A Slice of Pie is an ongoing publication keeping our readers informed about important public policy issues. It is the mission of the Policy Information Exchange to educate and inform Pennsylvanians with disabilities, their families and advocates, and the general public, regarding public policy issues and to further the exchange of policy information between the Pennsylvania Developmental Disabilities Council and federal, state, and local policy makers. The Policy Information Exchange is funded in part by the Pennsylvania Developmental Disabilities Council.

Download Volume 17, Issue 4, 2016 in PDF Format

STATE NEWS+

Bills of Interest

Below we summarize some bills of interest to the disability community from the 2015-2016 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, “Legislation Quick Search,” enter the bill number and click on “Search”.  The site contains lots of useful information.  So, take a few minutes and check it out.

HB 568. Introduced by Representative Eli Evankovich (R-Allegheny). This bill would amend the Pennsylvania Construction Code Act (Act 45 of 1999) which addresses accessibility/egress/fire safety requirements, to give local code administrators more flexibility in issuing certificates of occupancy to “uncertified” buildings. It would enable municipalities to use less stringent requirements without passing an ordinance. The bill passed the House and Senate in different forms.  There was no agreement and it was left in the House Rules Committee at the end of the session.

HB 2359. Introduced by Representative Marcia M. Hahn (R-Northampton). This bill would amend the Drug and Alcohol Abuse Control Act to specify that a parent or guardian can consent for treatment of their minor child when the child is refusing to consent.  The bill passed the House on October 19 and was referred to the Senate Public Health and Welfare Committee.

HB 2371. Introduced by Representative Michael H. Schlossberg (D-Lehigh). This bill would establish a state caregiver tax credit which would allow taxpayers who qualify for the federal dependent care credit to apply for a tax credit against their state income tax. The bill was introduced and referred to the House Finance Committee, September 23, 2016.

HB 2372. Introduced by Representative Michael H. Schlossberg (D-Lehigh). This bill would provide a state tax credit for people renovating an existing home or building a new home designed to improve accessibility or provide universal visitability.  The bill was introduced and referred to the House Finance Committee, September 23, 2016.

HB 2406. Introduced by Representative Mark B. Cohen (D-Philadelphia). This bill would establish a process for post-conviction relief for veterans incurring traumatic brain injury or post-traumatic stress disorder while serving in the military. It was introduced and referred to the House Judiciary Committee, October 17, 2016.

HB 2423. Introduced by Representative Thomas P. Murt (R-Montgomery). This bill would establish a new standard for court ordered assisted outpatient mental health treatment in the community, while leaving in place the clear and present danger standard for involuntary hospitalization. The new standard would be based on a medical determination of whether a seriously mentally ill individual needs and can benefit from assisted outpatient treatment to survive safely in the community. The bill was introduced and referred to the House Health Committee on October 20, 2016.

SB 984.  Introduced by Senator Camera Bartolotta (R-Beaver).  The bill provides for regulation of Transportation Networking Companies such as Uber, Lyft, etc.  It includes provisions on non-discrimination against people with disabilities.  It passed both chambers and was signed by the Governor on November 4, becoming Act Number 164 of 2016.

SB1382. Introduced by Senator John T. Yudichak (D-Carbon). This bill would provide tax credits to seniors and people with disabilities, who make modifications to their new or existing homes to improve accessibility.  It was introduced and referred to the Senate Finance Committee on October 12, 2016.

Election 2016

National and Statewide

  • Donald Trump (R) carried Pennsylvania and went on to a surprise victory in the race for President.
  • Pat Toomey (R) won a second term representing Pennsylvania in the US Senate.
  • Josh Shapiro (D) is Pennsylvania’s new Attorney General.
  • Eugene DePasquale (D) will serve a second term as Pennsylvania Auditor General.
  • Joe Torsella (D) will be Pennsylvania’s next State Treasurer.

To view the vote percentages, go to www.electionreturns.pa.gov/ENR_New/General/SummaryResults?ElectionID=54&ElectionType=G&IsActive=1.

U.S. House of Representatives

The party breakdown in Pennsylvania’s Congressional Delegation remains the same. There are thirteen Republicans and five Democrats. For a listing of winners and the number and percentage of votes received, go to www.electionreturns.pa.gov/ENR_New/General/OfficeResults?OfficeID=11&ElectionID=54&ElectionType=G&IsActive=1.

State Senate

Half of the 50 State Senate seats were open in this election.  Republicans gained three seats, bringing their majority to 34 to 16, enough to override gubernatorial vetoes.

