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Senate of Pennsylvania
Session of 2021 - 2022 Regular Session


Posted: December 1, 2020 03:10 PM
From: Senator Michele Brooks and Sen. Sharif Street
To: All Senate members
Subject: Presumptive Eligibility for In-Home Care
In the near future, Senator Street and I will be re-introducing legislation to give our loved ones greater opportunities to remain in their own homes instead of being admitted into nursing facility care.

This legislation, previously Senate Bill 277 of the 2019-2020 session, will make it easier for seniors to access long-term services and supports at home and avoid more costly institutional care. The bill allows providers to review an individual's finances quickly and use discretion to begin providing care immediately while that person waits for the lengthy Medicaid financial eligibility process to be completed.

Currently, when a person applies for Medicaid, the individual can be “deemed eligible” for nursing home services and receive those services without delay, while the Medicaid application is being fully reviewed. However, if the applicant wishes to receive in-home care, they must wait until the application is fully approved, which could take several months. Often this prolonged interval sends an applicant into nursing home care when the home setting would have been more appropriate, less expensive, and more rewarding for the applicant.

Our bill will expedite and equalize the process, providing greater access to in-home care by extending “deemed eligibility” to those who meet the qualifications for Medicaid and wish to remain in their home to receive services.

This program does not call for additional Medicaid funding and does not change the low-income criteria to become eligible, nor will it alter or lower standards of care or eligibility. Instead, it enables our loved ones to receive in-home care more swiftly.

SB 277 passed the Senate Health and Human Services Committee unanimously last session. Additional cosponsors included Senators Baker, Blake, Brewster, Browne, Collett, Gordner, Haywood, Hutchinson, Leach, Martin, Mensch, Muth, Phillips-Hill, Regan, Sabatina, Schwank, Tartaglione, Vogel, and A. Williams.

Please join us in correcting this disparity in the eligibility process to allow our seniors applying for Medicaid to receive the care that they prefer. Thank you.