Pennsylvania Administrative Code

PROVISION OF SERVICES § 15.91. General. (a) Protective services. Protective services are activities, resources and supports provided to older adults under the act after the initiation of an investigation to prevent, reduce or eliminate abuse, neglect, exploitation and abandonment…

§ 15.92. Assessment. (a) When a report is substantiated by the agency, or if an assessment is necessary to determine whether or not the report is substantiated, the agency shall, with the consent of the older adult, provide for a timely assessment. If the older adult does not con…

§ 15.93. Service plan. (a) Upon completion of the assessment and with the consent of the older adult, a service plan shall be prepared. The service plan shall be cooperatively developed by the agency staff, the older adult or his appointed guardian, and other family members, if a…

§ 15.94. Service delivery. (a) The agency shall, with the consent of the older adult, provide for implementation of the course of action recommended in the service plan. The implementation may be provided by direct provision of services by the agency, purchase of services from an…

§ 15.95. Case management. (a) Coordination of services. The protective services caseworker is responsible for coordination of sources of services being provided to the older adult who needs protective services. The caseworker shall also take reasonable steps to assure that servic…

§ 15.96. Termination of protective services. (a) The agency shall terminate protective services when the older adult is no longer ‘‘an older adult in need of protective services’’ under § 15.2 (relating to definitions). (b) Except when the older adult withdraws consent to the del…

GENERAL PROVISIONS § 20.1. Scope and authority. (a) The purpose of this chapter is to set forth regulations governing the administration and operation of the Program under the act. (b) This chapter applies to the Department, area agencies on aging, service providers under contrac…

PROGRAM ADMINISTRATION § 20.11. Administrative functions and responsibilities of the Department. (a) The Department will administer the Program under contract with area agencies on aging. (b) In the administration of the Program, the Department’s functions and responsibilities in…

§ 20.12. Administrative functions and responsibilities of area agencies on aging. (a) General. (1) Each area agency on aging shall administer a Program under this chapter in its planning and service area. (2) In the administration of the Program, the functions and responsibilitie…

§ 20.2. Definitions. The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise: Act—The Family Caregiver Support Act (62 P. S. § § 3061—3068). Area agency on aging—The local agency designated by the Depar…

CAREGIVER PARTICIPATION § 20.21. Eligibility for Program benefits. (a) General. The services and benefits of the Program are available to the primary caregiver of a functionally dependent older adult relative, or other adult relative suffering from a chronic dementia such as Alzh…

§ 20.22. Conditions of participation. (a) Certification of accountability. As a condition of participation in the Program, an eligible primary caregiver shall sign a certification of accountability as provided under § 20.32 (relating to assessment and care management). The primar…

§ 20.23. Income. (a) Income limits. (1) Caregivers whose household income exceeds 380% of poverty level are not eligible for the benefits and services under this chapter. (2) Caregivers whose income exceeds 200% of poverty level and does not exceed 380% of poverty level are requi…

§ 20.24. Appeals. Primary caregivers have the right to appeal an adverse decision by an area agency on aging regarding eligibility or the level of cost sharing determined by the agency. Appeals shall be filed under Chapter 3 (relating to fair hearings and appeals).

CORE PROGRAM SERVICES § 20.31. General. The core services of the Program include the assessment of the caregiver, carereceiver and caregiving environment; the development of a care plan responsive to the caregiver’s needs and burdens; ongoing casework services as needs may arise;…

§ 20.32. Assessment and care management. (a) Activities. Assessment and care management services include the following activities: (1) The assessment of the status and needs of the caregiver, the carereceiver and the caregiving environment. (2) The development and management of a…

§ 20.33. Benefits counseling. (a) General. (1) The family-centered assessment of caregiving needs and stresses required under § 20.32 (relating to assessments and care management) forms the basis for the provision of comprehensive counseling about resources and benefits appropria…

§ 20.34. Caregiver education and training. (a) General. The purpose of caregiver education and training is to strengthen caregiving skills and ease the burden of caregiving, with special attention to health problems of carereceivers, coping skills for caregivers and the performan…

REIMBURSEMENT BENEFITS § 20.41. General reimbursement. (a) Expenditure parameters. When an area agency on aging has annualized its Program and the ongoing caseload level has stabilized at, or around, the level projected in the approved Program plan, the following parameters on ex…

§ 20.42. Ongoing caregiving expenses. (a) Reimbursable expenses. To qualify for reimbursement under this chapter, ongoing expenses shall be for services or consumable supplies directly related and necessary to the care being provided to the carereceiver. To the extent that they a…

§ 20.43. Home modifications. (a) Preapproval. Area agencies on aging shall develop a system for the preapproval of home modifications to be authorized for reimbursement benefits. The system shall require all approved home modifications to be in response to specific details noted …

§ 20.44. Assistive devices. (a) Preapprovals. Area agencies on aging shall develop a system of preapproval of reimbursable purchases of assistive devices. An area agency on aging shall take appropriate steps to determine the availability of other funding—such as Medicare or Medic…

§ 20.45. Program violations and penalties. (a) Violations. Caregivers who receive services under the Program are subject to the administrative actions and penalties under this section if they commit one or more of the following acts: (1) Making or causing to be made a false state…

OTHER PROVISIONS § 20.61. Entitlement. The act does not create or provide an individual with an entitlement to services or benefits under this chapter. As provided in section 6 of the act (62 P. S. § 3066), it is the intent of the General Assembly that services under the act shal…

§ 20.62. Waivers. (a) The Department may for justifiable reasons, grant exceptions to and departures from this chapter to an area agency on aging when the area agency on aging can, by clear and convincing evidence, demonstrate that compliance would cause an unreasonable and undue…

GENERAL PROVISIONS § 21.1. Scope. This chapter establishes standards for domiciliary care service administered by AAAs.