For a district by district summary and vote percentages, go to www.electionreturns.pa.gov/ENR_New/General/OfficeResults?OfficeID=12&ElectionID=undefined&ElectionType=undefined&IsActive=undefined

State House

All 203 House seats were up for vote in the November election.  Republicans added three seats to their majority in the House bringing the total to 122 Republicans and 81 Democrats.

For a district by district summary and vote percentages, go to

www.electionreturns.pa.gov/ENR_New/General/OfficeResults?OfficeID=13&ElectionID=54&ElectionType=G&IsActive=1

PA Seats in Congress

A 2015 analysis by the Election Data Services predicts that Pennsylvania will lose one Congressional district in the upcoming 2020 Census. PA would drop from 20 to 19 votes in the Electoral College. Other states set to lose a seat include: Alabama, Illinois, Minnesota, Michigan, Ohio, New York, Rhode Island and West Virginia. Texas is set to gain three seats and Florida two. Arizona, Colorado, North Carolina and Oregon would each gain one.

Legislative Schedule

The 2015-16 state legislative session ended on November 30, 2016.  All bills which didn’t pass must be reintroduced in the new, 2017-18 session which begins with swearing-in-day on January 3.

2017 SENATE SESSION SCHEDULE

January          3, 23, 24, 25, 30, 31

February        1, 6, 7, 8

March             20, 21, 22, 27, 28, 29

April               17, 18, 19, 24, 25, 26

May                8, 9, 10, 22, 23, 24

June                5, 6, 7, 12, 13, 14, 19, 20, 21, 22, 26, 27, 28, 29, 30

2017 HOUSE SESSION SCHEDULE

January          3, 23, 24, 25 

February        6, 7, 8

March             13, 14, 15, 20, 21, 22

April               3, 4, 5, 18, 19, 24, 25, 26

May                8, 9, 10, 22, 23, 24

June                5, 6, 7, 12, 13, 14, 19, 20, 21, 22, 26, 27, 28, 29, 30

Governor Wolf’s budget address will be on February 7 and Senate budget hearings will be held Feb. 21, 22, 23, 24, 27, 28 and March 1, 2, 3, 6, 7, 8, 9, 10.  The primary election will be held on May 16th.

Legislative Leadership

State Senate Republicans

President Pro Tempore – Joe Scarnati (25th District)

Majority Leader – Jake Corman (34th District)

Majority Whip – John Gordner (27th District)

Appropriations Committee Chairman – Pat Browne (16th District)

Caucus Chairman – Bob Mensch (24th District)

Policy Committee Chairman – Dave Argall (29th District)

Caucus Administrator – Chuck McIlhinney (10th District)

Caucus Secretary – Rich Alloway (33rd District)

State Senate Democrats

Minority Leader – Jay Costa (43rd District)

Minority Whip – Anthony Williams (8th District)

Appropriations Committee Ranking Member – Vincent Hughes (7th District)

Caucus Chairman – Wayne Fontana (42nd District)

Policy Committee Ranking Member – Lisa Boscola (18th District)

Caucus Administrator – John Yudichak (14th District)

Caucus Secretary – Larry Farnese (1st District)

State House Republicans

Speaker of the House – Mike Turzai (28th District)

Majority Leader – Dave Reed (62nd District)

Majority Whip – Bryan Cutler (100th District)

Appropriations Committee Chair – Stan Saylor (94th District)

Caucus Chair – Marcy Toepel (147th District)

Policy Committee Chair – Kerry Benninghoff (171st District)

Caucus Administrator – Kurt Masser (107th District)

Caucus Secretary – Donna Oberlander (63rd District)

State House Democrats

Minority Leader – Frank Dermody (33rd District)

Minority Whip – Mike Hanna (76th District)

Appropriations Committee Ranking Member – Joe Markosek (25th District)

Caucus Chair – Dan Frankel (23rd District)

Policy Committee Chair – Mike Sturla (96th District)

Caucus Administrator – Neal Goodman (123rd District)

Caucus Secretary – Rosita Youngblood (198th District)

CHC

On August 30, 2016, the Departments of Human Services and Aging announced that the Commonwealth has agreed to negotiate agreements with three managed care plans for the Community HealthChoices (CHC) program. The CHC will coordinate physical health and long-term services and supports (LTSS), if needed, to more than 420,000 individuals who are dually eligible for Medicare and Medicaid, older Pennsylvanians, and people with disabilities. The managed care organizations (MCO) selected to proceed with negotiations to provide services beginning in 2017 are AmeriHealth Caritis, Pennsylvania Health and Wellness (Centene), and UPMC for You. A link to each MCO is at www.dhs.pa.gov/citizens/communityhealthchoices/ForProviders/index.htm  Fourteen MCOs had applied and several of the unsuccessful applicants have challenged the decision.

