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HOUSE AMENDED
A04474
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
906
Session of
2019
INTRODUCED BY YUDICHAK, BAKER, BROOKS, HUTCHINSON, PITTMAN,
GORDNER, J. WARD, BLAKE, STEFANO AND LEACH, OCTOBER 18, 2019
AS REPORTED FROM COMMITTEE ON HEALTH, HOUSE OF REPRESENTATIVES,
AS AMENDED, DECEMBER 17, 2019
AN ACT
Amending the act of October 20, 1966 (3rd Sp.Sess., P.L.96,
No.6), entitled "An act relating to mental health and
intellectual disability; authorizing county programs and
amending, revising and changing the laws relating thereto and
making an appropriation," in preliminary provisions, further
providing for definitions; and, in responsibilities of the
State, providing for State center closure moratorium
procedure.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The definitions of "department" and "secretary"
in section 102 of the act of October 20, 1966 (3rd Sp.Sess.,
P.L.96, No.6), known as the Mental Health and Intellectual
Disability Act of 1966, are amended and the section is amended
by adding a definition to read:
Section 102. Definitions.--As used in this act:
* * *
"Department" means the Department of [Public Welfare] Human
Services.
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"Secretary" means the Secretary of [Public Welfare] Human
Services.
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"State center" means a State operated facility, licensed by
the department, to provide a level of care specially designed to
meet the needs of persons who have an intellectual disability or
persons with related conditions who require specialized health
and rehabilitative services.
Section 2. The act is amended by adding a section to read:
Section 202.1. State Center Closure Moratorium.--(a) No
State center shall close until all Medicaid waiver-eligible
individuals in this Commonwealth are authorized to begin
receiving home and community-based services furnished under a
waiver granted pursuant to section 1915(c)(1) of the Social
Security Act (49 Stat. 620, 42 U.S.C. ยง 1396n(c)(1)).
(b) When all Medicaid waiver-eligible individuals have
received authorization under subsection (a), the department
shall transmit notice of that fact to the Legislative Reference
Bureau for publication in the Pennsylvania Bulletin. Upon
publication of the notice, the Task Force on the Closure of
State Centers is established within the department. Within sixty
days of publication of the notice, the secretary shall convene
an initial meeting of the task force. The task force shall
perform a comprehensive evaluation of the State centers and
provide recommendations to the department prior to the closure
of one or more State centers .
(c) The task force shall be comprised of the following
members:
(1) The secretary or a designee .
(2) One representative from each State center , which may
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include, but is not limited to, direct care providers or
administrative staff members, to be appointed by each center
director.
(3) One representative from the Governor's office.
(4) The chair and the minority chair of the Health and Human
Services Committee of the Senate or their designees .
(5) The chair and the minority chair of the Human Services
HEALTH Committee of the House of Representatives or their
designees .
(6) Two family members of residents of State centers , to be
appointed by the secretary.
(7) One representative of a nonprofit organization which
serves as an advocate for those with intellectual disabilities,
to be appointed by the secretary.
(8) One physician, psychiatrist or psychologist with
experience providing services to individuals with intellectual
disabilities to be appointed by the secretary in consultation
with the representatives appointed under paragraph (2).
(d) The task force shall meet biweekly to evaluate the
impact of a closure in all of the following areas:
(1) Residents of the State center and their families.
(2) Employes, both union and nonunion.
(3) The local economy in which the State center is located.
(4) Readiness of provider agencies in each region to expand
the community-based residential infrastructure to support
residents leaving State centers .
(e) If a State center is deemed eligible for closure by way
of a majority vote taken by the task force, the department shall
prepare a plan for the closure of the State center and the
transition of individuals with intellectual disabilities
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receiving care in the State center to a home or community-based
support system. The plan shall include all of the following:
(1) An assessment of the State center , including:
(i) A certified independent appraisal of the State center
property.
(ii) A report of the State employes employed at the State
center , both full time and part time, including the total number
of employes, the cost of the total wages and total benefits paid
to the employes and an organizational flow chart of employes
working at the State center .
(iii) A detailed report of the services provided at the
State center by contracted third-party vendors.
(iv) An inventory of assets located at and improvements on
the State center .
(v) A report of all electric, utility, water, landscaping,
snow removal and maintenance costs of the State center .
(vi) Geospatial images of the State center .
(vii) A detailed description of the existence, ownership
rights and appraised value of any mineral rights on the State
center property.
