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Children's Services

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Photo by Chewy on Unsplash

The Office of Children, Youth and Families (OCYF) has released this bulletin to advise County Children and Youth Agencies (CCYAs) and Statewide Adoption and Permanency Network (SWAN) affiliate agencies of adjustments to payment rates for SWAN direct units of service for State Fiscal Year (SFY) 2021–22 and tentative payment rates for SFY 2022–23.

This bulletin rescinds and replaces the payment chart on page 3 of the OCYF Bulletin 3350-20-04, titled “Statewide Adoption and Permanency Network Unit of Service Payment Rates and Programmatic Changes,” and replaces the unit costs on page 80 of OCYF Bulletin 3140-21-03, titled “Fiscal Year 2022–23 Children, Youth and Families Needs-Based Plan and Fiscal Year 2020–21 Implementation Plan Instructions.” The programmatic changes outlined in previous SWAN Unit of Service Payment Rates and Programmatic Changes bulletins remain in effect.

If you have further questions, please contact RCPA Children’s Director Jim Sharp or your OCYF Regional Office.

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The Office of Children, Youth and Families (OCYF) has released Bulletin 3130-21-03, entitled “Policies and Procedures for Implementation of the Title IV-E Prevention Program under the Family First Prevention Services Act.” This bulletin provides information and guidance on new prevention services requirements for serving children and families as a result of the Family First Prevention Services Act (Public Law (P.L.) 115-123) (Family First). Specifically, these new requirements must be implemented as part of Pennsylvania’s election to participate in the federal Title IV-E Prevention Program established under Family First. Participating in this program provides Pennsylvania the opportunity to strengthen efforts to prevent out-of-home placement of children by expanding the use of evidence-based services and programs to better support families in their own homes and communities.

The requirements outlined within this bulletin are effective October 1, 2021. Questions regarding this bulletin or requirements may be directed to RCPA Children’s Director Jim Sharp as well as your applicable OCYF Regional Office.

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Information from ANCOR and Invite to an ANCOR Member Only Meeting Friday, July 2

Just the Highlights

  • The Better Care Better Jobs Act seeks to translate President Biden’s proposal for $400 billion in HCBS funding into actionable legislation.
  • The proposal offers many positive provisions, some of which have the potential to transform the Medicaid HCBS program, as well as a couple that may potentially raise implementation challenges.
  • Join us this Friday at 11 am EDT to learn more during a members-only briefing that will include remarks from Michael Gamel-McCormick, Disability Policy Director for the U.S. Senate Special Committee on Aging.

Dear ANCOR members,

I write to share exciting news about a bill ANCOR is supporting that was introduced in Congress late last week. The Better Care Better Jobs Act, or “Better Care” (S. 2210 / H.R. 4131), is being led in the Senate by Senators Bob Casey (D-PA), Ron Wyden (D-OR), Chuck Schumer (D-NY), Patty Murray (D-WA), Tammy Duckworth (D-IL), Sherrod Brown (D-OH) and Maggie Hassan (D-NH), and in the House by Representatives Debbie Dingell (D-MI), Frank Pallone (D-NJ), Jan Schakowsky (D-IL) and Doris Matsui (D-CA). The bill has already garnered support from more than 40 co-sponsors in the Senate.

Better Care seeks to translate President Biden’s proposal for $400 billion in HCBS funding into actionable legislation. Although the bill includes a few challenging provisions, on the whole, Better Care is nothing short of transformative, and ANCOR supports it for the investments it would make in the Medicaid Home and Community Based Services (HCBS) program, including both significantly expanded funding and structural transformations to strengthen the program. If passed, Better Care would allocate as much as $50 billion per year for the next 10 years in new HCBS spending, making it the single largest investment in the 50-year history of HCBS.

The proposed legislation includes a wide array of provisions, which you can learn more about by reading the full text of the legislation or the accompanying summary. However, there are several key highlights ANCOR is particularly excited about, some of which were included in the proposal expressly because of our advocacy. Among other provisions, Better Care would:

  • Increase the Federal Medical Assistance Percentage (FMAP) by 10 percent for the next 10 years. This FMAP enhancement would be in addition to the current 10-percent increase that went into effect for one year starting on April 1.
  • Allocate $100 billion for states at the onset of the funding increase described above to initiate an implementation planning process that includes stakeholder engagement.
  • Safeguard the delivery of services to current HCBS beneficiaries without jeopardizing the ability of potential beneficiaries to receive services by making new federal funding contingent on agreement by states not to (1) cut existing services or (2) make eligibility standards more stringent.
  • Require that states pay sufficient reimbursement rates to providers and mandate that reimbursement rates be reviewed at least once every two years. The biennial review process would mandate stakeholder engagement, to include providers, people with disabilities and their family members, direct support professionals and others.
  • Establish in statute “direct support professional” as a professional classification (i.e., distinct from personal care attendants, home health aides, etc.) and direct the U.S. Department of Labor to work with the Centers for Medicare and Medicaid Services to establish a Standard Occupational Classification for DSPs.
  • Offer, for the first time, FMAP funding to U.S. territories such as Puerto Rico and American Samoa, to supplement the territories’ existing Medicaid block grant funding.
  • Commit to the establishment of a set of standardized quality measures within two years of the bill’s passage.

Individually, these seven provisions have the potential to be gamechangers. Together, their potential is nothing short of transformative.

And—as with all legislation—Better Care is not perfect. Included are two particular provisions that have the potential to raise implementation challenges or be problematic: (1) a requirement that providers pass through a minimum proportional percentage of their increased reimbursement revenue to DSPs, and (2) an additional 2% FMAP incentive if states establish, either directly or through contracting with one or more nonprofit entities, a registry to connect people seeking services with qualified direct care workers. I flag both of these challenges for you not to suggest that ANCOR will or will not ultimately support these provisions, but rather to underscore that the extent to which we support these provisions will ultimately depend on how the details surrounding their implementation are codified into law.

