Volume 14 Issue 1

State Budget

 February 5, 2013, Pennsylvania Governor Tom Corbett delivered his budget request for the 2013-14 fiscal year. The Governor devoted significant attention in his budget address to the need for increased funding to serve more people with intellectual and physical disabilities in the community. He spoke of his visit to Vision for Equality and introduced two young women with intellectual disabilities who were in the House Chamber for his speech. Here are some excerpts from that speech:

“They were put on a waiting list — a waiting list that delays their access to the help that would allow them to work, to live at home, to enjoy a full measure of life’s experiences. … All Brittany wanted was a chance to work, to have the same opportunity as the rest of us. She might have needed our help, but because we gave her that help last year, she is ready to chart her own course. … That waiting list is a powerful metaphor for what has gone wrong in our society. We need to act now and we must not turn our backs on all the other Brittanys who are out there currently on the waiting list. That is why I am counting on the general assembly to join with me to make certain we pass this next round of funding for expanded services for people with intellectual disabilities. … This budget reaffirms this commitment to helping individuals with intellectual and physical disabilities. … I am determined that by the time Chloe, and the thousands of other young people with disabilities, have reached adulthood, they will be able to step into a full and active life as citizens of this state. These young people and their families have waited long enough. We will find a way to erase this waiting list. I asked Chloe and her family to be here today so I could make that promise in person. And I hope you in the General Assembly will help me keep that promise. My budget will dedicate $40 million to provide critical services to an additional 3,000 men, women and children with physical and intellectual disabilities. This will allow them to live independently in their homes and communities. It means we will help more people with autism and Down syndrome and serve more people living with physical disabilities.”

Below PIE summarizes some items of interest to the disability community in the Governor’s budget. Remember that this is not the final budget. Attention now focuses on the General Assembly which will hold hearings over the next month. After that, a budget bill(s) will be moved. Any of the Governor’s proposals can be changed before the budget bills are signed, probably in late June. For more information, contact PIE at The Arc of Pennsylvania office at 717-234-2621 or pie@thearcpa.org.

 DEPARTMENT OF PUBLIC WELFARE

Intellectual Disability Waivers: State funding increased by $19,867,000 to serve 380 additional people from the waiting list, 700 graduates of special education and 100 people out of State Centers. Neither an increase nor a decrease is intended for provider rates.

Medical Assistance Expansion: The Governor will not accept the federal government’s offer, under the Affordable Care Act, to expand Medicaid eligibility. Both the Governor and Secretary Alexander seemed to leave the door open for the possibility in the future.

Autism: Increase in state funds of $1,497,000 to serve an additional 118 people.

State Centers: Institutions for people with intellectual disabilities will receive a $12 million increase for maintenance of current program.

Community Base Funding Intellectual Disabilities: There’s a small reduction in base funding.

Services to Persons with Disabilities: This line item includes funding for the Independence, OBRA and Commcare Waivers as well as specialized services in nursing homes. The line item would receive an additional $15,758,000 in state funds to serve an additional 1,280 people.

Attendant Care: The Attendant Care line item, which includes both the waiver and Act 150, would receive an additional $4,125,000 to serve an additional 400 people. It is not clear from the budget materials, but according to DPW Secretary Gary Alexander, this increase is intended only for the Attendant Care Waiver and not for the state funded Act 150 which has a growing waiting list.

Adult Protective Services: The Governor’s budget book lists $2,197,000 in the General Government Operations line to annualize funding for Adult Protective Services. We are told that the budget includes $2,391,000 in state funds and an additional $1,304,000 in federal funds for a total of $3,695,000 in the General Government Operations line and $80,000 in the Information Technology line.

Human Services Block Grant Pilot: This block grant pilot was created in the 2012-13 fiscal year and currently exists in 20 counties. It combines funds for a number of programs– Community Mental Health, the Behavioral Health Services Initiative, Intellectual Disability Base funds, County Child Welfare, Homeless Assistance, the Human Services Development Fund and Act 152 Drug and Alcohol—into one block grant and gives the county flexibility on how the money is spent. The Governor proposes a statewide expansion allowing any county in the state to voluntarily participate in 2013-14.

Mental Health: The proposed budget includes funding for 90 CHIPPs (people out of state hospitals and into the community).

Behavioral Health: BHSI is level funded.

