LeadingAge NY Participates in Second ACF Respite Workgroup Meeting
(June 25, 2024) On June 20th, LeadingAge NY participated in the second 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. The Department is continuing to proceed using the Special Needs Assisted Living Residence (SNALR) Voucher program application and process as a starting point, given that it is a recently developed State-funded program that is working well.
Application for Person Seeking Respite Care
In this second meeting, the group spent time further considering an application process for an individual who is seeking respite services. While the legislative language is vague, the purpose is to support caregivers in caring for their loved ones in the community, and that should be a guiding principle in the development of the program. Key questions were discussed, which we welcome member input on:
- How do you prioritize who receives respite services? What factors should be considered, and what information must be gathered for the State to make that determination?
- Should there be a financial consideration in determining eligibility for this State-funded respite program? If so, what should it be?
- How long would the respite be for, and might it be periodic rather than continuous days?
- On a high level, what information is needed to determine what type of ACF/assisted living (AL) provider is appropriate for providing respite? Memory impairment and wandering behaviors? Other issues?
Respite Reimbursement
The group discussed whether there should be a flat daily rate paid to the ACF provider, or a rate developed based on regional cost of care, for respite care. LeadingAge NY recommended that the rate be based on the region and type of licensure, given that the costs vary. We cautioned that the rate must be sufficient to ensure that providers will participate. We noted that even though the respite stay is temporary, the provider must go through a typical admission process, which is resource intensive and potentially more expensive than admitting a resident.
There was discussion about capturing information regarding cost of care to establish rates for reimbursement of respite services, similar to the process for the SNALR Voucher. DOH just issued a Dear Administrator Letter (DAL) and survey to update that data for the SNALR Voucher program (note that this link is provided as a guide to gain insight into how DOH might collect data for this purpose). It was noted that the information should be gathered according to licensure type, given that additional services – such as memory care – will cost more than services in an ACF. The group briefly discussed how this might work in the Enhanced Assisted Living Residence (EALR), and this remains an outstanding question. In addition, it was noted that there is not a need to capture information regarding the assisted living program (ALP) cost of care, since the State already has that information.
There were questions, logistically, about how respite in an ALP would work. These issues were deferred, but overall it was felt that someone would be regarded as an ACF resident, rather than an ALP resident, for the purposes of this respite program. DOH stated that Medicaid recipients could be eligible for this program.
Other Issues
In addition to the aforementioned issues, LeadingAge NY has identified some other questions that we would like member input on:
- Are there ways in which we could make it easier for an ACF to admit people seeking respite?
- Does a respite resident have the same rights as a resident in terms of termination of residency agreement? What if the resident or caregiver does not want the resident to leave when the respite stay concludes? DOH is looking into this issue from a legal perspective.
- Given the limited pool of funds, should there be a time limit for this program? The State allows for a maximum of 180 days of respite in an ACF in a 12-month period. Should there be any parameters regarding timeframe for this purpose?
Next Steps
This was the second 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 this will help inform our discussions in the subsequent meetings. The group is meeting weekly.
Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828