The MLTSS Medical Assistance Advisory Committee meets monthly to give input to the Department. Meeting transcripts and 2017 meeting dates are at www.dhs.pa.gov/communitypartners/informationforadvocatesandstakeholders/mltss/index.htm. Updated information on the program can be found at www.dhs.pa.gov/citizens/communityhealthchoices/index.htm

ODP

The Office of Developmental Programs has issued one new bulletin:

  • Proposed Regulations – Home and Community-based Support and Licensing, 00-16-07, was issued on November 7, 2016, effective on that date. The Bulletin announces the publication of proposed regulations for ODP programs, amendments to Chapters 2380, 2390, 6400 and 6500, and repeals and replaces Chapters 51 and 6200. The deadline to submit comments was December 20, 2016.

ODP Waiver Renewals

The Office of Developmental Programs published the applications for the renewal of the Person/Family Directed Services and Consolidated waivers for a public comment period through January 17, 2017. The changes include new services, revised service definitions, and eligibility changes for individuals with autism.  The documents and instructions for submitting comments are available at www.dhs.pa.gov/provider/developmentalprograms/2017waiverrenewals/.

OLTL

The Office of Long Term Living has issued two new Bulletins:

  • Guidance for Nursing Facilities – MDS Section Q, 03-16-10 and 59-16-10 was issued on October 3, 2016, effective October 1, 2016. The Bulletin provides guidance to nursing facilities on compliance with civil rights obligation to administer the Minimum Data Set (MDS) so that residents receive services in the most integrated setting for their needs.
  • Nursing Home Transition (NHT) Program Changes, 59-16-09, was issued on October 28, 2016 and was effective on December 1, 2016. The Bulletin notifies providers of NHT of expansion of the program, changes to payment methodology and changes in providing and reporting NHT activities.

OLTL Waivers

The Office of Long Term Living has made a number of changes to its HCBS waiver programs through renewals and amendments, including the addition of employment services and changes to service definitions. The current approved waivers and transition plans for complying with the CMS Community Settings Rule are found at www.dhs.pa.gov/learnaboutdhs/dhsorganization/officeoflongtermliving/oltlwaiverinfo/index.htm

Enrollment Hearing

On October 18th, the Pennsylvania Senate Aging and Youth Committee and the House Aging and Older Adult Services Committee held a joint hearing on problems faced by older adults applying for the Aging Waiver. Problems were cited with the enrollment process.  Maximus is the state’s Independent Enrollment Broker (IEB) responsible for handling applications and enrollments for the Office of Long Term Living (OLTL) Waivers. Senate and House Committee members expressed concerns about the delays and other enrollment problems and stressed the importance of solving these problems before Community HealthChoices is implemented.

OMHSAS

The Office of Mental Health and Substance Abuse Services has issued one new Bulletin:

  • Nursing Home Pre-Admission Screening and Resident Review Requirements Related to Mental Health Services, OMHSAS-16-11, was issued on November 10, 2016, effective immediately. The Bulletin clarifies procedures and responsibilities related to identification and services under OBRA 1987 and 1990.

Long Term Care Council

In late November, Governor Tom Wolf announced the formation of the Long-Term Care Council. The Council, which replaces the Intergovernmental Council on Long-Term Care, will focus on regulatory review and access to quality care; community access and public education; long-term care service models and delivery; workforce; housing; and behavioral health issues of seniors over the age of 60. Chaired by Secretary of Aging Teresa Osborne, the 35 member Council includes consumers, advocates, caregivers, providers, and policymakers.  Charles Quinnan is the executive director of the Council. The Council’s first meeting was held on November 30, 2016.  For more information and a list of members, go to www.media.pa.gov/Pages/aging_details.aspx?newsid=134.

PA ABLE

The Pennsylvania Achieving a Better Life Experience Act (PA ABLE), which was unanimously passed by the General Assembly on April 13 and signed by Governor Wolf on April 18, will provide individuals with a disability with a savings account without jeopardizing eligibility for important programs that they depend on. Information and updates as the program develops is found at this link: http://pa529.com/able.html

Direct Care Workers

In November, the Administration issued a policy clarification on the role of direct care workers (DCW), including personal attendants and other household aides in home- and community-based settings. Their activities are exempt from the licensure requirements under the Professional Nursing Law and Practical Nurse Law. These non-skilled, routine activities/services include:

  • assistance with bowel and bladder routines;
  • assistance with medication;
  • ostomy care;
  • clean intermittent catheterization;
  • assistance with skin care; and
  • wound care.