Aging Waiver: While the Aging Waiver would receive the same amount of state general funds as in 2012-13, the Governor proposes $21 million from the lottery, including an $8.1 million initiative to serve an additional 1,550 people. The Governor tied these additional lottery funds to the privatization of the lottery.

Nursing Homes: Nursing homes are slated for a rate increase of 2% at a cost of $44.3 million. Over objections from advocates, the Governor again proposes using more than $309 million in lottery funds for nursing homes.

Early Intervention (Birth to age 3): DPW’s Early Intervention program is slated for a $4.3 million supplemental appropriation in 2012-13 and an increase in 2013-14.

Medical Assistance Transportation: Funding is increased to cover increased use and trip costs.

Medical Assistance for Workers with Disabilities (MAWD): While state funding would be reduced, the reduction is more than offset by an increase in Tobacco Settlement Funds, resulting in a net increase.

Cost Saving: The cost saving measures noted in the DPW budget include imposing time limits on payments to injured workers in state hospitals, state centers and youth development centers ($3.5 million to be saved); enhanced auditing of providers ($20 million projected savings); and outsourcing third party liability collections ($1.5 million to be saved). They include a projected $8.3 million saved by imposing premiums on families of one (sometimes called “loophole families”). Efforts last year to impose co-payments on these families were unsuccessful.

Supplemental Appropriations: As part of the budget package, the Governor asks for supplemental appropriations for the current 2012-13 fiscal year for a total of $69.3 million. Programs slated for an increase include: Long Term Living; Services to Persons with Disabilities; Attendant Care; Early Intervention; Aging Home and Community Based Services; Medical Assistance for Workers with Disabilities (MAWD); and Medical Assistance Outpatient. Programs which would be decreased include: MA Capitation; State Centers; and Supplemental Grants for the Aged, Blind and Disabled.

Federal MA Matching Rate: The federal share of Medicaid funds dropped from 54.28% to 53.52%, costing the state $109 million in 2013-14.

DEPARTMENT OF AGING

Aging Services: The Governor proposes an additional $20 million from the lottery to take 5,400 people off the waiting list for OPTIONS home and community based services, $2 million for 193 people aging out of the attendant care program and $5 million for Area Agencies on Aging. There’s also $2 million in lottery funds which would go to Senior Centers.

DEPARTMENT OF LABOR AND INDUSTRY

Transfer to Vocational Rehabilitation Fund (OVR state match), Supported Employment, Centers for Independent Living (CILs), Assistive Technology Devices (alternative financing program)and Assistive Technology Demonstration and Training (lending library): All of these programs are level funded.

DEPARTMENT OF COMMUNITY AND ECONOMIC DEVELOPMENT

PA Accessible Housing Program: The PAHP program is part of the Keystone Communities line item which is level funded.

DEPARTMENT OF EDUCATION

Special Education: Special education is once again level funded. Advocates note that this sixth year of flat funding for the special education subsidy will force local school districts to cover the cost of living increases. Funding is also reduced by a mandatory transfer from school districts to a contingency fund.

Early Intervention (for ages 3 to 5): Will receive a $10,800,000 supplemental appropriation in the 2012-13 fiscal year and an increase of $5 million in the 2013-14 fiscal year to serve 1,500 additional children.

Approved Private Schools: Approved Private Schools are level funded.

PA Charter School for the Deaf and Blind (sic): Charter schools for children who are deaf and blind would receive a small increase to continue the current program.

DEPARTMENT OF HEALTH

AIDS Programs, Services for Children with Special Needs and Sickle Cell: All of these programs are level funded.

AIDS Special Pharmaceuticals are level funded in state dollars, but an increase in Pharmacy Rebates is anticipated resulting in a net gain.

Epilepsy Support and Tourette Syndrome: The Governor proposes eliminating funding for these two programs.

Children’s Health Insurance Program (CHIP): Funding is increased to serve an additional 9,330 children.

DEPARTMENT OF DRUG AND ALCOHOL PROGRAMS

Assistance to Drug and Alcohol Programs: State funding is level, but federal funding decreases, bringing total funding from $104,300,000 in 2012-13 to $103,211,000 proposed for 2013-14.

DEPARTMENT OF TRANSPORTATION

Shared Ride Program for Persons with Disabilities: There is no immediate threat to funding for the PWD program. But funding comes through Act 44 which may be repealed as part of the transportation reform package. So advocates need to pay attention to what happens to Act 44. Also, there is discussion about adding Allegheny County to the Counties that can participate in the PWD program.

