DOH NEWS

State of New York
Department of Health

ALBANY, June 28, 2002 – State Health Commissioner Antonia C. Novello, M.D., M.P.H., Dr.P.H. said that with the return of summer’s sweltering heat and humidity, the New York State Department of Health recently sent inspectors into 28 licensed Adult Care Facilities (ACFs) in the New York City Metropolitan area to ensure compliance with indoor temperature regulations.

The Department, the Commission on Quality Care for the Mentally Disabled (CQC) and the Office of Mental Health (OMH) are also working with the New York State Energy Research and Development Authority (NYSERDA) to provide ACFs with assistance to quickly purchase air conditioners. The 28 facilities reviewed were identified based upon previous physical plant inspections by State staff. The Department is monitoring all adult care facilities throughout the state and will conduct unannounced visits to monitor compliance with indoor temperature procedures and to ensure the health and safety of the residents.

"The high temperatures and humidity levels during the summer months pose a health risk for anyone who doesn’t take the proper precautions. This is particularly true of our residents in adult care facilities, " Dr. Novello said. "We conducted this aggressive round of visits to ensure that adult homes have heat policies in place and are following them to protect the residents of those facilities. We look forward to partnering with NYSERDA to help administrators maintain comfortable temperatures in their facilities."

James L. Stone, Commissioner of the Office of Mental Health said, "It’s important for adult homes to maintain reasonable temperatures not only to ensure the comfort of the residents, but also to ensure their health and safety. Individuals on psychotropic medications often have adverse reactions to high temperatures, and are vulnerable to other heat-related illnesses."

Gary O'Brien, Chairman of the Commission on Quality Care for the Mentally Disabled said, "The Commission is pleased with the Department of Health's action to ensure comfortable temperatures for residents within adult homes given the recent extreme heat conditions. Under Governor Pataki's leadership, New York is doing more than ever to protect adult home residents, who represent some of our state's most vulnerable citizens."

The New York State Energy Research and Development Authority (NYSERDA) is working with the Department of Health, CQC and OMH to help adult home operators ensure the health and safety of residents by providing incentives for the expedited purchase of Energy Star air conditioners, and also providing low-interest loans where needed for larger purchases. The Authority has also written operators offering technical and financial assistance for larger energy efficiency projects to help lower costs.

"NYSERDA is pleased to be working with the Department of Health to help ensure the safety and comfort of the State’s adult home population," said NYSERDA President William M. Flynn. " Working together, we can increase resident safety and comfort, while helping operators lower their energy costs."

In addition to ordering the reviews, Dr. Novello sent a package of information to ACF administrators that contained a list of steps that must be followed to ensure the comfort, health and safety of ACF residents, a list of medications that may cause residents to become more susceptible to heat, rebate options available from NYSERDA in the purchasing of air conditioners, and a list of signs and symptoms of heat illness.

Those steps include:

Steps to be taken by Adult Care Facilities

High heat and elevated temperatures can have a significant impact on residents in adult care facilities, including the elderly and those taking various medications. The New York State Department of Health requires that every adult care facility:

• Identify all facility residents at risk of heat-related illness or problems;
• Have a formal heat policy and ensure that staff is aware of and understands such policy;
• Activate the heat policy when the outside temperature reaches 80 degrees;
• Have cooled areas within the facility where residents can be safely accommodated; and,
• Monitor residents and conditions within the facility.

In fulfilling these requirements, there are four key steps that must be taken by all facilities:

• Adult care facilities must identify all residents at risk of heat illness, including those that use medications which may cause added sensitivity to heat, that engage in physical activity, or are obese or have other conditions that increase sensitivity to heat.
• Adult care facilities must monitor temperatures within the facility. Temperatures should be taken:

• Inside the facility every hour when the outside temperature is 80 degrees
• The temperature should be taken in non-air conditioned rooms at several locations on each floor, and should be taken within the room closest to where sunlight enters. The temperature readings should be recorded in a log that includes the time, room location of the reading, and the name of the recorder.
• In common areas, both air conditioned and non-air conditioned, the temperature should be taken every hour when the outside temperature is above 80 degrees. The temperature readings should be recorded in a log that includes the time, room location of the reading and the name of the recorder.

• In adult care facilities without individual air conditioned rooms, the facility must identify common areas that are cooler than 85 degrees so that residents can be located there in accordance with the facility heat policy. Common areas must be of sufficient size to safely accommodate the residents in the facility.
• If the resident exhibits any sign or symptom of heat illness, the facility must call 911 or a physician immediately and follow appropriate procedures, including: moving the resident to a cooler location; if the resident is conscious, offering cool fluids; and removing clothing to cool the resident.

High Heat Condition Checklist

The following checklist identifies a number of steps that facilities should follow during periods of high heat and elevated temperatures. At a minimum, all of these steps should be included in a facility’s heat policy. The policy should take effect when the outside temperature reaches 80 degrees.

• Monitor residents for signs and symptoms of heat illness.
• Notify the physician of observations and obtain medical treatment when needed.
• Utilize ventilation, air circulation and air conditioning.
• Close windows and blinds/shades on sun-exposed walls, open windows on shaded walls, turn off heat generating devices.
• Assure adequate availability and ensure that residents drink fluids, i.e., water and fruit juices.
• Adjust menus, incorporating cold plates and other light foods.
• Encourage residents to stay out of the sun.
• Monitor residents engaged in physical activities.
• Move residents to cooler rooms.
• Make sure residents dress appropriately.
• Review the policies and procedures for heat emergency situations with staff periodically.
• Implement your emergency procedures if temporary relocation becomes necessary.

The 28 adult care facilities reviewed by the Department of Health follow:

1. Brooklyn Manor
2. Parkview Home for Adults
3. Riverdale Manor
4. Green Briar Adult Home
5. Kings Heights Rest Home
6. Monticello Manor
7. Roscoe Manor
8. Park Lake
9. Bablyon Manor
10. Seaport Manor
11. Garden of Eden Home
12. Park Manor
13. Elm York Home
14. King Solomon Manor
15. Sanford House
16. Lakeside Manor
17. Spring Valley Rest Home
18. Swedish Manor
19. Bayview Manor
20. Oceanview Manor
21. Surf Manor
22. New Central Manor
23. New Haven Manor
24. Ocean House
25. Park Inn
26. Rockaway Manor
27. Seaview Manor
28. Wave Crest

6/28/02—67 OPA