PRIOR PRINTER'S NO. 519 PRINTER'S NO. 1174
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 26, 1985
AS REPORTED FROM COMMITTEE ON HEALTH AND WELFARE, HOUSE OF
REPRESENTATIVES, AS AMENDED, APRIL 24, 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.
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 (3) MOST CARE PROVIDED FOR ADULTS WITH LONG-TERM CARE <--
9 NEEDS IS DELIVERED BY FAMILY MEMBERS OR FRIENDS WHO ARE NOT
10 COMPENSATED FOR THEIR SERVICES. FAMILY INVOLVEMENT IS A
11 CRUCIAL ELEMENT FOR AVOIDING OR POSTPONING
12 INSTITUTIONALIZATION FOR MANY DISABLED ADULTS.
13 (4) FAMILY OR OTHER CAREGIVERS WHO PROVIDE CONTINUOUS
14 CARE IN THE HOME ARE FREQUENTLY UNDER SUBSTANTIAL PHYSICAL,
15 PSYCHOLOGICAL AND FINANCIAL STRESS. IF UNRELIEVED BY
16 COMMUNITY SUPPORT TO THE CAREGIVER, THIS STRESS MAY LEAD TO
17 PREMATURE OR UNNECESSARY INSTITUTIONALIZATION.
18 (5) IN-HOME AND COMMUNITY SERVICES FOR THE DISABLED
19 ADULT AND CAREGIVER COULD RELIEVE SOME OF THE STRESS,
20 MAINTAIN AND STRENGTHEN THE FAMILY STRUCTURE, AND POSTPONE OR
21 PREVENT INSTITUTIONALIZATION.
22 (4) (6) For many adults with long-term care needs, it <--
23 may be less costly for the Commonwealth to provide in-home
24 and community services than it is to provide care in
25 institutional settings.
26 (b) Policy.--The General Assembly declares it is the policy
27 of this Commonwealth that:
28 (1) The increased availability of in-home and community
29 services for adults with long-term care needs will enable <--
30 them MANY ADULTS WITH LONG-TERM CARE NEEDS to live in their <--
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1 own homes and communities.
2 (2) THE INCREASED AVAILABILITY OF IN-HOME AND COMMUNITY <--
3 SERVICES WILL ASSIST FAMILIES AND FRIENDS IN THEIR EFFORTS TO
4 KEEP ADULTS WITH LONG-TERM CARE NEEDS OUT OF INSTITUTIONS.
5 (2) (3) The priority recipients of in-home and community <--
6 services under this act shall be the elderly and physically
7 disabled adults who are at the greatest risk of being, or who
8 already have been, placed inappropriately in an institutional
9 setting.
10 (3) (4) A variety of agencies, facilities and licensed <--
11 or certified individual practitioners should be encouraged to
12 provide in-home and community services to which end the
13 General Assembly proposes to conduct a demonstration <--
14 AUTHORIZE A program for in-home and community services. <--
15 Section 3. Definitions.
16 The following words and phrases when used in this act shall
17 have the meanings given to them in this section unless the
18 context clearly indicates otherwise:
19 "Adults with long-term care needs." Persons 65 years of age
20 and over, PERSONS SUFFERING FROM ALZHEIMER'S DISEASE OR OTHER <--
21 CHRONIC DEGENERATIVE BRAIN DISORDERS, and physically disabled,
22 mentally alert, persons over 18 years of age who have
23 limitations which restrict their ability to carry out activities
24 of daily living and impede their ability to live independently,
25 or who are at risk of being, or who already have been, placed
26 inappropriately in an institutional setting.
27 "Agreement." A contract, grant or other method of payment.
28 "Area agency on aging." An agency designated by the
29 Department of Aging to administer and develop an area plan for a
30 comprehensive and coordinated system of services for older
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1 people within the boundaries of a defined planning and service
2 area.
3 "Department." The Department of Aging of the Commonwealth.
4 "In-home and community services." Health and social services
5 and other assistance required to enable adults with long-term
6 care needs to remain in their places of residence. The term
7 includes, but is not limited to, medical and diagnostic
8 services, professional nursing, physical, occupational and
9 speech therapy, dietary and nutrition services, home health aide
10 services, attendant care services, companion services, DAY CARE, <--
11 handyman, chore and homemaker services, respite care, counseling
12 services, various devices which lessen the effects of
13 disabilities and other appropriate and necessary social
14 services.
15 "Institutional settings." Boarding PERSONAL CARE BOARDING <--
16 HOMES AND OTHER RESIDENTIAL care facilities, intermediate care
17 and skilled nursing home facilities and hospitals and State
18 institutions.
