Proposal Presented for the Master Plan for Aging (#9)
Disclaimer
Throughout the MPA process, more than 100 proposals were developed thanks in particular to thousands of hours of work by external stakeholders and members of the public. These proposals and the MPA Council commentary are being submitted to the Governor and shared with policymakers and the public to inform policymaking. These proposals represent a starting point for discussion. Further discussion is necessary between relevant state agencies and stakeholders to both refine these proposals and assess which may be appropriate to adopt and implement.
Summary
Combine accreditation programs and regulatory reforms to drive higher quality care and improved access to specialized services at assisted living residences. Encourage integration, including digital systems, into larger network of care providers.
Justification
Accreditation of ALRs through tested and comprehensive quality metrics and the establishment of enhanced case management programs for ALRs to improve coordination of care will bolster consumer trust. This will also reduce the risk to ALR operators. Overall, this set of actions will result in improved clinical and social health outcomes.
Full Proposal
- All ALRs would begin the process of seeking accreditation from either the Joint Commission, CARF International or the Accreditation Commission for Health Care by 2028. This would provide ample time to focus on quality, secure funding and be actively engaged (after application) to prepare for survey readiness with the accrediting organization. Accreditation would allow for thoughtful building of quality driven organizations and would allow benchmarking of assisted living providers and would be considered as a requirement of licensure and re-licensure.
- Amend state law and regulations that currently prohibit ACFs from meeting the needs of higher-acuity residents that result in inefficient and untimely off-site medical and clinical care, ineffective segregated memory care units, low staffing ratios, and insufficiently trained staff. Ultimately, this will result in a less stressed healthcare ecosystem and recognizes the complexity of needs of an aging New York by:
- Creating a separate enhanced case management program which coordinates primary care, ancillary services, and therapies onsite at the ALRs.
- Requiring in-house or contract with social workers, nurses, and physicians to efficiently and timely address acute medical needs, including a repeal of sections of social services law 460-461.
- Requiring infection control standards and training for all ACFs that will result in decreased reliance on local health departments.
- Requiring all ALRs, as a condition of licensure, to obtain accreditation from a nationally accepted accrediting organization, including need for dementia certification from such accrediting institution to promote quality and standardization of how ALRs operate, professionalization of the staff employed by these facilities and overall decrease in reliance of emergency departments.
- By 2027, require and fund electronic health platforms for all nursing homes and assisted living providers, and recognize additional support may be needed, especially for those with limited access to broadband.
- Require that all ALRs have agreements in place to partner with other types of providers, including nurse practitioners, physician assistants, registered nurses, care managers, social workers, pharmacists, and others, including mental health providers that ensure residents are offered wrap-around services.
MPA Council Commentary
This proposal is categorized as long-term. Implementation of this proposal would require changes to existing policy and additional resource allocation, which would be subject to the annual budget process and the availability of resources. DOH has already issued several rounds of Transformational Grant and IT Modernization funding to support such initiatives. DOH is currently developing quality metrics and could pursue accreditation in future NYS budget cycles.