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Physical Disabilities & Aging

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The Long-Term Services and Supports (LTSS) Subcommittee meeting was recently held on July 2, 2025. During the meeting, a number of presentations were given. In addition to the presentations, the agenda and a document that provided follow-up information from the June 4, 2025, LTSS Subcommittee meeting were provided.

Members should take time to review the PowerPoint presentations from the meeting below:

The next LTSS Subcommittee meeting is scheduled for August 6, 2025. The meeting will be held from 10:00 am – 1:00 pm in the Forest Room at the Commonwealth Keystone Building, which is located at 400 North Street in Harrisburg, PA.

The option to participate virtually is also available. If attending virtually, please register here. After registering, you will receive a confirmation email containing information about joining the webinar. The option to call in is also available by dialing: (631) 992-3221; Access code: 625-783-611#.

Remote captioning and streaming services will be provided. If you require these services, please visit this remote captioning and streaming link.

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Image by Werner Moser from Pixabay

The Office of Long-Term Living (OLTL) is sharing the message below from the Pennsylvania Department of Aging (PDA):

As part of Aging Our Way, PA, PDA is conducting an evaluation of the PA Link to inform the design of a strategic plan. The goal is to improve and redesign the program to better serve older adults, people with disabilities, and caregivers. The entire project was informed by extensive stakeholder engagement, including consultation of an advisory committee.

Please use the Public Comment Form to review the DRAFT Evaluation Report and DRAFT Recommendation report. You will then be able to upload your comments.

The public comment period will close on Monday, July 28, 2025, and all comments will be considered in the creation of the final strategic plan to refresh the PA Link.

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In a strategic move to tackle persistent healthcare workforce shortages, the Shapiro Administration has announced that Pennsylvania will officially implement the Physical Therapy Compact (PT Compact) and the Nurse Licensure Compact (NLC) starting July 7, 2025.

These compacts will allow licensed practical nurses (LPN), registered nurses (RN), and physical therapists (PT) who reside in Pennsylvania to obtain multi-state privileges, enabling them to practice across state lines in any member state. This expansion of licensure flexibility is expected to bolster provider mobility, support faster deployment of qualified professionals, and relieve staffing gaps, especially in underserved and rural communities.

By reducing regulatory barriers and enabling a more fluid workforce, these licensure compacts provide a critical tool for healthcare systems facing staffing crises, travel demands, and surging patient needs. It also opens new opportunities for Pennsylvania clinicians to access broader job markets without the need for duplicative licensure.

For healthcare providers and employers seeking relief from workforce shortages, the PT Compact and NLC represent a step toward a more agile and responsive healthcare system.

To learn more, visit the PT Compact website or the NLC information page. To read the full announcement from the Shapiro Administration, visit here.

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On July 2, the U.S. Department of Labor (DOL) took an important step to restore fairness and flexibility in the home care industry by issuing a proposed rule that would rescind restrictive provisions introduced in 2013 under the Obama administration. Those earlier changes, fully enforced in 2015, significantly narrowed the “companionship services” exemption under the Fair Labor Standards Act (FLSA), adding complex and costly wage requirements for home care agencies and Medicaid-funded services.

The 2013 rule redefined key terms, eliminated the exemption for third-party employers, and imposed overtime obligations on agency-employed direct care workers — contributing to increased costs and administrative burdens. These unintended consequences have strained both providers and public programs, particularly in Medicaid-funded home and community-based services (HCBS).

Now, DOL is proposing to correct course. In its justification, the Department noted that the previous regulations “might not reflect the best interpretation of the FLSA and might discourage essential companionship services by making these services more expensive.”

Why This Matters
This proposed rule is a welcome change for providers, participants, and state Medicaid leaders alike. Overtime costs are a major driver of financial pressure in long-term services and supports. When direct care workers live in the same home as the individuals they serve, current law allows participant-directed employers to avoid overtime pay. However, because of the 2013 changes, agency-employed workers doing the exact same job do not receive the same treatment — creating an inequitable and unsustainable two-tiered system.

If finalized, the proposed rule would allow third-party agency employers to once again access the same companionship exemption. This would create consistency across employer types and make it easier to recruit and retain direct care staff — particularly in shared living or live-in arrangements that are vital to participant independence and stability.

Act Now: Submit a Letter of Support
The DOL is accepting public comments on this proposed rule, and it is crucial that the provider community raise its voice. RCPA encourages home care agencies, managed care partners, and Medicaid stakeholders to submit letters of support highlighting how this change will:

  • Increase flexibility in service delivery;
  • Align federal and state wage policy;
  • Promote cost-effective care models;
  • Support direct care worker retention; and
  • Sustain vital programs that keep individuals in their homes.

