Monday, July 16, 2007

PA's "Assisted Living Facility" Bill (likely, Law)

The Pennsylvania Legislature just approved new legislation regulating assisted living facilities; and Governor Rendell is reportedly ready to sign it into law . Five other bills involving medical providers were approved by the Legislature on July 14th, which likely will become law too.

My focus for today is
Senate Bill 704, Printer's No. 1272, which defines & establishes, for the first time in this Commonwealth, "assisted living" as a separate form of long-term care. I'll focus on the other five bills tomorrow.

The final form of SB 704 (Text version; PDF version) was signed in the Senate on Friday, July 13th, and in the House on Saturday, July 14th. The Bill goes to the Governor for signature into law, which is expected.

The Senate had approved its version of SB 704 on June 30, 2007 (46-3). The House then approved an amended version of SB 704 on July 6th (198-0); and the Senate concurred with those House amendments on July 13th (49-0). The full history of SB 704 is found here.

The official summary of
SB 704 reads as follows:

An Act amending the act of June 13, 1967 (P.L.31, No.21), known as the Public Welfare Code, further providing for State plan for regulating and licensing personal care homes, for Intra-Governmental Council on Long-Term Care and for rules and regulations for personal care homes and assisted living residences.
The Legislature made three findings supporting the need for such legislation on assisted living as an element of long-term care:
  1. Assisted living residences are a significant long-term care alternative nationwide.
  2. Assisted living residences are a combination of housing and supportive services, as needed. They are widely accepted by the general public because they allow people to age in place, maintain their independence and exercise decision making and personal choice.
  3. It is in the best interest of all Pennsylvanians that a system of licensure and regulation be established for assisted living residences in order to ensure accountability and a balance of availability between institutional and home-based and community-based long-term care for adults who need such care.
Penn-Live (Central PA) posted an Associated Press summary of this "long-term care" legislation on Friday evening, July 13th (7:47 pm), in its News from the Pennsylvania General Assembly, as follows:
The Senate unanimously approved legislation to require specific regulation of assisted-living residences by the state Department of Public Welfare. The bill goes to Rendell, who plans to sign it, a spokesman said.

Under the bill, department inspectors would conduct at least one unannounced inspection a year of each assisted living home. In addition, the department would be required to write regulations that require orientation and training for caregivers, as well as regulations that require qualifications for administrators.

The legislation also seeks to identify which health-care services can be offered by the residences in an effort to distinguish them from personal-care homes and nursing homes. Assisted-living facilities typically offer an intermediate level of care for residents who need fewer medical services than offered by a nursing home.

In the past, assisted-living facilities have been licensed by the state under rules governing personal-care homes, which house people who need help with tasks such as bathing, dressing and managing their personal finances, but do not provide around-the-clock medical care. * * *
This legislation was supported by AARP-Pennsylvania, which issued a press release on July 13, 2007, entitled "AARP Pennsylvania Applauds Approval of Assisted Living Legislation":
AARP Pennsylvania today praised the state's General Assembly for approving Senate Bill 704 * * *

"According to an AARP study, 95% of older Pennsylvanians prefer alternatives to nursing home placements," said AARP Pennsylvania State Director Dick Chevrefils.

"Assisted living represents an invaluable option for many individuals who can't live at home anymore, but don't require round the clock health care services."

Chevrefils thanked Rendell administration officials for working with State Senator Pat Vance and State Representatives Phyllis Mundy and Katharine Watson on the legislation that will define and regulate assisted living under Pennsylvania law.

"Pennsylvanians deserve to have assisted living officially added to the list of long-term care services available in the Commonwealth," he said.

"We're pleased our leaders approved a law that provides consumer-directed care, allows independence, and permits individuals to remain in assisted living residences as their health changes."

Chevrefils said national research shows assisted living facilities charge between one-half and two-thirds of the cost of daily skilled nursing care, which will help older Pennsylvanians stay off Medicaid rolls longer.

In addition, legally defining assisted living makes the state eligible for federal programs that provide financial assistance to assisted living residents, enabling those individuals to further delay moving to a more costly nursing home environment.

"Although some individuals will always need the 24 hour care provided by nursing homes, approval of assisted living legislation keeps Pennsylvania moving toward a long-term care system that better balances institutional care with home and community programs," he said. "In the end, that's the type of long-term care system older Pennsylvanians want and our state can best afford." * * *
The AP article mentioned various other bills governing the delivery of health care services by providers other than physicians. This concept is one element of Governor Rendell's "Prescription for Pennsylvania" proposal. See: PA EE&F Law Blog posting "PA Governor Unveils New Health Care Proposals" (01/19/07).

On Saturday, July 14, 2007, all these bills were signed by both the House & Senate, and also now go to the Governor for signature into law.

This package of legislation would define & regulate:
  • "Nurse practitioners" (House Bill 1253) [which became Act No. 48 of 2007, as signed on July 20, 2007]
  • "Nurse Clinicians" (House Bill 1254) [which became Act No. 49 of 2007, as signed on July 20, 2007]
Tomorrow I'll review these other bills likely to become law soon, and consider the broader setting in which they were compromised into adoption by the Legislature for the Governor's signature.

Updated: 07/17/07:

For a discussion of the other legislation referenced above, see:
PA EE&F Law Blog posting "Assistants to be Elevated in PA Healthcare" (07/17/07).

Updated: 07/26/07:

On July 25, 2007, Governor Rendell signed
Senate Bill 704, P.N. 1272, as Act No. 56 of 2007.

Act 56
addresses, for the first time in the Commonwealth, a statutory & regulatory framework governing operations of assisted living facilities.

For further commentary, see:
PA EE&F Law Blog posting "PA's Act No. 56 on Assisted Living Facilities" (07/26/07).

Update: 07/22/08:

For further developments, see PA EE&F Law Blog posting "
New PALCA for Assisted Living Standards" (07/22/08).