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CARIE sponsors monthly meetings of the Dorothy S. Washburn Legislative Committee. Please click here for August’s Agenda.
PA Assisted Living Final-Form Regulations
On May 3, 2010, the Pennsylvania Department of Public Welfare submitted its final-form regulation on assisted living residences to the Independent Regulatory Review Commission (IRRC), the House Aging and Older Adult Services Committee, and the Senate Public Health and Welfare Committee. IRRC is scheduled to meet and act on this regulation on June 3, 2010. CARIE submitted comments in support of the regulations noting some reservations. See below for more background information.
Medicare Advantage White Paper
Last fall, Medicare beneficiaries in Southeastern Pennsylvania were facing a loss of several Medicare Advantage plans impacting over 64,000 beneficiaries and overwhelming local SHIP/APPRISE programs. CARIE’s Dorothy S. Washburn Legislative Committee wrote a Medicare Advantage White Paper that was sent to numerous officials at CMS and the Pennsylvania Department of Aging. The paper includes recommendations based on the collective experience of the committee in working to assist these beneficiaries.
Nursing Facility Bed Hold Regulations
The Pennsylvania Department of Public Welfare has submitted proposed regulations to the Independent Regulatory Review Commission to stop reserved bed day payments to nursing facilities with low occupancy rates. CARIE submitted bed hold comments to IRRC in response to the proposal.
Proposed Pennsylvania Integrated Care Initiative
The Pennsylvania Department of Aging and Office of Long Term Living was planning to implement a voluntary integrated care program in July 2010. (It appears that any integrated care plan will be delayed until the next administration.) Older adults currently in Special Needs Plans or those who are eligible for both Medicare and Medicaid would have been offered voluntary enrollment. (Consumers receiving Aging Waiver services and nursing home residents would not be eligible to enroll.) Click here for the website offering more information about the integrated plan proposal and stakeholder information. The Department issued a Program Design Overview in June 2009 and an updated version in December 2009. CARIE submitted comments and recommendations on the Draft ICI Design in response to the draft proposal in June.
Office of Aging and Long Term Living
Representative Mundy introduced House Bill 1152 and Senator Vance introduced Senate Bill 927that would abolish the current Department of Aging in Pennsylvania and create an Office of Aging and Long Term Living in its place. The overall objective is to permanently establish the work of Governor Rendell’s Office of Long Term Living that was created through an Executive Order. Without legislation in place, the Office of Long Term Living would end once a new governor is sworn into office. CARIE has a number of concerns regarding the bill and the potential transition to a new department some of which have already been addressed in the amended version of the bill. CARIE’s concerns and recommendations are outlined in a House Bill 1152 Position Paper that was distributed to all members of the House Aging and Older Adult Services Committee as well as the Senate Aging & Youth Committee.
Housing Advocacy in Pennsylvania
Leigh Howard from Diana T. Myers and Associates was a special guest speaker at CARIE’s May 2009 Legislative Committee meeting to discuss how housing issues impact older Pennsylvanians. Leigh highlighted the following information.
This spring, the Housing Advisory Committee to the Pennsylvania Office of Long Term Living (OLTL) and the Pennsylvania Housing Finance Agency (PHFA) issued a September 2008 report, A Five Year Plan for Integrating Affordable Housing and Long Term Supports in the Commonwealth of Pennsylvania. According to the executive summary, “The Long- term Living Housing Advisory Committee was created in 2007 to develop a strategic plan for increasing affordable accessible housing options and opportunities for individuals needing long term living services. The Committee was composed of 27 representatives of public and private agencies from throughout the Commonwealth. The 5 year plan is presented as the foundation for an on-going process of data collection, analysis and strategy formulation. In crafting this report the Committee assumed that the type and level of necessary services to support individuals living in the community are available. Its focus was on increasing housing and housing opportunities and making sure that the coordinating mechanisms are available to link the housing to services.”
The Pennsylvania Intra-Governmental Council on Long Term Care created a Housing Alternatives Work Group (HAWG) to identify and research non-traditional
housing options for elderly and adults with disabilities to expand affordable and
accessible housing alternatives in Pennsylvania. In December 2007, HAWG issued a report, Housing Alternatives Work Group: A Report on Non-Traditional Housing Options, that was posted on the Department of Aging’s website in April 2009.
The concept of visitability is being advocated for as a way to ensure accessible housing. The brochure, Promoting Visitability in Philadelphia, describes the concept, provides links to national resources, and includes efforts that are occurring in Philadelphia.
CARIE Provides Testimony to PCA
On May 26, 2010, the Philadelphia Corporation for Aging (PCA) held a pubic hearing entitled, “Meeting the Needs of Philadelphia’s Elderly” that related to its upcoming budget for fiscal year 2009/10. CARIE submitted testimony.