Bills of Interest

Below we summarize some bills of interest to the disability community from the new 2013-2014 session. For more information about these or any other state bills, go to: www.legis.state.pa.us/cfdocs/legis/home/session.cfm. At the top of the page is a box labeled, “Find Legislation By”, choose “Bill #”, then enter the bill number and click on “Go”.

HB 2. Introduced by Representative Bernie O’Neill (R-Bucks). This bill would, among other things, establish the state’s first special education funding formula in over 20 years. It was voted out of the House Education Committee and given first consideration by the House on February 12, 2013. See also SB 470. These bills are identical to legislation from last session which passed both chambers unanimously, but failed to finally pass because of other issues which were attached to it. This session, advocates are asking the House and Senate to quickly pass a “clean bill.”

HB 12. Introduced by Representative Dan Frankel (D-Allegheny). This bill makes a number of changes to the Transportation and Vehicle Code, including amending the section on programs of statewide significance to allow Allegheny County to participate in the Shared Ride Program for Persons with Disabilities. It was introduced and referred to the House Transportation Committee on January 14, 2013.

HB 21. Introduced by Representative Glen Grell (R-Cumberland). This bill would allow psychologists to testify on insanity. It is like HB 1405 from last session, which passed the House unanimously, but did not receive third and final passage in the Senate before the end of the last session. HB 21 was introduced and referred to the House Judiciary Committee on January 16, 2013.

HB 29. Introduced by Representative Mauree Gingrich (R-Lebanon). The bill would make changes in the law on publically funded, home and community based services for people who are over age 60 and nursing home eligible. It was introduced and referred to the House Aging and Older Adult Services Committee on January 4, 2013

HB 252. Introduced by Representative RoseMarie Swanger (R-Lebanon). HB 252 would establish the Pennsylvania Long-term Care Council in the law. It was introduced and referred to the House Aging and Older Adult Services Committee on January 23, 2013.

HB 315. Introduced by Representative Gene DiGirolamo (R-Bucks). This bill would restore the 10% cut from a number of human service programs in the current 2012-13 budget. Programs affected include, mental health, intellectual disabilities community base program, behavioral health and Human Services Development Fund. The bill was reported out of the House Human Services Committee on February 12, 2013 and given first consideration by the full House.

HB 461. Introduced by Representative Jerry Knowles (R-Berks). This bill would expand the Human Service Block Grant program from the current 20 counties to all 30 of the counties which applied to be considered. It was introduced and referred to the House Health Committee on January 30, 2013.

HB 648. Introduced by Representative Tom Murt (R-Montgomery). This bill would require insurers to disclose information about their coverage of brain injury treatment. It was introduced and referred to the House Insurance Committee on February 11, 2013.

HB 650. Introduced by Representative Murt (R-Montgomery). This bill would create a new $2 per person admission fee for places with slot machines. Funds from the fees would go to an Intellectual Disabilities and Autism Waiting List Account. The bill was introduced and referred to the House Gaming Oversight Committee on February 11, 2013.

SB 64. Introduced by Senator Kim Ward (R-Westmoreland). This bill provides for Braille literacy assessments and requires certification of Pennsylvania teachers in Braille literacy standards. It was introduced and referred to the Senate Education Committee on January 4, 2013.

SB 77. Introduced by Senator Stewart Greenleaf (R-Montgomery). The bill amends the Mental Health Procedures Act to provide for assisted outpatient treatment programs. These are court-ordered programs. The bill was introduced and referred to the Senate Public Health and Welfare Committee on January 9, 2013.

SB 117. Introduced by Senator Greenleaf (R-Montgomery). This bill amends the law on guardianship of incapacitated people. Among the changes are those relating to end of life decisions. The bill was introduced and referred to the Senate Judiciary Committee on January 14, 2013.

SB 189. Introduced by Senator LeAnna Washington (D-Montgomery). This bill would prohibit people in outpatient involuntary mental health treatment from owning firearms. The bill was introduced and referred to the Senate Judiciary Committee on January 17, 2013.

SB 280. Introduced by Senator Christine Tartaglione (D-Philadelphia). This bill would establish the Governor’s Office for People with Disabilities and Advisory Committee for People with Disabilities in law. It was introduced and referred to the Senate State Government Committee on January 23, 2013.

