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PRINTER'S NO. 201
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
214
Session of
2015
INTRODUCED BY GINGRICH, JAMES, COHEN, DAVIDSON, MILLARD, SAYLOR,
DEASY, MURT, BAKER, KAUFFMAN, A. HARRIS, GRELL, M. K. KELLER,
ROSS AND WATSON, JANUARY 23, 2015
REFERRED TO COMMITTEE ON AGING AND OLDER ADULT SERVICES,
JANUARY 23, 2015
AN ACT
Providing for the powers and duties of the Department of Aging
and area agencies on aging and for annual review of care
plans; requiring criminal background checks and communicable
disease screenings of certain providers; prohibiting certain
provider financial interests; and providing for consumer
telephone access and for procedures for noncompliance.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Short title.
This act shall be known and may be cited as the Home and
Community-Based Services Accountability Act.
Section 2. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Area agency on aging." The single local agency designated
by the Department of Aging within each planning and service area
to administer the delivery of a comprehensive and coordinated
plan of social and other services and activities.
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"Care manager." A staff member at a local area agency on
aging who is assigned to write and maintain a care plan for each
consumer and to comply with responsibilities and duties as set
forth in procedures established by the Department of Aging.
"Care plan." A plan written by a care manager, developed in
collaboration and consultation with a consumer, which addresses
the consumer's needs and the services necessary to address those
needs.
"Consumer." An individual who:
(1) Is at least 60 years of age.
(2) Receives home and community-based services through
the Department of Aging waiver.
(3) Is assessed as nursing facility clinically eligible.
"Consumer representative." An individual designated by a
consumer to act on behalf of the consumer.
"Department." The Department of Aging of the Commonwealth.
"Employee." An individual who is paid by a provider to
provide home and community-based services to a consumer. The
term includes a contract employee who has direct contact with a
consumer or unsupervised access to the personal living quarters
of a consumer.
"Home and community-based services." Services provided in a
person's home or at a location in the community to assist
consumers to function as independently as possible.
"Nursing facility clinically eligible" or "NFCE." An
individual who requires health-related care and services because
the individual's physical condition necessitates care and
services that can be provided in the community with home and
community-based services or in a nursing facility.
"Other individual." Any person who:
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(1) Is not a consumer.
(2) Is at least 18 years of age.
(3) Has direct contact with a consumer and provides home
and community-based services on behalf of an employee.
"Provider." A medical assistance certified entity
responsible for payroll management and disbursement activities.
The term includes a private payroll company, an area agency on
aging, a medical assistance services provider and a Department
of Human Services attendant care provider currently providing
this service to Department of Human Services attendant care
waiver consumers.
"State police." The Pennsylvania State Police.
"Waiver." A Medicaid home and community-based services
waiver granted by the Centers for Medicaid and Medicare Services
to the Department of Human Services, under the authority of
section 1915(c) of the Social Security Act (49 Stat. 620, 42
U.S.C. ยง 301 et seq.).
Section 3. General duties of area agencies on aging.
An area agency on aging providing services under a waiver
shall:
(1) Retain overall responsibility to ensure that care
management of consumers is competently provided to consumers
in accordance with department standards and the care plan.
(2) Coordinate supportive services needed to promote and
maintain consumer independence and monitor consumers by using
consumer contact plans developed and administered through the
area agency on aging.
Section 4. Care plan home visits.
A care plan shall include provisions for a private, physical,
face-to-face home visit by the care manager with the consumer,
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without the presence of an employee or other individual, unless
the consumer requests the presence of a relative, a close friend
or a person who has the legal authority to represent the
consumer's interests. The frequency of the visits shall be based
on the consumer's acuity level as outlined in the consumer's
contact plan. At least one home visit per year shall be
conducted on an unannounced basis. The home visit may also
include a registered nurse whose responsibility shall be to
monitor the health of the consumer.
Section 5. Annual review of care plan.
