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House of Representatives
Session of 2017 - 2018 Regular Session


Posted: August 8, 2017 04:14 PM
From: Representative Aaron Bernstine
To: All House members
Subject: Medical Assistance Presumptive Eligibility Program for Home Care & Home Health Services
In the near future, I will be introducing legislation that gives seniors a greater opportunity to remain in their own homes.

Currently, when an individual applies for Medicaid, he or she can be “presumed eligible” for nursing home services and receive those services immediately while their Medicaid application is being fully reviewed. However, if the individual wishes to receive in-home care, he or she must wait until the application is fully approved, which could take months. Often times, this delay in services forces the individual into nursing home care when in-home care would have been more appropriate, preferred and less expensive.

My bill will provide greater access to in-home care by extending “presumptive eligibility” to those who meet the qualifications for Medicaid and who wish to remain in their own homes instead of in a more costly and restrictive setting. The qualifications for care still remain in place and eligibility criteria will not be altered or lowered. Instead, the bill will assist in expediting and equalizing the approval process for those who wish to receive care at home, as the process now does for nursing home care.

Not only does in-home care improve an individual’s quality of life, it saves tax dollars. The commonwealth saves an estimated $34,000 a year for every person who is served at home instead of in a long-term care facility. According to the Pennsylvania Homecare Association, individuals receiving care at home cost, on average, $31,000 per person a year, while nursing home care reaches approximately $65,148 per person per year.

Please join me in correcting this disparity in presumptive eligibility, so that our seniors applying for Medicaid can receive the care they qualify for, in the setting of their choice, conserving taxpayer resources while honoring their wishes for independence and dignity.

Introduced as HB1829