Critical Updates and Answers Regarding ALP OFD

Last week, the Department of Health (DOH) provided answers to submitted questions, as well as modifications to the Assisted Living Program (ALP) Opportunity for Development (OFD) application. Click here to view this updated information. We were pleased to see several clarifications and modifications regarding the federal Home and Community Based (HCBS) Settings rule, as we had raised many concerns about that aspect of the application which seemed to go beyond the federal rule's requirements. You will see in the new Attachment #4 that “the desired components of an ALP” have been revised, and the below “desired components” have been deleted:

• individual and shared (double occupancy) dwelling units must contain separate living, dining and sleeping areas which provide adequate space and comfortable, home-like surroundings;
• the unit must contain a full bathroom (including a toilet, washstand and shower or tub);
• kitchen is to include area for food storage, refrigeration and meal preparation; and
• residents must be provided full access to such features as a kitchen and cooking facilities and small dining areas, as appropriate.

At the same time, DOH added two new components:

• adequate space for congregate meals and activities, as well as additional space for smaller group meals and activities; and
• residents may have access to food stored in their own refrigerators and food pantries in their rooms and/or congregate areas. However, cooking appliances are prohibited within resident sleeping areas.

We note that the implications of the federal HCBS rule are still evolving, and are comitted to ensuring that issues such as sharing rooms, having access to food at all times and choice of services and supports will become clearer for applicants and existing ALP providers. Click here for guidance issued by the Centers for Medicare and Medicaid Services on the federal rule, and here for a fact sheet which provides a brief overview of key issues.

In the OFD, DOH notes that “it may not be practical for an ALP to create a setting which has every desirable component.” In those cases, the applicant needs to describe how their application meets the intent of the desired component. LeadingAge NY encourages interested members to apply even if all of the desired components are not met; however, it is critical to describe how the intent would otherwise be met.

Additional clarifications include, but are not limited to the following:

• the eight page limit and the ability to provide additional attachments that are not counted in this limit;
• applicants will be scored on their ability to demonstrate financial feasibility, and requests additional information to help demonstrate;
• NYC applicants are not required to submit a letter of support from NYC Department of Aging; and
• personal delivery of the application is allowed.

We urge members to review the questions, answers and amendments carefully to ensure you submit the strongest possible application.

Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828