LeadingAge NY Participates in Third Meeting of DOH ACF Licensure Streamlining Work Group
(Aug. 13, 2024) On Aug. 7, the Department of Health (DOH) held the third meeting of the Adult Care Facility (ACF) Licensure Streamlining work group. Focused sub groups have been developed to dive into specific issues and report back to the larger work group. 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 sub group progress:
Third Party Architectural Certification
The Department is evaluating a draft policy to remove the requirement for a 3rd 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 The draft guidance indicates that the primary architect is still responsible for design certification, but we will not need 3rd party architectural certification given that DOH currently has an architect to review the submissions.
It was acknowledged that if the policy is changed, the ACF Common Application and directions will need to be revised.
Revision of Routine Maintenance Procedure
A subgroup, which LeadingAge NY serves on, was established and met for the first time on Aug. 13th to revise 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).
We will begin by examining what is done for nursing homes and the Construction Notice process which was instituted in 2011. Nursing homes have a grid that can be consulted to determine what type of project needs what level of review, which the workgroup will consider to inform parameters for ACF submissions. We will consider what types of projects may be appropriate for a notice, versus what characteristics or threshold would trigger a full review. The group will examine the existing regulations and guidance to determine what parameters must be followed and what may need to be changed.
Character and Competence
This workgroup will be meeting next week, and their focus will be on the Department’s Out of State Character and Competence (C&C) process, with focus on Schedule 2b. They will look at how other states generally respond to C&C requests, and look at the process for other licensure types. They will consider developing a standard process for when to use affidavit, and then draft a guidance document.
ALP Need Methodology
The work group will begin discussing the development of the Assisted Living Program (ALP) Need Methodology. As a reminder, DOH is required to develop a needs-based application process for new ALP beds by April 1, 2025. DOH will share the data they have and we can identify what is missing that we feel we need. The Department plans to look at this issue through a broader lens, to include regional planning, workforce, and beneficiaries’ to access health related social services. They also indicated they want a methodology that is reliable, considers quality of care, quality of life and the federal home and community based settings rule.
LeadingAge NY had been engaged in a previous workgroup regarding the development of this need methodology prior to the pandemic, and will participate in this effort as well.
ALP Change of Operator Issues
The group discussed the confusion that stems from the Department’s requirement that ALPs follow closure plan guidance when there is a change in operator. The language confuses and alarms residents and staff who think that the ALP is being closed rather than transitioning to another operator. The Department is open to making changes to this communication, given that they are consistent with the statutory language and continue to emphasize the options that residents and patients have. The Department will examine this issue with their legal department and we will discuss at the next meeting.
The group also discussed the need to coordinate the home care and ALP/ACF licensure approvals for a change in operator or new ALP. The ALP is a combination of both the ACF and Home Care and therefore the approvals should ideally happen at the same time. Additionally, when there is a change in operator there needs to be a transition period. A workgroup member had some suggestions regarding the coordination, such as allowing the new operator to set the transition date after the approval, with the ACF/ALP and home care agency transitioning on the same date. That date would then be the date of the Operating Certificate. There could be a certain timeframe by which the transition occurs, such as 30 days. The workgroup will evaluate this suggestion.
It was also noted that home health aide training programs are sometimes lost in these transitions. The group will look at this issue as well.
Other Issues
A work group member suggested that this project provides an opportunity to review all of the ACF Common Application components and suggest further clarifications and updates. The Department indicated a willingness to consider further suggestions and indicated that at the end of this process everything on the ACF Common Application page would be updated at one time.
Conclusion
The next meeting of the larger workgroup will be held on Aug. 21st, 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 invite member feedback regarding these issues.
Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828