The details of the Better Care proposal—including its many positive provisions as well the few provisions that demand more detail—mean that you will be essential in its pathway toward becoming law. Like most legislation these days, we don’t anticipate the legislation will secure the 60 votes needed to break a filibuster in the Senate, meaning the surest route for this bill to become law is its inclusion in the budget reconciliation process this fall. If you want to lend your support, there are things you can do now, soon and later to increase its chances of passing:

  • Now: Register for a members-only briefing to learn more about the bill and its path to becoming law. The briefing will take place this Friday, July 2 at 11 am EDT, and will feature ANCOR’s government relations professionals, as well as Michael Gamel-McCormick, Disability Policy Director for the U.S. Senate Special Committee on Aging. Register for free today.
  • Soon: On Friday, we will be issuing an action alert to aggregate support for Better Care and urge members of Congress to sign on in support of the legislation. Be on the lookout for an email from us or visit the ANCOR Amplifier to take action starting Friday.
  • Later: Assuming the bill is destined for the reconciliation process, it will be essential that lawmakers on Capitol Hill hear from constituents like you to preserve its many positive provisions in the version that is ultimately voted on. Stay tuned for more as the events of the summer unfold.

We say it a lot, but the changes ANCOR is championing on your behalf in Washington simply would not be possible without your passion, support and commitment. Thank you for all you’re doing—now, soon and later—to help us ensure this significant federal legislation becomes the law of the land.

Sincerely,

Barbara Merrill

CEO, ANCOR

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From the Department of Human Services (DHS):

As you may know, on Monday, June 14, DHS submitted a preliminary spending plan to the Centers for Medicare & Medicaid Services (CMS) that serves as a foundation for Pennsylvania’s planning efforts by outlining our principles and overarching priorities for expanding and enhancing home and community-based services (HCBS). The preliminary plan encompasses many of the stakeholder recommendations that have been made to date. The overarching priorities include:

  1. Increasing access to Home and Community-Based Services (HCBS);
  2. Enhancing HCBS provider payment rates and benefits;
  3. Protecting the health and well-being of direct care workers and direct support professionals through the provision of supplies and equipment;
  4. Recruitment and retention efforts to support the workforce;
  5. Supporting caregivers;
  6. Assistive technology and other supports to improve functional capabilities of persons with disabilities;
  7. Supporting the transition of individuals to community-based living arrangements;
  8. Investing in activities to address Mental Health and Substance Use Disorder treatment and recovery needs of Medicaid beneficiaries; and
  9. Building HCBS capacity and rebalancing Long-term Services and Supports.

The Department of Human Services has already heard from many stakeholders about Pennsylvania’s plan to use the increased Federal Medicaid Assistance Percentages (FMAP) available under the American Rescue Plan, but for those who are unable to submit feedback via email, you are able to do so by participating in Wednesday’s virtual public comment session beginning at 10:00 am. To ensure all who register are able to speak, each individual will have 5 minutes to provide their feedback.

Click on this link to register for the session. You can click here to view Pennsylvania’s preliminary spending plan.

Thank you for your continued collaboration and for all you do to serve Pennsylvanians.

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The Centers for Disease Control and Prevention (CDC) has created a new COVID-19 Viral Testing tool. This interactive and mobile-friendly online tool will help to streamline the process of sorting through information about COVID-19 testing and next steps. The tool complements the CDC’s testing guidance and assists healthcare providers in making decisions and recommendations for their patients about the following:

  • Whether to order testing;
  • What kind of test to order;
  • How to interpret the test result;
  • What to do with conflicting test results;
  • Whether confirmatory (follow-up) testing is necessary; and
  • How vaccination affects decisions for testing.

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On Friday, the Pennsylvania General Assembly passed SB255, the 2021–22 General Appropriations bill, by a vote of 140-61 in the House and a vote of 43-7 in the Senate.

The accompanying budget code bills also passed on Friday. The Tax Code Bill, HB952, passed 46-4 in the Senate, 170-31 in the House. The Administrative Code, HB336, passed 28-22 in the Senate, 112-89 in the House, and the Fiscal Code, HB1348, passed 42-8 in the Senate and 168-33 in the House. The final code bill, the Public School Code, SB381, passed 154-47 in the House and 40-10 in the Senate.

The planned General Fund budget will spend $40.2 billion, which includes some Federal stimulus monies. The budget only appropriates approximately $2 billion out of the $7.3 billion in federal stimulus dollars. The state Department of Human Services (DHS) budget line-items are set to grow by $1.8 billion, or 11.7 percent.

While not everyone in the General Assembly was happy with the end product, the Governor is expected to sign the budget bills before June 30.

For your convenience, RCPA has compiled a summary of the Administrative and Fiscal Codes and a breakdown of the specific DHS line-items relevant to RCPA members. As more information comes to light concerning how DHS will spend these appropriations on health and human service programs, RCPA will update the membership.

If you have any questions, please contact Jack Phillips, Director of Government Affairs.

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This webinar will discuss vaccine hesitancy among direct service workers (DSWs), explore barriers they face, including access to information and transportation, and offer strategies to help increase vaccination rates.

Panelists:

  • Cory Nourie: Director of Community Services, Delaware Division of Developmental Disabilities Services
  • Ramu Iyer: National Alliance of Direct Support Professionals Advisory Council Member
  • Robert Espinoza: Vice President of Policy, PHI
  • Trudy Rebert: Federal Policy Counsel, National Domestic Workers Alliance

This webinar will be held on Thursday, July 1, 2021 from 3:00 pm–4:30 pm ET.

Click here to register.

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