The policy clarification is at http://dhs.pa.gov/cs/groups/webcontent/documents/document/c_251202.pdf.

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NATIONAL NEWS+

Federal Budget 2017

Shortly before the start of the current federal fiscal year which began on October 1, 2016, Congress passed a Continuing Resolution (CR) to fund the government through December 9, 2016.  They also voted to provide funding to fight the Zika virus. No individual appropriations bills have been passed, so Congress passed an extension of the CR through April 28, 2017 at FY  2016 spending levels on the last day before adjourning for the year.

Congressional changes

The incoming 115th Congress will be sworn in on January 3, 2017.  The 100 seat Senate will include 51 Republicans, 46 Democrats and 2 Independents (with one seat to be decided in a runoff on December 10 in Louisiana).  The 435 seat House of Representatives will be made up of 240 Republicans, 194 Democrats, and no Independents (with one seat to be decided in a runoff on December 10 in Louisiana). This Congress will be in power until the end of 2018.

Captioning & Audio Description

Attorney General Loretta Lynch in November signed a final rule revising the Justice Department’s Americans with Disabilities Act (ADA) Title III regulation to further clarify a public accommodation’s obligation to provide appropriate auxiliary aids and services for people with disabilities. An advance copy of the final rule and answers to frequently asked questions are available at www.ada.gov or call the ADA Information Line Voice: 1-800-514-0301; TTY: 1-800-514-3083. The final rule will take effect 45 days after publication in the Federal Register.

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RESOURCES+

MH Parity Guidelines

Governor Wolf and the Pennsylvania Insurance Department recently issued an official Notice to health plans and to the public detailing the requirements on access to mental health and drug and alcohol treatment. The Notice, “Guidance Regarding Parity in Mental Health and Substance Use Disorder Coverage; Notice 2016-15” is at www.pabulletin.com/secure/data/vol46/46-44/1884.html. The state also released a Consumer Guide to help Pennsylvanians know their rights in accessing these services.

The Consumer Guide and other resources around mental health and drug and alcohol treatment are available at www.insurance.pa.gov/Coverage/Pages/MentalHealthSUD.aspx.  Pennsylvanians with questions about the type of coverage they have, or about their rights to mental health and substance abuse treatments services, can contact the Insurance Department at 1-877-881-6388. Individuals can also call this number to report parity violations.

New Website

There’s new web page for the Governor’s Cabinet and Advisory Committee for People with Disabilities at www.dhs.pa.gov/communitypartners/GovCommitteeforPplwDisabil.

Mental Health Ranking

Mental Health America (MHA) has released its annual State of Mental Health Report, which ranks all 50 states and the District of Columbia based on several mental health and access measures. Pennsylvania ranked ninth in overall mental health, an improvement from a 2011 ranking of 15th.  Pennsylvania’s overall ranking indicates a lower prevalence of mental illness and higher rates of access to care in comparison to most states.  The report is available at www.mentalhealthamerica.net/issues/state-mental-health-america.

Medicaid Data

The Centers for Medicare & Medicaid Services (CMS) has posted the Medicaid Long-Term Services and Supports Beneficiaries Services and Supports Beneficiaries 2012 report .  Over 4.8 million people received Medicaid-funded long-term services and supports (LTSS) during calendar year 2012. Most LTSS beneficiaries (3.4 million or 70 percent) received home and community-based services (HCBS).  Fifty-five percent of beneficiaries were under age 65, including children and youth under age 21 (16 percent) and people age 21 through 64 (39 percent).  Older adults comprised 45 percent of beneficiaries.  For each age group, a majority of people received HCBS, but older adults were less likely to receive HCBS than people under age 65.   For the full report, go to: www.medicaid.gov/medicaid/ltss/reports-and-evaluations/index.html.  

CMS also posted annual updates to two reports that describe recent section 1915(c) Home and Community Based Services (HCBS) waiver program data.  Medicaid 1915(c) Waiver Data Based on the CMS 372 Report, 2012 – 2013 identifies the number of people who received HCBS waiver program services, and Medicaid expenditures and duration of service for participants during 2012 and 2013.  The other report, Medicaid Expenditures for Section 1915(c) Waiver Programs in FY 2014, provides data and trends regarding waiver expenditures.  Among the data, 1915(c) HCBS waiver programs accounted for a lower percentage of all Medicaid home and community-based services, 51%, than in any year since FY 1995, as some states closed their 1915(c) waiver programs and covered HCBS within state plan benefits such as personal care, home health, and Community First Choice as well as through Managed LTSS.    For the full reports, go to www.medicaid.gov/medicaid/ltss/reports-and-evaluations/index.html

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