PLAINS TWP. — At Friday’s Luzerne/Wyoming County Providers Association Legislative Breakfast, state legislators assured the 75 in attendance that they will work together in a bipartisan manner to get some help — especially financial help.
Workforce initiatives and funding were the main topics discussed at length during the morning-long event at The Woodlands Inn & Resort.
Attending the event were: Sen. Marty Flynn, D-Scranton; Rep. Aaron Kaufer, R-Kingston; Rep. Eddie Day Pashinski, D-Wilkes-Barre; Rep. Jim Haddock, D-Pittston Township; Rep. Dane Watro, R-Kline Township; and Sen. Dave Argall, R-Schuylkill. Sen. Lisa Baker, R-Lehman Township; and Rep. Alec Ryncavage, R-Plymouth, were unable to attend. Rep. Mike Cabell, R-Butler Township; and Sen. Lynda Schlegel Culver, R-Northumberland, sent staff representatives.
Richard Edley, President/CEO of RCPA — Rehabilitation and Community Providers Association, and Jack Phillips, Director of Government Affairs for RCPA, co-moderated the event.
“The round table today with RCPA of Wyoming Valley was very informative for me and my fellow legislators,” Haddock said. “The State of Pennsylvania provides founding resources to providers of home and community-based serves in the Intellectual Disabilities Community Base, Community Waiver and Adult Waiver programs in the state. These providers preform critical services for their clients.”
Rep. Haddock said the most pressing issue facing RCPA providers is a new performance bases initial proposed the ODP.
“We heard loud and clear that as legislators we have to make sure this new program is started,” Haddock said. “They would like input to assure this is rolled out correctly from the department.”
Sen. Flynn added, “It was eye-opening to learn about the day-to-day challenges faced by our local mental health and disability services providers. While financial obstacles are prevalent, there are also numerous efficiency issues that require attention.”
Flynn also encouraged the group to “show us what we’re fighting for,” suggesting they would benefit by “striking a cloud of empathy” that would clearly show the good work they do every day.
“As legislators, we need to receive as much information as possible so we can understand what the needs are,” Flynn said. “Show us how your work affects people’s lives.”
Flynn and the other legislators agreed that more awareness would help to gain support in Harrisburg.
Phillips said Gov. Josh Shapiro, in his proposed 2024 budget, supports the intellectual disability and autism community by making a major investment:
• $215 million — and draws down another $266 million in federal funds — to provide more resources for home and community-based service providers, so they in turn can pay competitive rates to attract and retain the staff who provide these essential services.
• $36 million to help get more Pennsylvanians the home and community-based services they need.
Key issues
Across RCPA Divisions
• Workforce initiatives and funding.
• DSPs, DCWs, counselors, case managers, peers and licensed staff.
• Regulatory reform: Decreasing administrative burden; reducing barriers to access for care.
• Advocate for funding that reflects true “cost-plus” and for meaningful, transparent, VBP models.
Behavioral Health (adult and children’s mental health; substance use disorder services).
• Support for the re-implementation of the national CCBHC model and funding.
• Focus on parity and integrated behavioral and physical health care models.
• Address redundancy and inconsistency among substance use disorder treatment audits and overseers.
• Enhance access to methadone for opioid use disorder and improve treatment models within programs.
• Ensure the sustainability and integrity of the Opioid Use Disorder Centers of Excellence (COE) program.
• Amend the IBHS regulations to address access issues, and payment equity between IBHS/ABA services.
• Resolve the CMS telehealth issues to ensure broad access.
Intellectual and Developmental Disabilities (IDD)
• Advocate for $430M additional funding for IDD services.
• Support stakeholder involvement in the Selective Contracting Waiver (Performance-Based Contracting).
• Support programs for the severely disabled (e.g., medical and behavioral complications).
• Focus on revamping CPS and respecting individual choices.
• Advocate for a broader, more inclusive interpretation of the CMS Settings Rule.
• Significant changes regarding the Supports Inventory Scale (SIS) and implementation of an appeal process.
• Implement recommendations from the Legislative IDD Task Force.
• Advocate for Standard Occupational Code (SOC) for DSPs.
Brain Injury/Physical Disabilities and Aging
• Establishing a rate refresh process for all OLTL services, based on OBRA Medicaid FFS.
• Meaningful involvement with the CHC procurement.
• Requiring consumer choice and consumer-directed service.
• Development of proactive partnerships with CHC-MCOs and BH-MCOs.
Brain Injury Services
• Meaningful changes and increases to funding and models by working with a legislative advocate.
• Submission of letter to CMS regarding the BI rates and budget shortfall.
Medical Rehabilitation
• Continued expansion of the 3-hour rule: Advancing the Access to Inpatient Rehabilitation Therapy Act.
Review Choice Demonstration
• 100% pre-claim review continues for all Medicare-participating IRFs in Alabama.
• Focus on CMS demonstration; CMS will provide 90 days’ notice.
• Novitas (Medicare Administrative Contractor in PA) Medical Director Requirement.
Early Intervention/Pediatrics
• Interim rate increase while early intervention rate methodology is completed for 2025/26 budget.
• Improve system consistency across counties.
• Clarify/expand access and eligibility criterion.