PRINTER'S NO. 484
No. 420 Session of 2003
INTRODUCED BY WATSON, HESS, PISTELLA, THOMAS, BAKER, BIANCUCCI,
CRAHALLA, DAILEY, MACKERETH, MAITLAND, SATHER, R. STEVENSON,
ADOLPH, BARD, BROWNE, BUNT, CLYMER, CORRIGAN, COY, CREIGHTON,
DALLY, DeLUCA, FLICK, FREEMAN, GEIST, GEORGE, HARHART,
HARPER, HENNESSEY, HERMAN, HERSHEY, HORSEY, LEDERER, MARSICO,
McILHATTAN, MELIO, MUNDY, NAILOR, PALLONE, PETRI, PETRONE,
PICKETT, RUBLEY, SAYLOR, SOLOBAY, E. Z. TAYLOR, TIGUE AND
TRUE, FEBRUARY 24, 2003
REFERRED TO COMMITTEE ON AGING AND OLDER ADULT SERVICES,
FEBRUARY 24, 2003
AN ACT
1 Providing for the licensure and regulation of adult living
2 residences; conferring powers and duties on the Department of
3 Public Welfare; adding members to the Intra-Governmental
4 Council on Long-Term Care; providing for an increase to State
5 supplemental assistance for persons in personal care homes;
6 and providing for penalties.
7 The General Assembly finds and declares as follows:
8 (1) Assisted living residences and services are a
9 rapidly growing long-term care alternative across the nation.
10 (2) Assisted living residences are a combination of
11 housing and supportive services as needed. They are widely
12 accepted by the general public because they allow people to
13 age in place, maintain their independence and exercise
14 decision making and personal choice.
15 (3) Consumers continue to say that the three things they
16 want most are:
1 (i) to stay independent and live at home and in
2 their community as long as possible;
3 (ii) respect and dignity for the individual; and
4 (iii) a choice of long-term care and supportive
5 services options.
6 (4) In Pennsylvania, assisted living residences and
7 supportive services are a private market phenomenon. There
8 is:
9 (i) no uniform definition of assisted living
10 residence;
11 (ii) no public oversight of entities which hold
12 themselves out as assisted living residences, although
13 many are licensed as personal care homes;
14 (iii) no uniform way of assuring quality; and
15 (iv) limited access for persons with lower incomes.
16 (5) It is in the best interest of all Pennsylvanians
17 that a system of licensure and regulation be established for
18 assisted living residences in order to ensure accountability
19 and a balance of availability between institutional and home-
20 based and community-based long-term care for older persons
21 and persons with disabilities.
22 TABLE OF CONTENTS
23 Section 1. Short title.
24 Section 2. Definitions.
25 Section 3. Intra-Governmental Council on Long-Term Care.
26 Section 4. Powers and duties of Commonwealth departments.
27 Section 5. Rules and regulations.
28 Section 6. Criminal history and reporting of suspected abuse.
29 Section 7. License required.
30 Section 8. Application for license.
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1 Section 9. Issuance of licenses.
2 Section 10. Standards for admission.
3 Section 11. (Reserved)
4 Section 12. Right to enter and inspect.
5 Section 13. Relocation of consumers in assisted living
6 residences.
7 Section 14. Assisted living residence administrators.
8 Section 15. Staff orientation and training in assisted living
9 residences.
10 Section 15.1. Staffing levels and training.
11 Section 16. Persons with special needs.
12 Section 17. Violations.
13 Section 18. Reasons for denial, nonrenewal or revocation of a
14 license.
15 Section 19. Licensure appeals.
16 Section 20. Effect of departmental orders.
17 Section 21. Actions against violations of law and regulations.
18 Section 22. Injunction or restraining order when appeal is
19 pending.
20 Section 23. Annual report.
21 Section 24. Legislative Budget and Finance Committee study.
22 Section 25. Committee regulation review.
23 Section 26. Increase to State supplemental assistance for
24 persons in personal care homes.
25 Section 27. Severability.
26 Section 28. Repeal.
27 Section 29. Effective date.
28 The General Assembly of the Commonwealth of Pennsylvania
29 hereby enacts as follows:
30 Section 1. Short title.
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1 This act shall be known and may be cited as the Adult Living
2 Residence License Act.
3 Section 2. Definitions.
4 The following words and phrases when used in this act shall
5 have the meanings given to them in this section unless the
6 context clearly indicates otherwise:
7 "Activities of daily living." Activities including eating,
8 bathing, dressing, toileting, transferring in and out of bed or
9 a chair and personal hygiene.
10 "Adult." A person who is 18 years of age or older.
11 "Adult living residence." A residential premises that
12 provides housing, food, assistance with activities of daily
13 living and scheduled or unscheduled supervision available on a
14 24-hour basis, through contract for more than three adults who
15 are unrelated to the operator of the residential premises and
16 who do not require care in a licensed long-term care nursing
17 facility as that term is defined in the act of July 19, 1979
18 (P.L.130, No.48), known as the Health Care Facilities Act,
19 regardless of whether the operator provides or allows
20 supplemental services such as additional assistance with
21 activities of daily living and intermittent health care services
22 provided by certified, registered or licensed health care
23 professionals. The term shall include a personal care home that
24 has a Category I license and an assisted living residence that
25 has a Category II license. The term shall not include
26 intermediate care facilities exclusively for the mentally
27 retarded, commonly referred to as ICF/MR.
28 "Adult living residency contract." A written agreement, in
29 the form of a contract or contracts between a provider and a
30 consumer needing adult living residence services, regarding the
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1 provision and terms of those services.
2 "Aging in place." The process of providing increased or
3 adjusted supportive services to a consumer to compensate for the
4 physical or mental decline that occurs with the aging process
5 over time in order to maximize individual dignity and
6 independence and to permit the person to remain in a familiar,
7 living environment of the person's choice for as long as
8 possible, where such supportive services are provided by a
9 licensed facility or a third party, in a home or community or
10 through volunteers, friends or family.
11 "Area agency on aging." The single local agency designated
12 by the Department of Aging within each planning and service area
13 to administer the delivery of a comprehensive and coordinated
14 plan of social and other services and activities.
15 "Assisted living." Activities as determined and self-
16 directed by a consumer or by a legal representative that permit
17 and assist the consumer to live in a community, including such
18 housing assistance or residency in an assisted living residence
19 that permits the consumer to safely be supported in a residence
20 in which the consumer's independence, dignity and ability to
21 make choices are maintained, to the extent of the consumer's
22 capabilities.
23 "Assisted living residence." A residential setting that:
24 (1) Offers, provides or coordinates a combination of
25 personal care services, recreation and social activities, 24-
26 hour supervision and assisted living services, whether
27 scheduled or unscheduled and that coordinates other health-
28 related services for consumers.
29 (2) Has a supportive service program and physical
30 environment designed to accommodate changing needs and
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1 preferences.
2 (3) Has an organized mission, service programs and a
3 physical environment designed to maximize consumer dignity,
4 autonomy, privacy and independence and encourages family and
5 community involvement.
6 (4) Provides that costs for housing and services are
7 independent of one another and that provides consumers with
8 the ability to choose their service provider and the services
9 to be provided.
