New York: Governor

Candidates

B. Thomas Golisano , Independent
H. Carl McCall, Democrat
George E. Pataki, Republican

Issues: Nursing Home Quality | Assisted Living Regulation | Prescription Drugs |

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Question

Would you support legislation that would require the Department of Health to create nursing home report cards and use fines collected from nursing homes to support quality improvement initiatives in these facilities?

AARP Response

The quality of care and the quality of life for nursing home residents in New York State is a priority for AARP. The increasing number of deficiencies cited by NYS Department of Health (DOH) must be addressed through public information and quality improvement initiatives.

The number of deficiencies being found and the number of facilities being cited for those deficiencies has been steadily rising. Fines for facilities not correcting violations have dramatically increased and the number of complaints alleging patient abuse nearly doubled between 1993 and 1999. Nursing homes in New York State are being cited more than the national average in a number of key, quality measuring, areas including pressure sores, dehydration, and failure to do pre-screenings on prospective employees.

AARP supports initiatives to expand the information available to the public regarding nursing homes. AARP also supports initiatives that would improve the quality of life for nursing home residents.

Issue	Yes	No	Unclear
Create nursing home report cards
Use fines for quality improvement initiatives

Candidate Response: B. Thomas Golisano

I support the dissemination of information on the quality of care in our state’s nursing homes, as long as this does not result in the creation of additional bureaucratic largesse. I also support applying fines collected from those who fail to meet minimum state standards toward quality improvement initiatives. Every day, more New Yorkers embark upon the confusing process of locating quality nursing homes for themselves and their loved ones. The market should work to provide them with quality choices. Disseminating information on the quality of care in nursing homes is one way we can ensure that the market provides safe and adequate housing and care for our loved ones.

Candidate Response: H. Carl McCall

As Comptroller, I have conducted audits demonstrating how the State’s inadequate oversight of facilities entrusted to provide care has compromised the health and safety of older New Yorkers, and eroded public confidence. As Governor, I will improve oversight of nursing homes, adult care facilities and other residences to ensure that our seniors receive the services they need and the quality they deserve. When fines are levied against care providers who violate regulations, I will reinvest the proceeds in efforts to improve staff recruitment and retention and other quality enhancements. Improved regulation of the senior health and residence industry will be complemented by the availability of better information for consumers, including report cards that offer facts in a clear, helpful and user-friendly manner.

Candidate Response: George E. Pataki

I support nursing home report card legislation, similar to the reports we are currently developing for

hospitals. To that end, I have directed the Department of Health to provide more information about the performance of nursing homes on their website. Included in the new information will be the results of nursing home inspections, as well as the details of any enforcement actions taken against those facilities. Developing and issuing report cards will help consumers make more informed choices about where to seek care. I also would support legislation to use nursing home fines to support quality improvement activities in the nursing homes. Such funds could promote programs to improve resident safety and well being.

Question

Would you support legislation that provides for the regulation and oversight of privately operated and financed assisted living facilities by the New York State. If yes, what should be the key elements of the regulation with regard to consumer protections?

AARP Response

Assisted Living is the fastest growing type of senior housing in the country. In 1998, assisted living facilities accounted for 75% of all new senior housing.

Assisted living facilities in New York provide housing and services to many older New Yorkers. According to the NYS Department of Health, the average age of assisted living residents is 78 years old. These individuals are spending anywhere from $1,500 to $6,500 per month for the accommodations.

Private pay facilities, though advertised as facilities where individuals can age in place, are neither licensed nor regulated by New York State. There are no requirements for disclosure to the public, no standardized contract language, and no consistency with regard to admission and discharge requirements. There is not even a clear definition of what constitutes assisted living.

AARP supports full licensure and regulation of assisted living and strong consumer protections for residents of these facilities.

Issue	Yes	No	Unclear
Regulation of assisted living facilities
Oversight of assisted living facilities
Consumer protections in assisted living facilities

Candidate Response: B. Thomas Golisano

Privately operated and financed assisted living facilities throughout New York State should meet minimum requirements for safe and adequate care. Better information about the performance of facilities will educate consumers as they make decisions about safety, comfort and staff qualifications. I support efforts to provide information and oversight for the consuming public, so that the market works to ensure that residents are receiving the care and support they need. However, I am concerned about the creation of additional, overlapping bureaucratic layers. Therefore, such oversight should principally focus on providing information to the consuming public about the level of care provided by privately operated and financed assisted living facilities.

