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 Pennsylvania 
9Community 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.

1"Applicant." An individual, agency, partnership,
2association, organization or corporate entity applying for a
3license to provide community adult respite services.

4"Area Agency on Aging" or "AAA." The single local agency
5designated by the department within each planning and service
6area to administer the delivery of a comprehensive and
7coordinated plan of social and other services and activities.

8"Assisted living residence." An assisted living residence as
9defined in section 1001 of the act of June 13, 1967 (P.L.31,
10No.21), known as the Public Welfare Code.

11"Community adult respite services." For purposes of this 
12act, services provided or arranged for part of a 24-hour day in
13a community adult respite services program to support
14independence of <-adults participants.

15"Community adult respite services participant" or
16"participant." A resident of this Commonwealth who:

17(1) Is 60 years of age or older.

18(2) Can actively or passively engage in social and
19leisure activities with others.

20(3) May demonstrate symptoms of mild cognitive

22(4) Does not need assistance, other than cueing, or is
23able to direct care for activities of daily living.

24(5) Does not demonstrate behaviors that may compromise
25personal safety or the safety of others.

26"Community adult respite services program" or "program." A 
27program which provides community adult respite services for part 
28of a 24-hour day.

29"Community adult respite services provider" or "provider."
30An individual, agency, partnership, association, organization or

1corporate entity that operates a community adult respite
2services program in a setting approved by the department.

3"Community senior center." For the purposes of this act, a
4facility developed and operated in accordance with provisions of
5Article XXII-A of the act of April 9, 1929 (P.L.177, No.175),
6known as The Administrative Code of 1929.

7"Continuing-care provider." A facility licensed by the
8Insurance Department under the act of June 18, 1984 (P.L.391,
9No.82), known as the Continuing-Care Provider Registration and
10Disclosure Act.

11"Cueing." Verbal or written assistance or prompts throughout
12an activity to assure its completion.

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

14"Designated person." An individual who is chosen by a
15participant, to be notified in case of an emergency, termination
16of community adult respite services, program closure or other
17situations as indicated by the participant or as required by
18this act. The term includes a participant's legal

20"Licensed long-term care service provider." The term shall

22(1) An assisted living residence.

23(2) A continuing-care provider.

24(3) A LIFE program.

25(4) A long-term care nursing facility.

26(5) An older adult daily living center.

27(6) A personal care home.

28"LIFE program." The program of medical and supportive
29services known as Living Independently for Elders <-under 42 CFR 
30Pt. 460 (relating to programs of all-inclusive care for the

1elderly (PACE)).

2"Local program administrator." The department or the area
3agency on aging on behalf of the department.

4"Long-term care nursing facility." A long-term care nursing
5facility as defined in section 802.1 of the act of July 19, 1979
6(P.L.130, No.48), known as the Health Care Facilities Act.

7"Mild cognitive impairment." Cognitive changes that are not
8severe enough to interfere with daily life or independent

10"Older adult daily living center." Premises operated for
11profit or not-for-profit in which older adult daily living
12services are simultaneously provided for four or more adults who
13are not relatives of the operator for part of a 24-hour day and
14which premises are subject to licensing under the act of July
1511, 1990 (P.L.499, No.118), known as the Older Adult Daily
16Living Centers Licensing Act.

17"Personal care home." A personal care home as defined in
18section 1001 of the act of June 13, 1967 (P.L.31, No.21), known
19as the Public Welfare Code.

20"Program coordinator." The individual designated by a
21provider to oversee and manage the daily activities and
22operations of a community adult respite services program.

<-23Section 3. Legislative findings and declaration.

24The General Assembly finds that:

25(1) This Commonwealth is rich in its diverse culture and
26demographic configuration.

27(2) Geographically, Pennsylvania's older adults live in
28a variety of settings and it is essential that every possible
29effort is made to help ensure that Pennsylvanians age and
30live well and that communities will be places to help them

1age and live well.

2(3) It is in the best interest of all Pennsylvanians to
3support policies that help older individuals maintain
4independence and dignity in their homes and communities,
5while also providing assurance to their loved ones that they
6are safe and afforded access to care and services at the
7right time, in the right setting and at the right intensity.

8(4) It is in the best interest of the Commonwealth to
9establish community adult respite services programs that
10provide programming designed to support independence of
11individuals, while also providing peace of mind to their
12loved ones who may have concerns that leaving them alone may
13jeopardize their health, safety and well-being.

14Section <-4 3. Program offered by licensed long-term care service 

16Notwithstanding any other act to the contrary, an individual, 
17agency, partnership, association, organization or corporate 
18entity licensed as a long-term care service provider shall not 
19be required to obtain a separate license to maintain, operate or 
20conduct a community adult respite services program in accordance 
21with the provisions of this act, provided that the individual, 
22agency, partnership, association, organization or corporate 
23entity so licensed notifies the department by letter of its 
24intent to establish and operate a community adult respite 
25services program, in accordance with the provisions of this act.

26Section <-5 4. License applicant letter of intent required.