10 (5) Has a goal of fostering aging in place and promoting
11 consumer self-direction and active participation in decision
12 making while emphasizing consumer privacy and dignity.
13 This term does not include a residential living unit maintained
14 by a continuing care provider who is certified by the Insurance
15 Department, a residential unit in a subsidized housing
16 apartment, unless required to be licensed under the Department
17 of Housing and Urban Development Assisted Living Conversion
18 Program, or a boarding home which merely provides room, board
19 and laundry services to persons who do not need personal care
20 services.
21 "Assisted living services." A combination of supportive
22 services, personal care services, personalized assistance
23 services, assistive technology and health-related services
24 designed to respond to the individual needs of consumers who
25 need assistance with activities of daily living and instrumental
26 activities of daily living. The terms includes publicly funded
27 home-based and community-based services available through the
28 medical assistance program and the Federal Medicaid Waiver
29 Program and State-funded options for home-based and community-
30 based services funded through the Department of Aging and the
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1 Department of Public Welfare.
2 "Assisted living services agreement." The contract or
3 contracts between a provider and a consumer needing assisted
4 living services regarding the provision and terms of the
5 assisted living services. This term includes contracts between
6 assisted living service providers and entities contracting for
7 services for consumers using public funding.
8 "Assistive technology." Devices and services, whether
9 medically necessary or not, that are used to increase, maintain
10 or improve the functional capabilities of persons with
11 disabilities which may or may not be needed to permit the
12 persons to live independently. The term shall include, but not
13 be limited to, reachers, adapted telephones, reading aids and
14 other nonmedical devices.
15 "Board." The Board of Hearings and Appeals within the
16 Department of Public Welfare of the Commonwealth.
17 "Category I license." An adult living residence license
18 issued under this act to a personal care home.
19 "Category II license." An adult living residence license
20 issued under this act to an assisted living residence.
21 "Cognitive support services." Services provided as part of a
22 comprehensive plan of care to individuals who have memory
23 impairments and other cognitive problems which significantly
24 interfere with their ability to carry out activities of daily
25 living without assistance and who require that supervision,
26 monitoring and programming be available to them 24 hours a day,
27 seven days a week, in order for them to reside safely in the
28 setting of their choice. The term includes assessment, health
29 support services and a full range of dementia-capable activity
30 programming and crisis management.
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1 "Compliance." A facility or assisted living services
2 provider that is found in compliance with the requirements of
3 this act and its regulations except for isolated Class III
4 violations, for which the assisted living residence
5 administrator has provided written certification of correction
6 of the isolated Class III violations within 30 days of the date
7 of the inspection and it has met all other requirements of this
8 act and its regulations.
9 "Comprehensive assessment." A thorough review and analysis
10 of a consumer's functional status. The term includes a personal
11 history, assessment of physical and emotional health, ability to
12 carry out activities of daily living, informal supports,
13 environmental factors and cognitive functioning, including
14 immobility assessment.
15 "Comprehensive service plan." A plan developed to meet a
16 consumer's individual needs, as determined by a comprehensive
17 assessment, and that is developed by an interdisciplinary team
18 that includes the consumer, the consumer's legal representative
19 and the consumer's family member.
20 "Consumer." A person who receives services in an adult
21 living residence, is in need of assisted living services or
22 personal care services and who lives in either an adult living
23 residence with a Category I license or a Category II license.
24 "Department." The Department of Public Welfare of the
25 Commonwealth.
26 "Direct service staff." A person who provides services in an
27 adult living residence, is 18 years of age or older and meets
28 the requirements of this act.
29 "Immobile person." An individual who is unable to move from
30 one location to another or has difficulty in understanding and
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1 carrying out instructions without the continued full assistance
2 of another person or is incapable of independently operating a
3 device such as a wheelchair, prosthesis, walker or cane to exit
4 to a point of safety.
5 "Instrumental activities of daily living." The term
6 includes, but is not limited to, meal preparation, using the
7 telephone, handling finances, banking and shopping, light
8 housekeeping, heavy housekeeping and getting to appointments.
9 "Isolated Class III violations." A finding by the Department
10 of Public Welfare at the annual inspection of less than three
11 Class III violations that had not been previously cited at the
12 last inspection and that related to the services provided to an
13 individual or did not present a threat to the health and well-
14 being of consumers.
15 "License." A Category I license or a Category II license.
16 "Long-term care ombudsman." An agent of the Department of
17 Aging who, pursuant to section 2203-A of the act of April 9,
18 1929 (P.L.177, No.175), known as The Administrative Code of
19 1929, investigates and seeks to resolve complaints made by or on
20 behalf of older individuals or adults with disabilities who are
21 consumers of adult living residences, which complaints may
22 relate to action, inaction or decisions of providers of assisted
23 living services or residences or of personal care homes or of
24 public agencies or of social service agencies or their
25 representatives and which complaints may adversely affect the
26 health, safety, welfare, interests, preferences or rights of
27 consumers.
28 "Options." The Long-Term Care Pre-Admission Assessment
29 Program and the Community Services for Nursing Facility
30 Eligibility Program administered by the Department of Aging and
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1 operated by the local area agencies on aging.
2 "Pattern of violations." A finding by the Department of
3 Public Welfare at the annual inspection of violations that had
4 been cited at one or both of the last two annual inspections.
5 "Personal care home." A premises in which food, shelter and
6 personal assistance or supervision are provided for a period
7 exceeding 24 hours for four or more consumers who are not
8 relatives of the operator of the premises, who do not require
9 the services in or of a licensed long-term care facility, but
10 who require assistance or supervision in such matters as
11 dressing, bathing, diet, financial management, evacuation of a
12 residence in the event of an emergency or medication prescribed
13 for self-administration.
14 "Personal care services." Assistance or supervision in
15 dressing, bathing, diet, financial management or evacuation of a
16 consumer in a personal care home, in the event of an emergency,
17 or medication prescribed for self-administration.
18 Section 3. Intra-Governmental Council on Long-Term Care.
19 (a) Additional members.--In addition to the members
20 appointed to the Intra-Governmental Council on Long-Term Care in
21 accordance with section 212 of the act of June 13, 1967 (P.L.31,
22 No.21), known as the Public Welfare Code, the Governor shall
23 appoint four representatives of the assisted living community,
24 one of whom shall be an owner or administrator of a licensed
25 assisted living residence and one of whom shall be a consumer of
26 a licensed assisted living residence, one of whom shall be a
27 licensed provider of assisted living services and one of whom
28 shall be a consumer of assisted living services from a licensed
29 provider of assisted living services.
30 (b) Recommendations to be considered.--In developing rules
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1 and regulations for licensure of assisted living residences, the
2 Department of Public Welfare shall work in cooperation with the
3 Department of Aging and shall take into consideration
4 recommendations of the Intra-Governmental Council on Long-Term
5 Care.
6 Section 4. Powers and duties of Commonwealth departments.
7 (a) General rule.--Within one year of the effective date of
8 this act, the following Commonwealth departments shall work in
9 consultation and in cooperation with each other to develop a
10 program of licensure and regulation to govern adult living
11 residences in this Commonwealth:
12 (1) The Department of Public Welfare shall serve as the
13 lead agency in the development and implementation of a
14 program for licensing and regulating adult living residences,
15 to include a Category I license and a Category II license.
