PRINTER'S NO. 1542
No. 1305 Session of 1983
INTRODUCED BY HOEFFEL, BARBER, WACHOB, BELOFF, IRVIS, MILLER,
McCALL, KASUNIC, TRUMAN, HARPER, MANDERINO, FATTAH, WIGGINS,
ITKIN, RICHARDSON, STUBAN, OLIVER, DeLUCA, SHOWERS, PISTELLA,
COHEN, STEIGHNER, RUDY, SEVENTY, ALDERETTE, MICHLOVIC,
F. E. TAYLOR, E. Z. TAYLOR, ANGSTADT, ZWIKL, SALOOM,
MICOZZIE, JOHNSON, GRUPPO, LASHINGER, FISCHER, J. L. WRIGHT,
MORRIS, HALUSKA, FREEMAN, PRESTON, MAIALE, CALTAGIRONE,
CLARK, COLE, BELFANTI, KUKOVICH, GALLAGHER, JAROLIN, RYBAK,
COY, KOSINSKI, CIMINI, MRKONIC, CIVERA, DOMBROWSKI, DAWIDA
AND PRATT, JUNE 29, 1983
REFERRED TO COMMITTEE ON HEALTH AND WELFARE, JUNE 29, 1983
AN ACT
1 To require the Department of Aging to provide home-based care as
2 an alternative to nursing home or other institutional care;
3 and making an appropriation.
4 The General Assembly of the Commonwealth of Pennsylvania
5 hereby enacts as follows:
6 Section 1. Short title.
7 This act shall be known and may be cited as the In-Home and
8 Community Services Act.
9 Sec. 2. Legislative findings and policy.
10 (a) Legislative findings.--The General Assembly finds as
11 follows:
12 (1) In-home and community services have not been
13 sufficiently available to many adults with long-term care
14 needs.
1 (2) Many adults with long-term care needs are at risk of
2 being or already have been placed in institutional settings
3 because in-home and community services or funds to pay for
4 these services have not been available to them.
5 (3) In some instances placement of adults with long-term
6 care needs in institutional settings can result in emotional
7 and social problems for these adults and their families.
8 (4) For many adults with long-term care needs, it may be
9 less costly for the Commonwealth to provide in-home and
10 community services than it is to provide care in
11 institutional settings.
12 (b) Policy.--The General Assembly declares it is the policy
13 of this Commonwealth that:
14 (1) The increased availability of in-home and community
15 services for adults with long-term care needs will enable
16 them to live in their own homes and communities.
17 (2) The priority recipients of in-home and community
18 services under this act shall be the elderly and physically
19 disabled adults who are at the greatest risk of being, or who
20 already have been, placed inappropriately in an institutional
21 setting.
22 (3) A variety of agencies, facilities and licensed or
23 certified individual practitioners should be encouraged to
24 provide in-home and community services.
25 Section 3. Definitions.
26 The following words and phrases when used in this act shall
27 have the meanings given to them in this section unless the
28 context clearly indicates otherwise:
29 "Adults with long-term care needs." Persons 65 years of age
30 and over and physically disabled, mentally alert, persons over
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1 18 years of age who have limitations which restrict their
2 ability to carry out activities of daily living and impede their
3 ability to live independently, or who are at risk of being, or
4 who already have been, placed inappropriately in an
5 institutional setting.
6 "Agreement." A contract, grant or other method of payment.
7 "Area agency on aging." An agency designated by the
8 Department of Aging to administer and develop an area plan for a
9 comprehensive and coordinated system of services for older
10 people within the boundaries of a defined planning and service
11 area.
12 "Department." The Department of Aging.
13 "In-home and community services." Health and social services
14 and other assistance required to enable adults with long-term
15 care needs to remain in their places of residence. The term
16 includes, but is not limited to, medical and diagnostic
17 services, professional nursing, physical, occupational and
18 speech therapy, dietary and nutrition services, home health aide
19 services, attendant care services, companion services, handyman,
20 chore and homemaker services, respite care, counseling services,
21 various devices which lessen the effects of disabilities and
22 other appropriate and necessary social services.
