July 30, 2007

CARIE Policy Update and Meeting Cancellation

Quote of the Month
“The clash of ideas is the sound of freedom.” – Lady Bird Johnson (December 22, 1912 -July 11, 2007)

All news items this month are relevant to Pennsylvania; please scroll down to “Just the Links” for information of potential interest to all. 

Assisted Living in Pennsylvania
On July 25, Governor Ed Rendell signed Senate Bill 704; now Act 56 of 2007, into law establishing licensure procedures for Pennsylvania’s assisted living facilities. Pennsylvania became the 40th state to mandate licensing standards for assisted living facilities. It could take up to two years for the Department of Public Welfare (DPW) to draft, get approval, and implement new regulations as a result of the new law. DPW will also be seeking approval for federal funding from CMS to use Medicaid Waiver funds to help subsidize the care of eligible assisted living residents. The new law defines assisted living residences, sets minimum standards, and the services that may be provided. Unfortunately, the law includes “informed consent agreements” that are essentially negotiated risk agreements. Negotiated risk has been used by providers in other states to avoid providing quality care, prevent regulatory action, and evade litigation. In sum, “negotiated risk” is a practice that can be categorized as a failure and as being quite harmful for consumers. Facilities will need to be licensed under this act to use the term or market itself as “assisted living.” Facilities that state they provide specialized care for residents with dementia must meet additional rules. DPW will establish a new unit of surveyors who will be dedicated to completing annual inspections at assisted living facilities. It is estimated that about 300 of the current 1,600 personal care home providers may qualify for the new assisted living status. For more information about the legislation, click here to read an article from the Pittsburgh Post Gazette that includes a link to the bill.   

Pennsylvania Budget Update
On July 17, Governor Rendell signed the 2007-08 budget bill, House Bill 1286. The $27.2 billion budget increases state general fund spending by 3.2% or 4.4% if including the $300 million in mass transit money being diverted to a special fund. There are no new taxes or tax increases included in the budget.

The budget moves all current general fund line items for the Department of Aging out of the “General Fund,” totaling over $19 million, with the exception of the Alzheimer’s Outreach program. The Family Caregiver Support Program will receive a 3% cost-of-living adjustment. It is anticipated that 5,545 families will receive these services in 2007-08. The budget includes $250,000 for Alzheimer’s Outreach Services. Federal funding used for memory loss programs are no longer available; however, it is anticipated that Pennsylvania will receive $350,000 in federal funds for an Alzheimer’s Demonstration Grant program. Funding for the Pre-Admission Assessment Program is increased by 34% for a total of $10.3 million in lottery funds. The lottery funded PENNCARE appropriation will increase by $15 million to increase the capacity of the current Attendant Care Program to serve an additional 346 recipients, to provide a 3% cost of living adjustment for direct care workers, and to provide services needed for nursing home transition. The budget includes a total of $12.9 million in lottery, tobacco and federal funds (the PENNCARE portion is $4.8 million) for an initiative "to reduce reliance on institutional long term care and promote growth of high quality home and community-based services."  An additional 2,200 individuals over the age of 60 may receive Aging Waiver services.  The budget will allow the average number of seniors covered by PACE, PACENET or PACE Plus Medicare to increase by 10% or to 357,725 participants which represents an additional 32,000 seniors.

The House Democratic Committee on Appropriations has issued a number of fact sheets providing an overview of the 2007-08 budget including:
2007/08 Budget Briefing: Tobacco Settlement Fund   

2007/08 Budget Briefing: DPW – Mental Health Services

2007/08 Budget Briefing: DPW – Medical Assistance

2007/08 Budget Briefing: The Commonwealth Checkbook

2007/08 Budget Briefing: Historic Commitment to Transportation Funding

PA Establishes Long Term Care Partnership Program 
On July 17, Governor Rendell signed Senate Bill 548, now Act 40 of 2007, into law. Following federal guidelines, the law establishes a “Long Term Care Partnership Program” for Pennsylvania. Individuals who purchase approved long term care insurance policies will be able to protect their assets equal to the amount of benefits purchased from being spent on their care as currently required by Medicaid. For more information, please see the article in the Pittsburgh Post Gazette.     

Time to Re-Register for PA's Do-Not-Call List 
As they say, “time flies” and it has been almost five years since Pennsylvania’s “Do-Not-Call” list has been in effect. Consumers must register every five years to remain on the list. Consumers can be added to the next list, good for the next five years, by visiting www.nocallsplease.com or by calling 1-888-777-3406 starting August 1 until September 15.

PA Now Posts Laws Online
Pennsylvania is the last state to make its statutes available on a public website. Consolidated laws are available but unconsolidated statutes are still not posted. Click here to access Pennsylvania’s consolidated statutes.  

Just the Links.....
The following are links to potential resources or documents of interest:

• CRS Report for Congress – “Labor, Health and Human Services, and Education: FY2008 Appropriations.” 
• A Kaiser Family Foundation Fact Sheet: “Medicare Low-Income Assistance Under the Medicare Drug Benefit.” 
• The National Center on Senior Transportation (NCST) has launched a new website. Individuals may sign-up to receive free NCST email newsletters. 
• The Center for American Progress released a report, “Caring About Long-Term Care.”
• The Center for Health Care Strategies released an issue brief: “State Approaches to Consumer Direction in Medicaid.”
• The Alliance for Health Reform issued a toolkit: “Medicare Private Fee-for-Service Plans.”
• Rutgers Center for State Health Policy issued a discussion paper: “The Minimum Data Set: Recommendations to Help States Better Support Nursing Home Residents Who Seek Community Living.” 
• The Brookings Institution released: “Mapping the Growth of Older America: Seniors and Boomers in the Early 21st Century.” 
• The Congressional Budget Office issued a background paper: “The Impact of Medicare’s Payment Rates on the Volume of Services Provided by Skilled Nursing Facilities.”     
• The Century Foundation published an issue brief: “Facing the Problems of Providing Long-Term Care for the Oldest Old.”
• The National Institute on Aging released a health and retirement study: “Growing Older in America.”
• OMB Watch released a summary, “E.O. 13422: Unanswered and Unaccountable,” regarding President Bush’s Executive Order 13422 that changes the federal regulatory process.
• NCCNHR has developed a tool for person-directed care: “My Personal Directions for Quality Living.”    
• Effective July 5, CMS has implemented a continuous Special Enrollment Period (SEP) for all Part D eligible beneficiaries who qualify for the Low-Income Subsidy (LIS). CMS has posted information for Medicare Advantage Drug plans and for stand alone Prescription Drug Plans (PDP). 

CARIE News
CARIE received a new computer server and staff did not receive email messages sent the end of last week until today. The CARIE OnLINE service was also affected temporarily. If you do not receive a response soon to your message or inquiry, please resend your request or feel free to contact us by phone at 215-545-5728 or 1-800-356-3606.

August Meeting Cancellation
Just a reminder that the August Legislative Committee meeting has been cancelled!  A meeting announcement will be sent before the next meeting as a reminder. As always, don't hesitate to contact me if you have any questions. Hope you’re enjoying the summer!
Kathy