16 The department shall coordinate with other State and local
17 agencies having statutory responsibilities relating to adult
18 living residences and providers of assisted living services.
19 (2) The Department of Aging shall formulate and provide
20 to the Aging and Youth Committee of the Senate and the Aging
21 and Older Adult Services Committee of the House of
22 Representatives, within one year of the effective date of
23 this act, recommendations for changes in existing State law
24 and regulations to extend provisions of the act of November
25 6, 1987 (P.L.381, No.79), known as the Older Adults
26 Protective Services Act, to adult living residences and the
27 consumers thereof.
28 (3) Within six months of the effective date of this act,
29 the Department of Health shall promulgate rules and
30 regulations to license providers of assisted living services
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1 who are not already licensed by that department. Such
2 licensure system shall include the following components:
3 (i) (A) Within nine months of the effective date of
4 this act, the Department of Health shall license
5 assisted living services providers.
6 (B) Direct care staff employed by assisted
7 living services providers or providing direct care
8 services to consumers in their homes shall meet all
9 training and testing requirements in this act
10 relating to assisted living residences that are not
11 specific to assisted living residence care. Prior to
12 start of training and testing, the applicant shall
13 pass a criminal history background check conducted by
14 the training and testing agency. Direct care staff
15 shall present to assisted living services recipients
16 documentation from the Department of Health that they
17 have passed a criminal history check and have
18 completed the required training.
19 (C) Entities that do not provide personal care
20 services, but that solely provide assistance with
21 instrumental activities of daily living shall be
22 exempt from the requirements of this act.
23 (ii) (A) Assisted living services providers shall
24 meet the following provisions of this act, except to
25 the extent that the Department of Health deems the
26 provisions applicable only to residents of assisted
27 living residences.
28 (B) Direct care staff shall provide assisted
29 living services consumers with 30 days' advance
30 written notice, where possible, of interruption or
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1 termination of service delivery, except where the
2 safety of the direct care staff is at risk. Direct
3 care staff shall be included under the reporting
4 requirements of review under the Older Adults
5 Protective Services Act. Direct care staff found to
6 be in violation of the advance notice provision of
7 this section may be sanctioned by the Department of
8 Health and have their documentation of training
9 necessary for employment withdrawn.
10 (iii) The Department of Health shall conduct annual
11 unannounced inspections of assisted living services
12 providers and shall include visits to a random sample of
13 consumers as part of the inspection process.
14 (4) Within one year of the effective date of this act,
15 the Department of Labor and Industry shall promulgate rules
16 and regulations applicable to assisted living residences in
17 accordance with the act of November 10, 1999 (P.L.491,
18 No.45), known as the Pennsylvania Construction Code Act, and
19 in accordance with this section. The regulations shall apply
20 to all assisted living residences not currently licensed by
21 the Department of Public Welfare as a personal care home and
22 to all personal care homes making an application to the
23 department for a Category II license. A personal care home
24 making an application for a Category II license shall have
25 three years from the effective date of this act to comply
26 with the Department of Labor and Industry rules and
27 regulations under this act.
28 (b) Consumer rights.--All consumer rights specified in this
29 act shall apply to consumers of assisted living services
30 providers, unless the right is specific to residency.
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1 Section 5. Rules and regulations.
2 The department shall promulgate rules and regulations for
3 adult living residences that:
4 (1) Provide that any regulations specifically related to
5 personal care homes, adopted prior to the effective date of
6 this act, set forth in 55 Pa. Code Ch. 2620 (relating to
7 personal care home licensing), and promulgated in accordance
8 with the act of June 13, 1967 (P.L.31, No.21), known as the
9 Public Welfare Code, shall continue to be applied to an owner
10 or administrator of a personal care home under a Category I
11 license. The department shall ensure consistency between such
12 currently existing regulations governing personal care homes
13 and any regulations promulgated in accordance with this act.
14 (2) Develop standards for a Category II license for
15 assisted living residences.
16 (3) Require personal care homes licensed by the
17 department prior to the effective date of this act and that
18 intend to obtain a Category II license to come into
19 compliance with department rules and regulations and to
20 obtain a Category II license as an assisted living residence
21 no later than three years after the effective date of this
22 act.
23 (4) Within 90 days of the effective date of this act,
24 adopt rules relating to the conduct of owners and employees
25 of assisted living residences relative to the endorsement or
26 delivery of public or private welfare, pension or insurance
27 checks by a consumer or an assisted living residence.
28 (5) Within 90 days of the effective date of this act,
29 and in consultation with the Department of Aging, the
30 Department of Health, the Intra-Governmental Council on Long-
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1 Term Care and the Personal Care Home Advisory Committee,
2 adopt rules for: classification of violations; enforcement
3 measures for violations, including closure of adult living
4 residences with extensive patterns of serious violations or
5 those which are found to have severe violations which
6 constitute a risk to safety of current or potential
7 residents; closure of adult living residences that have
8 failed to obtain a license and that have residents receiving
9 services covered by this act; responding to the needs of
10 residents with cognitive impairments; and protecting
11 residents' rights. Such rules shall be in effect until the
12 adoption of final regulations that cover the same subject
13 matter.
14 (6) Exempt from regulation under this act boarding homes
15 which merely provide room, board and laundry services to
16 persons who do not need adult living residence services.
17 (7) Promote the cost efficiency and effectiveness of
18 visitations and inspections.
19 (8) Delegate to other State and local agencies
20 responsibility for visitations, inspections, referral,
21 placement and protection of consumers residing in adult
22 living residences or receiving assisted living services from
23 a provider of assisted living services.
24 (9) Evaluate the State's fire and panic laws as applied
25 to adult living residences.
26 (10) Create a uniform standard policy for the discharge
27 of a consumer from an adult living residence, including, at a
28 minimum, advance notice provisions for the consumer.
29 (11) Create a listing of medical conditions or care
30 needs that shall preclude adult living residences from
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1 admitting or retaining consumers.
2 (12) Provide for the implementation of fire and safety
3 and consumer care standards relating to adult living
4 residences by cities of the first class, second class and
5 second class A.
6 (13) (i) Establish a process for promptly relocating
7 consumers of adult living residences by the department if
8 the assisted living residence is operating without a
9 license, is voluntarily closing and residents are being
10 displaced, is being involuntarily closed, or has engaged
11 in conduct that endangers the health and safety of its
12 residents, which shall include providing consumers with
13 referrals, options assessment and moving assistance.
14 (ii) Except in an emergency, the consumer shall be
15 involved in planning his transfer to another placement
16 and shall have the right to choose among the available
17 alternative placements. The department may make temporary
18 placement until final placement can be arranged.
19 Consumers shall be provided with an opportunity to visit
20 alternative placement before relocation or following
21 temporary emergency relocation. Consumers shall choose
22 their final placement and shall be given assistance in
23 transferring to such place.
24 (iii) Consumers shall not be relocated pursuant to
25 this section if the department determines in writing, and
26 consistent with consumer preference, that such relocation
27 is not in the best interest of the consumer.
