1Authorizing the Department of Aging to license and inspect
2community adult respite services programs; <-defining 
3"community adult respite service providers"; and imposing
4additional powers and duties on the Department of Aging.

5The General Assembly of the Commonwealth of Pennsylvania
6hereby enacts as follows:

7Section 1. Short title.

8This act shall be known and may be cited as the <-Community 
<-9Pennsylvania Community Adult Respite Services Program Act.

10Section 2. Definitions.

11The following words and phrases when used in this act shall
12have the meanings given to them in this section unless the
13context clearly indicates otherwise:

<-14"Activities of daily living" or "ADL." The term includes
15eating, drinking, ambulating, transferring in and out of bed or
16chair, toileting, bladder and bowel management, personal hygiene
17and proper turning and positioning in a bed or chair.

18"Applicant." An individual, agency, partnership,

1association, organization or corporate entity applying for a
2license to provide community adult respite services.

3"Area Agency on Aging" or "AAA." The single local agency
4designated by the department within each planning and service
5area to administer the delivery of a comprehensive and
6coordinated plan of social and other services and activities.

<-7"Client." An individual who receives community respite
8services in a community respite services program.

9"Community respite services." Services provided or arranged

<-10"Assisted living residence." An assisted living residence as
11defined in section 1001 of the act of June 13, 1967 (P.L.31,
12No.21), known as the Public Welfare Code.

13"Community adult respite services." For purposes of this 
14act, services provided or arranged for part of a 24-hour day in
15a community <-adult respite services program to support
16independence of <-individuals 60 years of age or older who:

17(1) Are independent in ambulation or able to
18independently use an assistive device for ambulation.

19(2) Are independent in dressing, toileting and eating
20and drinking skills.

21(3) May need assistance with simple meal tasks such as
22cutting food.

23(4) Do not require medication administration.

24(5) May need reminders or gentle redirection. <-adults.

25"Community adult respite services participant" or
26"participant." A resident of this Commonwealth who:

27(1) Is 60 years of age or older.

28(2) Can actively or passively engage in social and
29leisure activities with others.

30(3) May demonstrate symptoms of mild cognitive

1impairment.

2(4) Does not need assistance, other than cueing, or is
3able to direct care for activities of daily living.

4(5) Does not demonstrate behaviors that may compromise
5personal safety or the safety of others.

6"Community adult respite services program" or "program." <-An 
7entity licensed by the department to provide community respite 
8services in a setting approved by the department. <-A program 
9which provides community adult respite services for part of a 
1024-hour day.

11"Community adult respite services provider" or "provider."
12An individual, agency, partnership, association, organization or
13corporate entity that operates a community adult respite
14services program in a setting approved by the department.

15"Community senior center." For the purposes of this act, a
16facility developed and operated in accordance with provisions of
17Article XXII-A of the act of April 9, 1929 (P.L.177, No.175),
18known as The Administrative Code of 1929.

19"Continuing-care provider." A facility licensed by the
20Insurance Department under the act of June 18, 1984 (P.L.391,
21No.82), known as the Continuing-Care Provider Registration and
22Disclosure Act.

23"Cueing." Verbal or written assistance or prompts throughout
24an activity to assure its completion.

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

26"Designated person." An individual who <-may be is chosen by a
<-27client and documented in the client's record participant, to be
28notified in case of an emergency, termination of <-service 
<-29community adult respite services, program closure or other
30situations as indicated by the <-client participant or as required

1by this act. The term includes a <-client's participant's legal
2representative.

3"Licensed long-term care service provider." The term shall<-
4include:

5(1) An assisted living residence.

6(2) A continuing-care provider.

7(3) A LIFE program.

8(4) A long-term care nursing facility.

9(5) An older adult daily living center.

10(6) A personal care home.

11"LIFE program." The program of medical and supportive
12services known as Living Independently for Elders.

13"Local program administrator." The department or the area
14agency on aging on behalf of the department.

15"Long-term care nursing facility." A long-term care nursing
16facility as defined in section 802.1 of the act of July 19, 1979
17(P.L.130, No.48), known as the Health Care Facilities Act.

18"Mild cognitive impairment." Cognitive changes that are not
19severe enough to interfere with daily life or independent
20function.

