PRIOR PRINTER'S NO. 612 PRINTER'S NO. 1480
No. 518 Session of 2003
INTRODUCED BY HESS, PISTELLA, SATHER, BAKER, BELFANTI, CAPPELLI,
CAUSER, CIVERA, COSTA, COY, CRAHALLA, CRUZ, CURRY, GEIST,
GRUCELA, HARHAI, HARPER, HERMAN, LEDERER, MAITLAND, MELIO,
R. MILLER, PICKETT, RUBLEY, SAYLOR, SOLOBAY, STABACK, STERN,
E. Z. TAYLOR, TIGUE, WASHINGTON, WATSON, HORSEY, THOMAS AND
REICHLEY, FEBRUARY 26, 2003
AS REPORTED FROM COMMITTEE ON AGING AND OLDER ADULT SERVICES,
HOUSE OF REPRESENTATIVES, AS AMENDED, APRIL 28, 2003
AN ACT
1 Amending the act of July 19, 1979 (P.L.130, No.48), entitled "An
2 act relating to health care; prescribing the powers and
3 duties of the Department of Health; establishing and
4 providing the powers and duties of the State Health
5 Coordinating Council, health systems agencies and Health Care
6 Policy Board in the Department of Health, and State Health
7 Facility Hearing Board in the Department of Justice;
8 providing for certification of need of health care providers
9 and prescribing penalties," further providing for
10 definitions; and providing for licensure of home care and for <--
11 PROVIDING FOR LICENSURE OF HOME CARE AGENCIES AND HOME CARE <--
12 REGISTRIES; ESTABLISHING CERTAIN CONSUMER RIGHTS AND
13 PROTECTIONS; AND PROVIDING FOR INSPECTIONS AND PLANS OF
14 CORRECTION AND FOR report to General Assembly.
15 The General Assembly finds and declares that:
16 The intent of this act is to license home care agencies AND <--
17 REGISTRIES in order to provide for consumer protection by
18 establishing oversight, by requiring criminal background checks
19 AND COMMUNICABLE DISEASE SCREENS for individuals referred by a <--
20 home care agency OR REGISTRY to provide care, and by ensuring <--
21 the physical health and competency of individuals referred by a
1 home care agency OR REGISTRY to provide care. <--
2 The General Assembly of the Commonwealth of Pennsylvania
3 hereby enacts as follows:
4 Section 1. The definitions of "health care facility" and
5 "home health care agency" in section 802.1 of the act of July
6 19, 1979 (P.L.130, No.48), known as the Health Care Facilities
7 Act, amended December 18, 1992 (P.L.1602, No.179) and October
8 16, 1998 (P.L.777, No.95), are amended and the section is
9 amended by adding definitions to read:
10 Section 802.1. Definitions.
11 The following words and phrases when used in this chapter
12 shall have, unless the context clearly indicates otherwise, the
13 meanings given them in this section:
14 "Activities of daily living." This term includes services <--
15 furnished to a person by an individual referred from a home care
16 agency in the person's place of residence or other independent
17 living environment for compensation and which provide assistance
18 to the individual with home management activities, respite care,
19 "ACTIVITIES OF DAILY LIVING." THIS TERM INCLUDES, BUT IS NOT <--
20 LIMITED TO, SERVICES FURNISHED TO A PERSON BY AN EMPLOYEE
21 REFERRED FROM A HOME CARE AGENCY OR AN INDEPENDENT CONTRACTOR
22 REFERRED FROM A REGISTRY IN THE CONSUMER'S PLACE OF RESIDENCE OR
23 OTHER INDEPENDENT LIVING ENVIRONMENT FOR COMPENSATION AND WHICH
24 PROVIDE ASSISTANCE TO THE CONSUMER WITH HOME MANAGEMENT
25 ACTIVITIES, RESPITE CARE, companionship services or with
26 personal care which includes, but is not limited to, assistance
27 with self-administered medications, feeding, oral, skin and
28 mouth care, shaving, assistance with ambulation, bathing, hair
29 care and grooming, dressing, toileting and transfer activities.
