LeadingAge NY Participates in Fifth ACF Licensure Streamlining Workgroup Meeting
(Sept. 9, 2024) On Sept. 4th, the Department of Health (DOH) held the fifth meeting of the Adult Care Facility (ACF) Licensure Streamlining Workgroup. Focused subgroups have been working to dive into specific issues and report back to the larger workgroup. All of the concepts discussed thus far are suggestions that DOH will evaluate for implementation; any policy change will be formally announced by DOH. Below is a summary of the issues discussed and subgroup progress:
ALP Needs-Based Application Process
DOH reported that they are working on compiling the data that was identified as helpful in guiding a needs-based application process for new assisted living program (ALP) beds. As a reminder, DOH is required to develop this process for new ALP beds by April 1, 2025.
Identified data needs include:
- How many nursing home residents in NY are in Resource Utilization Group (RUG) categories that could be served in the ALP
- What counties have no ALP or only one ALP
- What counties have high ALP occupancy
- The availability of other services in the region that may influence need, such as nursing home and home care
- Census data, including current and future older adults and likely caregivers, people living alone
They hope to have some of this data available for the next meeting and plan to spend the next meeting focused on the ALP needs-based application process.
LeadingAge NY shared suggestions we had made in 2019 when we participated in a workgroup to talk about the development of this process. DOH has also recirculated some of the information that they had circulated in that process.
It was again stressed that we should work to get the process available as quickly as possible, so people can begin to apply for new ALP beds by April 1, 2025, given that the public has been waiting for this process for years.
Third-Party Architectural Certification
As noted prior, DOH is evaluating a draft policy to remove the requirement for a third-party architect to approve architectural submissions. The draft guidance indicates that the primary architect is still responsible for design certification, but we will not need third-party architectural certification given that DOH currently has an architect to review the submissions. It is hoped that this policy, currently under review with DOH, can be changed soon. Any entities that are contemplating submitting an application for ACF or assisted living services should be aware of this potential future change.
Revision of Routine Maintenance Procedure
A subgroup on which LeadingAge NY serves is focused on revising the current process by which routine maintenance projects have to go through the NYS Electronic Certificate of Need (NYSECON) system, as outlined in this Dear Administrator Letter (DAL). DOH is in the process of reviewing the Construction Notice process which was instituted in 2011 for nursing homes. The workgroup will attempt to modify the grid that exists for nursing home projects to determine what type of project needs what level of review. The objective is to provide greater clarity and parameters for what types of projects may be appropriate for a notice to DOH, versus what characteristics or threshold would trigger a full review by DOH.
The group will examine the existing regulations and guidance to determine what parameters must be followed and what may need to be changed. Any member experience with this is invited to help inform the process
Character and Competence
This focused workgroup is looking at the Department’s Out of State Character and Competence (C&C) process, with focus on Schedule 2D. They met again last week and are brainstorming regarding developing a checklist for review and discussion. The applicant can indicate what they requested and the date they made the request for the State regulator to help clarify and expedite the process. They are exploring establishing timelines and affidavit to match Article 28 language. They will consider developing a standard process for when to use affidavit and then draft a guidance document.
Change of Ownership for ALP LHCSAs
DOH reviewed the legal issues regarding how to approach a change in ownership in a way that does not unnecessarily confuse residents, staff, and the community. Historically, DOH has required the selling entity to use the closure process and language. DOH believes that they may be able to modify language to reflect the nature of the transaction while still informing the residents of their rights and options. DOH is looking more closely at this issue to determine how they can change that process.
DOH is also looking at the transition dates for change of operator transitions for the ALP so that the licensed home care services agency (LHCSA) and ACF transition dates are aligned. DOH is looking at the communication between the teams processing LHCSA and ACF/ALP applications and is considering a way to flag such projects in the NYSECON so they can be better coordinated.
Other Issues
Members are reminded that this effort provides an opportunity to review all of the ACF Common Application components and suggest further clarifications and updates, so please share any suggestions.
Conclusion
The next meeting of the larger workgroup will be held on Sept. 26th; however, subgroups will also be meeting and reporting back to the larger group along the way. LeadingAge NY will keep members informed of these discussions and invites member feedback regarding these issues.
Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828