New York: New York Assembly, District 4

Candidates

Steven Englebright, Democrat
Nicholas S. Klissas, 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: Steven Englebright

Yes, I support legislation to require the DOH to create nursing home report cards and use fines collected to support quality improvement initiatives in those same facilities. I am currently a co-sponsor of A.4171 (Gottfried, Englebright) which establishes minimum staffing levels of types of various personnel in nursing homes throughout any particular day; creates the advisory council on nursing home staffing to make recommendations to the governor, legislature and commissioner of health on nursing home staffing; requires public disclosure by each nursing home of its staffing levels and reporting thereof to the department of health. I will also support such a bill as outlined in the above question.

Candidate Response: Nicholas S. Klissas

I support the creation of Nursing Home Report Cards, which would enable people to compare facilities according to clear and objective criteria. Selecting a skilled nursing facility for my father was a very difficult decision to make. A nursing home report card would have helped our family, and my mother in particular, in making an informed choice during a very trying time. I support the use of monies collected by fines to improve the quality of care in nursing homes. Regulations concerning the imposition of fines must be carefully crafted so that they serve as an inducement to improve the operation of nursing homes for residents, and not as a source of funding to promote any particular political party’s agenda.

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: Steven Englebright

Yes, I support state oversight of Assisted Living residences and I am the prime sponsor of such legislation—A.9266-B. The key consumer protection elements include:

• Requiring every assisted living residence to be licensed or registered with the Department of Health (DOH);
  
  
• Development of a care plan for each admitted resident;
  
  
• A Resident’s Bill of Rights;
  
  
• Strict guidelines over an operator who controls a resident’s money, property or things of value;
  
  
• Maintenance of resident councils and family councils;
  
  
• Protections against the involuntary discharge of residents;
  
  
• A consumer information guide to assist seniors in selecting an assisted living residence;
  
  
• Regular and unannounced DOH inspection of licensed assisted living residences;
  
  
• Establishment of an Assisted Living Residence Quality Oversight Fund.
  
  

Candidate Response: Nicholas S. Klissas

The creation of a regulatory and oversight regime covering assisted living communities should be carefully considered so that it serves a clear purpose. All too often, in our rush to regulate certain industries and sectors of the economy, government creates a lot of red tape and burdens us with paperwork that adds costs and provides little benefit.

With respect to assisted living, certain minimum standards would appear to be in order, such as:

• Building and fire code compliance, including minimum room sizes per resident,
  
  
• Availability of emergency medical professionals, whether on site or nearby,
  
  
• Training of support staff in first aid,
  
  
• Sanitation/cleanliness requirements,
  
  
• Food safety and nutrition,
  
  
• Group activities.
  
  

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: Steven Englebright

I wholeheartedly support the continuation and expansion of the EPIC program. EPIC may be the most cost effective program in the state as nearly every dollar spent goes to subsidize essential medications of fixed income seniors. Beginning in 1987, New York’s EPIC program has already survived “difficult economic times.” In short this program is as permanent as any state program and to date has only been expanded. Currently EPIC has over 288,000 state residents enrolled and I predict its maintenance and expansion will continue to be one of the highest priorities of the Assembly majority. Yes, I have supported the expansion of EPIC including handicapped seniors who have not yet reached sixty-five.

Candidate Response: Nicholas S. Klissas

We owe the senior citizens of Suffolk County a break. Suffolk is one of the highest cost counties in New York, yet the way the EPIC program is now determined many seniors in Suffolk cannot qualify because of income threshold requirements that may be reasonable Upstate, but not here in Suffolk County. We have many seniors here in Suffolk who do not have enough to make ends meet, yet cannot obtain EPIC coverage. This is wrong; our seniors should not be forced into making heartbreaking decisions, like having to forego vital medication in order to pay for food bills, utilities, or rent. I have proposed an “EPIC Extra” plan that would extend prescription drug benefits to all seniors in New York State, regardless of income.