21"Older adult daily living center." Premises operated for
22profit or not-for-profit in which older adult daily living
23services are simultaneously provided for four or more adults who
24are not relatives of the operator for part of a 24-hour day and
25which premises are subject to licensing under the act of July
2611, 1990 (P.L.499, No.118), known as the Older Adult Daily
27Living Centers Licensing Act.

28"Personal care home." A personal care home as defined in
29section 1001 of the act of June 13, 1967 (P.L.31, No.21), known
30as the Public Welfare Code.

1"Program coordinator." The individual designated by a
2provider to oversee and manage the daily activities and
3operations of a community adult respite services program.

4Section 3. Legislative findings and declaration.

5The General Assembly finds that:

6(1) This Commonwealth is rich in its diverse culture and
7demographic configuration.

8(2) Geographically, Pennsylvania's older adults live in
9a variety of settings and it is essential that every possible
10effort is made to help ensure that Pennsylvanians age and
11live well and that communities will be places to help them
12age and live well.

13(3) It is in the best interest of all Pennsylvanians to
14support policies that help older individuals maintain
15independence and dignity in their homes and communities,
16while also providing assurance to their loved ones that they
17are safe and afforded access to care and services at the
18right time, in the right setting and at the right intensity.

19(4) It is in the best interest of the Commonwealth to
20establish community <-adult respite services programs that
21provide programming designed to support independence of
22individuals, while also providing peace of mind to their
23loved ones who may have concerns that leaving them alone may
24jeopardize their health, safety and well-being.

25Section 4. Program <-operation and maintenance without license 
26prohibited.

27No person may maintain, operate or conduct a community
28respite services program without having a license issued by the
29department.

30Section 5. License term and content. <-offered by licensed long-

1term care service providers.

2Notwithstanding any other act to the contrary, an individual, 
3agency, partnership, association, organization or corporate 
4entity licensed as a long-term care service provider shall not 
5be required to obtain a separate license to maintain, operate or 
6conduct a community adult respite services program in accordance 
7with the provisions of this act, provided that the individual, 
8agency, partnership, association, organization or corporate 
9entity so licensed notifies the department by letter of its 
10intent to establish and operate a community adult respite 
11services program, in accordance with the provisions of this act.

12Section 5. License applicant letter of intent required.

13In order to obtain a license to maintain, operate or conduct
14a community adult respite services program in accordance with
15this act, the applicant must notify the department by letter of
16its intent to apply for a license to establish and operate a
17community adult respite services program.

18Section 6. Program operation and maintenance without license
19prohibited.

20Except for licensed long-term care service providers that
21fall within the provisions of section 4, no individual, agency,
22partnership, association, organization or corporate entity may
23maintain, operate, conduct or hold itself out as a community
24adult respite services program provider without having a license
25issued by the department.

26Section 7. License term and content and designation of a
27program coordinator.

28(a) General rule.--The department shall, after an
29investigation and after a departmental determination that the
30applicant complies with the provisions of this act, issue to an

1applicant a license to operate a program.

2(b) Term and content.--A license shall:

3(1) Be issued for a specified period of not more than 12
4months.

5(2) Be on a form prescribed by the department.

6(3) Not be transferable.

7(4) Be issued only to the <-person entity for the program
8named in the application.

9(c) Interim license.--The department shall have the power to
10issue an interim license in accordance with department
11regulations.

12(d) Recordkeeping.--The department shall keep a record of
13all applications and all licenses issued under this act.

<-14(e) Identification of program coordinator.--An applicant
15shall identify and designate a program coordinator who shall be
16on site and serve as the official representative and contact for
17a community adult respite services program. A program
18coordinator and any employee of the program are prohibited from
19being assigned power of attorney or guardianship for any
20Participant.

21(f) Responsibility of program coordinator.--The program
22coordinator shall be responsible for the intake and enrollment
23of community adult respite services participants through a
24process that ensures the eligibility of the participants in the
25program.

<-26Section 6. Local program administration and designation of a
27program coordinator.

28(a) Determination by AAA.--

29(1) Prior to implementation of this act, the AAA in each
30planned services area shall make a determination of whether

1it will assume monitoring and oversight of programs, in
2accordance with department regulations.

3(2) If an AAA determines to assume monitoring and
4oversight responsibility, the AAA may require plans of
5correction and require other action to bring a program into
6compliance.

