Monday, November 3, 2014

PA Law Encourages Expansion of Community Respite Services



Pennsylvania’s new Community Adult Respite Services Program law gives senior centers, adult day centers and licensed long term care facilities the ability to offer supportive services for seniors (over age 60) who are living at home. The legislation (HB 1702 now Act 166 – 2014) was introduced by Representative Chris Ross (R-158) and signed into law on October 22nd.
The Act targets individuals who need more than the normal scope of services offered at senior centers, but not the full attention of licensed Adult Day Centers.  Programs will be overseen by local Area Agencies on Aging.
HB 1702 was inspired by an assisted senior program that has been operated for over 20 years by the Kennett Area Senior Center. A similar program is in operation at the Downingtown Area Senior Center. 
The legislation authorizes the licensing and oversight of “community adult respite services" programs. These programs are intended for seniors who are living at home and require only minimal assistance. They provide the senior with social interaction, exercise and cognitive stimulation, thereby enhancing the potential for longer-term independence. And they provide family members with a much needed break from caregiving duties.
Program participants must be age 60 and over and be able to actively or passively engage in social and leisure activities with others. Participants may suffer from mild cognitive or physical impairment and need cueing. But the program is not intended for seniors with higher care needs such as individuals needing assistance with medication, personal hygiene care or whose behaviors may compromise their safety or the safety of others.
Participants will be subject to ongoing assessment. Those who develop more intense care needs are to be transitioned to other providers.
The Act clarifies the role to be provided by senior respite programs like the Kennett Area Senior Center program. It demarcates them from the higher level of assistance available in adult day care centers. Adult day centers provide personal care, nursing services, social services, therapeutic activities, nutrition and therapeutic diets and emergency care. [See the Directory of Pennsylvania Adult Day Services Providers here.]
The Act provides a safe harbor which helps clear the way for additional senior centers and other providers to offer senior respite services. It may energize the geographic expansion of programs to other senior centers across the state. It may also encourage other non-profit and for-profit organizations to offer senior respite.  
An ultimate goal of this type of support program is to allow seniors to continue to live in their communities for as long as possible. It can help participants maintain independence by enhancing their abilities and supporting their caregivers. It represents another small cog in the continuum of care.
Licensed long-term care service providers will be able to provide senior respite services without a separate license. But they must notify the Department of Aging of their intent to operate a program. Other providers must obtain a license.
For the purpose of this exemption, licensed long-term care service providers include:
An assisted living residence.
A continuing-care provider.
A Life program.
A long-term care nursing facility.
An older adult daily living center.
A personal care home.
Within a year and a half of enactment, the Department of Aging is charged to develop guidance for the program – via regulations or statements of policy.
Program monitoring will be provided by either the Department of Aging or by local area agencies on aging (AAAs) acting “as agents of the Department.” Programs may be operated by existing AAA senior centers as well as other providers. Employees of senior respite services programs will be prohibited from serving as power of attorney or guardian for a participant.
The Act includes no provision for funding. The lack of any public financing means that programs will need to come up with creative ways to pay for the services provided. It’s possible that senior centers could offer respite on a sliding-fee schedule based on ability to pay. Other providers could subsidize their respite services as a means of marketing or for charitable reasons.  
Act 166 takes effect in 180 days (April 2015).

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