H. B. 2801
(By Delegate Anderson, By Request)
[Introduced March 28, 1997; referred to the
Committee on Government Organization then Finance.]
A BILL to amend chapter eighteen of the code of West Virginia,
one thousand nine hundred thirty-one, as amended, by adding
thereto a new article, designated article ten-j, relating to
creation of a job opportunity program for individuals on
welfare or aid to dependent children in order to create an
effective personal assistance services act; short title;
legislative policy; establishment of programs; designating
the department of health and human resources as agency
responsible for programs; demonstration projects; rules; and
report.
Be it enacted by the Legislature of West Virginia:
That chapter eighteen of the code of West Virginia, one
thousand nine hundred thirty-one, as amended, be amended by
adding thereto a new article, designated article ten-j, to read as follows:
ARTICLE 10J. JOB OPPORTUNITY PROGRAM AND PERSONAL ASSISTANCE
SERVICES ACT.
§18-10J-1. Short title.
This article shall be known and may be cited as the "Job
Opportunity Program and Personal Assistance Services Act."
§18-10J-2. Declaration of policy.
It is hereby declared to be the public policy of this state
that:
(a) There is an increased need for personal assistance
services to assist adults with disabilities or serious illnesses
to permit them to remain and live, as independently as possible,
in the residence and community of their choice or otherwise
maintain their ability to work;
(b) Simultaneously to receiving assistance, individuals on
welfare or families receiving aid for dependent children must
seek gainful employment or perform volunteer work for a minimum
of twenty hours per week or such assistance shall be
discontinued;
(c) Priority recipients of personal assistance shall be those
individuals with the most severe disabilities or illnesses,
including, mental, cognitive, speech, sensory or physical
impairments, and who are in danger of being moved from the living arrangement of their choice to a more restrictive and potentially
more costly habitats;
(d) Recipients of personal assistance services or their
guardians have the right to make decisions about, direct the
provision of and control their personal attendant or personal
assistant services by way of, establishing a mutually agreeable
individualized service plan. This includes, but is not limited
to, interviewing, hiring, managing, paying and terminating the
relationship of their attendant or service provider;
(e) Any program receiving the allotted funds must have within
its framework the following seven basic principles:
(1) Services are provided where they are needed, either at
home, in the community or work setting.
(2) Services are available when needed, while being
accessible twenty-four hours a day, seven days a week including
back-up attendant services or services needed on an emergency
basis.
(3) Eligible individuals shall contribute to the cost of
services based on their ability to pay.
(4) Eligible individuals choose how, when and by whom
services are provided.
(5) Eligibility is based on functional needs rather than on
a medical diagnosis or type of disability.
(6) Health-related tasks can be delegated to or performed by unlicensed, yet qualified, personal attendants.
(7) Personal attendants should receive adequate wages and
benefits.
(f) Subject to available funds, including program fees,
medicaid, other block grants or medicare, including waivers or
vouchers, other personal assistance projects shall be developed
to increase the availability of services throughout the state in
order to serve eligible individuals.
§18-10J-3. Definitions.
The following words and phrases when used in this article
have the following meanings:
(a) "Personal assistance services" means the following
services provided by an unlicensed person to a person with a
disability or illness:
(1) Basic and ancillary services which enable eligible
individuals to live in their homes and communities rather than in
institutions and to carry out functions of daily living,
self-care, mobility, communications and work;
(2) Personal care services including, but not limited to:
(A) Getting in and out of a bed, wheelchair or motor vehicle;
(B) Assistance with the performance of routine bodily
functions and activities, including, but not limited to:
(i) Health maintenance and related tasks;
(ii) Bathing and personal hygiene;
(iii) Dressing and grooming;
(iv) Feeding;
(v) Child care; and
(C) Household services including, but not limited to:
(i) Meal preparation;
(ii) Shopping for essential and nonessential items;
(iii) Light, general housekeeping activities;
(iv) Laundry; and
(D) Assistance with the performance of cognitive functioning
designed to assist individuals with:
(i) Money management;
(ii) Use of medications; and
(iii) Cuing with services provided in subdivisions (A), (B)
and (C) as well as other important activities associated with
day-to-day living;
(E) Facilitation of communication by providing sign language
interpreters for persons who have speech or hearing impairments,
or personal readers for those individuals who are legally blind;
(F) Transportation to stores, meetings, social or religious
gatherings or to recreational or entertainment events, where the
attendant acts as an escort or driver;
(b) "Individuals on welfare" means the population of
individuals who receive either federal or state financial
assistance who are receiving a larger portion of funds directly from the state from federal block grants and who are required to,
within a five-year period, acquire gainful employment or
volunteer their time for a minimum of twenty hours per week to
continue receiving financial aid;
(c) "Designated agency" means the particular governmental
agency that administers and oversees the operation of the job
opportunity program under the provisions of this article. It
shall be advised by a consumer responsive board in planning,
startup, and delivery of personal assistance services. The
designated agency, as necessary, may involve other state agencies
including, but not limited to, the state board of education and
profit and nonprofit service providers, to coordinate and provide
services at the community level;
(d) "Consumer responsive board" means twelve persons composed
of a majority of individuals receiving personal assistance
services, or their advocates, and a designated member from each
of the following: The developmental disabilities planning
council, the West Virginia commission on aging, the statewide
independent living council, the university affiliated center for
developmental disabilities and the department of health and human
resources;
(e) "Service providers" means health care providers or
agencies, centers of independent living, senior citizen's centers
and other providers, whether operating on a profit or charitable basis. This includes self employed or eligible individuals
acting as employers. Service providers shall coordinate
scheduling, train and credential individuals, or refer them for
training or credentialing needed for such individuals to become
qualified personal attendants. They shall also be responsible
for salary administration as well as verifying that volunteer
service hours were actually performed.