7(3) If an AAA determines not to assume monitoring and
8oversight of a program, the department shall assume
9monitoring and oversight responsibilities.

10(b) Identification of program coordinator.--Each program 
11shall identify and designate a program coordinator who shall be 
12onsite and serve as the official representative and contact for 
13a community respite services program.

14Section <-7 8. Right to enter and inspect.

<-15The local program administrator as established in accordance 
16with section 6 <-(a) General rule.--Subject to section 7, the 
17department may enter, visit and inspect any program licensed or
18requiring a license under this act. In accordance with
19applicable regulatory authority, the <-monitoring and oversight 
20entity <-department shall have full and free access to the records
21of a community adult respite services program and to the <-clients 
22and full opportunity to interview, inspect or examine such 
23clients <-participants to interview and evaluate such 
24participants.

25(b) Local AAAs as agents.--At the department's discretion,
26representatives of the local AAAs may act as agents of the
27department, as specified in subsection (a).

28Section <-8 9. Determination of eligibility.

29(a) General rule.--The department shall work in cooperation
30with the AAA to develop a standard application packet for

1prospective <-clients participants.

2(b) Ongoing monitoring.--The program shall include a process
3whereby <-clients participants shall be monitored regularly to
4ensure that they <-do not become ineligible for community respite 
5services. The process shall be overseen by either the AAA or the 
6department, in accordance with section 6 and with applicable 
7regulations of the department. <-do not become ineligible for 
8community adult respite services.

9Section <-9 10. Conditions of ineligibility.

<-10(a) General rule.--No individual may receive community
11respite services if the individual:

12(1) presents with a history or risk of wandering, beyond
13gentle redirection;

14(2) requires medication assistance;

15(3) requires assistance with personal care, as defined
16in 55 Pa. Code Ch. 2600 (relating to personal care homes); or

17(4) is unable to express critical needs.

<-18(a) General rule.--An enrolled participant who no longer
19meets the definition of a community adult respite services
20participant must be disenrolled from the program in accordance
21with the provisions of subsection (b).

22(b) Determination of ineligibility.--In the event that a
23client participant is determined ineligible for community <-adult
24respite services, the program coordinator of a program shall:

<-25(1) Immediately notify the monitoring and oversight
26entity and the designated person for the client and shall
27follow procedures outlined in regulation for program
28disenrollment.

29(2) Provide the designated person with written notice of
30ineligibility and a list of community resources that may be

1available.

<-2(1) Provide the participant or designated person with
3written notice of ineligibility and a list of community
4resources that may be available.

5(2) Work with the participant or designated person and
6local program administrator to develop a transition plan
7before the participant is disenrolled from the community
8adult respite services program.

9(c) AAA eligibility assessment required.--When a participant
10is determined to be ineligible for community adult respite
11services while in a program, the program coordinator shall
12contact the AAA to request an eligibility assessment.

13Section <-10. Regulations. 11. Regulations and statements of 
14policy.

15(a) General rule.--The department shall work in cooperation
16with the AAAs, representatives of the adult day community<- 
17licensed long-term care service providers and <-representatives of 
18the senior centers to promulgate regulations <-representatives of 
19community senior centers to promulgate guidance such as 
20regulations or statements of policy governing community <-adult
21respite services programs, no later than one year after the
22effective date of this section. The regulations shall establish
23minimum standards, including, but not limited to:

24(1) Building, equipment, operation, care and assessment
25processes for functional and cognitive status of clients.

26(2) Staff credentials and staffing requirements,
27including <-staff-to-client staff-to-participant ratios.

28(3) Programs and services in order to implement a
29process for issuance of licenses and interim licenses.

30(4) <-To establish a A licensing appeal process, and to

1establish and collect fees to offset the cost of issuing
2licenses.

3(5) A referral system for participants who are<-
4determined to be ineligible to enter a community adult
5respite services program.

6(6) Enforcement provisions.

7(b) Procedure.--Regulations shall be promulgated in
8accordance with the provisions of the act of June 25, 1982
9(P.L.633, No.181), known as the Regulatory Review Act.

10Section <-11 12. Construction.

11Nothing in this act shall be construed to preclude continued
12participation by individuals under 60 years of age who are
13participating in a community <-adult respite services program on
14the effective date of this <-act section.

15Section <-12 13. Effective date.

16This act shall take effect in 180 days.