Candidate Response: H. Carl McCall

I support regulation and oversight of assisted living facilities. The current Administration has failed to effectively respond to calls for state involvement in this rapidly emerging field. As a result, New York seniors do not have as many options or as much information as they should to make informed choices about their living arrangements. I would work with senior organizations and industry representatives to ensure that people who are in reasonably good health but are finding it difficult to live in their own homes have the opportunity to stay in New York. Together, we can offer a wide variety of assisted living options that meet seniors needs and keep them close to their families, while ensuring that they are safe and receiving quality care.

Candidate Response: George E. Pataki

I have twice submitted an “Assisted Living Reform Act,” to regulate assisted living facilities in NYS. The Legislature has failed to act on both occasions. I will continue to push for this strong and needed legislation. My proposed legislation will firmly establish these protections. Key elements of the plan would include:

- a Bill of Rights that would require background checks on the owners of the assisted living facilities,

- inspections by the Department to ensure that services are appropriately provided, and that residents’ rights are being protected and,

- a plain language consumer guide that provides clear and understandable consumer information to help prospective assisted living residents make sound choices about assisted living.

Question

Would you support the continuation of the EPIC program in spite of the total cost to the state? What specific recommendations would you make to ensure the continuation of the EPIC program even during difficult economic times? Would you support expansion of EPIC to individuals under sixty-five years of age?

AARP Response

Prescription drugs have become an increasingly important part of health care, especially for older persons and persons with disabilities. However, innovations in treatment have been accompanied by drastic increases in prescription drug costs for consumers.

New York State has one of the premiere prescription drug programs in the country. The Elderly Pharmaceutical Insurance Program (EPIC) provides comprehensive coverage for nearly 300,000 older New Yorkers. With the growth in enrollment, and the increasing costs of drugs, the cost of the EPIC program has reached $485 million. While the cost of the program has increased dramatically, EPIC remains a critical health care program for older New Yorkers.

AARP supports the continuation of EPIC without any reduction in the affordability of, or accessibility to the full range of necessary drugs.

Issue	Yes	No	Unclear
Continuation of EPIC
Expansion of EPIC to those under 65

Candidate Response: B. Thomas Golisano

The cost of prescription drugs constitutes the major medical expense for most seniors, and is one of the reasons for the need for EPIC. Rising drug costs driven by monopolistic drug companies possessing exclusive patent rights have corrupted the market’s prices and values. Affordability and value are no longer a part of the equation for seniors. One of my priorities will be to ensure that all seniors have access to the marketplace of quality medical care, and that monopoly influences are reduced. I will work to reduce the over-priced costs of prescription drugs by encouraging access and availability of safe generic alternatives, exploring purchasing options, and working with manufacturers on rebate programs, while ensuring the continuation of the EPIC program despite our state’s fiscal crisis.

Candidate Response: H. Carl McCall

We need to lower the cost of prescription drugs for New Yorkers, especially our seniors. I have a plan that will leverage the State’s purchasing clout to obtain price discounts on prescription drugs in government programs that cover 4 million people. Despite appearing in ads for EPIC, Governor Pataki repeatedly delayed needed expansion of the program. My plan will: cut out-of-pocket costs by 25 percent for seniors already in the EPIC program, producing average savings for seniors of about $100 a year; expand eligibility for the EPIC to income eligible residents between 55 and 64; and expand eligibility for the EPIC program to the disabled. At the same time, I will lobby for an expansion of Medicare to include prescription drug coverage.

Candidate Response: George E. Pataki

I enthusiastically support the continuation of EPIC for our seniors. EPIC has more than doubled in size in the one year since I signed the program improvements into law. We now have more than 290,000 enrollees. This clearly demonstrates the importance and the continued need for this program. New York seniors enrolled in EPIC on average save more than $1,700 each annually.

I would also consider expansion of the program to those under age 65 if a Medicare prescription benefit (which I strongly support) is established by Congress, relieving the State of some of its current EPIC costs, or if there is some other mechanism—such as a special waiver—that would allow the federal government to share in the costs of EPIC.