CARIE Provides Comments About Proposed Assisted Living Regulations
CARIE submitted comments about assisted living to the Office of Long Term Living and the Independent Regulatory Review Commission (IRRC) about Pennsylvania’s proposed assisted living regulations. (Please see next item below for more information.) Diane Menio also presented testimony about the assisted living regulations before the Pennsylvania House Aging and Older Adult Services Committee on September 18, 2008.
Pennsylvania Assisted Living Consumer Alliance
The PA Health Law Project has organized the PA Assisted Living Consumer Alliance (PALCA) comprised of consumers, caregivers, and advocates who want to ensure that the rights and needs of consumers are addressed in the assisted living regulations being developed in response to Act 56 of 2007. Click here for a press release. CARIE is pleased to be a member of the PALCA and fully supports its goals. Act 56 created a new assisted living license that will be distinguished from personal care homes in that residents with higher level of health care needs will be able to “age in place” or be served in assisted living rather than being transferred to a nursing facility. PALCA has recently launched a website that includes links to news articles and will post information regarding the proposed assisted living regulations.
The Department of Public Welfare (DPW) has submitted the proposed assisted living regulations to the Independent Regulatory Review Commission. Click here to review. The official proposed regulations are expected to be published in the Pennsylvania Bulletinon August 9, 2008 which will mark the beginning of the 30 day public comment period that will end on September 8, 2008. DPW’s regulatory analysis form states: “Currently, there is no regulation of assisted living residences in Pennsylvania. However, assisted living residences are a significant long-term care alternative which combines housing and supportive services. They are designed to allow people to age in place, maintain their independence and exercise decision making and personal choice. This regulation establishes the minimum standards for licensure of assisted living residences to allow individuals to age in place. The regulation protects consumers’ health and safety, privacy and autonomy while at the same time balancing providers’ concerns related to liability and individual choice.” DPW also estimates that 100 assisted living residences will be licensed in FY 2009-2010; 150 assisted living residences in FY 2010-2011; 200 assisted living residences in FY 2011-2012; and 250 assisted living residences in FY 2012-2013.
A preliminary review of the proposed regulations raises concerns that the needs and rights of residents may not be fully addressed. The PALCA is collecting personal stories, both positive and negative experiences with assisted living facilities as well as personal care homes in Pennsylvania. The stories can either reflect a personal experience or a professional observation. If you don’t have a story to tell, you can help by forwarding this link to those who may be able to help. The stories can be very brief or extensive; all will help in developing a response to the proposed regulations.
DPW has also begun to post personal care home inspection results online and later this year, plans to post its progress in inspecting the state’s 1,500 personal care homes. (Simply enter the name of the facility, the county, or zip code to find information about a particular facility.) The Legislative Budget and Finance Committee has posted a report, “State Efforts to Fund Assisted Living Services.”
Pennsylvania Elder Economic Security Standard Index
Wider Opportunities for Women (WOW) and the Gerontology Institute at the University of Massachusetts Boston created the Elder Economic Security Initiative (EESI), a measure of income adequacy that attempts to reflect the amount of income older adults need to meet basic expenses. Currently, the Elder Economic Security Index is available for California, Illinois, Massachusetts, Pennsylvania and Wisconsin on WOW’s website.
In Pennsylvania, Pathways PA partnered with CARIE, the United Way of Southeastern PA and others to develop the EESI Index for PA. PA’s Index demonstrates that while one out of four older Pennsylvanians rely solely on Social Security, the average Social Security payment in Pennsylvania is not enough to support their basic needs. Housing costs consume between 19 to 45% of older adults monthly expenses. If an older Pennsylvanian needs home and community-based long term care, the cost can double and even triple their monthly expenses. The Index provides typical monthly expenses for an older adult as well as a couple specific to every county in Pennsylvania and includes a separate chart for home and community-based long term care costs by county.
Here is PA EESI information:
Elder Economic Security Standard Index for Pennsylvania (full report)
Elders Living on the Edge: When Incomes Fall Short in Retirement (policy brief)
PA EESI and the Family Caregiver Support Program (fact sheet)
PA EESI for Advocates (fact sheet)
At A Glance: Pennsylvania’s Women in Retirement- (Added 5/09)
The Office of Long Term Living is Clarifying its NFCE Definition
The Office of Long Term Living (OLTL) sought feedback on its draft Nursing Facility Clinically Eligible (NFCE) clarification. The OLTL also drafted NFCE background information. On May 22, 2008, CARIE submitted NFCE comments concerning the draft document.
“Take Action” Archives
To review previous “Take Action” advocacy alerts, please visit CARIE’s ”Archives” in the “Policy” section of our website or to simply access a list click here. (COMING SOON!)