28 (14) Ensure that any regulations established in
29 accordance with this section shall be consistent with
30 regulations of the department relating to the funding of
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1 residential care for the mentally ill or mentally retarded
2 adults and any regulations of the Department of Aging
3 relating to domiciliary care.
4 (15) Develop standards and qualifications for assisted
5 living residence administrators.
6 (16) Develop standards for orientation and training for
7 all direct service staff in an assisted living residence.
8 (17) Provide for the posting in adult living residences
9 of information regarding the Long-Term Care Ombudsman
10 Program, including the process whereby the services of the
11 local ombudsman care be readily accessed including the
12 telephone number, and name of the contact person. Such
13 information shall be posted in a conspicuous location that is
14 readily accessible and shall be presented in a form easily
15 understood and read by consumers.
16 (18) Develop standards, for admission to adult living
17 residences and for provision of assisted living services,
18 including:
19 (i) Completion of a comprehensive assessment process
20 and development of a comprehensive service plan for each
21 consumer.
22 (ii) Requirements for information which must be
23 provided to consumers of adult living residences and
24 assisted living services.
25 (iii) Requirements for adult living residency
26 contracts, including development of a standardized adult
27 living residency contract.
28 Section 6. Criminal history and reporting of suspected abuse.
29 The requirements of Chapters 5 and 7 of the act of November
30 6, 1987 (P.L.381, No.79), known as the Older Adults Protective
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1 Services Act, shall apply to adult living residences.
2 Section 7. License required.
3 No person shall establish, maintain, operate or hold itself
4 out as authorized to establish, maintain or operate:
5 (1) A personal care home without first having obtained a
6 Category I license issued by the department.
7 (2) An assisted living residence without first having
8 obtained a Category II license issued by the department.
9 Section 8. Application for license.
10 (a) Submission to department.--Any provider desiring to
11 secure a Category I license or Category II license shall submit
12 an application on a form prescribed by the department and shall
13 submit any other information required by the department.
14 (b) Fees.--The following fee shall accompany an application
15 for a license or for renewal of a license until modified by the
16 department by regulation:
17 (1) Residences with less than 20 beds - $50.
18 (2) Residences with 20-50 beds - $100.
19 (3) Residences with 51-100 beds - $250.
20 (4) Residences with more than 100 beds - $500.
21 Section 9. Issuance of licenses.
22 A license issued by the department under this act shall:
23 (1) Be issued for a period not to exceed one year.
24 (2) Be issued only to the applicant.
25 (3) Be issued only when the applicant has achieved
26 compliance with the rules and regulations of the Commonwealth
27 departments provided for under sections 4 and 5.
28 (4) Not be transferable unless the department approves
29 the transfer of license. The department may deny transfers to
30 friends, relatives or business associates, if it appears that
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1 the purpose of the transfer is to avoid licensure action or
2 if it appears that the previous owner will continue to have
3 involvement in the facility or business.
4 (5) Be posted at all time in a conspicuous and readily
5 accessible place on the premises of the adult living
6 residence.
7 (6) There shall be four classes of licensure:
8 (i) Exceptional quality licensure shall be awarded
9 to assisted living residences and assisted living
10 services providers based on a finding by a panel
11 established by the department that the provider is in
12 compliance with licensure requirements and should be
13 recognized for its use of best practices and high
14 consumer satisfaction, and positive outcomes. Assisted
15 living residences with this licensure classification may
16 advertise and the department shall post names of those
17 assisted living residences with this licensure
18 classification on its World Wide Web site.
19 (ii) Compliance licensure shall be provided to
20 assisted living residences with either no violations or
21 isolated Class III violations which the administrator has
22 certified in writing to the department have been
23 corrected within 30 days of the date of the annual
24 licensure inspection.
25 (iii) Provisional licensure shall be given to
26 assisted living residences or assisted living services
27 providers with a pattern of Class III violations or
28 isolated Class II violations for a period of six months.
29 Substantial improvement must be demonstrated for assisted
30 living residences to receive a second six-month
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1 provisional license. Those assisted living residences or
2 assisted living services providers which do not meet the
3 standards for a compliance license at the next scheduled
4 inspection shall have their licenses revoked by the
5 department.
6 (iv) Provisional licensure with ban on admissions
7 shall be given for a six-month period to assisted living
8 residences or assisted living services providers with a
9 pattern of Class II, isolated Class I or a pattern of
10 Class I violations.
11 Section 10. Standards for admission.
12 The rules and regulations for the licensing of adult living
13 residences promulgated by the department not later than one year
14 after the effective date of this act shall provide that:
15 (1) Prior to admission to an adult living residence, an
16 initial standardized screening instrument shall determine the
17 appropriateness of the admission and shall be completed for
18 all consumers. This standardized screening instrument shall
19 be developed by the Department of Public Welfare, in
20 cooperation with the Department of Aging, the Department of
21 Health and the Intra-Governmental Council on Long-Term Care.
22 In no way shall the utilization of this standardized
23 instrument be in lieu of an options assessment for any
24 consumer who may need publicly funded services.
25 (2) In addition to the screening, a medical evaluation
26 shall be completed and signed by a physician prior to
27 admission to an adult living residence, using a form approved
28 by the department. Thereafter, each consumer shall receive a
29 screening and an annual evaluation or an evaluation upon a
30 significant change in condition of the consumer.
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1 (3) Following completion of a comprehensive assessment,
2 an appropriately trained person at the residence shall work
3 in cooperation with an interdisciplinary team that includes
4 the consumer, the consumer's legal representative or the
5 consumer's family member to develop a written comprehensive
6 service plan consistent with the consumer's unique physical
7 and psychosocial needs with recognition of the consumer's
8 capabilities and preferences.
9 (4) Adult living residences may not admit a consumer
10 before a determination has been made that the needs of the
11 consumer can be met based upon:
12 (i) The completed screening instrument.
13 (ii) The medical evaluation report.
14 (iii) An interview between the adult living
15 residence and the consumer.
16 (5) Assisted living residences with a Category II
17 license shall:
18 (i) Foster aging in place and promote consumer self-
19 direction and active participation in decision making
20 while emphasizing a consumer's privacy and dignity.
21 (ii) Permit consumers to live independently in the
22 residential environment of their choice with privacy and
23 dignity.
24 (iii) Promote integration of consumers into the
25 community and participation in the mainstream of
26 activities.
27 (iv) Maximize consumer choice to promote and support
28 the consumer's changing needs and preferences.
29 (v) Be consumer oriented and meet professional
30 standards of quality.
20030H0420B0484 - 21 -
1 (6) An assisted living residence administrator shall
2 refer a consumer whose needs cannot be met by an assisted
3 living residence for a standardized screening.
4 (7) A comprehensive service plan shall be on file for
5 each consumer and shall be strictly adhered to in the
6 provision of care and services provided to the consumer.
7 (8) Each consumer, or the consumer's legal
8 representative, shall receive an information packet at the
9 time of application which shall include the following items,
10 to be presented in a form easily understood and read by the
11 consumer:
12 (i) A copy of the adult living residence's policies.
13 (ii) Advance directive information, including
14 information on the right to have or not have an advance
15 directive.
16 (iii) Information regarding licensure status.
