New York: New York Senate, District 41

Candidates

Paul T. Reagan, Democrat
Stephen M. Saland, 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: Paul T. Reagan

The term itself seems antiquated and unfair. Many of them are likely substandard in my estimation. State guidelines and Health Dept. requirements tend to apply the least influence to improve services until there is a tragic or near fatal incident in the operation of the lowest level of nursing home care, estimated at 676 homes by AARP. More statewide oversight is necessary. Staffing standards are necessary. Funded programs to survey the problems are absolutely necessary. NYS needs an ombudsman to oversee the problems apart from the Department of Health; and, to serve as an advocate for the frail elderly who are the most likely to be victims. Fines need to be made public and surveys need to be reviewed regularly by the NYS Legislature.

Candidate Response: Stephen M. Saland

I would support legislation to create nursing home report cards and to use fines collected from nursing homes to support quality improvement initiatives. Any violation that endangers a patient’s health and safety needs to be dealt with swiftly and strongly. I believe, however, that the application of fines should be done in a judicious manner—the fine being commensurate with the violation. If the problem is occurring in a nursing home that is financially struggling, taking more money out of the home could prove contrary to the goal of improving conditions. Absent significant quality of life violations, compliance should be preferred over closure.

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: Paul T. Reagan

I support all measures intended to assure the safety and security of those in assisted living facilities. There needs to be a full review of all State certified facilities for the safety and well being of all those being cared for in private and public and not for profit facilities. Social protection is the major concern here for all groups. Written contracts is a good initial measure followed by periodic assessments conducted at the county level. Joint efforts between the State and county to assure that these protections are in place should be a first task of the “new” State Senate in 2003.

Candidate Response: Stephen M. Saland

I support legislation that would provide for the regulatory oversight of currently unregulated private pay assisted living facilities. I am a co-sponsor of S.5382-A which would provide oversight of these facilities and important consumer protections. It is important that any legislation enacted to provide oversight contain consumer protections such as: a description of the services to be provided which are included in the base rate; a fee schedule spelling out the additional costs for services not included in the base rate; the process for changing or terminating the agreement on the part of the resident and on the part of the facility; procedures for discharge; the contract should be in plain language and readable print.

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: Paul T. Reagan

Should NYS continue EPIC’s costs in 2003? EPIC applies to the community who can afford the cost of premiums and has a fairly stable (yet costly) need for medications. Far more economy is possible for a greater number of eligible seniors if the State of New York utilizes its appreciable influence in the market place to reduce brand name prescription medicines to lessen costs or greater availability for all those now eligible for Medicare. Generic medicines are absolutely necessary for everyone needing to economize. Enabling legislation to encourage sale and production of generic medications through an enlarged EPIC Medicare eligibility would assist many who must decide which one of many necessary prescriptions must first be filled.

Candidate Response: Stephen M. Saland

I support continuation of the EPIC Program, notwithstanding state fiscal difficulties. Due to continued fiscal difficulties I do not believe, however, further expansion of the program can be realistically expected at this time. For SFY 2002-03, NYS is expected to expend $485 million for the EPIC Program. As of August 2002, there are over 290,000 enrollees and growing. But we also know we have not reached all the current eligible people. I think we need to do more outreach to reach the current targeted group the program is designed for before considering more changes. My Senate colleagues and I worked hard to bring about a dramatic expansion of EPIC in 2000 which took effect on January 1, 2001. At that time, there were 154,380 enrollees.