2008-09-24 / Local & State

Lawmakers Mull Assisted Living Regulations

By Martha Raffaele ASSOCIATED PRESS WRITER

HARRISBURG, Pa. (AP) - Consumer advocates and industry groups have found shortcomings with proposed licensing standards for assisted living residences that are intended to provide a new long-term care alternative in Pennsylvania for the elderly and disabled.

But the state's top public welfare official said the proposal represents the best compromise in such a polarized debate.

Both sides aired their concerns during a legislative hearing Thursday on the regulations proposed by the Department of Public Welfare.

Assisted living facilities are designed for people who need services beyond assistance with bathing, dressing, and other tasks of daily living that the state's personal-care homes provide, but who are not sick enough to require 24-hour nursing home care.

The department is developing the regulations under a 2007 state law that mandates assisted-living licensing standards and has set a goal of implementing them by Nov. 30.

The testimony revealed disagreements over whether the new rules would ensure that residents receive safe, adequate care and whether they would impose excessive costs on facility operators.

The Pennsylvania Assisted Living Consumer Alliance, a coalition of advocates for the elderly and disabled, expressed particular concern that the rules set no minimum hours of training for direct care workers and do not require them to be trained in first aid or CPR.

Alissa Halperin of the Pennsylvania Health Law Project, a member of the alliance, noted by comparison that legislation that calls for licensing dog groomers would require them to complete at least 300 hours of training.

"Surely caring for human lives calls for as much if not more training,'' Halperin told the House Aging and Older Adult Services Committee.

The rules also would allow assisted living operators to dictate which doctors and other health care providers can care for their residents, said Linda Anthony, policy director for the Disability Rights Network of Pennsylvania.

"People must have the right to their choice of (health care) providers,'' said Anthony, who uses a wheelchair due to a spinal cord injury she suffered 25 years ago in a car accident. "Although some would say a doctor is a doctor is a doctor, for those of us living with a disabling condition, it is all too often a matter of life and death.''

Nursing home groups complained that proposed licensing fees of $500 per residents and $105 per bed were too high. They also said the cost of complying with certain provisions, such as minimum square-footage requirements for residential units, would discourage the construction of new facilities.

The resulting shortage of facilities would make assisted living affordable only to the wealthiest and place it out of reach for low-income residents who rely on Medicaid, said Dr. Stuart Shapiro, president and chief executive officer of the Pennsylvania Health Care Association.

"The proposed regulations are likely to raise the cost of assisted living in Pennsylvania so greatly that they will suffocate development of assisted living and ensure that the potential for a vibrant assisted living sector will not become a reality,'' Shapiro said.

Public Welfare Secretary Estelle Richman said the regulations are intended to clarify the long-term care options that are available to aging Pennsylvanians, and provide settings where they can still live independently while receiving certain supplemental health care services.

Richman said the agency would decide whether any revisions are needed after considering feedback from the public, advocacy groups, lawmakers, and an independent regulatory board that is reviewing the regulations.

"We've tried to come in the middle and cut the baby a bit, but that doesn't mean we aren't still listening,'' Richman said.

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