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Funding

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The sustained funding of community-based mental health services, such as community residential programs, family-based support, outpatient care, and crisis intervention, are critical to the wellbeing of our constituents and our communities. Funding levels for county mental health services have direct impacts on whether these important community and family supports will be available. Yet for too many years, state funding for mental health services has lagged far behind its needs. Counties find themselves advocating to prevent funds from being cut instead of achieving the increases that are needed to catch up from years of underfunding.

This year, RCPA and other system stakeholders have teamed with the County Commissioner Association of Pennsylvania (CCAP) through the Mental Health Safety Net Coalition. We join this campaign to bring awareness of the critical funding needs of mental health services for vulnerable Pennsylvanians. We ask our members, stakeholders, and partners to join us in this collaborative effort by engaging with your legislators. “County mental health services provide a critical piece to the public safety net for people in need,” notes Richard S. Edley, PhD, President and CEO of RCPA. “The system sustained cuts over a decade ago with little relief since then. It is time to restore those dollars and further enhance the system. Not only will it provide critical funding for the individuals receiving services, but there are positive benefits — both financially and clinically — to the entire community.”

The time to act is now for engaging with your representative, as local communities and providers have come together to sustain the safety net and serve those who need it most. The reality is that the demand for service far outweighs capacity and rate structures to serve this population. CCAP has created the following materials to assist in providing strategic talking points for our outreach:

If you have further thoughts or questions, please contact your RCPA Policy Director.

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The Office of Long-Term Living (OLTL) has updated its guidance about payments to strengthen the home and community-based services (HCBS) workforce and assist Adult Day Service (ADS) providers. The updated Frequently Asked Questions (FAQ) document is available under the “Strengthening the Workforce” heading on the DHS Long-Term Care Providers page.

To maximize the use of federal funding under Section 9817 of the American Rescue Plan Act (ARPA) of 2021, OLTL has moved the date by which providers must spend “Strengthening the Workforce” and “Adult Day Services” funds from March 31, 2024, to October 1, 2023. This change allows sufficient time for providers to file an expenditure report and return unspent funds as applicable. OLTL will offer additional details about ARPA expenditure reporting in coming months.

Providers that have questions about this information should contact the OLTL Provider Helpline at 800-932-0939.

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ODPANN 22-019 American Rescue Plan Act (ARPA) Funding for Respite and Family Driven Support Services (FDSS) informs stakeholders of ARPA funds that are available to AEs to disperse in order to meet respite and/or the Family Driven Support Services (FDSS) needs of individuals on the waiting list who do not currently receive waiver funded services. This communication is intended to:

  • Describe eligibility criteria for the use of these funds;
  • Describe eligible expenditures;
  • Describe responsibilities of counties in allocating funding; and
  • Reporting requirements.

You can also view the family supports funds tracker here.

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Capitolwire: Wolf Budget Proposal Spurs Debate on Mental Health Funding
By Robert Swift

HARRISBURG (Feb. 14) — A budget proposal by Gov. Tom Wolf is spurring a new debate about providing more state mental health services during this time of pandemic-related stress.

The governor proposes spending $36.6 million from the taxpayer-supported General Fund in Fiscal Year 2022-23 to restore much of a decade-old cut in state aid to county-run mental health programs.

He would also direct $75 million in federal American Rescue Plan funds for support payments to help keep and hire new employees for qualifying home and community service providers.

A 21-member Mental Health Safety Net Coalition sent a letter Monday to lawmakers asking them to consider the proposed $36.6 million increase as a starting point in budget negotiations.

“The governor’s proposed increase will help offset the loss in purchasing power due to a decade of level funding,” wrote the coalition that includes service providers, hospitals, treatment centers and professional groups. “This money is critical to help counties get back to the effective level of resources they had 10 years ago, but it does not even begin to address all the gaps in our mental health system or surging demand for mental health services as we enter the third year of the global pandemic.”

Not only has the pandemic increased demand for services, it has also led to significant health staff shortages and increases in suicides and opioid deaths, the coalition said.

Also the County Commissioners Association of Pennsylvania issued a statement Monday calling on lawmakers to support Wolf’s proposal. It would restore two-thirds of a 10 percent cut to the budget line item in 2012 if enacted.

“If the funding continues to be uneven with the growing demand, counties will continue to struggle to in meeting the needs of their residents,” said CCAP President and Bradford County Commissioner Daryl Miller.

A key feature of county mental health programs is they are available to the entire community regardless of income, said Brinda Penyak, CCAP deputy executive director.

