SENATE AMENDED
PRIOR PRINTER'S NOS. 779, 2057, 3147, PRINTER'S NO. 3912
3433
No. 698 Session of 1989
INTRODUCED BY KUKOVICH, O'DONNELL, FOX, STUBAN, RICHARDSON,
STAIRS, SCHULER, SALOOM, RYBAK, KOSINSKI, BELFANTI, WAMBACH,
COWELL, GRUPPO, PISTELLA, VROON, BOYES, ROBINSON, TRELLO,
MAINE, BILLOW, MARKOSEK, NAHILL, CARLSON, LUCYK, TIGUE,
PETRARCA, McVERRY, CAWLEY, GLADECK, FREIND, CORNELL,
ANGSTADT, GEIST, MORRIS, HESS, HERMAN, MICOZZIE, GANNON,
DURHAM, JOSEPHS, DALEY, LEVDANSKY, E. Z. TAYLOR, LaGROTTA,
RUDY, FREEMAN, STABACK, MAIALE, BELARDI, McCALL, BUNT,
DeLUCA, CORRIGAN, D. W. SNYDER, MELIO, JOHNSON, VEON, BLAUM,
SAURMAN, REBER, BISHOP, HAYDEN, SERAFINI, GIGLIOTTI, RAYMOND,
HALUSKA, SEMMEL, DIETTERICK, MICHLOVIC, FLICK, LAUGHLIN,
ITKIN, HECKLER, HAGARTY, HARPER, OLASZ, J. H. CLARK, HUGHES,
BROUJOS, MRKONIC, KAISER, TANGRETTI AND McHALE,
MARCH 13, 1989
SENATOR TILGHMAN, APPROPRIATIONS, IN SENATE, RE-REPORTED AS
AMENDED, JUNE 29, 1990
AN ACT
1 Establishing a program to assist persons who bear primary
2 responsibility for the at-home care of functionally dependent
3 older adults and victims of chronic dementia.
4 The General Assembly recognizes that:
5 (1) There is an enormous need in this Commonwealth for
6 services to assist families that provide at-home care to
7 functionally dependent older adults and other adults who are
8 victims of chronic dementia such as Alzheimer's Disease.
9 (2) Most care provided for such individuals is delivered
10 by family members. Family involvement is a critical element
11 for avoiding or postponing institutionalization of
1 functionally dependent older adults or those adults who are
2 victims of a chronic dementia such as Alzheimer's Disease.
3 (3) Primary caregivers who provide continuous care in
4 the home are frequently under substantial physical,
5 psychological and financial stress. Respite care and other
6 supportive services for the caregiver could relieve some of
7 the stress while maintaining and strengthening the family
8 structure.
9 The General Assembly of the Commonwealth of Pennsylvania
10 hereby enacts as follows:
11 Section 1. Short title.
12 This act shall be known and may be cited as the Family
13 Caregiver Support Act.
14 Section 2. Intent.
15 It is the intent of this act to ease the strain of caregiving
16 and to assist relatives who bear primary responsibility for the
17 at-home care of functionally dependent older adults and other
18 adults who are victims of chronic dementia by providing
19 resources for services such as the following:
20 (1) Assistance to the caregiver to assure that supports
21 to the functionally dependent older adult or adult suffering
22 from a chronic dementia are adequate and appropriate to
23 maintain these individuals in the home.
24 (2) Intermittent, planned or emergency relief to the
25 caregiver.
26 (3) Restoration or maintenance of the caregiver's well-
27 being.
28 (4) Preservation of the caregiver's informal supports,
29 such as family and friends.
30 (5) Supportive social services to the caregiver.
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1 (6) Affordable services through a cost sharing mechanism
2 developed by the department for those families whose
3 household incomes do not exceed 380% of the poverty level.
4 Section 3. Definitions.
5 The following words and phrases when used in this act shall
6 have the meanings given to them in this section unless the
7 context clearly indicates otherwise:
8 "Adult." A person 18 years of age or older residing within
9 this Commonwealth who is suffering from a chronic dementia such
10 as Alzheimer's Disease.
11 "Area agency on aging." The single local agency designated
12 by the department within each planning and service area to
13 administer the delivery of a comprehensive and coordinated plan
14 of social and other services and activities in the planning and
15 service area.
16 "Chronic dementia." An irreversible global loss of cognitive
17 function causing evident intellectual impairment which always
18 includes memory loss, without alteration of state of
19 consciousness as diagnosed by a physician and is severe enough
20 to interfere with work or social activities, or both and to
21 require continuous care or supervision.
22 "Department." The Department of Aging of the Commonwealth.
23 "Functionally dependent older adult." A person 60 years of
24 age or older residing within this Commonwealth who, because of
25 his or her inability to perform tasks required for daily living
26 as defined through regulation and as assessed by the area agency
27 on aging, needs continuous care or supervision.
28 "Home modification." Reasonable modifications to the
29 structure of a home for the purpose of reducing the caregiving
30 burden of the caregiver as approved by the department.
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1 Modifications do not include repairs, and payment for such
2 repairs is prohibited.