27In order to obtain a license to maintain, operate or conduct
28a community adult respite services program in accordance with
29this act, the applicant must notify the department by letter of
30its intent to apply for a license to establish and operate a

1community adult respite services program.

2Section <-6 5. Program operation and maintenance without license

4Except for licensed long-term care service providers that
5fall within the provisions of section <-4 3, no individual,
6agency, partnership, association, organization or corporate
7entity may maintain, operate, conduct or hold itself out as a
8community adult respite services program provider without having
9a license issued by the department.

10Section <-7 6. License term and content and designation of a
11program coordinator.

12(a) General rule.--The department shall, after an
13investigation and after a departmental determination that the
14applicant complies with the provisions of this act, issue to an
15applicant a license to operate a program.

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

17(1) Be issued for a specified period of not more than 12

19(2) Be on a form prescribed by the department.

20(3) Not be transferable.

21(4) Be issued only to the entity for the program named
22in the application.

23(c) Interim license.--The department shall have the power to
24issue an interim license in accordance with department

26(d) Recordkeeping.--The department shall keep a record of
27all applications and all licenses issued under this act.

28(e) Identification of program coordinator.--An applicant
29shall identify and designate a program coordinator who shall be
30on site and serve as the official representative and contact for

1a community adult respite services program. A program
2coordinator and any employee of the program are prohibited from
3being assigned power of attorney or guardianship for any

5(f) Responsibility of program coordinator.--The program
6coordinator shall be responsible for the intake and enrollment
7of community adult respite services participants through a
8process that ensures the eligibility of the participants in the

10Section <-8 7. Right to enter and inspect.

11(a) General rule.--Subject to section <-7 6, the department
12may enter, visit and inspect any program licensed or requiring a
13license under this act. In accordance with applicable regulatory
14authority, the department shall have full and free access to the
15records of a community adult respite services program and to the 
16participants to interview and evaluate such participants.

17(b) Local AAAs as agents.--At the department's discretion,
18representatives of the local AAAs may act as agents of the
19department, as specified in subsection (a).

20Section <-9 8. Determination of eligibility.

21(a) General rule.--The department shall work in cooperation
22with the AAA to develop a standard application packet for
23prospective participants.

24(b) Ongoing monitoring.--The program shall include a process
25whereby participants shall be monitored regularly to ensure that
26they do not become ineligible for community adult respite 

28Section <-10 9. Conditions of ineligibility.

29(a) General rule.--An enrolled participant who no longer 
30meets the definition of a community adult respite services

1participant must be disenrolled from the program in accordance 
2with the provisions of subsection (b).

3(b) Determination of ineligibility.--In the event that a
4participant is determined ineligible for community adult respite
5services, the program coordinator of a program shall:

6(1) Provide the participant or designated person with
7written notice of ineligibility and a list of community
8resources that may be available.

9(2) Work with the participant or designated person and
10local program administrator to develop a transition plan
11before the participant is disenrolled from the community
12adult respite services program.

<-13(c) AAA eligibility assessment required.--When a participant
14is determined to be ineligible for community adult respite
15services while in a program, the program coordinator shall
16contact the AAA to request an eligibility assessment.

<-17(3) The program coordinator, with the consent of the
18participant or designated person, shall make a referral to
19the Area Agency on Aging to assess eligibility for and access
20to other appropriate long-term care services.

21(c) Appeals.--The participant has the right to appeal the
22ineligibility determination. The department shall promulgate
23regulations and issue statements of policy establishing a formal
24appeals process.

25(d) Emergency situations.--The department shall promulgate
26regulations and issue statements of policy regarding emergency
27situations, where an immediate change in settings is needed for
28a participant to address an imminent threat or health or safety

30Section <-11 10. Regulations and statements of policy.

1(a) General rule.--The department shall work in cooperation
2with the AAAs, representatives of licensed long-term care 
3service providers and representatives of community senior 
4centers to promulgate <-guidance such as regulations or and issue 
5statements of policy <-as necessary or appropriate governing
6community adult respite services programs, no later than one
7year after the effective date of this section. The regulations
8shall establish minimum standards, including, but not limited

10(1) Building, equipment, operation, care and assessment
11processes for functional and cognitive status of clients.

12(2) Staff credentials and staffing requirements,
13including staff-to-participant ratios.

14(3) Programs and services in order to implement a
15process for issuance of licenses and interim licenses.

16(4) A licensing appeal process, and to establish and
17collect fees to offset the cost of issuing licenses.

18(5) A referral system for participants who are
19determined to be ineligible to enter a community adult
20respite services program.

21(6) Enforcement provisions.

22(b) Procedure.--Regulations shall be promulgated in
23accordance with the provisions of the act of June 25, 1982
24(P.L.633, No.181), known as the Regulatory Review Act.

25Section <-12 11. Construction.

26Nothing in this act shall be construed to preclude continued
27participation by individuals under 60 years of age who are
28participating in a community adult respite services program on
29the effective date of this section.

30Section <-13 <-12. Effective date.

1This act shall take effect in 180 days.