PRINTER'S NO. 2966
No. 2099 Session of 2007
INTRODUCED BY WATSON, GINGRICH, BEAR, MAJOR, KENNEY,
BENNINGHOFF, BIANCUCCI, BOBACK, CLYMER, COX, CREIGHTON,
DENLINGER, EVERETT, HARHART, HARPER, HELM, HENNESSEY, HESS,
KOTIK, R. MILLER, MOUL, MOYER, MURT, MUSTIO, O'NEILL,
PICKETT, REICHLEY, RUBLEY, SOLOBAY, SONNEY, SWANGER AND
YOUNGBLOOD, DECEMBER 6, 2007
REFERRED TO COMMITTEE ON AGING AND OLDER ADULT SERVICES,
DECEMBER 6, 2007
AN ACT
1 Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
2 act to consolidate, editorially revise, and codify the public
3 welfare laws of the Commonwealth," further providing for
4 State plan for regulating and licensing personal care homes,
5 for Intra-Governmental Council on Long-Term Care and for
6 rules and regulations for personal care homes and assisted
7 living residences.
8 The General Assembly of the Commonwealth of Pennsylvania
9 hereby enacts as follows:
10 Section 1. Sections 1021(a) and 1057.3(a) of the act of June
11 13, 1967 (P.L.31, No.21), known as the Public Welfare Code,
12 amended July 25, 2007 (P.L. , No.56), are amended to read:
13 Section 1021. Regulations.--(a) (1) The department shall
14 adopt regulations establishing minimum standards for building,
15 equipment, operation, care, program and services, training and
16 staffing and for the issuance of licenses.
17 (2) Regulations for assisted living residences shall:
18 (i) Meet or exceed standards established in 55 Pa. Code §
1 2600 (relating to personal care homes). Residents' rights in
2 those or subsequent regulations shall not be subject to waiver.
3 (ii) Require an assisted living residence to provide a
4 resident with the resident's own living unit. Two residents may
5 voluntarily agree to share one unit provided that the agreement
6 is in writing and contained in each of the residency agreements
7 of those residents. A licensee shall not require residents to
8 share a unit.
9 (iii) Provide that supplemental health care services shall
10 be packaged, contracted and priced separately from the resident
11 agreement.
12 (iv) Require that each living unit contain a private
13 bathroom, living and bedroom space, kitchen capacity, which may
14 mean electrical outlets to have small appliances such as a
15 microwave and refrigerator, closets and adequate space for
16 storage and a door with a lock, except where a lock or
17 appliances in a unit under special care designation would pose a
18 risk or be unsafe.
19 (v) Establish minimum square footage requirements for
20 individual living units, which excludes bathrooms and closet
21 space. Exceptions to the size of the living unit may be made at
22 the discretion of the department.
23 (vi) Establish a special care designation for assisted
24 living residences and units that require specialized staff
25 training, service planning, activity programming and security
26 measures for residents receiving cognitive support services.
27 (vii) Create standards for informed consent agreements that
28 promote aging in place which includes written acknowledgment of
29 the risks that residents assume while directing their own care
30 and which releases the [facility] assisted living residence from
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1 liability for adverse outcomes resulting from actions consistent
2 with the terms of the informed consent agreement. Such informed
3 consent agreements shall only be entered into upon the mutual
4 agreement of the resident and the assisted living residence.
5 (viii) Create standards for transfer and discharge that
6 require the assisted living residence to make a reasonable
7 accommodation for aging in place that may include services from
8 outside providers.
9 * * *
10 Section 1057.3. Rules and Regulations for Personal Care Home
11 and Assisted Living Residences.--(a) The rules and regulations
12 for the licensing of personal care homes and assisted living
13 residences promulgated by the department shall require that:
14 (1) (i) Prior to a resident's admission to a personal care
15 home or assisted living residence, an initial standardized
16 screening instrument be completed for that resident by the
17 provider or a human service agency. Such standardized screening
18 instrument shall be developed by the department.
19 (ii) For a personal care home, the screening will be done to
20 determine that the potential resident does not require the
21 services in or of a long-term care facility and whether the
22 potential resident requires the services of a personal care home
23 and, if so, the nature of the services and supervision
24 necessary.
25 (iii) For an assisted living residence, the screening will
26 be done to determine whether the potential resident requires the
27 services provided by an assisted living residence. A resident
28 who currently does not require assistance in obtaining
29 supplemental health care services, but who may require such
30 services in the future or who wishes to obtain assistance in
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1 obtaining such services or reside in a facility in which such
2 services are available, may be admitted to the assisted living
3 residence, provided the resident is only provided service
4 required or requested by the resident. Where services are
5 required, the assisted living residence shall develop a support
6 plan as defined in 55 Pa. Code § 2600 (relating to personal care
7 homes) and any other regulations applicable to assisted living
8 residences.