19 "Provider." Any entity, agency, facility or individual which
20 or who meets standards developed by the department and which or
21 who offers or plans to offer any demonstration in-home or <--
22 community services.
23 "Secretary." The Secretary of Aging of the Commonwealth.
24 Section 4. Demonstration programs PROGRAMS. <--
25 (a) Establishment.--The department shall develop and
26 establish under this act demonstration programs of preadmission <--
27 assessment, case management and in-home and community services
28 for adults with long-term care needs. The demonstration programs <--
29 shall be administered by area agencies on aging at the local
30 level.
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1 (b) Eligibility.--An adult with long-term care needs is
2 eligible for the demonstration in-home and community services <--
3 under this act if the area agency on aging, or its designee,
4 determines that the adult:
5 (1) Is at risk of being or already has been placed
6 inappropriately in an institutional setting.
7 (2) Has a substantial need for in-home and community
8 services to enable him or her to live in his or her own home
9 and community.
10 (3) Has no or insufficient personal income or other <--
11 INSUFFICIENT support from public services, family members and <--
12 neighbors TO MEET ADULT LONG-TERM NEEDS. <--
13 Section 5. Delivery of services.
14 (a) Agreements with providers.--In order to provide
15 demonstration in-home and community services, an area agency on <--
16 aging may enter into agreements with providers. Each agreement
17 shall include at least the number of clients to be served, the
18 types of in-home and community services to be provided on a <--
19 demonstration basis, the cost of the services, the method of
20 payment and the criteria to be used for evaluating the
21 provisions of services.
22 (b) Solicitation of proposals.--The area agencies on aging
23 shall solicit proposals from providers who desire to provide in-
24 home and community services on a demonstration basis under this <--
25 act. Providers shall submit proposals in the form and manner
26 required by the department. The area agencies on aging shall
27 select proposals based on the criteria developed by the
28 department.
29 Section 6. Funding.
30 (a) Federal and private funds.--The department shall apply
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1 for and use any Federal or private funds which become available
2 to carry out any demonstration program of in-home and community <--
3 services.
4 (b) Fee scale.--The department shall develop, wherever
5 practicable, a sliding fee scale for the demonstration in-home <--
6 and community services provided.
7 (c) Disbursement of funds.--The department shall disburse
8 funds in a manner that ensures equitable distribution of
9 services among adults with long-term care needs and among the
10 various regions of the Commonwealth.
11 (D) LIMITATION.--IN-HOME AND COMMUNITY SERVICES SHALL BE <--
12 AVAILABLE ONLY TO THE EXTENT THAT THEY ARE FUNDED THROUGH ANNUAL
13 APPROPRIATIONS AND PROGRAM INCOME.
14 Section 7. Demonstration projects.
15 The department may initiate additional RESEARCH AND <--
16 demonstration projects to test new ways of providing in-home and
17 community services, as well as conduct specific research in <--
18 EVALUATION OF ways to best provide community-based services in <--
19 both urban and rural environments.
20 Section 8. Rules and regulations.
21 The department shall promulgate such rules and regulations,
22 including those which specify the criteria to be used in ranking
23 proposals, as may be necessary for the effective administration
24 of any demonstration programs of in-home and community services <--
25 under this act.
26 Section 9. Report.
27 Prior to June 30, 1985 ONE YEAR AFTER THE EFFECTIVE DATE OF <--
28 THIS ACT, the secretary shall submit a report to the legislative
29 committees having jurisdiction over appropriations and the
30 legislative committees having jurisdiction over health and
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1 welfare services. This report shall include at least the
2 following information regarding the demonstration in-home and <--
3 community services authorized by this act:
4 (1) An overview of the types, cost and clients of in-
5 home and community services in this Commonwealth.
6 (2) A summary of the types, cost and clients of the in-
7 home and community services under this act.
8 (3) A comparative analysis of the costs of in-home and
9 community services compared to the cost of services provided
10 in institutional settings.
11 (4) Recommendations regarding the direction of and
12 funding priorities for in-home and community services for
13 adults with long-term care needs in fiscal years 1985-1986
14 and 1986-1987.
15 (5) An analysis of the feasibility and desirability of
16 using funds under the Social Security Act (42 U.S.C. § 301 et
17 seq.), as amended, and under other Federal programs for
18 attendant care services and other in-home and community
19 services.
20 Section 10. Appropriation.
21 The sum of $25,000,000 is hereby appropriated to the
22 Department of Aging from the State Lottery Fund FOR FISCAL YEAR <--
23 JULY 1, 1985, TO JUNE 30, 1986, to implement the demonstration <--
24 programs for in-home and community services and to carry out the
25 purposes of this act.
26 Section 11. Effective date.
27 This act shall take effect immediately.
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