PRINTER'S NO. 519
No. 460 Session of 1985
INTRODUCED BY KUKOVICH, LASHINGER, IRVIS, MARKOSEK, BOYES,
O'DONNELL, HALUSKA, LINTON, HERMAN, D. R. WRIGHT, KOSINSKI,
AFFLERBACH, E. Z. TAYLOR, DALEY, OLIVER, VAN HORNE, FATTAH,
DEAL, PRATT, COHEN, DAWIDA, CARN, PRESTON, PISTELLA, MORRIS,
D. W. SNYDER, STABACK, HOWLETT, MAIALE, FISCHER, TELEK, ARTY,
PRESSMANN, HARPER, BELFANTI, BELARDI, SEVENTY, DeLUCA,
KASUNIC, NAHILL, LIVENGOOD, PETRARCA, ITKIN, SAURMAN, BLAUM,
SHOWERS, MICHLOVIC, FREEMAN, COLAFELLA, TRELLO, JOSEPHS AND
FOX, FEBRUARY 27, 1985
REFERRED TO COMMITTEE ON HEALTH AND WELFARE, FEBRUARY 27, 1985
AN ACT
1 To require the Department of Aging to provide on a demonstration
2 basis home-based care as an alternative to nursing home or
3 other institutional care; 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 Section 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.
15 (2) Many adults with long-term care needs are at risk of
1 being or already have been placed in institutional settings
2 because in-home and community services or funds to pay for
3 these services have not been available to them.
4 (3) In some instances placement of adults with long-term
5 care needs in institutional settings can result in emotional
6 and social problems for these adults and their families.
7 (4) For many adults with long-term care needs, it may be
8 less costly for the Commonwealth to provide in-home and
9 community services than it is to provide care in
10 institutional settings.
11 (b) Policy.--The General Assembly declares it is the policy
12 of this Commonwealth that:
13 (1) The increased availability of in-home and community
14 services for adults with long-term care needs will enable
15 them to live in their own homes and communities.
16 (2) The priority recipients of in-home and community
17 services under this act shall be the elderly and physically
18 disabled adults who are at the greatest risk of being, or who
19 already have been, placed inappropriately in an institutional
20 setting.
21 (3) A variety of agencies, facilities and licensed or
22 certified individual practitioners should be encouraged to
23 provide in-home and community services to which end the
24 General Assembly proposes to conduct a demonstration program
25 for in-home and community services.
26 Section 3. Definitions.
27 The following words and phrases when used in this act shall
28 have the meanings given to them in this section unless the
29 context clearly indicates otherwise:
30 "Adults with long-term care needs." Persons 65 years of age
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1 and over and physically disabled, mentally alert, persons over
2 18 years of age who have limitations which restrict their
3 ability to carry out activities of daily living and impede their
4 ability to live independently, or who are at risk of being, or
5 who already have been, placed inappropriately in an
6 institutional setting.
7 "Agreement." A contract, grant or other method of payment.
8 "Area agency on aging." An agency designated by the
9 Department of Aging to administer and develop an area plan for a
10 comprehensive and coordinated system of services for older
11 people within the boundaries of a defined planning and service
12 area.
13 "Department." The Department of Aging of the Commonwealth.
14 "In-home and community services." Health and social services
15 and other assistance required to enable adults with long-term
16 care needs to remain in their places of residence. The term
17 includes, but is not limited to, medical and diagnostic
18 services, professional nursing, physical, occupational and
19 speech therapy, dietary and nutrition services, home health aide
20 services, attendant care services, companion services, handyman,
21 chore and homemaker services, respite care, counseling services,
22 various devices which lessen the effects of disabilities and
23 other appropriate and necessary social services.
24 "Institutional settings." Boarding care facilities,
25 intermediate care and skilled nursing home facilities and
26 hospitals and State institutions.
27 "Provider." Any entity, agency, facility or individual which
28 or who meets standards developed by the department and which or
29 who offers or plans to offer any demonstration in-home or
30 community services.
