2008-10-23 / Family

Panel Says Assisted-Living Regs Need Revisions

By MARTHA RAFFAELE ASSOCIATED PRESS WRITER

HARRISBURG, Pa. (AP) - State welfare officials have more work to do as they try to clarify for consumers the difference between personal care homes and "assisted-living'' residences, both of which provide care for the elderly and disabled.

A state regulatory panel said Wednesday that the state's first proposal to license assisted living residences did not eliminate confusion over the term.

"We believe this distinction is vital to potential residents and their families in their evaluation of which path best fits their current health needs, future health needs and ability to pay, and promotes happiness and wellness,'' the Independent Regulatory Review Commission said in a written opinion evaluating the proposed regulations.

Assisted living facilities are designed to care for people who need services beyond assistance with tasks of daily living - which is already provided by personal-care homes - but who are not sick enough to require 24-hour nursing home care.

The Department of Public Welfare is developing the regulations under a 2007 state law that mandates the state's first-ever licensing for assisted-living residences.

The distinction between personal care homes and assisted living will be critical for residents who need government assistance to pay for long-term care services. The federal Medicaid program for the poor and disabled does not pay for personal care home expenses, but it can defray the cost of assisted living in states that have received federal approval for that purpose.

The welfare department has set a goal of making the regulations final by Nov. 30; the rules would take effect July 1. But department spokeswoman Stacey Witalec said officials are willing to extend that deadline, if necessary.

"We may not have gone far enough yet (in defining assisted living), yet we're hopeful we can get there,'' Witalec said.

Consumer advocates and industry groups have expressed dissatisfaction with the department's initial regulatory proposal. At a legislative hearing in September, both sides argued over whether the new rules would ensure that residents receive safe, adequate care and whether they would impose costly mandates on facility operators.

The department has proposed licensing fees of $500 per resident and $105 per bed. Other provisions include minimum square-footage requirements for residential units.

The commission noted that if the cost deters many personal-care homes from upgrading to assistedliving facilities, the resulting assistedliving shortage will force many low-income residents who need medical care to move into nursing homes, which already accept Medicaid.

The department should survey existing personal-care homes to determine the capacity for those facilities to provide assisted-living services under the new regulations, the commission said.

"The department should explain how the limitations and requirements in this regulation will result in availability of (assisted living residences) to Pennsylvanians at a cost they can afford,'' the commission said.

The regulations must also address how personal-care homes that want to convert a portion of their facilities to assisted living can obtain dual licenses, which the state law also envisions, the commission said.

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