|
1.
FAMILY HEALTH CARE DECISIONS ACT (FHCDA)
The
Family Health Care Decisions Act A.5406A give next-of-kin the right to make health care decisions for incapacitated
relatives. The Act, which has not been passed, includes
protections to make sure the relative acting as surrogate makes
decisions consistent with the patient's wishes and interests. It sets standards for decisions about withholding life-sustaining
treatment that both provide protections against abuse and allow
patients' wishes to be honored.
IMPORTANCE
- Unlike
most states, New York now allows surrogate decisions only by legal
guardians or agents named in a health care proxy. Most people
do not have guardians and do not sign health care proxies.
- In
nursing homes, when family and doctors are in conflict, relatives
can be shut out of the decision - making and denied access to
information. Relatives may not be able to monitor the patient's
conditions or insist on needed care. They may find themselves
unable to honor promises made to dying patients that artificial
life-sustaining treatment would not be used.
- A
broad based coalition of professionals, providers, consumers civic
and religious groups support this bill. It has languished
because of opposition from the religious right. More information
is at www.familydecisions.org
STATUS & UPDATES
- The
long battle to obtain rights for next-of-kin to make medical decisions
for incapacitated relative may succeed this year! There is growing
consumer and professional support and several new senate sponsors. During
the legislative session, go to: http://assembly.state.ny.us/leg/?bn=A05406
HOW
YOU CAN HELP
- Support
this bill. Contact Senators Hannon and Seward, Assembly
member Gottfried, and your own elected officials. To find out
how to contact public officials, click
here .
- Join
the Family Decisions Coalition. Contact FRIA at 212-732-5667 or fria@fria.org.
2. MEDICAID CHANGES
The US House of Representatives and Senate have passed legislation which will cut Medicaid expenditures and, in so doing, make it harder to qualify for eligibility for benefits. A conference bill has emerged that would:
- Extend 'look back' period form three years to five years
- Change that date of the look back to the date of application
- Count "excess' equity in community spouse's home as Medicaid asset
NYS Governor Pataki has issued his budget for the coming year, and also proposes cuts in Medicaid funding. Of great concern, is his proposal to eliminate spousal refusal. Contact your legislator with your comments.
3. COMMISSION ON HEALTH CARE FACILITES IN THE 21ST CENTURY
NYS ‘s Commission on Health Facilities in the 21st Century
Gov. Pataki created a Commission to review the need for and location of hospitals and nursing homes in New York State. His action was spurred by the reported financial losses and unoccupied beds that both hospitals and nursing homes are said to experience. The Commission is holding meetings throughout the state and is soliciting comments from the public. The Commission will make final recommendations on ‘rightsizing’ New York State's hospitals and nursing homes by December 1, 2006. These recommendations will include possible consolidation, closure, conversion, and restructuring of institutions, and reallocation of local and statewide resources presumably to support more home-based long term care. If the recommendations are approved by the Governor and the Legislature, they become law. For information and to submit your comments go to the website, www.nyhealthcarecommission.org/
STATUS & UPDATES
The Commission recommended elimination of minimum of 3,000 nursing home beds statewide, with conversion to Assisted Living Program beds and other forms of care. Read FRIA’s testimony given on before the NYS Assembly and Senate.
4.
SAFE STAFFING DIVERSION ACT
The
Diversion Act (A. 08866) is a first step toward
required staffing standards. It prohibits new admissions in
any nursing home with staffing levels resulting in less than 3 hours
direct care on average per resident per day. This is a danger
point identified in a recent National Institute of Health study. Below this level, residents are likely to suffer harm.
IMPORTANCE
- Widespread,
chronic understaffing in nursing homes leads to poor care, neglect
of residents and dangerous working conditions for direct care
staff. While legislating mandatory staffing levels in not
feasible now, New York can take a first step toward safe staffing. Diverting new admissions away from nursing homes with dangerously
low staffing protects residents and imposes a financial penalty
on those homes.
HOW
YOU CAN HELP
- Support
this bill. Contact Governor Pataki, Senators Hannon
and Bruno, Assembly leaders Silver and Gottfried and your own
elected officials. To find out how to contact public officials, click here.
- "Take
Action Now" by going to The Long Term Care Community
Coalition's website at www.ltccc.org
which offers a fast and easy way to send support via the
internet.
5.
ASSISTED LIVING PROTECTIONS
In
mid-August, 2004, the New York State Legislature, after five years
of failed attempts, finally passed legislation
to regulate assisted living facilities (Senate Bill 7748/Assembly
Bill 11820). New York joins 32 other states that define and regulate
such facilities. The new law requires the state to develop regulations
for assisted living. This will happen after publication, in June
2005, of the recommendations of a state task force.
Governor
Pataki said the legislation "will help seniors make more informed
decisions about their care and housing, encourage new development
of much-needed assisted living residences across the State, and
hold providers accountable for the services they provide to our
loved ones."
IMPORTANCE
- Assisted
living is defined as residences that "provide or arrange for housing,
on site monitoring, and personal care services and/or home care
services (either directly or indirectly) in a home-like stetting
to five or more adult residents unrelated to the assisted living
provider."
- Assisted
living facilities must supply food service, 24 hour on site monitoring,
case management and individualized service plans for all residents.
- To
obtain a license to provide assisted living care, a facility must
first be certified as an adult home or licensed as an enriched
housing program.
- In
addition to the basic license, facilities must obtain an "enhanced
assisted living certificate if they want to allow residents to
remain in the residence even with extensive care needs "age-in." Examples of increased care needs that would require this certificate
are staff helps to transfer form bed to chair or to climb stairs.
- Facilities
that want to care for cognitively impaired residents must obtain
an additional "special needs assisted living certificate."
- Consumer
protections in the new law include disclosure requirements, a
complete and consumer friendly contract and a residents "Bill
of Rights" and a role - and funding - for the long-term care ombudsman
service.
If
you have questions about the new law, you can call FRIA's helpline
at (212) 732-5667.
STATUS & UPDATES
- The law took effect in January, 2005. A task force has been established to recommend implementing regulations. To date, the task force has not instituted its recommendations. All facilities seeking assisted living licensure must submit a plan to the DOH describing the levels and skills of their staffs and the specific services offered to residents. The DOH will post on its website the licensure provided to each facility. Click here to be directed to the DOH - Assisted living website.
6. NYS FALSE CLAIMS ACT
The Act would authorize treble damages against the perpetrators of such frauds, and also provides individuals with a financial incentive to provide information about fraudulent activities involving government funds. In a 'qui tam' action an individual with knowledge of fraud may bring a law suit on behalf of the state and share in the recoveries. Similar provisions exist in federal law and in other states.
Getting such a bill passed could open up nursing homes to appropriate accountability.
7. LONG TERM CARE COMPACT
The NYS Bar Association, Elder Law Section, has proposed a new way for the state to approach the funding of long term care. The Senate has passed this proposal. Click here for FRIA’s testimony at a Public Hearing Held before The New York State Assembly COMMITTEES ON AGING, HEALTH, AND INSURANCE.
|