30 The term also includes instrumental activities of daily living.
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1 The term does not include services provided by a religious
2 organization for the purpose of providing services exclusively
3 to clergymen or other persons in a religious profession who are
4 members of a religious denomination.
5 * * *
6 "Health care facility." For purposes of Chapter 8, a health
7 care facility includes, but is not limited to, a general,
8 chronic disease or other type of hospital, a home health care
9 agency, a home care agency, A HOME CARE REGISTRY, a hospice, a <--
10 long-term care nursing facility, cancer treatment centers using
11 radiation therapy on an ambulatory basis, an ambulatory surgical
12 facility, a birth center regardless of whether such health care
13 facility is operated for profit, nonprofit or by an agency of
14 the Commonwealth or local government. The department shall have
15 the authority to license other health care facilities as may be
16 necessary due to emergence of new modes of health care. When the
17 department so finds, it shall publish its intention to license a
18 particular type of health care facility in the Pennsylvania
19 Bulletin in accordance with the act of June 25, 1982 (P.L.633,
20 No.181), known as the "Regulatory Review Act." The term health
21 care facility shall not include an office used primarily for the
22 private practice of a health care practitioner, nor a program
23 which renders treatment or care for drug or alcohol abuse or
24 dependence unless located within a health facility, nor a
25 facility providing treatment solely on the basis of prayer or
26 spiritual means. The term health care facility shall not apply
27 to a facility which is conducted by a religious organization for
28 the purpose of providing health care services exclusively to
29 clergymen or other persons in a religious profession who are
30 members of a religious denomination.
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1 "Home care agency." An organization or part thereof, <--
2 exclusive of a home health care agency, that supplies, arranges,
3 schedules or refers individuals to provide activities of daily
4 living or instrumental activities of daily living on an hourly,
5 shift or continual basis to any person in the person's place of
6 residence or other independent living environment for which the
7 organization receives a fee, consideration or compensation of
8 any kind. The term shall not include durable medical equipment
9 providers or volunteer providers.
10 "HOME CARE AGENCY." AN ORGANIZATION OR PART THEREOF, <--
11 EXCLUSIVE OF A HOME HEALTH CARE AGENCY, THAT SUPPLIES, ARRANGES
12 OR SCHEDULES EMPLOYEES TO PROVIDE ACTIVITIES OF DAILY LIVING OR
13 INSTRUMENTAL ACTIVITIES OF DAILY LIVING OR SPECIALIZED CARE ON
14 AN HOURLY, SHIFT OR CONTINUAL BASIS TO ANY CONSUMER IN THE
15 CONSUMER'S PLACE OF RESIDENCE OR OTHER INDEPENDENT LIVING
16 ENVIRONMENT FOR WHICH THE ORGANIZATION RECEIVES A FEE,
17 CONSIDERATION OR COMPENSATION OF ANY KIND. THE TERM SHALL NOT
18 INCLUDE DURABLE MEDICAL EQUIPMENT PROVIDERS OR VOLUNTEER
19 PROVIDERS.
20 "HOME CARE REGISTRY" OR "REGISTRY." AN ORGANIZATION OR
21 BUSINESS ENTITY OR PART THEREOF, THAT SUPPLIES, ARRANGES OR
22 REFERS INDEPENDENT CONTRACTORS TO PROVIDE ACTIVITIES OF DAILY
23 LIVING OR INSTRUMENTAL ACTIVITIES OF DAILY LIVING OR SPECIALIZED
24 CARE IN THE CONSUMER'S PLACE OF RESIDENCE OR OTHER INDEPENDENT
25 LIVING ENVIRONMENT FOR WHICH THE REGISTRY RECEIVES A FEE,
26 CONSIDERATION OR COMPENSATION OF ANY KIND.
27 "Home health care agency." An organization or part thereof
28 staffed and equipped to provide nursing and at least one
29 therapeutic service to persons who are disabled, aged, injured
30 or sick in their place of residence[.] or other independent
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1 living environment. The agency may also provide other health-
2 related services to protect and maintain persons in their [own
3 home.] place of residence or other independent living
4 environment.
