PRINTER'S NO. 1400
No. 1162 Session of 1997
INTRODUCED BY GERLACH, O'PAKE, THOMPSON, MADIGAN, WAGNER,
KUKOVICH, TARTAGLIONE, MUSTO, LEMMOND, AFFLERBACH, COSTA,
EARLL AND WENGER, OCTOBER 20, 1997
REFERRED TO AGING AND YOUTH, OCTOBER 20, 1997
AN ACT
1 Providing for the coordination of long-term care services, for
2 consumer education, advocacy, information and referral, for
3 independent comprehensive assessment of functional need for
4 care, for access to long-term care options, for purchase of
5 long-term care services and for monitoring of in-home service
6 quality and consumer satisfaction; and conferring additional
7 responsibilities on the Department of Aging and area agencies
8 on aging.
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 Aging and
13 Long-Term Care Services Access Act.
14 Section 2. Legislative intent.
15 The General Assembly finds and declares as follows:
16 (1) The Department of Aging shall implement a policy to
17 ensure that a continuum of long-term care services are
18 available and accessible to individuals in need of them.
19 (2) Coordinated, cost-effective long-term care services
20 shall be available to assist older Pennsylvanians and other
1 adults to remain in their homes, in the community or in other
2 appropriate settings, based on personal choice, level of
3 functional need and payment arrangements.
4 (3) Area agencies on aging shall be access points which
5 shall:
6 (i) Assist older Pennsylvanians, their families and
7 other adults in obtaining long-term care services
8 information, referral to various services and act as a
9 resource for information regarding aging and long-term
10 care services.
11 (ii) Assist older Pennsylvanians and other adults
12 seeking long-term care services in receiving a
13 comprehensive assessment of need and information about
14 the options available in order for these individuals to
15 knowledgeably choose options which best suit their needs
16 and financial situations.
17 (iii) Serve as advocates for older Pennsylvanians
18 and other adult consumers of long-term care.
19 (4) Older Pennsylvanians, their families and other
20 adults with long-term care service needs shall be educated so
21 that they can become careful, critical and reasonable
22 consumers of long-term care services through the provision of
23 impartial factual information and benefits counseling about
24 medical plans, services, insurance policies, care facilities
25 and care providers.
26 (5) There exist a range of long-term care planning and
27 long-term care management options which correspond to the
28 desire of adult consumers of long-term care services to plan
29 and manage their own care or delegate that activity to a care
30 manager.
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1 Section 3. Definitions.
2 The following words and phrases when used in this act shall
3 have the meanings given to them in this section unless the
4 context clearly indicates otherwise:
5 "Access points." A program of the local area agency on aging
6 through which a consumer gains entry into publicly financed
7 aging and long-term care services.
8 "Area agencies on aging." An agency designated by the
9 Department of Aging in accordance with the Older Americans Act
10 of 1965 (Public Law 89-73, 42 U.S.C. § 3001 et seq.) and Article
11 XXII-A of the act of April 9, 1929 (P.L.177, No.175), known as
12 The Administrative Code of 1929, to plan and provide a
13 comprehensive and coordinated system of services for older
14 adults and to serve as the advocate for older persons in the
15 community.
16 "Care manager." An individual designated by an area agency
17 on aging to coordinate the provision of long-term care services
18 to a consumer of long-term care services.
19 "Comprehensive assessment." An assessment of individual
20 status in a number of functional areas. The term includes
21 physical health, emotional health, cognitive functioning,
22 physical functioning, ability to carry out activities of daily
23 living, informal supports, environment and finances.
24 "Comprehensive care plan." A coordinated plan of long-term
25 care services developed as a result of the comprehensive
26 assessment.
27 "Department." The Department of Aging of the Commonwealth.
28 "Home and community care." Long-term care services provided
29 to an individual in the home or the community. The term includes
30 meal preparation or delivery, personal care services, homemaker
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1 services, adult day care, transportation for health care
2 services, in-home physical therapy and nursing services.
3 "Long-term care." The provision of assessment, care
4 management and diagnostic, preventative, therapeutic,
5 rehabilitative, support and maintenance services for older
6 adults and other adults with functional limitations in a
7 continuum of settings ranging from in-home community-based care
8 to care provided in a long-term care nursing facility, necessary
9 to support optimal functioning, autonomy and self-determination.
10 Section 4. Powers and duties of department.
11 (a) Regulations.--The department shall promulgate
12 regulations to implement this act.
13 (b) Interagency coordination.--The department shall
14 implement and administer the access point program in cooperation
15 with the Department of Health and the Department of Public
16 Welfare.
17 (c) Area agencies on aging.--Area agencies on aging shall be
18 the access point under contract to the department.
19 (d) Responsibilities of department.--The department shall
20 develop standards and monitor access point performance and
21 outcomes on a regular basis. The department shall issue a
22 biannual report by October 1 to the General Assembly detailing
23 the implementation and operation of the access point program and
24 other provisions of this act.
25 Section 5. Powers and duties of access points.
26 Access points shall act as a community information resource
27 for older Pennsylvanians and other adult consumers of long-term
28 care services, implement program activities specified in the
29 Older Americans Act of 1965 (Public Law 89-73, 42 U.S.C. § 3001
30 et seq.) and carry out such additional functions as specified by
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1 departmental regulation and interagency agreements. This
2 includes all of the following:
3 (1) Provide information and referral to individuals
4 seeking information about long-term care service options.
5 (2) Provide for counseling on insurance and benefits in
6 coordination and cooperation with the Insurance Department.
7 (3) Conduct and/or arrange for a comprehensive
8 assessment, preadmission screening and clinical eligibility
9 determination for those seeking long-term care services. For
10 individuals needing publicly financed long-term care services
11 in a long-term care nursing facility and for those who are
12 within 12 months of financial eligibility for publicly
13 financed long-term care services in a long-term care nursing
14 facility, a comprehensive assessment and eligibility
15 determination is required as a condition of receiving
16 services.
17 (4) Refer to long-term care nursing facilities those
18 individuals who choose such facilities and who, as a result
19 of the comprehensive assessment, are found to be appropriate
20 for this level of care.
21 (5) Develop comprehensive care plans, as necessary, for
22 consumers of long-term care services who are eligible for in-
23 home community-based care under eligible individual funding
24 sources. The comprehensive care plan shall be based on
25 functional need and shall be accompanied, when appropriate,
26 by a medical plan of care developed by a medical
27 professional. An individual, the individual's family, a care
28 manager or other designated persons shall be given the
29 opportunity to participate in the development of the
30 comprehensive care plan.
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1 (6) Arrange, coordinate and authorize the in-home
2 community-based care services specified in the comprehensive
3 care plan of an individual.
4 (7) Offer care manager options in which a consumer can
5 choose to direct the consumer's own care plan or utilize a
6 combination of self-directed and access-point-directed care
7 management tailored to individual consumer need. The
8 individual may also choose individual's participating care
9 provider or providers.
10 (8) Monitor the implementation and outcomes of the
11 comprehensive care plan and long-term care services provided
12 and make periodic adjustments of the plan in consultation
13 with the individual consumer and associated long-term care
14 service providers and health care practitioners. This
15 includes an evaluation of service quality and consumer
16 satisfaction.
17 Section 6. Statement of nonentitlement.
18 The provision of a comprehensive assessment and the
19 development of a comprehensive care plan by an access point
20 shall not establish entitlement to services for an eligible
21 individual beyond that established by law or beyond the amounts
22 appropriated therefor.
23 Section 7. Effective date.
24 This act shall take effect immediately.
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