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State officials backpedal on assisted-living revisions
Wednesday, October 22, 2008

State officials intent on creating a new "assisted-living" housing category in Pennsylvania announced yesterday they will postpone trying to win approval of the new regulations until next year.

The Department of Public Welfare has received hundreds of criticisms and comments on an initial version of the regulations published in August, and those require more time to review than initially planned, said Michael Hall, the Rendell administration's deputy secretary of long-term living.

The guidelines, originally to be submitted for formal state approval by Nov. 30, will undergo revisions and be presented publicly in early 2009, Mr. Hall said. It's possible, but not certain, that they will take effect as originally intended next July 1.

Among the key entities seeking revisions from the welfare department is the Independent Regulatory Review Commission, the agency that ultimately must approve the regulations to make them final.

The commission sent comments to welfare officials last week saying they needed to better spell out how they came up with various rules, what their impact would be and what would distinguish the assisted-living category from existing personal care homes.

The Legislature mandated the new category in 2007 after wrestling for years with how to give the public a long-term care option that ranged between the rigid medical model of the nursing home industry and more wide-open standards of Pennsylvania's nearly 1,500 personal care homes. The intent of assisted living is to let people age in place, with higher care requirements than in the personal-care sector but more homelike environments than nursing homes.

For the past year, the welfare department has wrestled with sharply different opinions from provider groups and consumer advocacy organizations on issues such as how much space should be required in assisted-living units and what training the facilities' staffs should have.

"Some of these issues will be very difficult to get consumers and providers on the same page," Mr. Hall acknowledged, though he said the department would continue trying.

The key challenge for the department is creating a category that will sufficiently upgrade standards over what personal care homes must have -- since assisted-living residents may be frailer than those in lesser facilities -- without making requirements so expensive for providers that few of them enter the field.

"We'll make a lot of adjustments, and some will be in response to comments from consumers and some in response to feedback from providers," said Mr. Hall, who has been nominated by Gov. Ed Rendell to become the state's secretary of aging next month. "We're trying to refine our position so if in fact we missed something, or went too far, we'll get to a reasonable place in the middle."

He said he was unsure if the department would call new meetings with the wide range of groups interested in the regulation, as the regulatory review commission urged in its comments.

At least 216 different groups or individuals have offered feedback on the proposed regulations, he said.

Gary Rotstein can be reached at grotstein@post-gazette.com or 412-263-1255.
First published on October 22, 2008 at 12:00 am
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