Proposal Presented for the Master Plan for Aging (#11)
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
Create a more home-like environment through the development of the Green House Project model or other small house-type facilities in new and renovated nursing homes. The proposal also includes recommendations to update regulatory requirements to facilitate complementary transformations to the nursing home industry.
Justification
Most nursing home buildings are old, built several decades ago, are institutional in nature and don’t fit the population’s needs or wants. Nursing home reforms provide modifications such as in-unit dining, additional communal and activity space, environmental and life safety codes, and updated equity contributions. Creating a set of actions to support the development of a facility-based LTC setting, such as the Green House Project model or other small house-type facilities, will create a more home-like environment, improving the quality of life for older adults in residential care.
Full Proposal
Create a more home-like environment through the development of the Green House Project model or other small house-type facilities. To accomplish this objective, New York would:
- Revisit certificate of need and equity contribution requirements for new bed construction (see proposal 6) to reduce barriers that may impede the development of innovative nursing home models.
- Modify safety, building and environmental codes for facility-based care and prevention of infectious diseases.
- Expand capital financing and revisit capital grant award methodologies for existing grant programs to prioritize support for innovative nursing home models.
- Exempt nursing home Medicaid capital reimbursement from 70/40 requirements.
- Review access to capital for not-for-profit facilities.
- Support streamlining for local planning and zoning facilities to allow for homes and care facilities.
MPA Council Commentary
This proposal is categorized as long-term. The FY23 enacted budget included $50M in capital funding to support innovative nursing home models, including but not limited to the Green House Project model. Component 4 of this proposal may require a statutory amendment to change Medicaid capital reimbursement requirements and would be subject to the annual budget process and the availability of resources. The additional components of the proposal would require further discussion by the Department of Health and a continued review of Certificate of Need (CON) methodology and engagement with all relevant State partners.