23 "Institutional settings." Boarding care facilities,
24 intermediate care and skilled nursing home facilities and
25 hospitals and State institutions.
26 "Provider." Any entity, agency, facility or individual which
27 or who meets standards developed by the department and which or
28 who offers or plans to offer any in-home or community services.
29 "Secretary. The Secretary of Aging.
30 Section 4. Programs.
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1 (a) Establishment.--The department shall develop and
2 establish under this act programs of preadmission assessment,
3 case management and in-home and community services for adults
4 with long-term care needs. The programs shall be administered by
5 area agencies on aging at the local level.
6 (b) Eligibility.--An adult with long-term care needs is
7 eligible for in-home and community services under this act if
8 the area agency on aging or its designee determines that the
9 adult:
10 (1) Is at risk of being or already has been placed
11 inappropriately in an institutional setting.
12 (2) Has a substantial need for in-home and community
13 services to enable him or her to live in his or her own home
14 and community.
15 (3) Has no or insufficient personal income or other
16 support from public services, family members and neighbors.
17 Section 5. Delivery of services.
18 (a) Agreements with providers.--In order to provide in-home
19 and community services, an area agency on aging may enter into
20 agreements with providers. Each agreement shall include at least
21 the number of clients to be served, the types of in-home and
22 community services to be provided, the cost of the services, the
23 method of payment and the criteria to be used for evaluating the
24 provisions of services.
25 (b) Solicitation of proposals.--The area agencies on aging
26 shall solicit proposals from providers who desire to provide in-
27 home and community services under this act. Providers shall
28 submit proposals in the form and manner required by the
29 department. The area agencies on aging shall select proposals
30 based on the criteria developed by the department.
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1 Section 6. Funding.
2 (a) Federal and private funds.--The department shall apply
3 for and use any Federal or private funds which become available
4 to carry out any program of in-home community services.
5 (b) Fee scale.--The department shall develop, wherever
6 practicable, a sliding fee scale for in-home and community
7 services provided.
8 (c) Disbursement of funds.--The department shall disburse
9 funds in a manner that ensures equitable distribution of
10 services among adults with long-term care needs and among the
11 various regions of the Commonwealth.
12 Section 7. Demonstration projects.
13 The department may initiate demonstration projects to test
14 new ways of providing in-home and community services, as well as
15 conduct specific research in ways to best provide community-
16 based services in both urban and rural environments.
17 Section 8. Rules or regulations.
18 The department shall promulgate such rules or regulations,
19 including those which specify the criteria to be used in ranking
20 proposals, as may be necessary for the effective administration
21 of any programs of in-home and community services under this
22 act.
23 Section 9. Report.
24 Prior to June 30, 1984, the secretary shall submit a report
25 to the legislative committees having jurisdiction over
26 appropriations and the legislative committees having
27 jurisdiction over health and welfare services. This report shall
28 include at least the following information regarding in-home and
29 community services:
30 (1) An overview of the types, cost and clients of in-
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1 home and community services in this Commonwealth.
2 (2) A summary of the types, cost and clients of the in-
3 home and community services under this act.
4 (3) A comparative analysis of the costs of in-home and
5 community services compared to the cost of services provided
6 in institutional settings.
7 (4) Recommendations regarding the direction of and
8 funding priorities for in-home and community services for
9 adults with long-term care needs in fiscal years 1984-1985
10 and 1985-1986.
11 (5) An analysis of the feasibility and desirability of
12 using funds under the Social Security Act (42 U.S.C. § 301 et
13 seq.), as amended, and under other Federal programs for
14 attendant care services and other in-home and community
15 services.
16 Section 10. Appropriation.
17 The sum of $50,000,000 is hereby appropriated to the
18 Department of Aging from the State Lottery Fund to carry out the
19 purposes of this act.
20 Section 11. Effective date.
21 This act shall take effect immediately.
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