Your voice matters. Together, we can ensure federal policy reflects the realities and needs of today’s home and community-based care system. View a sample letter for public comments here.

How to Submit Your Letter of Support
Visit the Regulations government website and search for the DOL proposed rule on companionship services. Comments must be submitted by July 31, 2025

If you have any questions, contact Fady Sahhar, RCPA PD&A Division Director.

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Hearing All Perspectives: The Development of a Multi-State, Multi-Diagnosis Youth Advisory Council
Free RCPA Members-Only Webinar

Wednesday, August 6, 2025
11:00 am – 12:00 pm
Register Here

This presentation will discuss the formation of a novel and innovative version of a standard Youth Advisory Council (YAC). This particular YAC adds a twist to the traditional means of involving youth by creating a council combining voices of individuals served who have two very different diagnoses: those with an emotional/behavioral disorder (EBD) and those with an autism/intellectual disability (ASD/IDD). Spanning across three states, this internal YAC has been established to hear the voices of and to teach leadership principles and skills to those who are receiving the services offered by Devereux Advanced Behavioral Health.

Presenters:

  • Amy Kelly, MBA, MNM, National Director of Family Engagement, Devereux Advanced Behavioral Health
  • Judy Starr, JD, Deputy General Counsel, Devereux Advanced Behavioral Health

Objectives: Following this course, the learner will:

  • Describe the value of constituents’ voices from services and programs provided, regardless of individual communication type, cognitive ability, or diagnosis;
  • Discuss how to engage leadership and staff to support and sponsor a youth/constituent advisory council; and
  • List some “lessons from the journey” with do’s and don’ts when developing a youth advisory council.

Certificates of attendance are available to RCPA members who attend this webinar; anyone interested in a certificate should contact Cathy Barrick. To apply for CEs, you will need to register for the RCPA Annual Conference Strive to Thrive and indicate you attended the webinar in your CE packet, which will be made available on the mobile app.

Contact Carol Ferenz, Conference Coordinator, for details, or visit the RCPA Conference website for information on workshops, sponsors, exhibitors, and more!

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Image by BestGraphics_Com from Pixabay

Today, the House voted and passed HR 1 by a margin of 218–214, to advance the bill known as the “Big Beautiful Bill,” which now moves to the White House to Trump’s desk to be signed into law in time to beat a self-imposed July 4 deadline.

The final version cuts about $1 trillion from Medicaid, the federal health insurance program for low-income individuals and people with disabilities, and other health care programs. It reduces spending on anti-hunger programs, including SNAP, the Supplemental Nutrition Assistance Program formerly known as food stamps, by $185 billion.

The Pennsylvania Congressional Delegation all voted on party lines, with the exception of Representative Brian Fitzpatrick, who was one of only two Republicans to join all Democrats in voting against the measure. RCPA thanks Congressman Brian Fitzpatrick for meeting with RCPA last week and for voting against this bill. We are grateful for the Congressman’s support in protecting the most vulnerable populations that rely on Medicaid.

Main Points Relating to Medicaid Include
About 71 million Americans are enrolled in Medicaid, according to the government’s most recent data. According to a Congressional Budget Office report published this week, the changes to Medicaid and the Affordable Care Act in the current version would result in an increase of nearly 12 million more uninsured people by 2034. It is estimated that nearly 600,000 Pennsylvanians could lose Medicaid coverage.

Work Requirements
The bill outlines new work requirements for the popular entitlement program that provides government-sponsored health care for low-income Americans and people with disabilities. They require adults to work, volunteer, or study 80 hours a month to qualify for enrollment, unless they have an exception. The bill also requires parents of children over the age of 14 to work, as well as those receiving SNAP benefits.

Reporting Requirements
The bill also requires Medicaid recipients to prove their eligibility twice a year, instead of annually.

From our Partners at the National Council on Mental Wellbeing
The scale of the funding reductions and new administrative burdens is immense. But it is also important to recognize that some last-minute changes made to the bill in the past week provide an opening for further advocacy efforts that could potentially mitigate some of the impacts. Most relevant provisions of the bill will not take effect immediately, and in some cases, the effects will be phased in gradually over the course of several years. In addition, several provisions require agency rulemaking for full implementation, and there will likely be opportunities for you to engage through the notice and comment process.

RCPA will continue to review the final bill language and will follow up with a detailed analysis on the impacts of the bill; and through ongoing advocacy channels we will engage in with our national and state partners.

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