1Providing for the powers and duties of the Department of Aging
2and area agencies on aging and for annual review of care
3plans; requiring criminal background checks and communicable
4disease screenings of certain providers; prohibiting certain
5provider financial interests; and providing for consumer
6telephone access and for procedures for noncompliance.

7The General Assembly of the Commonwealth of Pennsylvania
8hereby enacts as follows:

9Section 1.  Short title.

10This act shall be known and may be cited as the Home and
11Community-Based Services Accountability Act.

12Section 2.  Definitions.

13The following words and phrases when used in this act shall
14have the meanings given to them in this section unless the
15context clearly indicates otherwise:

16"Area agency on aging."  The single local agency designated 
17by the Department of Aging within each planning and service area 
18to administer the delivery of a comprehensive and coordinated 
19plan of social and other services and activities.

1"Care manager."  A staff member at a local area agency on 
2aging who is assigned to write and maintain a care plan for each 
3consumer and to comply with responsibilities and duties as set 
4forth in procedures established by the Department of Aging.

5"Care plan."  A plan written by a care manager, developed in 
6collaboration and consultation with a consumer, which addresses 
7the consumer's needs and the services necessary to address those 
8needs.

9"Consumer."  An individual who:

10(1)  Is at least 60 years of age.

11(2)  Receives home and community-based services through
12the Department of Aging waiver.

13(3)  Is assessed as nursing facility clinically eligible.

14"Consumer representative."  An individual designated by a 
15consumer to act on behalf of the consumer.

16"Department."  The Department of Aging of the Commonwealth.

17"Employee."  An individual who is paid by a provider to 
18provide home and community-based services to a consumer. The 
19term includes a contract employee who has direct contact with a 
20consumer or unsupervised access to the personal living quarters 
21of a consumer.

22"Home and community-based services."  Services provided in a 
23person's home or at a location in the community to assist 
24consumers to function as independently as possible.

25"Nursing facility clinically eligible" or "NFCE."  An 
26individual who requires health-related care and services because 
27the individual's physical condition necessitates care and 
28services that can be provided in the community with home and 
29community-based services or in a nursing facility.

30"Other individual."  Any person who:

1(1)  Is not a consumer.

2(2)  Is at least 18 years of age.

3(3)  Has direct contact with a consumer and provides home
4and community-based services on behalf of an employee.

5"Provider."  A medical assistance certified entity 
6responsible for payroll management and disbursement activities. 
7The term includes a private payroll company, an area agency on 
8aging, a medical assistance services provider and a Department 
9of Public Welfare attendant care provider currently providing 
10this service to Department of Public Welfare attendant care 
11waiver consumers.

12"State police."  The Pennsylvania State Police.

13"Waiver."  A Medicaid home and community-based services 
14waiver granted by the Centers for Medicaid and Medicare Services 
15to the Department of Public Welfare, under the authority of 
16section 1915(c) of the Social Security Act (49 Stat. 620, 42 
17U.S.C. § 301 et seq.).

18Section 3.  General duties of area agencies on aging.

19An area agency on aging providing services under a waiver
20shall:

21(1)  Retain overall responsibility to ensure that care
22management of consumers is competently provided to consumers
23in accordance with department standards and the care plan.

24(2)  Coordinate supportive services needed to promote and
25maintain consumer independence and monitor consumers by using
26consumer contact plans developed and administered through the
27area agency on aging.

28Section 4.  Care plan home visits.

29A care plan shall include provisions for a private, physical,
30face-to-face home visit by the care manager with the consumer,

1without the presence of an employee or other individual, unless
2the consumer requests the presence of a relative, a close friend
3or a person who has the legal authority to represent the
4consumer's interests. The frequency of the visits shall be based
5on the consumer's acuity level as outlined in the consumer's
6contact plan. At least one home visit per year shall be
7conducted on an unannounced basis. The home visit may also
8include a registered nurse whose responsibility shall be to
9monitor the health of the consumer.

10Section 5.  Annual review of care plan.

11In accordance with procedures established by the department
12for home and community-based services, an area agency on aging
13shall maintain on file a care plan for each consumer that is
14reviewed and signed every six months by the consumer or the
15consumer representative, care manager, care manager's supervisor
16and a registered nurse. The care manager shall determine the
17type and frequency of contact with a consumer based upon the
18degree of consumer impairment and the involvement needed to
19ensure the effectiveness and stability of the care plan.