5 * * *
6 "Inspection." An examination by the department or its
7 representatives, including interviews with the office staff,
8 clients, individuals providing care and review of documents
9 pertinent to initial and continued licensure so that the
10 department may determine whether a home care agency is operating
11 in compliance with licensure requirements.
12 "Instrumental activities of daily living" or "IADL." This
13 term includes, but is not limited to, meal preparation, shopping
14 and errands, telephone use, light housework, laundry and
15 transportation.
16 * * *
17 Section 2. Section 806 of the act is amended by adding a
18 subsection to read:
19 Section 806. Licensure.
20 * * *
21 (d.1) Home care agency AND REGISTRY regulations.-- <--
22 (1) In developing rules and regulations for licensure of
23 home care agencies AND REGISTRIES, the department shall <--
24 ensure that an individual accepted for referral by a home
25 care agency OR REGISTRY after the effective date of this <--
26 subsection shall have the following training or experience
27 prior to referral to clients: <--
28 (i) successful completion of a nurse aide training
29 program approved by the State or successful completion of
30 a competency examination;
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1 (ii) successful completion of a home health aide
2 training program approved by the State or successful
3 completion of a competency examination;
4 (iii) successful completion of a personal care
5 worker training credentialing program approved by the
6 State or successful completion of a competency
7 examination approved by the State; or
8 (iv) successful completion of a written examination
9 demonstrating competency for persons performing only IADL
10 services.
11 Documentation of at least one of subparagraphs (i) through
12 (iv) shall be kept in each individual's file in the home care
13 agency office. In addition, documentation of applicable State
14 licensure for any health care practitioner shall be kept on
15 file in the home care agency office.
16 (2) Prior to licensing a home care agency, the
17 department shall ensure that all individuals referred by a
18 home care agency, office staff working for a home care agency
19 and owners of each home care agency shall have criminal
20 history record information, in accordance with the
21 requirements of section 503 of the act of November 6, 1987
22 (P.L.381, No.79), known as the "Older Adults Protective
23 Services Act," on file in the office.
24 (3) Prior to referral to clients, all individuals and
25 any other office staff or contractors with client contact
26 shall have documentation in the home care agency files from a
27 physician or other appropriate health care professional that
28 the individual is free of communicable disease including, at
29 a minimum, a tuberculosis screening.
30 Section 3. The act is amended by adding a section to read:
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1 CONSUMERS: <--
2 (I) VALID NURSE'S LICENSE;
3 (II) SUCCESSFUL COMPLETION OF A NURSE AIDE TRAINING
4 PROGRAM APPROVED BY THE STATE OR SUCCESSFUL COMPLETION OF
5 A COMPETENCY EXAMINATION;
6 (III) SUCCESSFUL COMPLETION OF A HOME HEALTH AIDE
7 TRAINING PROGRAM APPROVED BY THE STATE OR SUCCESSFUL
8 COMPLETION OF A COMPETENCY EXAMINATION;
9 (IV) SUCCESSFUL COMPLETION OF A PERSONAL CARE WORKER
10 TRAINING CREDENTIALING PROGRAM APPROVED BY THE STATE OR
11 SUCCESSFUL COMPLETION OF A COMPETENCY EXAMINATION
12 APPROVED BY THE STATE; OR
13 (V) SUCCESSFUL COMPLETION OF A STATE-APPROVED SKILLS
14 EXAMINATION DEMONSTRATING COMPETENCY FOR PERSONS
15 PERFORMING ONLY INSTRUMENTAL ACTIVITIES OF DAILY LIVING
16 SERVICES.
17 (2) DOCUMENTATION OF AT LEAST ONE OF PARAGRAPH (1)(I)