9 (iv) An initial screening shall not be required to commence
10 supplemental health care services to a resident of an assisted
11 living residence who was not receiving such services at the time
12 of the resident's admission; to transfer a resident from a
13 portion of an assisted living residence that does not provide
14 supplemental health care services to a portion of the residence
15 that provides such service; or to transfer a resident from a
16 personal care home to an assisted living residence licensed by
17 the same operator.
18 (2) In addition to the screening, each resident receive a
19 complete medical examination by a physician prior to, or within
20 thirty days of, admission and that, once admitted, each resident
21 receive a screening and medical evaluation at least annually.
22 (3) A personal care home or assisted living residence
23 administrator refer an applicant whose needs cannot be met by
24 the home or residence to an appropriate assessment agency.
25 (3.1) Prospective or current residents for whom placement in
26 a skilled nursing facility is imminent shall be given priority
27 for assisted living residence services funded through a home-
28 and community-based waiver.
29 (3.2) All individuals receiving services under the home- and
30 community-based [waivers] waiver for assisted living services
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1 shall have a comprehensive assessment of their needs using an
2 instrument that provides comparable data elements and at
3 comparable time intervals as specified by the State for Medicaid
4 for nursing facilities.
5 (4) Each resident be provided by the administrator with
6 notice of any Class I or Class II violations uncorrected after
7 five days.
8 (5) All residents sign a standard written admission
9 agreement which shall include the disclosure to each resident of
10 the actual rent and other charges for services provided by the
11 personal care home or assisted living residence.
12 (6) For residents eligible for Supplemental Security Income
13 (SSI) benefits, actual rent and other charges not exceed the
14 resident's actual current monthly income reduced by a personal
15 needs allowance for the resident in an amount to be determined
16 by the department, but not less than twenty-five dollars ($25).
17 (7) A personal care home or assisted living residence not
18 seek or accept any payments from a resident who is a
19 Supplemental Security Income (SSI) recipient in excess of one-
20 half of any funds received by the resident under the act of
21 March 11, 1971 (P.L.104, No.3), known as the "Senior Citizens
22 Rebate and Assistance Act."
23 (8) A personal care home or assisted living residence not
24 seek or accept from a resident who is eligible for Supplemental
25 Security Income (SSI) benefits any payment from any funds
26 received as lump sum awards, gifts or inheritances, gains from
27 the sale of property, or retroactive government benefits:
28 Provided, however, That an owner or operator may seek and accept
29 payments from funds received as retroactive awards of Social
30 Security or Supplemental Security Income (SSI) benefits, but
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1 only to the extent that the retroactive awards cover periods of
2 time during which the resident actually resided in the personal
3 care home or assisted living residence.
4 (9) Each resident who is a recipient of, or an eligible
5 applicant for, Supplemental Security Income (SSI) benefits be
6 provided, at no additional charge to the resident, necessary
7 personal hygiene items and personal laundry services. This
8 requirement does not include cosmetic items.
9 (10) All residents may leave and return to a personal care
10 home or assisted living residence, receive visitors, have access
11 to a telephone and mail and participate in religious activities.
12 (11) Personal care home and assisted living residence
13 owners, administrators or employees be prohibited from being
14 assigned power of attorney or guardianship for any resident.
15 (12) Each assisted living residence demonstrate the ability
16 to provide supplemental health care services in a manner duly
17 protective of the health, safety and well-being of its residents
18 utilizing employes, independent contractors or contractual
19 arrangements with other health care facilities or practitioners
20 licensed, registered or certified to the extent required by law
21 to provide such service. To the extent prominently disclosed in
22 a written admission agreement, an assisted living residence may
23 require residents to use providers of supplemental health care
24 services designated by the assisted living residence.
25 (13) A personal care home not provide supplemental health
26 care services to residents, provided, however, that a personal
27 care home may assist residents in obtaining health care services
28 in the manner provided by 55 Pa. Code §§ 2600.29 (relating to
29 hospice care and services), 2600.142 (relating to assistance
30 with health care) and 2600.181 (relating to self-administration)
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1 through 2600.191 (relating to [medications] resident education)
2 or as otherwise provided by regulations adopted by the
3 department not inconsistent with the requirements of this
4 section.
5 * * *
6 Section 2. This act shall take effect October 23, 2007, or
7 immediately, whichever is later.
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