Special Projects Fund

Grantee Name

Foundation for Long Term Care, Inc.

Funding Area

Special Projects Fund

Publication Date

July 2016

Grant Amount


Grant Date:

October 2013 – March 2015

The six-county Eastern Adirondack region is a reflection of the aging trend currently unfolding in rural New York State: 14.8% of the region’s population is over the age of 65, with 9% of those having incomes at or below the poverty level.

With limited transportation, the expansive and rural geography of the region creates formidable challenges to developing, operating, and financially sustaining long-term care services and supports (LTCSS). As a medically underserved area, only four long-term home health care programs and eight certified home health care agencies serve the region.

In 2013, NYHealth awarded the Foundation for Long Term Care (FLTC) a grant to develop a multifaceted action plan to ensure access to a range of high-quality LTCSS. Under this grant, FLTC sought to establish and convene a core group of partner organizations to determine options for sharing and potentially integrating services and functions. The goal of the action plan was to effect organizational mergers and restructuring; reimbursement changes and regulatory modifications; quality improvement processes; and recommendations on statewide strategies to improve LTCSS.

Outcomes and Lessons Learned

  • Analyzed regional demographic trends, nursing home bed capacity, future bed needs, and availability of other types of LTCSS;
  • Developed the Long-Term Care Services Demand Model that estimates demand for five types of long-term care services in the Eastern Adirondack region: adult day health, assisted living, home health, personal care, and skilled nursing; and
  • Developed six policy recommendations and advanced these recommendations through the North County’s Delivery System Reform Incentive Payment (DSRIP) initiative:
    • Increase alternatives to nursing home services.
    • Address health care workforce availability and preparation for realigned service delivery.
    • Address other service infrastructure issues.
    • Expand the concept of villages for successful aging/medical villages.
    • Promote adoption of health information technology and exchange among LTCSS providers.

FLTC played a role in advancing legislation in support of a rural Medicaid rate add-on for long-term and post-acute care services. This add-on would enhance Medicaid funding for long-term care providers; address unique needs and challenges facing rural health care providers; and support infrastructure development for integrated care.

Based on FTLC’s recommendations, the State allocated $200 million in its 2016–17 budget for a program, jointly administered by the New York State Department of Health and Dormitory Authority State of New York, to make capital grants to replace inefficient and outdated facilities as part of a merger, consolidation, acquisition, or other restructuring activity intended to create a financially sustainable system of care. A minimum of $30 million is set aside for community-based providers, including home care agencies.

FLTC’s recommendations to efficiently use existing resources and consolidate the essential health, wellness, prevention, care coordination, and social programs required for successful aging also are being put to use. The Adirondack Health Institute Performing Provider System has selected a DSRIP project that will convert outdated or unneeded hospital capacity into a stand-alone emergency department/urgent care center. Three of the medical villages identified (Champlain Valley Physicians Hospital in Plattsburgh, Moses Ludington Hospital in Ticonderoga, and Glens Falls Hospital in Glens Falls) plan to use the new spaces as the center for each community’s coordinated health network, supporting service integration and providing a platform for primary care and behavioral health integration. These platforms have the potential to serve as the locus for offering other services, including those aimed at seniors and at individuals of all ages with disabilities.

Co-Funding and Additional Funds Leveraged: N/A