(f) "Eligible individual" and "consumer" mean any physically,
cognitively or mentally impaired adult, or other adult who has a
severe speech or hearing impairment, or is legally blind, or has
a serious illness and, who:
(1) Experiences any physical, mental, cognitive, speech or
sensory impairment which can be expected to recur or last for a
given period of not less than twelve months, as determined by a
mutually agreed upon, individualized functional assessment,
between a representative of the designated agency or appointed
designee and the eligible individual. The designated agency, as
directed by the governing board, has the responsibility of
determining eligibility based on the findings of these
assessments;
(2) Is capable of selecting, supervising, training, and if
needed, firing a personal attendant:
Provided, That in the event
such an individual is incompetent or otherwise incapable of
making informed judgments, a legal guardian or family member may assume those responsibilities;
(3) Is capable of managing his or her own financial or legal
affairs with or without the support of a legal guardian or family
member; and
(4) Requires assistance to complete three or more functions
enumerated under subsection (a) of this section.
(g) "Individualized service plan" means the initial or
revised plan that includes:
(1) Specific personal assistance services based on the
mutually agreed upon individualized functional assessment
evaluation as provided for in subsection (a) of this section, to
be provided in accordance with, and in conjunction with:
(i) Hours of service per week or month;
(ii) Day and time of services;
(iii) Alternate sources for attendant services;
(iv) Means to ensure back-up and emergency attendant
services. These services shall include a method for consumers to
access back-up and emergency services;
(v) Methods of service delivery, including vouchers, waivers,
direct cash, agency providers or self-employed providers:
(vi) Frequency of reassessment, when necessary;
(vii) Means to adjust services and hours when changes in need
occur;
(viii) Mechanism to coordinate attendant services with any other health care services received by the consumer;
(ix) Degree and frequency of supervision, if necessary, for
the delivery of attendant services;
(x) Amount of copay cost-sharing, if any;
(xi) Outcome measures used to assess the quality of services;
(xii) Complaint and appeal process; and
(xiii) Name or names of personal attendants specifically
providing services to the eligible individual being served.
(h) "Personal assistant or attendant" means a person of the
consumer's choice who provides attendant care services for the
eligible individual. Due to the skills required for performing
personal assistant services, individuals on welfare are potential
candidates for such job opportunities along with other
individuals currently providing services or wishing to become a
personal assistant. A personal assistant is not required to be
proficient in all potential service areas and may have special
skills, such as sign language interpreting;
(i) "Self-employed individual" means an independent provider
who receives payment for services, works alone or with a team of
individuals to provide personal assistant services. Such self- employed individuals shall assume the responsibility to pay FICA,
unemployment insurance, state and federal taxes. A self-employed
individual may be a family member, friend or neighbor of an
eligible individual;
(j) "Personal assistant qualification" means the licensing,
credentials, certification, experience or acquired training which
may vary depending on the personal assistance services rendered.
Minimum requirements shall be set by the designated agency as
directed by the consumer board. The designated agency shall
maintain a statewide database on each personal assistant, their
qualifications, trustworthiness, integrity, honesty, prior
employment history and criminal record;
(k) "Unlicensed person" means a personal assistant who is not
licensed as a health care professional;
(l) "Health maintenance or related tasks" means tasks that
can be done by an unlicensed person or which can be delegated to
an unlicensed person after being trained by a health care
professional such as a physician or registered nurse, in order
that the unlicensed person becomes qualified to conduct such
specific health-related tasks. Tasks include, but are not
limited to: Dispensing medications, ventilator care and tube
feedings;
(m) "Personal reader" means an individual who reads newspaper
articles, mail, books, magazines and other material to an
individual who is legally blind;
(n) "Appeal or complaint process" means the procedure to file
an appeal or grievance if personal attendant services are
perceived as being inadequate, unreliable or denied to an eligible individual or to an applicant seeking personal
assistance services.
§18-10J-4. Program.
(a)
Establishment. -- The designated agency shall establish
the consumer responsive advisory board, develop programs of
personal assistance services for eligible individuals and
integrate, whenever possible, welfare participants within this
program. The designated agency shall pay expenses incurred by
the board in performing its duties and provide a reasonable
stipend to those individuals not employed by the state.