In accordance with procedures established by the department
for home and community-based services, an area agency on aging
shall maintain on file a care plan for each consumer that is
reviewed and signed every six months by the consumer or the
consumer representative, care manager, care manager's supervisor
and a registered nurse. The care manager shall determine the
type and frequency of contact with a consumer based upon the
degree of consumer impairment and the involvement needed to
ensure the effectiveness and stability of the care plan.
Section 6. Criminal background checks.
(a) General rule.--Prior to provision of services under a
waiver, a provider shall, at its own expense, ensure that any
employee or other individual meets the requirements of Chapter 5
of the act of November 6, 1987 (P.L.381, No.79), known as the
Older Adults Protective Services Act, regarding criminal
history. For the purposes of this section, a provider shall be
deemed a facility in accordance with Chapter 5 of the Older
Adults Protective Services Act.
(b) Employees and other individuals.--
(1) For any employee or other individual continuing to
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provide waiver services, a provider shall comply with
subsection (a) every five years from the initial date of the
report.
(2) For any employee or other individual who provides
services under a waiver on the effective date of this
section, a provider shall comply with subsection (a) within
one year.
Section 7. Communicable disease screenings.
(a) General rule.--Prior to provision of services under a
waiver, a provider shall, at its own expense, obtain
documentation as required under subsection (c) for any employee
and any other individual.
(b) Employees and other individuals.--
(1) For any employee or other individual continuing to
provide waiver services, a provider shall comply with
subsection (a) every five years from the initial receipt of
the documentation.
(2) For any employee or other individual who provides
services under a waiver on the effective date of this
section, a provider shall comply with subsection (a) within
one year.
(c) Type of documentation.--
(1) Documentation required under this section shall be
obtained from a physician or other appropriate health care
professional and shall state that the employees and other
individuals are free from communicable disease and have
passed a tuberculosis screening as outlined by screening
guidelines of the Department of Health.
(2) Employees and other individuals shall comply with
Federal, State and local health requirements related to
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communicable disease and follow procedures recommended in the
Centers for Disease Control and Prevention guidelines and
regulations of the Occupational Safety and Health
Administration, including provisions of protective articles
and in-service training on universal precautions.
Section 8. Recordkeeping.
(a) General rule.--Each provider shall maintain on file
documentation of compliance with the provisions of sections 6
and 7.
(b) Confidentiality.--Documentation of compliance maintained
on file with a provider shall not be subject to access under the
act of February 14, 2008 (P.L.6, No.3), known as the Right-to-
Know Law.
Section 9. Financial interest prohibition.
(a) General rule.--No employee or other individual shall:
(1) Be appointed or act as guardian of a consumer.
(2) Engage in any activity under a power of attorney of
a consumer.
(3) Be a beneficiary of any insurance policy or annuity
of a consumer.
(4) Serve as an executor of the estate of a consumer.
(b) Duty to inform consumers.--A care manager shall inform
each consumer of the provisions of subsection (a).
Section 10. Consumer telephone access.
No employee or other individual shall restrict or prevent a
consumer's access to local telephone service.
Section 11. Applicability.
The provisions of this act shall not apply:
(1) to any employee or other individual who is a family
member of a consumer to whom the employee or other individual
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provides services; or
(2) to a private contract between persons where public
funding is not involved.
Section 12. Procedures for noncompliance; promulgation of
regulations.
(a) General rule.--The department shall cooperate with the
Department of Human Services to:
(1) Develop procedures, no later than 90 days after the
effective date of this section, to be followed in the event
of noncompliance with the provisions of this act.
(2) Promulgate regulations within one year after the
effective date of this section to administer this act.
(b) Certain persons to be prohibited from participation in
waiver.--Procedures and regulations under subsection (a) shall
include, but not be limited to, prohibiting participation in a
waiver for:
(1) an employee or any other individual who fails to
meet the requirements of sections 6 and 7;
(2) an employee who fails to notify a provider of any
other individual providing home and community-based services
on behalf of the employee; or
(3) a provider who fails to comply with sections 6 and
7.
Section 13. Effective date.
This act shall take effect in 60 days.
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