SB 470. Introduced by Senator Patrick Browne (R-Lehigh). This bill would, among other things, establish the state’s first special education funding formula in over 20 years. The bill was reported out of the Senate Education committee on February 12, 2013, given two considerations by the full Senate and is currently in the Senate Appropriations Committee. See also HB 2. These bills are identical to legislation from last session which passed both chambers unanimously, but failed to finally pass because of other issues which were attached to it. This session, advocates are asking the House and Senate to quickly pass a “clean bill.”

HR 43. Introduced by Representative Robert Matzie (D-Allegheny). This resolution urges the state to celebrate January 30, 2013 as “Pennsylvanians with Disabilities Day” and to make that an annual event. The resolution was referred to the House Health Committee on January 24, 2013.

HR 78. Introduced by Representative Rosemary Brown (R-Monroe) The resolution designates the week of July 21 through July 27, 2013, as “ADA Week” in Pennsylvania. It was introduced as noncontroversial resolution on February 11, 2013.

SR 6. Introduced by Senator Stewart Greenleaf (R-Montgomery). This resolution, which passed the Senate on February 1, calls for the Joint State Government Commission to establish a task force and to work with them to study and report on violent crime, mass shootings and related issues such as “mental illness and mental health treatment, keeping firearms out of the hands of criminals and the mentally ill, school security, bullying, gang- related activity, educational issues and cultural influences, including violent video games.”

COMMITTEE CHAIRS

State House Republican (Majority) and Democratic (Minority) Chairs of key committees:

Aging and Older Adult Services:

• Republican: Tim Hennessey, Chester County
• Democrat: Steve Samuelson, Lehigh County

Appropriations:

• Republican: William Adolph, Delaware County
• Democrat: Joe Markosek, Allegheny County

Children and Youth:

• Republican: Kathy Watson, Bucks County
• Democrat: Louise Bishop, Philadelphia County

Education:

• Republican: Paul Clymer, Bucks County
• Democrat: James Roebuck, Philadelphia County

Health:

• Republican: Matt Baker, Bradford County
• Democrat: Flo Fabrizio, Erie County

Human Services:

• Republican: Gene DiGirolamo, Bucks County
• Democrat: Angel Cruz, Philadelphia County

Insurance:

• Republican: Nick Micozzie, Delaware County
• Democrat: Tony DeLuca, Allegheny County

Judiciary:

• Republican: Ron Marsico, Dauphin County
• Democrat: Thomas Caltagirone, Berks County

Labor and Industry:

• Republican: Mario Scavello, Monroe County
• Democrat: Bill Keller, Philadelphia County

Transportation:

• Republican: Dick Hess, Bedford County
• Democrat: Michael P. McGeehan, Philadelphia County

Veterans Affairs and Emergency Preparedness:

• Republican: Stephen E. Barrar, Chester County
• Democrat: Chris Sainato, Beaver County

State Senate Republican (Majority) and Democratic (Minority) Chairs of key committees:

Aging & Youth:

• Republican: Bob Mensch, Bucks County
• Democrat: Leanna Washington, Philadelphia County

Appropriations:

• Republican: Jake Corman, Centre County
• Democrat: Vincent Hughes, Philadelphia County

Banking & Insurance:

• Republican: Don White, Armstrong County
• Democrat: Mike Stack, Philadelphia County

Education:

• Republican: Mike Folmer, Lebanon County
• Democrat: Andrew Dinniman, Chester County

Judiciary:

• Republican: Stewart J. Greenleaf, Montgomery County
• Democrat: Daylin Leach, Montgomery County

Labor & Industry:

• Republican: John R. Gordner, Columbia County
• Democrat: Tina Tartaglione, Philadelphia County

Public Health & Welfare:

• Republican: Patricia H. Vance, Cumberland County
• Democrat: Shirley Kitchen, Philadelphia County

Transportation:

• Republican: John C. Rafferty, Jr., Berks County
• Democrat: John Wozniak, Cambria County

Veterans Affairs & Emergency Preparedness:

• Republican: Lisa Baker, Luzerne County
• Democrat: Tim Solobay, Washington County

Special Elections

Two vacant House seats will be filled during the spring primary on May 21. The vacant seats are the 42nd district in Allegheny County and the 95th district in York County – both previously held by Democrats. The 42nd district seat became vacant in early January when former Representative Matt Smith was sworn into his new office in the state Senate. The 95th district seat became vacant when former Representative Eugene DePasquale was sworn in as the new Auditor General.