17 (iv) Telephone numbers of the local long-term care
18 ombudsman program and the local area agency on aging.
19 (v) A copy of the adult living residency contract
20 used by the adult living residence and all rates charged.
21 (vi) A copy of the internal complaint resolution
22 mechanism used by the adult living residence.
23 (vii) A disclosure stating the rights of consumers
24 under this act.
25 (viii) Information regarding the discharge policy of
26 the adult living residence.
27 (9) All consumers shall receive a standard written adult
28 living residency contract which shall include the actual rent
29 and other charges for services provided by the adult living
30 residence. The contract shall also include a disclosure
20030H0420B0484 - 22 -
1 statement which shall include the following:
2 (i) That the consumer shall have 24 hours from the
3 time of presentation to sign the contract.
4 (ii) That if the contract is signed upon
5 presentation, the consumer shall have 72 hours to rescind
6 the contract.
7 (10) A consumer shall have the right to leave and return
8 to the adult living residence, receive visitors, have access
9 to a telephone and mail and participate in religious
10 activities.
11 (11) Adult living residence owners, administrators and
12 direct service staff shall be prohibited from being assigned
13 power of attorney or guardianship for consumers.
14 Section 11. (Reserved)
15 Section 12. Right to enter and inspect.
16 (a) General rule.--The department shall have the right to
17 enter and inspect any adult living residence that is licensed or
18 required to be licensed under this act, with or without prior
19 notice. The department shall have the right to free and full
20 access to inspect and examine the assisted living residence and
21 its grounds and the records of the residence and the licensee.
22 The department shall also have immediate and full opportunity to
23 privately interview any member of the direct service staff. The
24 department shall contact the Long-Term Care Ombudsman and shall
25 utilize any consumer-related information available to be
26 provided by that office when conducting inspections under this
27 section.
28 (b) Initial licensure inspection.--Before a facility is
29 licensed and permitted to open, operate or admit residents and
30 before assisted living services are provided to consumers, it
20030H0420B0484 - 23 -
1 shall be inspected by the department and be found in compliance
2 with the requirements set forth in this act and the resulting
3 regulations.
4 (c) Annual unannounced inspections required.--The department
5 shall annually conduct at least one onsite, unannounced
6 inspection of each adult living residence.
7 (d) Special unannounced inspections.--Within 24 hours, upon
8 receipt of a complaint from any person alleging an immediate
9 serious risk to the health or safety of a consumer in an adult
10 living residence, the department shall conduct an onsite
11 unannounced inspection of the adult living residence. Complaints
12 prompting an inspection pursuant to this subsection may include
13 severe injury or death of a consumer in the adult living
14 residence, reports of abuse or conditions or practices that
15 create an immediate and serious risk to a consumer.
16 (e) Time period for unannounced inspections.--Except for
17 complaints under subsection (d), the department shall determine
18 the acceptable time period in which complaints shall be
19 investigated based upon the seriousness of the complaint.
20 (f) Surveys.--The department shall develop:
21 (1) A process for implementing an abbreviated survey and
22 inspection process for good performers and an intensified
23 survey and inspection process for poor performers.
24 (2) A process for incorporating outcomes and consumer
25 satisfaction into the survey process.
26 (3) A process for determining and communicating provider
27 satisfaction with the survey and inspection process.
28 (4) A process that requires administrator certification
29 of the truth of the statements made on all plans of
30 correction and reports of corrective steps taken with the
20030H0420B0484 - 24 -
1 administrator at risk of fine and loss of ability to be an
2 administrator for false statements.
3 (5) An appeal process that is expeditious with no appeal
4 or request for reconsideration outstanding for more than 60
5 days and that precludes the granting of a supersedeas unless
6 the provider demonstrates a substantial likelihood of
7 prevailing on the merits.
8 (6) The department shall develop a uniform survey tool
9 to be used by inspectors.
10 (g) Annual report.--The department shall submit on an annual
11 basis a report to the Aging and Youth Committee of the Senate
12 and the Aging and Older Adult Services Committee of the House of
13 Representatives regarding the findings of the inspections
14 required by this section.
15 (h) Administrative search warrants.--Notwithstanding the
16 inspection and access powers of the department under subsection
17 (a), upon showing probable cause that there is a violation of
18 this act or regulations under this act, a court of competent
19 jurisdiction or a district justice where the residence is
20 located shall issue an administrative search warrant to the
21 department. The warrant shall identify the address of the adult
22 living residence to be searched, the hours during which the
23 search will occur and any documents or objects to be seized.
24 Section 13. Relocation of consumers in assisted living
25 residences.
26 (a) Conditions.--Except as provided in subsection (c), the
27 department, in conjunction with appropriate local authorities,
28 shall relocate consumers from an assisted living residence if
29 any of the following conditions exist:
30 (1) The assisted living residence is operating without a
20030H0420B0484 - 25 -
1 license.
2 (2) The licensee is voluntarily closing the assisted
3 living residence and relocation is necessary for the health
4 and safety of the consumers.
5 (b) Assistance.--The department shall offer relocation
6 assistance to consumers relocated under this section. Except in
7 an emergency, consumers shall be involved in planning their
8 transfer to another placement and shall have the right to choose
9 among the available alternative placements. The department may
10 make temporary placement until final placement can be arranged.
11 Consumers shall be provided with an opportunity to visit
12 alternative placement before relocation or following temporary
13 emergency relocation. Consumers shall choose their final
14 placement and shall be given assistance in transferring to such
15 place.
16 (c) When prohibited.--Consumers may not be relocated
17 pursuant to this section if the department determines in writing
18 that such relocation is not in the best interest of the
19 consumers.
20 Section 14. Assisted living residence administrators.
21 (a) Appointment.--Ninety days after the effective date of
22 this act, all assisted living residences shall identify and
23 appoint an assisted living residence administrator or
24 administrators who meet, within one year of the effective date
25 of the regulations promulgated under section 5, at a minimum,
26 the qualifications provided in this section.
27 (b) Qualification.--An assisted living residence
28 administrator shall satisfy either of the following
29 qualifications:
30 (1) (i) be 21 years of age or older and be of good
20030H0420B0484 - 26 -
1 moral character;
2 (ii) have a high school diploma or a GED
3 equivalency; and
4 (iii) have knowledge, education and training, as it
5 pertains to assisted living residences, in all of the
6 following:
7 (A) Fire prevention and emergency planning.
8 (B) First aid and cardiopulmonary resuscitation
9 (CPR) certification, medications, medical terminology
10 and personal hygiene.
11 (C) Federal, State and local laws and
12 regulations.
13 (D) Nutrition, food handling and sanitation.
14 (E) Recreation.
15 (F) Matters relating to dementia, including
16 normal aging, cognitive, psychological and function
17 abilities of older persons.
18 (G) Mental health issues.
19 (H) Assisted living philosophy.
20 (I) Use and benefits of assistive technology.
21 (J) Team building and stress reduction for
22 assisted living residence staff.
23 (K) Working with family members.
24 (L) Awareness, identification, prevention and
25 reporting of abuse and neglect.
26 (M) Mission and purpose of services to
27 individuals with cognitive impairments.
28 (N) Communication skills and management of
29 behavioral challenges.
