedroom units connected to common areas for common dining and recreation, and two and three bedroom independent housing units; (b) include a series of buildings for common use that will house a variety of non-medical services available to community residents; (c) include both persons with developmental disabilities and persons without developmental disabilities among the residents;S. 4851 3
(d) include extensive use of volunteers to supplement the services provided by the required professional staff; and (e) provide regular reports to the state consistent with its obli- gations under section 2818 of the public health law. S 3. Notwithstanding subdivision 6 of section 461-c and subparagraph (ii) of paragraph (d) of subdivision 1 and subparagraph (iii) of para- graph (d) of subdivision 2 of section 461-l of the social services law, an eligible person who has been admitted to the adult home or assisted living program at Camphill Ghent, who is otherwise no longer eligible for participation in an adult home or assisted living program because such person is in need of continual nursing or medical care, chronically bedfast or chairfast, or cognitively, physically or medically impaired to such a degree that his or her safety would otherwise be endangered, may remain in the adult home or assisted living program at Camphill Ghent provided that the program provides such additional nursing, medical or other care as necessary for such person to be safely and adequately cared for, as determined by the program and such person or his or her legal representative. The rates payable to the assisted living program at Camphill Ghent shall be adjusted to reflect the cost of such additional medical, nursing or other care. S 4. Where eligible persons residing in the assisted living program at Camphill Ghent, or persons residing in the assisted living program at Camphill Ghent pursuant to section three of this act, would otherwise be eligible to reside in a supervised individualized residential alterna- tive established pursuant to regulations of the commissioner of the office for people with developmental disabilities, the assisted living program at Camphill Ghent shall be entitled to a supplemental payment from the office for people with developmental disabilities equal to the difference between the assisted living program rate attributable to that person and the regional average supervised individualized residential alternative rate that would have been paid had that person resided in a supervised individualized residential alternative, inclusive of both the residential habilitation and room and board components, trended to the current operating year and annually updated. Such supplemental rate shall be used to support additional case management services, protective oversight and the following residential habilitation services, as appro- priate: training, support and assistance in pursuing personal valued outcomes, self-advocacy, relationship building, and self direction in making informed choices; training, support and assistance in personal hygiene tasks; training, support and assistance in self-care tasks; training, support and assistance in general household chores including meal preparation; mobility training; training, support and assistance in personal health care; training to maximize personal financial manage- ment; training, support and assistance in appropriate normative social behaviors and community inclusion activities; training in fire evacu- ation procedures and other appropriate life safety activities; and necessary transportation. The Legislature shall appropriate the funding necessary to support such supplemental payment on an annual basis. In no event shall the adult home or assisted living program at Camphill Ghent be required to be licensed under any provision of the mental hygiene law by virtue of such supplemental payment or the services it supports. S 5. Camphill Ghent shall be exempt from the following provisions of the social services law: subdivision 6 of section 461-c of the social services law regarding retention standards in adult care facilities; subdivision 4 of section 461-d of the social services law regarding compensation of residents of certain adult care facilities for servicesS. 4851 4
performed on behalf of such adult care facility; and subparagraph (ii) of paragraph (d) of subdivision 1 of section 461-l of the social services law regarding retention standards in assisted living programs. Camphill Ghent shall also be exempt from subdivision 15 of section 4651 and section 4654 of the public health law regarding enhanced assisted living certification. The exemption from subdivision 6 of section 461-c of the social services law and subparagraph (ii) of paragraph (d) of subdivision 1 of section 461-l of the social services law shall apply only to the extent that Camphill Ghent meets the requirements of section three of this act. S 6. This act shall take effect immediately.