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Authors Posts by Tim Sohosky

Tim Sohosky

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On Tuesday, July 29, the Governor’s Office of the Budget provided an update on the status of the Fiscal Year (FY) 2025/26 state budget. The update outlines projected impacts across various departments within the Department of Human Services (DHS) over the next six weeks resulting from the ongoing budget impasse. Although the Governor, Senate, and House leadership have described ongoing negotiations as respectful, they have also been described as inching along. The letter from Secretary Monson cites funding for public schools and mass transit as top challenges in finalizing a budget.

Following is a summary of payments from Pennsylvania health and human services departments that will be delayed without a budget.

Department of Aging cannot distribute:

  • $12.88 million in payments to the Area Agencies on Aging, for July and August.

Department of Drug and Alcohol Programs cannot distribute:

  • $9.95 million quarterly payments to the Single County Authorities.
  • $187,000 quarterly payments for training of substance use disorder and problem gambling service professionals.
  • $21 million quarterly payments for State Opioid Response funding.

Department of Health cannot distribute:

  • $9.405 million in anticipated quarterly reimbursements to County Municipal Health Departments.
  • More than $4.7 million in quarterly funding to support operation and administration of EMS services.
  • $9.405 million in quarterly funding to school districts for health services.
  • More than $3.466 million in quarterly payments for the Prescription Drug Monitoring Program, beginning in July.
  • Payments for critical health services, including, but not limited to: Tuberculosis screening, Cystic Fibrosis, Lyme Disease and Cancer Screening, beginning in July.
  • More than $1 million in quarterly payments for Maternal and Child Health services and $1.8 million in quarterly for Newborn Screening.

Department of Human Services cannot distribute:

  • $15 million in quarterly advances for Behavioral Services, beginning in July.
  • Quarterly advances for Breast Cancer Screening services.
  • $390 million in County Child Welfare payments for July and August.
  • $8.5 million in payments for Domestic Violence for July and August.
  • $3.5 million in quarterly advances from the Human Services Development Fund.
  • An estimated $33 million in Child Support Enforcement payments, for July and August.
  • $3.4 million in payments for Rape Crisis for July and August.
  • Approximately $10 million for Community-Based Family Centers for July and August.
  • $5.6 million in quarterly advance payments for Homeless Assistance.

Read the letter from Secretary Monson here. If you have any questions, please contact your respective RCPA Policy Director.

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The Office of Developmental Programs (ODP) has released a significant update on the status of the Performance-Based Contracting (PBC) framework for Supports Coordination Organizations (SCO). Key changes reflect both public feedback and a shift towards a more unified and outcomes-driven service system. Based on comments from over 140 stakeholders, ODP has confirmed that all SCOs will be held to the same performance standards through a phased approach — eliminating previously proposed tiers. The timeline for tier determination has been adjusted (now set for 8/15/25 – 9/15/25), with performance measure submissions required between 10/1/25 – 11/1/25 to allow time for preparation and systems development.

In terms of payment structure, the transition to a monthly case rate model for all SCOs is scheduled to begin July 1, 2026. The definition of “Intensive TSM” has been revised, and billing guidance will now include qualified tasks for Associate SCs. These changes reflect a broader move away from task-based reimbursement toward an outcome- and quality-focused model, aligning with CMS’s HCBS Quality Measure Set and Pennsylvania’s population health priorities.

Next steps include the submission of 1915(b)(4) and (c) waiver amendments to CMS in late July, publication of finalized documents (including an implementation guide and preparedness toolkit), and SCO forums starting July 28. A new Performance Analysis Services (PAS) vendor is also developing a data system to support outcome tracking and analysis. ODP emphasizes that this transition requires a mindset shift — from measuring quantity to prioritizing quality and individual outcomes such as employment, community living, and health stabilization.

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The U.S. Department of Labor (DOL) has announced it is withdrawing its previously proposed rule that would have phased out the issuance of subminimum wage certificates authorized under Section 14(c) of the Fair Labor Standards Act (FLSA). The proposed rule, initially published in December 2024, aimed to amend 29 CFR Part 525 to phase out the use of special wage certificates for workers with disabilities.

This withdrawal means Section 14(c) certificates remain in effect, and DOL will continue to issue and renew them as authorized by federal law.

Rationale for Withdrawal:

After receiving more than 17,000 comments — including strong opposition from Members of Congress, service providers, individuals with disabilities, and their families — the DOL determined:

  • It lacks clear statutory authority to unilaterally eliminate a program that Congress has explicitly mandated.
  • Section 14(c) uses the word “shall”, not “may,” indicating a mandatory duty for the Department to provide for the issuance of certificates “to the extent necessary to prevent curtailment of employment opportunities.”
  • The continued use of 14(c) certificates by over 40,000 workers as of 2024 indicates ongoing need.
  • Eliminating the program without Congressional action could result in unintended disruptions to employment and disability support services.

Impact on Providers:

  • Employers currently operating under valid 14(c) certificates may continue to do so, subject to existing legal requirements.
  • The DOL has no immediate plans to change the regulatory framework of 29 CFR Part 525.
  • A future rulemaking process could still be initiated, but any substantive changes would likely require Congressional action.

The full text of the rescission can be found here.

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This issue of the Positive Approaches Journal, “The Intersection of Mental and Physical Health Impacting Our Communities: Part 2,” continues the theme of the previous issue in exploring and emphasizing the importance of the balanced pursuit of physical and mental wellbeing. Topics include behavior as communication, pica and lead exposure, positive interactions, and more.

This issue of Positive Approaches Journal is available to view in digital form online or download at MyODP’s website.

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