30 (O) Community resources and social services.
20030H0420B0484 - 27 -
1 (P) Staff supervision, budgeting, financial
2 recordkeeping and training; or
3 (2) Be a licensed nursing home administrator or
4 certified personal care home administrator who has completed
5 a course of instruction in the administration of an assisted
6 living residence, including instruction in all areas
7 enumerated under paragraph (1)(iii).
8 (c) Training.--All administrators shall complete a
9 department-approved training course of a minimum of 120 hours.
10 All administrators shall pass a test which has been approved by
11 the department and administered by an entity approved by the
12 department at the end of training to demonstrate proficiency in
13 the application of skills and knowledge.
14 (d) Continuing education.--Every two years, all
15 administrators shall complete 36 hours of continuing education
16 that has been approved by the department and is applicable to
17 the practice of assisted living administrators.
18 Section 15. Staff orientation and training in assisted living
19 residences.
20 (a) General rule.--The department shall promulgate
21 regulations, not later than 60 days after the effective date of
22 this act, that require orientation and training for all direct
23 service staff in assisted living residences. Such orientation
24 and training shall include the following areas:
25 (1) Fire prevention and emergency planning.
26 (2) First aid and CPR certification, medications,
27 medical terminology and personal hygiene.
28 (3) Federal, State and local laws and regulations.
29 (4) Nutrition, food handling and sanitation.
30 (5) Recreation.
20030H0420B0484 - 28 -
1 (6) Matters relating to dementia, including normal
2 aging, cognitive, psychological and functional abilities of
3 older persons.
4 (7) Mental health issues.
5 (8) Assisted living philosophy.
6 (9) Use and benefits of assistive technology.
7 (10) Team building and stress reduction for assisted
8 living residence staff.
9 (11) Working with family members.
10 (12) Awareness, identification, prevention and reporting
11 of abuse and neglect.
12 (13) Mission and purpose of services to individuals with
13 cognitive impairments.
14 (14) Communication skills and management of behavioral
15 challenges.
16 (15) Community resources and social services.
17 (b) Standards.--Not later than 90 days after the effective
18 date of this act, the department shall, by regulation, develop
19 such standards for knowledge, education or training to meet the
20 requirements of this section.
21 (c) Department administered training.--If not otherwise
22 available, the department shall schedule and offer, at cost,
23 training and educational programs for a person to meet the
24 knowledge, educational and training requirements established by
25 this act.
26 Section 15.1. Staffing levels and training.
27 (a) General rule.--The department shall establish staffing
28 levels for assisted living residences depending upon the
29 facility population, mobility of residents and cognitive
30 impairments to insure:
20030H0420B0484 - 29 -
1 (1) Twenty-four-hour-a-day awake direct care staff to
2 meet the unplanned and unscheduled needs of consumers.
3 (2) Direct care staff to meet consumers' planned and
4 scheduled needs as required in their comprehensive service
5 plans.
6 (3) Additional staff or contracted services to meet
7 laundry, food service, housekeeping, transportation and
8 maintenance needs of the assisted living residence.
9 (b) Training.--All direct care staff shall complete a
10 department-approved education and training program which has
11 been approved by the department for a minimum of 40 hours and
12 obtain a certificate of completion. Direct care staff shall
13 complete training and demonstrate proficiency in a manner
14 approved by the department in each training component prior to
15 independent work in that area.
16 Section 16. Persons with special needs.
17 (a) Immobile persons.--The department shall not prohibit
18 immobile persons who do not require the services of a licensed
19 long-term care facility, but who require assisted living
20 residence services, from residing in an adult living residence
21 with a Category II license, provided that the design,
22 construction, staffing or operation of the assisted living
23 residence allows for safe emergency evacuation.
24 (b) Alzheimer's disease, dementia and cognitive
25 impairment.--For consumers with Alzheimer's disease or dementia
26 or where the adult living residence holds itself out to the
27 public as providing services or housing for persons with
28 cognitive impairments, adult living residences shall disclose to
29 consumers and provide:
30 (1) the residence's written statement of its philosophy
20030H0420B0484 - 30 -
1 and mission which reflects the needs of individuals with
2 cognitive impairments;
3 (2) a description of the residence's physical
4 environment and design features to support the functioning of
5 adults with cognitive impairments;
6 (3) a description of the frequency and types of
7 individual and group activities designed specifically to meet
8 the needs of residents with cognitive impairments;
9 (4) a description of security measures provided by the
10 facility;
11 (5) a description of training provided to staff
12 regarding provision of care to consumers with cognitive
13 impairments;
14 (6) a description of availability of family support
15 programs and family involvement; and
16 (7) the process used for assessment and establishment of
17 a plan of services for the consumer, including methods by
18 which the plan of services will remain responsive to changes
19 in the consumer's condition.
20 (c) Cognitive support services.--
21 (1) An adult living residence shall provide to a
22 cognitively impaired consumer cognitive support services,
23 including dementia-specific activity programming.
24 (2) Within 30 days of admission of a cognitively
25 impaired consumer, the adult living residence shall register
26 the consumer with the Commonwealth's Safe Return Program for
27 individuals with cognitive impairments and tendencies to
28 wander.
29 Section 17. Violations.
30 (a) Classification of violations.--There shall be three
20030H0420B0484 - 31 -
1 classes of violations:
2 (1) Class I. A violation including failure to or
3 negligent provision of services in the service plan, which
4 indicates a substantial probability that death or serious
5 mental or physical harm to a consumer may result or death
6 actually results.
7 (2) Class II. A violation including failure to or
8 negligent provision of services in the service plan, which
9 has a potential or actual substantial adverse effect upon the
10 health, safety or well-being of a consumer.
11 (3) Class III. A minor violation which has an adverse
12 effect upon the health, safety or well-being of a consumer.
13 (b) Notice of violations.--If the department, whether upon
14 inspection, investigation or complaint, finds a violation of
15 this act or regulations promulgated under this act, it shall
16 give written notice to the licensee specifying the violation or
17 violations found. The notice shall require the licensee to take
18 action or to submit a plan of correction to bring the adult
19 living residence into compliance with applicable law or
20 regulation within a specified time.
21 (c) Remedies and penalties.--The remedy and penalty for
22 violations shall depend on the violation as follows:
23 (1) Isolated Class III violations. Within 30 days of the
24 date of the citation, the assisted living residence
25 administrator or assisted living services provider must
26 correct the violation and certify in writing to the
27 department that the violation has been corrected.
28 (2) Pattern of Class III violations. Within ten days of
29 the date of the citation, the assisted living residence
30 administrator or assisted living services provider must
20030H0420B0484 - 32 -
1 submit a plan of correction for departmental approval. Within
2 30 days of the date of the citation, the assisted living
3 residence administrator or assisted living services provider
4 must correct the violations and certify in writing that
5 corrections have been made. The department shall issue fines
6 and grant a provisional license which shall be in effect only
7 until written certification of corrections has been received
8 by the department. Immediate correction of the violation to
9 the inspector's satisfaction during the survey process will
10 preclude the application of a penalty under this subsection.