18 THROUGH (V) SHALL BE KEPT IN EACH INDIVIDUAL'S FILE IN THE
19 HOME CARE AGENCY OR REGISTRY OFFICE, AND DOCUMENTATION OF
20 APPLICABLE STATE LICENSURE FOR ANY HEALTH CARE PRACTITIONER
21 SHALL BE KEPT ON FILE IN THE HOME CARE AGENCY OR REGISTRY
22 OFFICE.
23 (3) PRIOR TO LICENSING A HOME CARE AGENCY OR REGISTRY,
24 THE DEPARTMENT SHALL ENSURE THAT ALL INDIVIDUALS REFERRED BY
25 THE HOME CARE AGENCY OR REGISTRY, OFFICE STAFF WORKING FOR
26 THE HOME CARE AGENCY OR REGISTRY AND OWNERS OF THE HOME CARE
27 AGENCY OR REGISTRY SHALL HAVE CRIMINAL HISTORY RECORD
28 INFORMATION, IN ACCORDANCE WITH THE REQUIREMENTS OF SECTION
29 503 OF THE ACT OF NOVEMBER 6, 1987 (P.L.381, NO.79), KNOWN AS
30 THE "OLDER ADULTS PROTECTIVE SERVICES ACT," ON FILE IN THE
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1 OFFICE. IF THE AGENCY OR REGISTRY PROVIDES SERVICES TO
2 PERSONS WHO ARE UNDER 18 YEARS OF AGE, THEN PRIOR TO THE
3 LICENSING OF THE HOME CARE AGENCY OR REGISTRY, THE DEPARTMENT
4 SHALL ENSURE THAT ALL INDIVIDUALS REFERRED BY THE HOME CARE
5 AGENCY OR REGISTRY, OFFICE STAFF WORKING FOR THE HOME CARE
6 AGENCY OR REGISTRY AND OWNERS OF THE HOME CARE AGENCY OR
7 REGISTRY SHALL OBTAIN CLEARANCE FORM THE CHILD ABUSE
8 REGISTRY, IN ACCORDANCE WITH 23 PA.C.S. CH. 63 (RELATING TO
9 CHILD PROTECTIVE SERVICES).
10 (4) PRIOR TO REFERRAL TO CONSUMERS, ALL INDIVIDUALS AND
11 ANY OTHER OFFICE STAFF OR CONTRACTORS WITH CONSUMER CONTACT
12 MUST OBTAIN DOCUMENTATION IN THE HOME CARE AGENCY OR REGISTRY
13 FILES FROM A PHYSICIAN OR OTHER APPROPRIATE HEALTH CARE
14 PROFESSIONAL THAT THE INDIVIDUAL IS FREE FROM COMMUNICABLE
15 DISEASE INCLUDING, AT A MINIMUM, A TUBERCULOSIS SCREENING AS
16 OUTLINED BY THE SCREENING GUIDELINES OF THE DEPARTMENT.
17 (5) ONGOING SUPERVISION OF AN EMPLOYEE BY A HOME CARE
18 AGENCY SHALL BE MAINTAINED TO ENSURE THAT THE EMPLOYEE HAS
19 THE SKILLS NEEDED TO PROVIDE THE CARE REQUIRED BY THE
20 CONSUMER.
21 SECTION 3. THE ACT IS AMENDED BY ADDING SECTIONS TO READ:
22 SECTION 806.2. CONSUMER RIGHTS AND PROTECTIONS.
23 (A) GENERAL RULE.--A CONSUMER SHALL HAVE THE FOLLOWING
24 RIGHTS WHEN RECEIVING SERVICE:
25 (1) NO INDIVIDUAL, AS A RESULT OF THE INDIVIDUAL'S
26 AFFILIATION WITH A HOME CARE AGENCY OR REGISTRY, MAY ASSUME
27 POWER OF ATTORNEY OR GUARDIANSHIP OVER THE CONSUMER.
28 (2) THE CONSUMER MAY NOT BE REQUIRED TO ENDORSE CHECKS
29 OVER TO A HOME CARE AGENCY OR REGISTRY.
30 (3) THE CONSUMER HAS THE RIGHT TO:
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1 (I) BE INVOLVED IN THE SERVICE PLANNING PROCESS AND
2 TO RECEIVE SERVICES WITH REASONABLE ACCOMMODATION OF
3 INDIVIDUAL NEEDS AND PREFERENCES, EXCEPT WHERE THE HEALTH
4 OR SAFETY OF THE INDIVIDUAL DIRECT CARE WORKER IS AT
5 RISK.
6 (II) HAVE PRIVACY, CONFIDENTIALITY AND FREEDOM FROM
7 ABUSE, NEGLECT AND FINANCIAL EXPLOITATION.
8 (III) REFUSE TREATMENT OR SERVICES UNDER THE PLAN.
