PRINTER'S NO. 440
No. 376 Session of 2007
INTRODUCED BY WATSON, HENNESSEY, GINGRICH, BASTIAN, BEYER,
BISHOP, CALTAGIRONE, FREEMAN, GALLOWAY, GEIST, GEORGE,
GILLESPIE, McILHATTAN, NAILOR, O'NEILL, PETRI, RAPP,
REICHLEY, RUBLEY, STEIL, J. TAYLOR, WANSACZ, WILLIAMS,
YOUNGBLOOD AND PICKETT, FEBRUARY 13, 2007
REFERRED TO COMMITTEE ON HEALTH AND HUMAN SERVICES,
FEBRUARY 13, 2007
AN ACT
1 Providing for admission and retention of consumers in personal
2 care homes, for appeals to the Bureau of Hearings and
3 Appeals, for the powers and duties of the Department of
4 Public Welfare and for report to the General Assembly.
5 The General Assembly of the Commonwealth of Pennsylvania
6 hereby enacts as follows:
7 Section 1. Short title.
8 This act shall be known and may be cited as the Personal Care
9 Home Admission and Retention Act.
10 Section 2. Definitions.
11 The following words and phrases when used in this act shall
12 have the meanings given to them in this section unless the
13 context clearly indicates otherwise:
14 "Assisted living residence." A residential setting that:
15 (1) Meets or exceeds the minimum standards for a
16 personal care home, as defined under 55 Pa. Code Ch. 2600
17 (relating to personal care home licensing).
1 (2) Offers, provides or coordinates a combination of
2 personal care services, recreation and social activities, 24-
3 hour supervision and assisted living services, whether
4 scheduled or unscheduled, and that coordinates other health-
5 related services for consumers.
6 (3) Has a supportive service program and physical
7 environment designed to minimize the need for consumers to
8 move within or from the setting in order to accommodate
9 changing needs and preferences.
10 (4) Has an organized mission, service programs and a
11 physical environment designed to maximize consumer dignity,
12 autonomy, privacy and independence and encourages family and
13 community involvement.
14 (5) Provides that costs for housing and services may be
15 independent of one another.
16 (6) Provides consumers with the ability to choose the
17 services to be provided, their service provider and the
18 services to the extent that the assisted living residence
19 does not offer particular services to consumers.
20 (7) Has a goal of fostering aging and place and
21 promoting consumer self-direction and active participation in
22 decision making while emphasizing consumer privacy and
23 dignity.
24 (8) Will disclose services offered, provided or
25 coordinated and the costs thereof.
26 This term does not include a residential living unit maintained
27 by a continuing care provider that is certified by the Insurance
28 Department; a residential unit in a subsidized housing
29 apartment, unless required to be licensed under the Department
30 of Housing and Urban Development Assisted Living Conversion
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1 Program; or a boarding home that merely provides room, board and
2 laundry services to persons who do not need personal care
3 services.
4 "Bureau." The Bureau of Hearings and Appeals in the
5 Department of Public Welfare.
6 "Department." The Department of Public Welfare of the
7 Commonwealth.
8 "Personal care home." A premises in which food, shelter and
9 personal assistance or supervision are provided for a period
10 exceeding 24 hours for four or more adults who are not relatives
11 of the operator and do not require the services in or of a
12 licensed long-term care facility, but who require assistance or
13 supervision in activities of daily living or instrumental
14 activities of daily living. The term includes a premises that
15 holds itself out as a personal care home and provides food and
16 shelter to four or more adults who need personal care services
17 but are not receiving the services.
18 Section 3. Conditions precluding admission and retention in
19 personal care home.
20 No personal care home/assisted living residence may admit or
21 retain consumers with any of the following conditions or care
22 needs:
23 (1) Ventilator dependency.
24 (2) Stage III and IV, or multiple stage II decubiti and
25 vascular ulcers that are not in a healing stage.
26 (3) Continuous intravenous fluids.
27 (4) Reportable infectious diseases, including, but not
28 limited to, tuberculosis, in a communicable state that
29 requires isolation of the consumer or requires special
30 precautions by the caretaker to prevent transmission of the
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1 disease, unless the Department of Health directs that
2 isolation be established within the assisted living
3 residence.