11 (3) Isolated Class II violations. Within ten days of the
12 date of the citation, the assisted living residence
13 administrator or assisted living services provider must
14 submit a plan of correction for departmental approval. Within
15 30 days of the date of citation, the assisted living
16 residence administrator or assisted living services provider
17 shall correct the violations and certify in writing to the
18 department that corrections have been made. The department
19 shall fine the assisted living residence or assisted living
20 services provider and issue a provisional license until
21 certification of corrections has been received by the
22 department. Immediate correction of violation to the
23 inspector's satisfaction during the survey process will
24 preclude the application of a penalty under this subsection.
25 (4) Pattern of Class II violations. Within ten days of
26 the date of the citation, the assisted living residence
27 administrator or assisted living services provider shall
28 submit a plan of correction for departmental approval. Within
29 30 days of the date of the citation, the assisted living
30 residence administrator or assisted living services provider
20030H0420B0484 - 33 -
1 shall correct the violations and shall certify in writing to
2 the department that all corrections have been made. The
3 department shall fine the provider and issue a provisional
4 license with a ban on admissions or service until written
5 certification of corrections has been received and
6 corrections have been verified by the department. The
7 department shall conduct an onsite inspection to verify
8 corrections within two business days of receipt of the
9 certification of correction. The department shall conduct
10 intensified inspections of the provider with more numerous
11 unannounced inspections.
12 (5) Isolated Class I violations. Upon a finding by the
13 department of a Class I violation, the department shall
14 immediately decide whether:
15 (i) to give a provisional license with a ban on
16 admissions or services and allow the assisted living
17 residence or assisted living services provider to correct
18 the violation;
19 (ii) to require the appointment of a master at the
20 assisted living residence's expense to oversee the
21 immediate correction of the violations; or
22 (iii) to revoke the license and arrange for the
23 immediate relocation or transfer of consumers.
24 The department shall fine the provider and should the
25 provider remain in operation, subject it to intensified and
26 more numerous unannounced inspections.
27 (6) Pattern of Class I violations. Upon a finding by the
28 department that a provider has a pattern of Class I
29 violations, the department shall immediately revoke the
30 provider's license and arrange for relocation or transfer of
20030H0420B0484 - 34 -
1 the consumers or appoint a master at the assisted living
2 residence's expense to bring the assisted living residence
3 into compliance within 30 days. The department shall issue a
4 provisional license with a ban on admissions or service if
5 the provider is permitted to continue in operation and shall
6 fine the provider. Should the provider remain in operation,
7 the department shall conduct intensified and more numerous
8 inspections.
9 (7) Any administrator who falsely certifies to the
10 department that violations have been corrected shall be fined
11 by the department and shall lose the administrator license.
12 (8) Within six months of the date of this act, the
13 department shall issue regulations governing this section.
14 The regulations shall ensure that inspections are not
15 invasive of consumer's privacy or dignity, support the
16 principles of assisted living and can be uniformly and
17 consistently applied by the department.
18 (9) The department may revoke a license before providing
19 notice or before a plan of correction is submitted whenever a
20 violation poses a significant threat to the health or safety
21 of the consumers in an adult living residence.
22 (d) Administrative fines.--
23 (1) If the department determines that an adult living
24 residence has failed to comply with the provisions of this
25 act or the regulations promulgated under this act, it may
26 assess an administrative fine of not more than $1,000 per day
27 per violation. In setting the fine, the department shall
28 consider the severity of the violation and whether there is a
29 pattern of violations.
30 (2) Money collected by the department under this section
20030H0420B0484 - 35 -
1 shall be first used to defray the expenses incurred by
2 consumers relocated under this act. Any moneys remaining
3 shall be used by the department for enforcing the provisions
4 of this act. Fines collected pursuant to this act shall not
5 be subject to the provisions of 42 Pa.C.S. § 3733 (relating
6 to deposits into account).
7 (e) Criminal penalties.--A licensee that intentionally
8 commits a violation or continues to operate an adult living
9 residence without a license by the department commits a
10 misdemeanor of the second degree and shall, upon conviction, be
11 sentenced to pay a fine of $5,000 or to imprisonment for not
12 more than two years, or both.
13 (f) Appeal of violations.--
14 (1) A provider appealing a departmental ban on
15 admissions or license revocation or nonrenewal shall be
16 denied a supersedeas unless the provider demonstrates
17 substantial likelihood of prevailing on the merits.
18 (2) Where a supersedeas is granted, it shall be revoked
19 if the department presents evidence of any intervening Class
20 I or II violations.
21 (3) Where a supersedeas is granted:
22 (i) The department shall inspect a facility or
23 assisted living services provider at least monthly or
24 more frequently to ensure residents' or recipients'
25 safety and well-being. Those inspection reports shall be
26 maintained as part of the public record for the assisted
27 living residence or assisted living services provider.
28 (ii) Where a supersedeas has been granted, a Class I
29 or II violation cited after the granting of the
30 supersedeas shall lead to a revocation of the
20030H0420B0484 - 36 -
1 supersedeas.
2 (g) Expedited hearings.--The department's Bureau of Hearings
3 and Appeals shall make the assisted living residence or assisted
4 living services provider appeals a priority, with no appeal
5 outstanding more than 60 days beyond the date on which the
6 appeal was filed.
7 (h) Expedited reconsideration.--The secretary shall rule on
8 reconsiderations within 60 days.
9 Section 18. Reasons for denial, nonrenewal or revocation of a
10 license.
11 The department may deny, refuse or renew or revoke a license
12 for all or any portion of an adult living residence or may
13 suspend or restrict admissions to the residence for any of the
14 following reasons:
15 (1) Failure of a licensee to submit an acceptable plan
16 of correction with a reasonable timetable to correct
17 violations.
18 (2) The existence of a pattern of violations.
19 (3) Failure to comply with a plan of correction or to
20 report violations in accordance with a timetable submitted by
21 the applicant and agreed upon by the department.
22 (4) Fraud or deceit in obtaining or attempting to obtain
23 a license.
24 (5) Lending, borrowing or using the license of another
25 or in any way knowingly aiding or abetting the improper
26 granting of a license.
27 (6) Incompetence, negligence or misconduct in operating
28 the adult living residence.
29 (7) Mistreatment or abuse of a consumer of the adult
30 living residence.
20030H0420B0484 - 37 -
1 (8) Violation of the provisions of this act or the
2 regulations promulgated under this act.
3 (9) Violation of other applicable Federal or State laws.
4 Section 19. Licensure appeals.
5 (a) Nature of proceeding.--A licensee aggrieved by a
6 decision of the department under this act shall have the right
7 to an appeal. The appeal shall be conducted in accordance with 2
8 Pa.C.S. Ch. 5 Subch. A (relating to practice and procedure of
9 Commonwealth agencies) to the board.
10 (b) Time for hearing.--
11 (1) Except as provided in paragraph (2), a hearing shall
12 be held by the board within 90 days of receipt of the notice
13 of request for a hearing.
14 (2) If the board determines that continued operation,
15 pending administrative review, poses an immediate threat to
16 the consumers in the assisted living residence or if the
17 department has implemented an emergency action pursuant to
18 section 21(c) and a timely request for a hearing has been
19 made, a hearing shall be held within 15 days after the
20 receipt of the response or request for a hearing.