DPW Secretary

Department of Public Welfare Secretary Gary Alexander has resigned effective February 15, 2013. Beverly Mackereth has been appointed Acting Secretary. Mackereth served eight years in the Pennsylvania House of Representatives and as Executive Director of the York County Department of Human Services. Most recently she has served as Deputy Secretary of DPW’s Office of Children, Youth and Families.

OMHSAS Deputy

Dennis Marion has been appointed Deputy Secretary of the Office of Mental Health and Substance Abuse Services. Before his appointment, he had served as the Cumberland County’s Chief Operations Officer, Human Services Administrator, Administrator of Mental Health/Intellectual & Developmental Disabilities and Executive Director of the Cumberland-Perry Drug & Alcohol Commission.

MA Expansion

Under the Affordable Care Act states can expand Medicaid to cover more people who are uninsured. The federal government is to pay 100 percent of the expansion at first and 90 percent after 2020. On January 24, the Pennsylvania State Senate Democratic Appropriations Committee held a discussion in Philadelphia on the impact of Medicaid expansion in Pennsylvania. Supporters testified that Medicaid expansion in Pennsylvania would bring $4 billion federal dollars into Pennsylvania’s budget, provide access to health insurance to a half a million Pennsylvanians, create an estimated 285,000 jobs over ten years, save hospitals $1 billion in uncompensated care costs and reduce costs to counties which currently provide mental health services to the uninsured. The Corbett administration has announced that, for now, Pennsylvania will not participate in Medicaid expansion. In a February 5 letter to HHS Secretary Kathleen Sebelius, the Governor said that Medicaid expansion under the ACA would cost Pennsylvania almost $1 billion of new state dollars through fiscal year 2015-16, rising to a total cost of over $4.1 billion of new state dollars by the end of 2020-21. For more on the state’s position, go to www.dpw.state.pa.us and click on “Affordable Care Act News.” For more on the advocates’ position, go to the Health Law Project website at www.phlp.org.

Adult Protective Services

The Department of Public Welfare (DPW) has released a draft Request for Proposals (RFP) to be used to select agencies to provide protective services to adults with disabilities between the ages of 18 – 59. Pennsylvania’s Adult Protective Services law, Act 70 of 2010, calls for the creation of an adult protective services program to investigate allegations of abuse, neglect or exploitation to adults with disabilities. The Act requires DPW to seek competitive bids for the contracts. DPW has also been working with advocates to draft regulations for the program. Start-up funding was included in the 2012-13 budget. Comments on the draft RFP were due by February 19.

FMS Transition

The Department of Public Welfare continues to address problems with the transition from the 37 previous Financial Management Services (FMS) providers to one new statewide vendor, Public Partnerships, LLC (PPL). The problems caused the interruption of thousands of paychecks to consumer-directed workers in January. According to the Philadelphia Inquirer, home-care workers and their clients have also complained about poor service from PPL, such as not receiving information packets needed to get signed up with PPL and the inability to reach anyone on the phone. The Department and PPL are working to correct the problems so that a return to normal payroll cycles can occur for the more than 10,000 workers of close to 20,000 consumers who rely on personal assistance and other consumer-directed services through the Office of Long Term Living (OLTL) and the Office of Developmental Programs (ODP).

According to a January 31 statement from DPW Secretary Alexander, since January 1, 91 percent of all timesheets filed with the department on behalf of direct care workers have been validated and paid. The DPW press release indicates 1,800 workers continue to have payment problems. Secretary Alexander blames the former FMS providers for the problems. A number of legislators have raised concerns about the situation and Representative Mike Hanna (D-Centre) has called for an investigation by Attorney General Kathleen Kane and Auditor General Eugene DePasquale of the delay in payments.

ODP Waivers

In the January 26, 2013 edition of the Pennsylvania Bulletin, the Department of Public Welfare (DPW) published notice that the Centers for Medicare and Medicaid Services (CMS) approved the renewal of the Consolidated and the Person/Family Directed Support (P/FDS) waivers. DPW said that CMS approved these waivers with an effective date of July 1, 2012.