(viii) A historical report of the institutional property,
including the date it was acquired or constructed, the dates of
any improvements on the property, any changes in property
records, such as subdivision of the property, historical
employment or complement levels and other historical data.
(2) The timeline, specific to each State center , for the
transition to a home and community-based support system for all
of the individuals with intellectual disabilities living at the
State center . Information required under this clause shall
specify the critical milestones in the closure process for the
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State center and the department's planned course of action to
effectuate the closure of the State center , including available
and necessary resources.
(3) The home and community-based support providers available
in the immediate geographic area surrounding the State center .
(4) The process the department will utilize at each State
center to transition individuals with intellectual disabilities
supported at each State center to a home and community-based
support system as provided under this section.
(5) The process the department will utilize at the State
center to close buildings and reassign staff when individuals
with intellectual disabilities are transitioning from State
centers to a home and community-based support system.
(6) Any other information deemed appropriate by the
department as part of the plan.
(f) A State center subject to closure must continue to
operate with the level of staff necessary until all residents
have been transitioned into home or community-based services.
(g) As used in this section, the term "task force" means the
Task Force on the Closure of State Centers established in
accordance with subsection (b).
Section 202.1. State Center Closure Procedure.--(a) Upon
the department's decision to close a State center, or the
department's desire to explore the closure of a State center,
the following steps, at a minimum, shall occur in relation to
resident planning:
(1) The creation of a transition analysis for each resident,
or the review thereof, to include consultations with the
resident, the resident's medical decision maker, the resident's
family where applicable and related staff, to review the
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resident's level of care and need and to discuss how and where
that level of care and need can be met in a community-based
system.
(2) The creation of a medical review board, which, upon
request of the resident, the resident's medical decision maker
or the director of the State center, shall convene to ensure
that the possible transition of the resident to a community-
based system would not have a negative impact on the resident's
health or to determine the steps that would be necessary and
reasonably accessible to ensure a positive outcome for the
resident. The following shall apply:
(i) The medical review board shall consist of the following:
(A) The Physician General or Secretary of Health, or a
designee of the Physician General or Secretary of Health.
(B) The supervising physician of the State center.
(C) A physician with expertise in the field, appointed by
the Pennsylvania Medical Society.
(ii) The resident may not be transferred under this section
without the approval of the majority of the members of the
medical review board.
(b) Upon the department's decision to close a State center,
or the department's desire to explore the closure of a State
center, the following steps, at a minimum, shall occur in
relation to employee and community assistance:
(1) Within ten days of the department's decision or
expressed desire, notice shall be provided to all employees of
the State center and their State and local union leaders, which
must include a proposed initial meeting date with the union to
occur on a business day within thirty days of the notice.
(2) Within ten days of the department's decision or
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expressed desire, notice shall be provided to all the members of
the General Assembly who represent the location of the State
center.
(3) In accordance with the applicable collective bargaining
agreements, employment resources shall be made available to all
union and nonunion employees of the State center, including
continued employment opportunities with the department that
provide equivalent or similar duties, either in a facility or in
a community-based model, as well as the coordination of private-
based employment opportunities in an equivalent or similar
field.
(c) A State center shall remain open to provide services and
opportunities as required by law for any resident who is deemed
medically unable to transfer to a community-based system,
another State center or a similar residential facility.
(d) The department shall publish annually an assessment of
State centers and related community-based programs, to include,
at a minimum, staff wages and benefits, staff turnover rates,
unionization rate of non-exempt personnel, incidents and
allegations of abuse, community integration of residents,
vocational experiences of residents and the geographic
availability of community-based support providers.
(e) Unless required by law, or at the direction of the
resident or the resident's medical decision maker, a transfer of
the resident may only be made to a community-based program that
certifies to the department an employee turnover rate for the
program in the previous year of less than thirty percent.
(f) No later than six months after the effective date of
this subsection, the department shall provide a report to the
General Assembly that includes:
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(1) An analysis of the fee structure related to payment to
community-based support program.
(2) Information on the wages, healthcare benefits and
retirement benefits of the employees providing daily care under
the community-based support program.
(3) A comparison of related data for this Commonwealth to
other states.
(4) A proposed three-year plan that considers compensation
increases and other professional enhancements that could
stabilize the workforce and improve care.
Section 3. The addition of section 202.1 of the act shall
apply to closures made after October 1, 2019.
Section 4. This act shall take effect immediately.
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