21 (3) Hearing dates specified in this subsection may be
22 extended by the board for good cause if agreed to by all
23 parties.
24 (c) Decisions.--A decision shall be issued within 60 days
25 after the final day of the hearing. In the case of an expedited
26 hearing under subsection (b)(2), a decision shall be issued
27 within five days after the final date of the hearing.
28 (d) Subpoenas.--The presiding officer may issue a subpoena
29 at the request of either party.
30 (e) Discovery.--Discovery shall be limited to reasonable
20030H0420B0484 - 38 -
1 requests for production of documents and identification of
2 witnesses. All other discovery shall be by mutual agreement of
3 the parties.
4 Section 20. Effect of departmental orders.
5 Orders of the department from which no appeal is taken to the
6 board and orders of the board from which no timely appeal is
7 taken to the court shall be final orders and may be enforced by
8 a court of competent jurisdiction.
9 Section 21. Actions against violations of law and regulations.
10 (a) Violations.--Whenever any person, regardless of whether
11 such person is a licensee, has violated any of the provisions of
12 this act or the regulations issued pursuant thereto, the
13 department may maintain an action in the name of the
14 Commonwealth for an injunction or other process restraining or
15 prohibiting such person from engaging in such activity.
16 (b) Residence closure for threat to health or safety.--
17 Whenever the department determines that a violation poses an
18 immediate and serious threat to the health or safety of the
19 consumers of an adult living residence, the department may
20 direct the closure of the assisted living residence and the
21 transfer of the consumers to other adult living residences with
22 a Category II license or other appropriate locations. The
23 department may petition the Commonwealth Court or the court of
24 common pleas of the county in which the adult living residence
25 is located to appoint the department temporary management of the
26 adult living residence. If granted, the department shall assume
27 operation of the adult living residence at the licensee's
28 expense until there is an orderly closure of the adult living
29 residence.
30 (c) Unlicensed adult living residences.--
20030H0420B0484 - 39 -
1 (1) Whenever a license is required by this act, the
2 department may maintain an action in a court of competent
3 jurisdiction in the name of the Commonwealth for an
4 injunction or other process restraining or prohibiting any
5 person from establishing, maintaining or operating an adult
6 living residence that does not possess a Category I license
7 or Category II license.
8 (2) If a person who is refused a license or the renewal
9 of a license to operate or conduct an adult living residence,
10 or whose license to operate or conduct an adult living
11 residence is revoked, fails to appeal, or should such appeal
12 be decided finally favorable to the department, then the
13 court shall issue a permanent injunction upon proof that the
14 person is operating or conducting an adult living residence
15 without a license as required by this act.
16 Section 22. Injunction or restraining order when appeal is
17 pending.
18 Whenever the department refuses to renew or revokes a license
19 or orders a person to refrain from violating this act or the
20 regulations promulgated under this act and the person, deeming
21 himself aggrieved by the refusal, revocation or order, appeals
22 from the action of the department to the board or from the order
23 of the board to the court, the court may during pendency of the
24 appeal:
25 (1) issue a restraining order or injunction upon a
26 showing that the continued operation of the adult living
27 residence adversely affects the health, safety or care of the
28 consumers of the adult living residence; or
29 (2) authorize continued operation of the residence or
30 make such other order, pending final disposition of the case,
20030H0420B0484 - 40 -
1 as justice and equity require.
2 Section 23. Annual report.
3 (a) Contents of.--The Department of Public Welfare shall,
4 after consulting with the Department of Aging and the Department
5 of Health, provide an annual report to the Intra-Governmental
6 Council on Long-Term Care. The annual report shall include, at a
7 minimum, the following:
8 (1) The total number of adult living residences and
9 assisted living services providers in this Commonwealth as
10 well as the numbers of residences and providers newly
11 licensed within the previous year. Such report shall also
12 include information presented separately regarding Category I
13 Personal Care Homes and Category II Assisted Living
14 Residences.
15 (2) Complaints received by the licensing departments,
16 the ombudsman program or the protective services units in
17 each area agency on aging and the outcome of any
18 investigations.
19 (3) Commonwealth costs associated with the licensing,
20 inspection and payment of assisted living services.
21 (4) The availability of assisted living residences and
22 assisted living services to consumers and any barriers
23 experienced by consumers in accessing assisted living
24 residences and assisted living services.
25 (5) General profile information regarding the types of
26 consumers accessing assisted living residences and assisted
27 living services.
28 (6) The costs experienced by consumers in assisted
29 living residences and by consumers using assisted living
30 services.
20030H0420B0484 - 41 -
1 (7) Recommendations for additional legislative or
2 regulatory action to improve the quality, affordability or
3 accessibility of assisted living in this Commonwealth.
4 (b) Review process.--The Intra-Governmental Council on Long-
5 Term Care shall have 30 days to review the report and to prepare
6 written comments thereto. Such comments shall include
7 recommendations regarding legislation or regulations and
8 reporting methods. After the 30-day review and comment period,
9 the council shall forward the department's report and their
10 written comments to the Governor, the Aging and Youth Committee
11 of the Senate and the Aging and Older Adult Services Committee
12 of the House of Representatives.
13 Section 24. Legislative Budget and Finance Committee study.
14 Within nine months after the effective date of this act, the
15 Legislative Budget and Finance Committee shall report to the
16 General Assembly on existing Federal and other states'
17 initiatives and programs that provide financial assistance for
18 assisted living. This study shall include information on other
19 Federal or state assisted living programs that are effectively
20 administered and can be considered a model.
21 Section 25. Committee regulation review.
22 In accordance with the act of June 25, 1982 (P.L.633,
23 No.181), known as the Regulatory Review Act, all regulations
24 promulgated pursuant to this act shall be referred to the Aging
25 and Youth Committee of the Senate and the Aging and Older Adult
26 Services Committee of the House of Representatives.
27 Section 26. Increase to State supplemental assistance for
28 persons in personal care homes.
29 (a) General rule.--Notwithstanding any other provision of
30 the act of June 13, 1967 (P.L.31, No.21), known as the Public
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1 Welfare Code, or regulations of the department to the contrary,
2 the amount of the State supplemental assistance payable to a
3 person who is eligible under section 432(2)(ii) of the Public
4 Welfare Code and who is a resident of a personal care home shall
5 be increased by an amount of $15 per day.
6 (b) Consumer Price Index Adjustment.--The amount of State
7 supplemental assistance payable under subsection (a) shall be
8 increased beginning July 1, 2002, by an amount equal to the
9 increase in the Consumer Price Index for Urban Wage Earners for
10 the immediately preceding calendar year, which amount shall be
11 published in the Pennsylvania Bulletin annually by the
12 department on or before the preceding November 30.
13 Section 27. Severability.
14 If any provision of this act or the application thereof to
15 any person or circumstances is held invalid, such invalidity
16 shall not affect other provisions or applications of the act
17 which can be given effect without the invalid provision or
18 application, and to this end the provisions of this act are
19 declared to be severable.
20 Section 28. Repeal.
21 All acts and parts of acts are repealed insofar as they are
22 inconsistent with this act.
23 Section 29. Effective date.
24 This act shall take effect in one year.
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