9 (IV) RECEIVE FROM THE HOME CARE AGENCY, REGISTRY OR
10 INDEPENDENT CONTRACTOR TWO BUSINESS DAYS' ADVANCE WRITTEN
11 NOTICE OF THE INTENT OF THE HOME CARE AGENCY, REGISTRY OR
12 INDEPENDENT CONTRACTOR TO TERMINATE SERVICES WITH THE
13 CONSUMER, EXCEPT WHERE IMMEDIATE THREAT TO THE HEALTH OR
14 SAFETY OF CONSUMERS OR PROVIDERS, AS DETERMINED BY THE
15 DEPARTMENT, WARRANTS SHORTER NOTICE.
16 (V) RECEIVE FROM THE HOME CARE AGENCY OR REGISTRY
17 CONTACT INFORMATION ON THE DEPARTMENT'S 24-HOUR HOTLINE
18 AND THE ABILITY TO ACCESS THE HOTLINE AT ANY TIME.
19 (VI) BE FREE FROM DISCRIMINATION ON THE BASIS OF
20 RACE, COLOR, RELIGIOUS CREED, DISABILITY, HANDICAP,
21 ANCESTRY, SEXUAL ORIENTATION, NATIONAL ORIGIN, AGE, SEX
22 OR PROTECTED CLASS.
23 (B) INFORMATION TO BE PROVIDED.--AS A CONDITION OF
24 LICENSURE, EACH CONSUMER OR THE CONSUMER'S LEGAL REPRESENTATIVE
25 OR RESPONSIBLE FAMILY MEMBER SHALL RECEIVE AN INFORMATION PACKET
26 FROM THE HOME CARE AGENCY OR REGISTRY AT THE SERVICE INITIATION
27 WHICH INCLUDES THE FOLLOWING ITEMS TO BE PRESENTED IN A FORM
28 ABLE TO BE EASILY UNDERSTOOD AND READ BY THE CONSUMER:
29 (1) A STANDARDIZED FORM DEVELOPED BY THE DEPARTMENT
30 CONTAINING:
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1 (I) INFORMATION REGARDING HOW TO CONTACT AND OBTAIN
2 WHAT IS REQUIRED BY THE DEPARTMENT FOR HOME CARE
3 AGENCIES.
4 (II) INFORMATION ABOUT AVAILABILITY AND ACCESS TO
5 AND CONTACT INFORMATION FOR THE DEPARTMENT'S 24-HOUR
6 HOTLINE.
7 (III) DETAILS ABOUT THE DEPARTMENT'S EXTERNAL
8 COMPLAINT MECHANISMS AVAILABLE TO CONSUMERS.
9 (IV) GENERAL INFORMATION ABOUT THE ADMISSION AND
10 APPLICATION PROCESS.
11 (2) THE CONSUMER RIGHTS AS DESCRIBED IN SUBSECTION (A).