The Consolidated waiver can be found at

www.dpw.state.pa.uslearnaboutdpw/waiverinformation/consolidatedwaiver forindividualswithintellectualdisabilities/index.htm.

The P/FDS waiver can be found at

www.dpw.state.pa.us/learnaboutdpw/waiverinformation/personfamilydirectedsupportwaiver/index.htm

Waiver Amendments

The Office Long Term Living has submitted waiver amendments to the Centers for Medicare and Medicaid (CMS) to account for the January 1, 2013 change to a single statewide vendor for Financial Management Services (FMS). For the Attendant Care and Independence waivers, the amendments also include a limit on the number of participants that can be served at any one point in time. These two waivers currently do not have point in time limits. The amendments have been approved, and the waivers as amended can be found at www.portal.state.pa.us/portal/server.pt?open=514&objID=733116&mode=2

HealthChoices

The Department of Public Welfare (DPW) is in the final stage of statewide expansion of HealthChoices mandatory managed care. HealthChoices is now in 45 counties and 4 zones (Southeast, Southwest, Lehigh/Capital and New West). The remaining 22 counties will make up the HealthChoices-New East Zone. The new zone is scheduled to begin on March 1, 2013.

Service Coordination

Changes in Service Coordination payment rates in OLTL programs, effective on July 1, 2012, caused severe financial problems for many service coordination entities, especially in the Aging Waiver. After review of stakeholder input and the rates, the Department of Public Welfare issued an increase to Service Coordination rates for the MA Aging, Attendant Care, COMMCARE, Independence and OBRA waivers and the Act 150 Program effective on January 26, 2013, as well as an increase to the enrollment fee for the Area Agencies on Aging that process applications for Aging Waiver services. The changes were announced in the January 26, 2013 edition of the Pennsylvania Bulletin.

The rate is available at

www.dpw.state.pa.us/dpworganization/officeoflongtermliving/providers/index.htm.

The fee schedule rate is available at

www.dpw.state.pa.us/dpworganization/officeoflongtermliving/providers/index.htm.

Lottery

The Corbett administration signed a contract to privatize the management of the state lottery. The contract is with a British firm, Camelot Global Services. The deal is controversial, with legislators and reporters, as well as unions and other stakeholders raising questions about the lack of information about the financial benefits. On February 14, Attorney General Kathleen Kane announced that her office had found the contract to be illegal for three reasons: the administration exceeded its powers under the state Constitution by awarding the contract without legislative approval; the contract might allow the state to be sued for damages; and the contract gave Camelot the right to create computerized gambling games in violation of the State Lottery Act. The contract is now voided. The administration is considering a challenge to the Attorney General’s ruling in Commonwealth Court.

Seventy-five percent of the Department of Aging’s budget is funded by the Lottery, while the rest comes from federal funding and the Tobacco Settlement Fund. Governor. Corbett has said that he plans to include an additional $50 million for senior programs from anticipated revenue generated by the deal. The largest portion of the $50 million would be $21 million for the Aging Waiver Program. The OPTIONS Program, which provides care management, meal deliveries, protective services and in-home services for individuals 60 years and older, would see $20 million to address waiting lists. The 52 Area Agencies on Aging would share $5 million. Two million dollars would go to senior centers. It is unclear what effect, if any, the voiding of the contract will have on these proposed additional funds for Aging services.

Alzheimer’s Group

On February 7, Governor Corbett issued an executive order creating a committee to develop a state plan on Alzheimer’s disease. The Pennsylvania Alzheimer’s Disease State Planning Committee will include representatives from state agencies, as well as those affected by Alzheimer’s disease, and be chaired by state Secretary of Aging Brian Duke. The committee will have one year to plan an approach for Pennsylvania relating to Alzheimer’s disease and other related brain disorders.

ODP

The Office of Developmental Programs has issued one new Bulletin which can be seen at www.dpw.state.pa.us/publications/bulletinsearch/index.htm.

• Clarifying the applicability of Chapter 6400 to private homes – statement of policy (6400-13-01) was issued on January 14, 2013 and was effective on January 12, 2013. The bulletin removes the licensure requirement for those renting private homes and getting more than 30 hours of service a week.

OMHSAS

The Office of Mental Health and Substance Abuse Services has issued one new Bulletin which can be seen at www.dpw.state.pa.us/publications/bulletinsearch/index.htm.