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1 "Secretary." The Secretary of Aging of the Commonwealth.
2 Section 4. Demonstration programs.
3 (a) Establishment.--The department shall develop and
4 establish under this act demonstration programs of preadmission
5 assessment, case management and in-home and community services
6 for adults with long-term care needs. The demonstration programs
7 shall be administered by area agencies on aging at the local
8 level.
9 (b) Eligibility.--An adult with long-term care needs is
10 eligible for the demonstration in-home and community services
11 under this act if the area agency on aging, or its designee,
12 determines that the adult:
13 (1) Is at risk of being or already has been placed
14 inappropriately in an institutional setting.
15 (2) Has a substantial need for in-home and community
16 services to enable him or her to live in his or her own home
17 and community.
18 (3) Has no or insufficient personal income or other
19 support from public services, family members and neighbors.
20 Section 5. Delivery of services.
21 (a) Agreements with providers.--In order to provide
22 demonstration in-home and community services, an area agency on
23 aging may enter into agreements with providers. Each agreement
24 shall include at least the number of clients to be served, the
25 types of in-home and community services to be provided on a
26 demonstration basis, the cost of the services, the method of
27 payment and the criteria to be used for evaluating the
28 provisions of services.
29 (b) Solicitation of proposals.--The area agencies on aging
30 shall solicit proposals from providers who desire to provide in-
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1 home and community services on a demonstration basis under this
2 act. Providers shall submit proposals in the form and manner
3 required by the department. The area agencies on aging shall
4 select proposals based on the criteria developed by the
5 department.
6 Section 6. Funding.
7 (a) Federal and private funds.--The department shall apply
8 for and use any Federal or private funds which become available
9 to carry out any demonstration program of in-home and community
10 services.
11 (b) Fee scale.--The department shall develop, wherever
12 practicable, a sliding fee scale for the demonstration in-home
13 and community services provided.
14 (c) Disbursement of funds.--The department shall disburse
15 funds in a manner that ensures equitable distribution of
16 services among adults with long-term care needs and among the
17 various regions of the Commonwealth.
18 Section 7. Demonstration projects.
19 The department may initiate additional demonstration projects
20 to test new ways of providing in-home and community services, as
21 well as conduct specific research in ways to best provide
22 community-based services in both urban and rural environments.
23 Section 8. Rules and regulations.
24 The department shall promulgate such rules and regulations,
25 including those which specify the criteria to be used in ranking
26 proposals, as may be necessary for the effective administration
27 of any demonstration programs of in-home and community services
28 under this act.
29 Section 9. Report.
30 Prior to June 30, 1985, the secretary shall submit a report
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1 to the legislative committees having jurisdiction over
2 appropriations and the legislative committees having
3 jurisdiction over health and welfare services. This report shall
4 include at least the following information regarding the
5 demonstration in-home and community services authorized by this
6 act:
7 (1) An overview of the types, cost and clients of in-
8 home and community services in this Commonwealth.
9 (2) A summary of the types, cost and clients of the in-
10 home and community services under this act.
11 (3) A comparative analysis of the costs of in-home and
12 community services compared to the cost of services provided
13 in institutional settings.
14 (4) Recommendations regarding the direction of and
15 funding priorities for in-home and community services for
16 adults with long-term care needs in fiscal years 1985-1986
17 and 1986-1987.
18 (5) An analysis of the feasibility and desirability of
19 using funds under the Social Security Act (42 U.S.C. § 301 et
20 seq.), as amended, and under other Federal programs for
21 attendant care services and other in-home and community
22 services.
23 Section 10. Appropriation.
24 The sum of $25,000,000 is hereby appropriated to the
25 Department of Aging from the State Lottery Fund to implement the
26 demonstration programs for in-home and community services and to
27 carry out the purposes of this act.
28 Section 11. Effective date.
29 This act shall take effect immediately.
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