LeadingAge NY Participates in Fourth ACF Respite Workgroup Meeting
(July 12, 2024) On July 10th, LeadingAge NY participated in the fourth of five workgroup meetings to inform the development of a respite program established in the 2023-24 final budget. $7.2 million was appropriated for services and expenses related to providing relief to high-need family caregivers in respite care at adult care facilities (ACFs). LeadingAge NY’s Diane Darbyshire, as well as LeadingAge NY member John Schuster, Senior Administrator, Wartburg, serve on the workgroup convened by the Department of Health (DOH). Click here for background on this effort and the scope and charge of the workgroup.
Refining Documents to Implement Program
LeadingAge NY has worked with other stakeholders to refine the various documents that the Department will use for the program, including the application and eligibility information that individuals would use to apply for the voucher. We also refined a draft cost of care survey that would go out to providers that offer respite to establish average regional voucher program rates. We will also work to assist the Department in the development of a website to educate the public regarding this program. DOH will also, in the future, ask providers if they want to participate in the program. Participation is voluntary.
Respite Reimbursement
As noted prior, DOH plans to issue a cost of respite care survey to collect average rate information from current respite providers to establish an average regional rate for different licensure types. There remains debate about whether the individual receiving respite should be asked to contribute to their payment for the respite stay. It was felt that individuals who are Medicaid-eligible likely will not have the means to contribute, but perhaps others would. It was also noted that providers should be able to accept a contribution from a voucher recipient to bring the rate up to the facility rate, in the event the voucher rate is below the facility’s respite rate.
Process
There remains debate about how the process will best work. DOH feels that an individual interested in respite should first be “accepted” by an ACF or assisted living provider participating in the voucher program before submitting an application to DOH. LeadingAge NY noted that it will likely happen both ways in actuality. Regardless, the processing of the voucher application must be timely, and we stressed that the provider may not have availability or the individual’s condition may have changed if the voucher application review process takes too long.
Ongoing Issues
The group is continuing to grapple with the following issues:
- How should the State prioritize applicants if they have multiple applications at any given time? How do you ensure that those who need this support the most are prioritized?
- What financial threshold should be used to determine financial eligibility? How do you ensure that those who truly need it access the program, and not those who do not?
- There was discussion regarding how to guard against a situation where an individual is unable to return to the community unexpectedly. There is concern that the provider should not be held financially responsible in that circumstance. The Model Respite Addendum allows the termination of the agreement by either party with three days' notice. We are exploring what other language we can add to clarify that this program is intended for temporary stays. There is concern, however, about what will occur if the resident or caregiver does not want the resident to leave when the respite stay concludes.
Next Steps
This was the fourth of five workgroup meetings, and there are some complicated issues to resolve before the program can be implemented. We encourage member input and questions on these issues as we conclude our work.
Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828