• Targeted Case Management (TCM) – Travel and Transportation Guidelines (OMHSAS-13-01) was issued on January 18, 2013 and was effective on February 1, 2013. The Bulletin provides the DPW policy on payment for mental health targeted case management services.

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Budget & Fiscal Cliff

The current federal fiscal year (FY 2013) began on October 1, 2012. Funding is being provided through a continuing resolution in effect through March 31, 2013. Spending rates are slightly higher than the previous year.

Congress passed a compromise bill, the American Taxpayer Relief Act of 2012, to deal with many of the impacts of the “fiscal cliff.” As part of the fiscal cliff deal, the required spending cuts (often referred to as “sequestration”) have been delayed until March 1, 2013. By finding ways to save $24 billion, the amount of required cuts has been reduced from $109 million to $85 billion. Congress and the President must continue to deal with very difficult decisions about tax changes and cuts in spending which could affect many disability programs and public benefits. Medicaid is exempt from sequester spending cuts.

On February 4, 2013, the President signed a bill (HR 325) that suspends the federal debt limit through May 18, 2013 and also would temporarily withhold Congressional pay if Congress fails to adopt a budget resolution for the 2014 budget by the April 15 deadline. To read the bill, go to

http://thomas.loc.gov/cgi-bin/thomas.

As this issue of Slice of PIE goes to press, Congress has two key budget issues to address: 1) Whether to postpone or replace the planned March 1 spending cuts (sequester); 2) How to fund the government for the remainder of fiscal year 2013 after March 31.

2014 Federal Budget

President Barack Obama did not present to Congress his budget request for the federal fiscal year that will start on October 1, 2013 by the usual February 4 due date. The expected delay until sometime in March has been attributed to uncertainty over fiscal cliff negotiations. Budget committees in both the House and Senate must develop budget resolutions and adopt them by April 15.

Harkin to Retire

Senator Tom Harkin (D-Iowa) plans to retire next year. “After 40 years, I just feel it’s somebody else’s turn,” Harkin said in a statement. Harkin was a leading force behind the landmark Americans with Disabilities Act and has played an active role in many other disability related legislative efforts. According to disability advocates on Capitol Hill, Harkins’ “laser focus” on people with disabilities will be hard to replace. The Senator often speaks of his late brother, Frank, who was deaf and whose experiences inspired Harkins’ efforts to make life better for Americans with disabilities.

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MA Expansion

The Pennsylvania Health Law Project (PHLP) is urging the state to use the opportunity to expand Medicaid and thus to “improve the lives and health of hundreds of thousands of uninsured Pennsylvanians, with the federal government covering the full cost.” In support of this goal, PHLP has released several reports:

•        “Medicaid Expansion: A Benefit for Rural Pennsylvania”, co-authored by the Pennsylvania Office of Rural Health, describes the benefits for the nation’s third largest rural population.

•        “Expanding Medicaid in PA: Consider the Savings”, highlights how expanding Medicaid in 2014 to cover 600,000 uninsured adults would create $400 million per year in budget savings and new revenues.

•        “Medicaid Expansion is Good for Families”, co-authored with Georgetown University’s Center for Children and Families, details how 131,000 uninsured parents and families will benefit from expanding Medicaid. The paper is supported by several of Pennsylvania’s leading child and family advocacy organizations.

The complete series can be read or downloaded from PHLP’s website www.phlp.org.

LTSS Quality

A new advocates’ guide provides information and recommendations to help Medicaid beneficiaries and their advocates improve quality in long term services and supports (LTSS). The guide, entitled Identifying and Selecting LTSS Outcome Measures, is by the Disability Rights Education and Defense Fund (DREDF) and the National Senior Citizens Law Center.

County Priorities

On January 23 the County Commissioners Association of Pennsylvania (CCAP) released their nine priorities for the 2013-14 state budget. Their top priority is the continuation of human services funding and further reform of the system. To view their paper on human services funding, including block grant expansion, go to www.pacounties.org/GovernmentRelations/Documents/2013PrioritiesHumanServicesReform.pdf.

Regulatory Agenda

In the February 2, 2013 Pennsylvania Bulletin, the Governor’s Office published its agenda of regulations under development or consideration. Agency contacts are listed for more information regarding the regulation and the procedure for submitting comments. To read the agenda, go to www.pabulletin.com.

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