12 (3) A DESCRIPTION OF THE SERVICES PROVIDED BY THE HOME
13 CARE AGENCY OR REGISTRY.
14 (4) A DESCRIPTION OF THE RELATIONSHIP BETWEEN THE
15 CONSUMER, THE REFERRED EMPLOYEE OR INDEPENDENT CONTRACTOR AND
16 THE AGENCY OR REGISTRY.
17 (5) A DESCRIPTION OF ONGOING SUPERVISION MAINTAINED BY A
18 HOME CARE AGENCY OR REGISTRY TO ENSURE THAT THE EMPLOYEE HAS
19 THE SKILLS NEEDED TO PROVIDE CARE THAT IS REQUIRED BY THE
20 CONSUMER.
21 (6) DOCUMENTATION FROM THE HOME CARE AGENCY OR REGISTRY
22 THAT DEMONSTRATES PERSONAL FACE-TO-FACE INTERVIEWS WITH ALL
23 EMPLOYEES OR INDEPENDENT CONTRACTORS REFERRED BY THE HOME
24 CARE AGENCY OR REGISTRY AND DOCUMENTATION OF AT LEAST TWO
25 SATISFACTORY REFERENCE CHECKS PRIOR TO REFERRAL TO THE
26 CONSUMER.
27 Section 806.2 806.3. Inspections and plans of correction. <--
28 (a) Consent to entry and access.--An application for
29 licensure or the issuance and renewal of any license by the
30 department shall constitute consent by the applicant for the
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1 home care agency OR REGISTRY and the owner of the premises for <--
2 the department's representatives to enter the premises for the
3 purpose of conducting an inspection during regular business
4 hours.
5 (b) Violations and plan of correction.--If violations are
6 identified as a result of an inspection, the home care agency OR <--
7 REGISTRY will be given a report of inspection that clearly
8 outlines the nature of the violation. The home care agency OR <--
9 REGISTRY shall submit a written plan of correction in response
10 to the report, stating actions to be taken by the agency OR <--
11 REGISTRY to correct the violations and a time frame for those
12 corrective actions.
13 Section 4. Section 807(b) of the act, amended December 18,
14 1992 (P.L.1602, No.179), is amended to read:
15 Section 807. Application for license.
16 * * *
17 (b) Fees.--Application for a license or for renewal of a
18 license shall be accompanied by the following fees:
19 (1) Regular or special license:
20 Home health agency $250.00
21 Home care agency 100.00
22 HOME CARE REGISTRY 100.00 <--
23 Ambulatory surgical facility 250.00
24 Birth center 70.00
25 Long-term care nursing facility 250.00
26 Plus per each long-term care bed in excess of
27 75 beds 2.00
28 Hospital
29 Every two years 500.00
30 Plus per each inpatient bed
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1 every two years 4.00
2 Other health care facility 100.00
3 (2) Provisional license all facilities:
4 Provisional I $400.00
5 Plus per each inpatient bed 4.00
6 Provisional II 600.00
7 Plus per each inpatient bed 6.00
8 Provisional III 800.00
9 Plus per each inpatient bed 8.00
10 Provisional IV 1,000.00
11 Plus per each inpatient bed 10.00
12 * * *
13 Section 5. Section 808(b) of the act, amended October 16,
14 1998 (P.L.777, No.95), is amended to read:
15 Section 808. Issuance of license.
16 * * *
17 (b) Separate and limited licenses.--Separate licenses shall
18 not be required for different services within a single health
19 care facility except that home health care, home care, hospice, <--
20 REGISTRY or long-term nursing care will require separate
21 licenses. A limited license, excluding from its terms a
22 particular service or portion of a health care facility, may be
23 issued under the provisions of this act.
24 * * *
25 Section 6. The act is amended by adding a section SECTIONS <--
26 to read:
27 Section 903.1. Report to General Assembly.
28 Within one year of the effective date of this section, the
29 Department of Aging shall provide to the General Assembly a
30 report on programs within this Commonwealth and throughout the
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1 United States that seek to maximize the effectiveness of
2 charitable pharmaceutical programs and to provide
3 recommendations for new laws and initiatives within this
4 Commonwealth to enhance the ability of Pennsylvanians to take
5 advantage of such programs.
6 SECTION 903.2. NONAPPLICABILITY. <--
7 NOTHING IN THIS ACT SHALL APPLY TO A PRIVATE CONTRACT OR
8 ARRANGEMENT ENTERED INTO BY A CONSUMER AND CAREGIVER, PROVIDED
9 THAT THE CAREGIVER WAS NOT SUPPLIED, ARRANGED, SCHEDULED OR
10 REFERRED TO THE CONSUMER BY A HOME CARE AGENCY OR REGISTRY.
11 Section 7. This act shall take effect in 60 days.
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