FAIR HEARINGS AND APPEALS § 21.101. Fair hearings and appeals. (a) All parties have the right to express grievances and complaints and to appeal and receive a fair hearing on adverse actions regarding services or activities funded by the Department under Chapter 3 (relating to fa…

OTHER ADMINISTRATIVE PROVISIONS § 21.111. Forms, documents and other written materials. The Department may supplement or interpret this chapter by developing and issuing forms, documents or other written materials necessary for the effective administration of the program.

§ 21.2. Definitions. The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise: AAA (Area Agency on Aging)—The governing authority designated by the Department within each planning and service area to dev…

ELIGIBILITY DETERMINATION, CERTIFICATIONAND APPLICATION PROCESSES § 21.21. Eligibility for domiciliary care service. (a) To receive domiciliary care service, an applicant shall meet the following criteria as determined by the appropriate AAA: (1) Be a resident of this Commonwealt…

§ 21.22. Eligibility for the domiciliary care supplement. To receive the domiciliary care supplement, an applicant shall meet the following criteria: (1) Be eligible for SSI, as determined by the appropriate Social Security District Office and verified by the CAO, or be receiving…

§ 21.23. Application process for domiciliary care service and the domiciliary care supplement. The following procedure shall be used for determining the eligibility of an applicant for domiciliary care service and making payment for the domiciliary care supplement: (1) The applic…

§ 21.24. Redetermination of eligibility. The following procedure will be used to redetermine the eligibility of clients for domiciliary care service and the domiciliary care supplement. (1) Clients are responsible for: (i) Requesting a redetermination appointment with the AAA and…

§ 21.25. Termination of eligibility for domiciliary care service or the domiciliary care supplement. The following procedures shall be used to terminate a client’s eligibility for domiciliary care service or the domiciliary care supplement, or both: (1) The AAA is responsible for…

§ 21.26. Domiciliary care home provider eligibility. To be eligible to act as a domiciliary care home provider, a prospective provider shall meet the following criteria, as determined by the AAA: (1) Be a resident of this Commonwealth and 21 years of age or older. (2) Reside in t…

§ 21.27. Domiciliary care home certification and recertification standards. To become certified and to retain certification as a domiciliary care home, a domiciliary care home shall meet the basic standards in this section, as determined by the AAA from a site inspection and revi…

§ 21.28. Provider application and home certification process. The following process shall be used to determine the eligibility of a prospective domiciliary care home provider and to certify a prospective domiciliary care home. (1) The prospective provider application process shou…

§ 21.29. Redetermination of provider eligibility and recertification of domiciliary care homes. The following process shall be used to redetermine the eligibility of providers and recertify domiciliary care homes: (1) The provider is responsible for: (i) Permitting access to the …

§ 21.3. Waivers. The Department may grant waivers on provisions in this chapter which are not required by Federal, State or local laws. A request for a waiver shall be submitted in accordance with, and meet the standards provided in, the generic policies and procedures for reques…

§ 21.30. Special program and recertification standards for domiciliary care homes with four or more clients. (a) For domiciliary care homes with four or more clients, the following special building recertification standards apply. Domiciliary care homes with four or more clients …

§ 21.31. Provisional certifications. The AAA may grant provisional certification of a domiciliary care home if the home is in substantial compliance with this chapter so that the health and safety of clients are not endangered. Provisional certification may not exceed 90 days and…

§ 21.32. Joint certifications. (a) For homes which are jointly certified on or after January 6, 1990 or had been jointly certified prior to January 6, 1990 and had a certified capacity of three or fewer total clients, the following applies: The AAA may not conduct placement activ…

§ 21.33. Decertification of domiciliary care homes and removal of provider eligibility. The AAA shall notify the provider in writing of the provider’s right to appeal and receive a fair hearing under Chapter 3 (relating to fair hearings and appeals), if the home has been decertif…

§ 21.4. Nondiscrimination. Domiciliary care service shall be provided in accordance with Title VI, Section 601, of the Civil Rights Act of 1964 (42 U.S.C.A. § 2000d), section 504 of the Rehabilitation Act of 1973 (29 U.S.C.A. § 706), the Age Discrimination Act of 1975 (42 U.S.C.A…

DEPARTMENT OF AGING RESPONSIBILITIES § 21.41. Departmental responsibilities. The Department is responsible for the following activities under this chapter: (1) To develop regulations and to supervise and administer domiciliary care service on the State level under section 2203-A(…

§ 21.5. Service goals. The following are the goals of domiciliary care service: (1) To provide supportive, homelike, community-based living arrangements for adults who cannot live independently in the community. (2) To encourage and assist clients in developing and maintaining ma…

AAA RESPONSIBILITIES § 21.51. General provisions. The AAA is responsible for the overall local administration and operation of domiciliary care service in the PSA.