Assisted living services help people who need assistance with activities like bathing, dressing, toileting, and eating. They can also supplement healthcare services that individuals may already be using, such as occupational therapy and behavioral health services.

Currently, assisted living services are not covered under Pennsylvania’s Medicaid plan. Because assisted living services are not Medicaid reimbursable, persons needing help to live independently in PA frequently must utilize services that are far more costly to the Commonwealth like being placed in a 24-hour nursing home. In addition to being much more expensive, nursing homes are significantly more restrictive environments that may not be appropriate settings for individuals who can live with assistance.

This simple change of allowing assisted living services to be Medicaid reimbursable would save our Commonwealth tens of millions annually, per a 2007 PA House fiscal impact summary, since unnecessary nursing home services would not need to be borne. For example, the average annual cost of assisted living services is $41,400, compared to over $120,000 for skilled nursing facilities. Pennsylvanians who require assistance but who need more than in-home services should not have a nursing home as their only option.

Our bill would allow Pennsylvania to make the simple legislative change so that our commonwealth can join the 47 other states and the District of Columbia that already allow for reimbursement of assisted living services under Medicaid.
This bill was introduced in the last session as HB 2432.
 
Please join us in cosponsoring this much-needed, bipartisan legislation.