Continuing Care Retirement Communities Oversight Reform

Proposal Presented for the Master Plan for Aging (#60)

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

Encourage the growth of Continuing Care Retirement Communities by consolidating oversight to the Department of Health, updating the priority reservation fee deposit, and reallocate state resources to the DOH to support expanded oversight. This proposal includes alternative opportunities to reduce barriers to growth, all of which align with the recommendations to reduce oversight and improve CCRCs ability to effectively serve their populations.

 

Justification

Development of continuing care retirement communities, a senior housing model which incentivizes the use of retirement funds to pay for care rather than incurring spend-down or estate planning for Medicaid, is hindered by significant barriers. To encourage growth of CCRCs and reduce potential for Medicaid spending, New York should consolidate oversight of CCRCs and eliminate other important barriers to growth.

 

Full Proposal

Consolidate oversight of Continuing Care Retirement Communities to the Department of Health to eliminate barriers that hinder growth.

  • Consolidate oversight of CCRCs into a single State agency – the Department of Health (DOH) – which would expedite oversight functions, enabling CCRCs to operate more nimbly and be responsive to consumer needs and preferences. It would also shift the CCRC Council to an advisory role, consistent with nearly all other councils in the health sector and consolidate the authority of the Council into DOH functions.
  • Allow DOH to update the priority reservation fee deposit, capped in statute at $2,000 since 1991. Enabling DOH to update this cap could help ensure that the deposit amount reflects current market conditions and is indicative of a genuine interest in the community.
  • Reallocate existing State resources to DOH to facilitate its expanded oversight functions.

Alternatively:

Encourage growth of Continuing Care Retirement Communities by:

  • Changing the current structure of the CCRC Board.
  • Eliminating multi-agency review and oversight.
  • Overhauling the regulatory process to prevent duplication.
  • Bringing New York Continuing Care Retirement Communities in line with national CCRC investment strategies
  • Assisting the development of a clinical practice model across all levels of care within the CCRC (including consolidated medical record platform available to all components for the CCRC and eliminating burdensome and bifurcated surveillance functions)
  • Clarifying the purpose of CCRC contracts and that they represent all levels of care within the CCRC.
  • Eliminating duplicative cost reports required of CCRC facilities.

 

 

MPA Council Commentary

This proposal is categorized as long-term. Policymakers may reference this proposal during the legislative session, as implementation would likely require legislative action. DOH and the Department of Financial Services, which both play a role in overseeing CCRCs today, continue to evaluate CCRC regulation on an ongoing basis to identify opportunities for streamlining and encouraging the growth of the model.