20Section 6.  Criminal background checks.

21(a)  General rule.--Prior to provision of services under a 
22waiver, a provider shall, at its own expense, ensure that any 
23employee or other individual meets the requirements of Chapter 5 
24of the act of November 6, 1987 (P.L.381, No.79), known as the 
25Older Adults Protective Services Act, regarding criminal 
26history. For the purposes of this section, a provider shall be 
27deemed a facility in accordance with Chapter 5 of the Older 
28Adults Protective Services Act.

29(b)  Employees and other individuals.--

30(1)  For any employee or other individual continuing to

1provide waiver services, a provider shall comply with
2subsection (a) every five years from the initial date of the
3report.

4(2)  For any employee or other individual who provides
5services under a waiver on the effective date of this
6section, a provider shall comply with subsection (a) within
7one year.

8Section 7.  Communicable disease screenings.

9(a)  General rule.--Prior to provision of services under a
10waiver, a provider shall, at its own expense, obtain
11documentation as required under subsection (c) for any employee
12and any other individual.

13(b)  Employees and other individuals.--

14(1)  For any employee or other individual continuing to
15provide waiver services, a provider shall comply with
16subsection (a) every five years from the initial receipt of
17the documentation.

18(2)  For any employee or other individual who provides
19services under a waiver on the effective date of this
20section, a provider shall comply with subsection (a) within
21one year.

22(c)  Type of documentation.--

23(1)  Documentation required under this section shall be
24obtained from a physician or other appropriate health care
25professional and shall state that the employees and other
26individuals are free from communicable disease and have
27passed a tuberculosis screening as outlined by screening
28guidelines of the Department of Health.

29(2)  Employees and other individuals shall comply with
30Federal, State and local health requirements related to

1communicable disease and follow procedures recommended in the
2Centers for Disease Control and Prevention guidelines and
3regulations of the Occupational Safety and Health
4Administration, including provisions of protective articles
5and in-service training on universal precautions.

6Section 8.  Recordkeeping.

7(a)  General rule.--Each provider shall maintain on file
8documentation of compliance with the provisions of sections 6
9and 7.

10(b)  Confidentiality.--Documentation of compliance maintained
11on file with a provider shall not be subject to access under the
12act of February 14, 2008 (P.L.6, No.3), known as the Right-to-
13Know Law.

14Section 9.  Financial interest prohibition.

15(a)  General rule.--No employee or other individual shall:

16(1)  Be appointed or act as guardian of a consumer.

17(2)  Engage in any activity under a power of attorney of
18a consumer.

19(3)  Be a beneficiary of any insurance policy or annuity
20of a consumer.

21(4)  Serve as an executor of the estate of a consumer.

22(b)  Duty to inform consumers.--A care manager shall inform
23each consumer of the provisions of subsection (a).

24Section 10.  Consumer telephone access.

25No employee or other individual shall restrict or prevent a
26consumer's access to local telephone service.

27Section 11.  Applicability.

28The provisions of this act shall not apply:

29(1)  to any employee or other individual who is a family
30member of a consumer to whom the employee or other individual

1provides services; or

2(2)  to a private contract between persons where public
3funding is not involved.

4Section 12.  Procedures for noncompliance; promulgation of
5regulations.

6(a)  General rule.--The department shall cooperate with the
7Department of Public Welfare to:

8(1)  Develop procedures, no later than 90 days after the
9effective date of this section, to be followed in the event
10of noncompliance with the provisions of this act.

11(2)  Promulgate regulations within one year after the
12effective date of this section to administer this act.

13(b)  Certain persons to be prohibited from participation in
14waiver.--Procedures and regulations under subsection (a) shall
15include, but not be limited to, prohibiting participation in a
16waiver for:

17(1)  an employee or any other individual who fails to
18meet the requirements of sections 6 and 7;

19(2)  an employee who fails to notify a provider of any
20other individual providing home and community-based services
21on behalf of the employee; or

22(3)  a provider who fails to comply with sections 6 and
237.

24Section 13.  Effective date.

25This act shall take effect in 60 days.