(b)
Solicitation of proposals. -- The designated agency shall
solicit proposals to provide personal assistance services under
this article. Service providers, self-employed individuals or
eligible individuals acting as employers, shall submit proposals
in the form and manner required by the designated agency.
(c)
Proposal selection criteria. -- Proposals shall be
selected, based on service priorities developed by the designated
agency as defined by the consumer board:
Provided, That priority
shall be given to proposals that serve persons with severe
disabilities and those at greatest risk of being
institutionalized as determined by the designated agency.
(d)
Agreements with service providers or self-employed
individuals. -- In order to provide personal assistance services, the designated agency shall enter into agreements with service
providers, self-employed individuals or eligible individuals
acting as employers. Each agreement shall include, at minimum,
the number of consumers to be served, a signed mutually agreeable
individualized service plan and the criteria to be used for
evaluating the provision of services.
(e) Consumer assessment reports. -- Determination of
eligibility and the need for personal assistance services shall
be supported by consumer assessment reports which shall be
developed by the designated agency.
(f)
Weekly hours of service. -- Each personal attendant shall
work, not necessarily for the same eligible individual, a minimum
of twenty hours a week, or as needed, but in no event may such
work exceed forty hours, except when exceptional circumstances
require otherwise.
(g)
Waiting list. -- The designated agency and service
providers shall develop a waiting list, by service priority, for
those eligible individuals who cannot be served or accommodated
immediately.
(h)
Welfare recipients. -- With federal block grants being
distributed to each state and the need for certain individuals to
find gainful employment or perform volunteer services twenty
hours each week in order to continue receiving financial aid, the public at large should be solicited in order to identify those
persons possessing the potential to serve as personal assistants.
Upon making such identifications, appropriate training may be
offered and incorporated into the program to provide personal
assistant services statewide.
(i)
Training of eligible individuals. -- The designated
agency shall provide voluntary training to eligible individuals
to select, manage, train and dismiss personal attendants. As
part of this training, they shall receive information regarding
FICA, state and federal taxes and other reporting
responsibilities for individuals acting as employers under the
provisions of this article.
(j)
Quality assurance and safeguard. -- A quality assurance
instrument based on the provisions of section two of this article
shall be instituted. Quality is determined by the results
obtained in relation to the life outcomes of persons with
disabilities. This criteria includes, but is not limited to:
Integration into the community, increased mobility, increased
productivity, employment and self-direction. A mechanism to
protect against abuse, neglect or exploitation of consumers shall
be developed. Consumer satisfaction with service shall be
construed as an important component toward the purposes of this
article.
§18-10J-5. Fundings.
(a)
Use of funds. -- Funds made available under this article
shall be used solely for planning, designing, delivering and
administering personal assistance services, and training of
personal attendants and eligible individuals.
(b)
Program moneys. -- Programs for personal assistance
services, under this article, shall use program funds from
sources, including state and federal block grant funds, other
federal funds, program fees, vouchers or waivers and other
allotted moneys. The designated agency shall apply for all
potentially available funding sources.
(c)
Program fee schedule. -- The designated agency shall
develop, wherever practical, a sliding fee schedule for personal
attendant services.
(d)
Disbursement of funds. -- Funds shall be disbursed in a
manner which ensures a maximum consumer control with the service
of the program.
(e)
Availability of services. -- Personal assistance services
shall be available to the extent they are funded through annual
appropriations of state and federal funds, program fees and other
allotted moneys.
§18-10J-6. Demonstration projects.
The designated agency may initiate further demonstration projects as funding becomes available. Funding may be derived
from a variety of sources, which may include, but is not limited
to, state and federal appropriations, program fees and other
allotted moneys. These funds may be used to test new ways of
providing personal assistance services, as well as to conduct
specific research into ways to best provide personal assistance
services within the state.
§18-10J-7. Rules.
The designated agency, as directed by the consumer responsive
board, shall propose rules, subject to legislative approval, as
may be necessary for the effective administration of any programs
of personal assistance services provided for under this article.
§18-10J-8. Report.
The designated agency shall appoint a consumer responsive
board to oversee the project on an ongoing basis. One year after
the initiation of the demonstration project, the consumer board
shall report to any legislative committee having jurisdiction
over appropriations and human resource services that requests
such a report. This report shall include at a minimum the
following information:
(a) A summary of the personal assistance services provided
under this article, including, but not limited to, a description
of service models utilized, costs related to particular service models, units of service distributed per consumer and consumer
demographics;
(b) A summary of how many welfare recipients were utilized in
the program; and
(c) Recommendations regarding the direction of funding for
the demonstration projects for upcoming fiscal years.
NOTE: The purpose of this bill is to create a "Job
Opportunity Program and Personal Assistance Resources Act" to be
administered by the Department of Health and Human Resources in
order to provide jobs and basic and ancillary services which
enable eligible individuals with severe disabilities, to live in
their homes and communities rather than in institutions, and to
carry out functions of daily living, self-care, mobility and
employment.
Article 10J is new; therefore, strike-throughs and
underscoring have been omitted.