4 (5) Psychotropic medications without appropriate
5 diagnosis and treatment plan.
6 (6) Nasogastric tubes.
7 (7) Gastric tubes, except when the consumers are capable
8 of self-care of the tube.
9 (8) Physical restraints.
10 (9) Tracheostomy except when the individuals are
11 independently capable of self-care of the tracheostomy.
12 (10) Consumers presenting an imminent physical threat or
13 danger to themselves or others.
14 (11) Other conditions for which care cannot be provided
15 in a safe and effective manner in an assisted living
16 residence as determined by regulations adopted by the
17 department.
18 (12) Individuals for whom a certification is made by
19 their physician or medical director of the facility that
20 admission or retention in an assisted living residence is not
21 appropriate.
22 (13) Individuals for whom a determination is made that
23 their health care needs cannot be met by an assisted living
24 residence, including:
25 (i) individuals requiring skilled nursing care 24
26 hours per day;
27 (ii) individuals requiring sliding scale insulin
28 administration unless the individuals are capable of
29 self-administration or the medication is administered by
30 a licensed health care professional or other individual
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1 qualified to administer medication;
2 (iii) individuals requiring intermittent intravenous
3 therapy unless such therapy is managed by a licensed
4 health care professional;
5 (iv) individuals requiring insertions, sterile
6 irrigation and replacement of a catheter except for
7 routine maintenance of a urinary catheter, unless the
8 individuals are capable of self-administration or it is
9 administered by a licensed health care professional;
10 (v) individuals requiring oxygen, unless the
11 individuals are capable of self-administration or it is
12 administered by a licensed health care professional;
13 (vi) individuals requiring inhalation therapy,
14 unless the individuals are capable of self-administration
15 or are administered such therapy by a licensed health
16 care professional; or
17 (vii) individuals for whom it is certified that
18 admissions or retention is not appropriate by their
19 physician, medical director or assisted living residence
20 administrator acting in consultation with supplemental
21 health care professionals.
22 Section 4. Retention.
23 A resident of a personal care home who develops one of the
24 conditions listed in section 3 while residing in the personal
25 care home:
26 (1) May be temporarily transferred to an appropriate
27 health care setting for treatment and recovery, but may not
28 be permanently discharged from the personal care home and
29 shall be permitted to return to the personal care home on
30 completion of treatment and recovery at that appropriate
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1 health care setting. The personal care home shall retain the
2 resident's bed during this time and continue to charge as if
3 the resident were present in the facility.
4 (2) May remain in the personal care home during
5 treatment and recovery, if treatment and recovery may be
6 achieved by receipt of supplemental services from an outside
7 health care provider and those services are arranged and
8 received.
9 Section 5. Appeals.
10 (a) General rule.--A consumer who is not admitted to or
11 retained by a personal care home due to conditions or care needs
12 other than those as set forth under section 3 shall have
13 available to him an appeal procedure to be conducted through the
14 bureau. In the event that a consumer is successful in an appeal
15 and a determination to not admit or retain the consumer in the
16 personal care home is overturned, the consumer shall have the
17 right to be admitted to or retained by the personal care home no
18 later than 30 days following the final decision by the bureau.
19 (b) Nonapplicability.--The provisions of this section shall
20 not apply in the case of a consumer whose health care needs
21 cannot be met in the specific personal care home as determined
22 by the personal care home pursuant to section 3(13).
23 Section 6. Enforcement.
24 If the department determines that a personal care home has
25 failed to comply with the provisions of this act or the
26 regulations promulgated under this act, it may assess an
27 administrative fine of not more than $150 per day per violation.
28 Section 7. Regulations.
29 (a) General rule.--Except as provided in subsection (b), the
30 department shall promulgate regulations to implement the
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1 provisions of this act within six months of the effective date
2 of this section.
3 (b) Appeal procedure.--The department shall promulgate
4 regulations to implement the appeal procedure required by
5 section 5 within three months of the effective date of this
6 section.
7 Section 8. Effective date.
8 This act shall take effect in one year.
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