3 "Household income." The income of all members of the
4 household with the exception of a minor or dependent student.
5 "Income." All income, from whatever source derived,
6 including, but not limited to, wages, salaries, Social Security
7 or Railroad Retirement income, public assistance income,
8 realized capital gains and workmen's compensation. The
9 department shall have the authority to determine income amounts <--
10 and inclusions for purposes of this act through regulation.
11 "Primary caregiver." The one identified relative who has
12 assumed the primary responsibility for the provision of care
13 needed to maintain the physical or mental health of a
14 functionally dependent older adult or other adult suffering from
15 chronic dementia, who lives in the same residence with such
16 individual on a continuous basis and does not receive financial
17 compensation for the care provided. A substantiated case of
18 abuse, neglect, exploitation, abandonment as defined in the act
19 of November 6, 1987 (P.L.381, No.79), known as the Older Adults
20 Protective Services Act or pursuant to any other civil or
21 criminal statute regarding an older adult, shall prohibit a
22 caregiver from receiving benefits under this act unless
23 authorized by the department to prevent further abuse.
24 "Relative." A spouse or parent, child, stepparent,
25 stepchild, grandparent, grandchild, brother, sister, half-
26 brother, half-sister, aunt, great aunt, uncle, great uncle,
27 niece, nephew; by blood, marriage or adoption.
28 "Respite care service." A regular, intermittent or emergency
29 service which provides the primary caregiver of a functionally
30 dependent older adult or other adult suffering from a chronic
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1 dementia with relief from normal caregiving duties and
2 responsibilities.
3 Section 4. Caregiver support program.
4 (a) Description.--The persons to be served under this act
5 are primary, unpaid caregivers who live with and provide
6 continuous care to a functionally dependent older adult or other
7 adult suffering from a chronic dementia, such as Alzheimer's
8 disease.
9 (b) Authority.--The department shall have sole authority in <--
10 developing DEVELOP operating procedures and guidelines and shall <--
11 contract with area agencies on aging to provide the benefits set
12 forth in this act. The department shall have the authority to
13 develop criteria through regulation relating to eligibility for
14 caregivers to receive assistance pursuant to this act.
15 (c) Supportive services.--The department shall have the <--
16 authority to identify by regulation supportive services which
17 are directly related to the provision of care to the
18 functionally dependent older adult or other adult suffering from
19 chronic dementia. Supportive services include, but are not
20 limited to:
21 (1) Benefits counseling and caregiver counseling,
22 education and training.
23 (2) Reimbursement to primary caregivers whose households
24 financially qualify for assistance pursuant to section 5 and
25 as set forth through regulation for expenses incurred in
26 obtaining day or night respite care services, transportation
27 to respite care service locations or other supportive
28 services defined by regulation, and consumable supplies such
29 as incontinence pads.
30 (3) Reimbursement to primary caregivers whose households
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1 financially qualify for assistance pursuant to section 5 and
2 as developed through regulation for expenses incurred in
3 obtaining home modifications or assistive devices as approved
4 by the department which help the functionally dependent older
5 adult or adult suffering from chronic dementia to carry out
6 tasks required for daily living such as grab bars, safety
7 devices and wheelchair ramps.
8 Section 5. Reimbursements.
9 (a) General rule.--The department through contracts with
10 area agencies on aging, shall provide the services described in
11 section 4(c)(1) and shall reimburse qualified primary caregivers
12 for purchase of approved services described in section 4(c)(2)
13 and (3).
14 (b) Maximum amounts.--
15 (1) The maximum amount available to a qualified
16 caregiver whose household income is under 200% of poverty
17 level shall be established by regulation, but shall not
18 exceed $200 per month, for out-of-pocket expenses incurred
19 for services described in section 4(c)(2).
20 (2) The maximum amount available to a qualified
21 caregiver whose household income is under 200% of poverty
22 level shall be established by regulation, but shall not
23 exceed $2,000, for the entire duration of the case, for
24 expenses incurred for home modifications or assistive devices
25 as described in section 4(c)(3).
26 (c) Scale of benefits.--A sliding benefits scale shall be
27 established by the department by regulation to ensure that
28 caregivers who qualify under this act and whose household income
29 exceeds 200% of poverty level shall pay some portion of the out-
30 of-pocket expenses for services described in section 4(c). In no
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1 event will caregivers whose household income exceeds 380% of the
2 poverty level be considered eligible for benefits under this
3 act.
4 Section 6. Entitlement not created.
5 Nothing in this act creates or provides any individual with
6 an entitlement to services or benefits. It is the intent of the
7 General Assembly that services under this act shall be made
8 available only to the extent of the availability and level of
9 appropriation APPROPRIATIONS made by the General Assembly from <--
10 the General Fund.
11 Section 7. Other benefits.
12 Funding authorized under this act shall not be used to
13 displace benefits, entitlements or resources available under
14 other programs.
15 Section 8. Enforcement.
16 The department shall have authority to establish penalties,
17 by regulation, associated with the violation of this act or
18 departmental rules or regulations promulgated under this act.
19 Section 9. Effective date.
20 This act shall take effect July 1, 1990.
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