CCAP made rebuilding a “crumbling” mental health system its top priority this year. For the past six decades, counties have carried the responsibility to provide and contract for a range of community-based mental health services, including crisis intervention, treatment, education and prevention.

“We would strongly support advance planning and (mental health funding) increases that are practical and sustainable to ensure increased system availability for the long term,” said Dr. Kathy Quick, executive director of the Pennsylvania Mental Health Consumer Association while voicing concern that the proposed funding hikes for this year can’t be sustained in the future.

The issue of pandemic-related mental health challenges facing the general population and students as well has been the subject of several legislative hearings during the past two years.

The Senate Agriculture and Rural Affairs Committee held a hearing last month focusing on mental health issues facing agricultural workers. Pennsylvania has received a $500,000 grant from the U.S. Department of Agriculture to provide more resources to support mental health programs in rural areas by linking to national hotline networks and providing education and training, said state Agriculture Secretary Russell Redding at that hearing.

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Photo by Markus Winkler on Unsplash

RCPA staff reviewed the Governor’s proposed budget, and while many details still need to be sorted out, RCPA can provide some high-level facts about the proposed budget from the House Democrat Appropriations Committee 2022/23 Executive Budget Proposal At–A-Glance and the Governor’s 2022/23 Executive Budget Spreadsheet. Of note, please see pages 12–13 for the Department of Human Services line items and page 6 for the Department of Drug and Alcohol Programs.

The highlights of the Governor’s proposed budget include:

Education Funding

  • Spending $43.7 billion in state General Funds;
  • $1.55 billion, a 24% increase, in basic education funding;
  • $1.25 billion to be distributed through the fair funding formula;
  • $300 million in Level Up funding to the 100 most underfunded districts; and
  • $200 million, a 16% increase, in special education funding.

Economy

Proposed increase to state’s minimum wage to $12 per hour effective July 1, 2022, including tipped workers, with 50 cent annual increases up to $15 per hour ($74.6 million direct revenue increase).

Protecting the Most Vulnerable

  • $91.25 million ($190.1 million total funds) to increase MA rates for skilled nursing facilities, effective January 2023, to comply with regulatory changes planned for July 2023;
  • $50 million, or a 44% increase to state supplemental programs for aged, blind, and individuals with disabilities, to increase the personal care home state supplement from $439.30 to $1,351.80 per month;
  • $75 million in federal funds to recruit and retain behavioral health providers;
  • $36.6 million to invest in critical county behavioral health services;
  • $15 million in federal funds to stabilize payments to substance use disorder treatment providers and assist with pandemic related expenses;
  • NEW: $14.3 million to increase the monthly Supplemental Nutrition Assistance Program (SNAP) benefit from $20 to $35 for 75,000 to 95,000 seniors and individuals with disabilities;
  • NEW: $280,000 to implement Agency with Choice, preserving the ability for home and community-based waiver participants to choose their worker while allowing workers to obtain the support of an agency;
  • $18.8 million to serve an additional 832 individuals with intellectual disabilities and autism currently waiting for services;
  • $1 million to provide community placements for individuals residing in intermediate care facilities;
  • $1.25 million to discharge 20 individuals from state hospitals through the Community Hospital Integration Project Program (CHIPP);
  • $2.4 million for Department of Aging and Department of Human Services to strengthen older adult protective services (8 positions), create a child welfare crisis response team (4 positions), and support increased regulatory, licensing, budgetary, and administrative functions (30 positions) through increasing complement;
  • NEW: $8 million to extend postpartum coverage for birthing parents eligible for Medical Assistance to 12 months;
  • $15 million, a 77% increase, to implement additional evidence-based home visiting and family support services to 3,800 additional families;
  • $1.8 million to support court-appointed volunteer advocacy; and
  • NEW: $10 million for State Disaster Assistance, a new initiative to provide disaster assistance to individuals and to improve access to safe, secure, and weathertight homes.

In addition to the above proposed funding, the Governor and Democratic legislative leaders support allocating the unused American Rescue Plan funds from last year’s budget to various programs, which are outlined in the Democrat’s American Rescue Plan Act — State Fiscal Recovery plan, to help Pennsylvanians rather than letting the funds be transferred to the General Fund to sit in reserve.

The above information is a high-level overview of the Governor’s budget proposal. The specific line items contained in the Governor’s 2022/23 Executive Budget Spreadsheet are the overall dollars allocated for health and human services. The Department of Human Services (DHS) has not yet released their Budget Blue Book, which breaks down these line items and provides a detailed dollar amount allocated to specific human service programs. We are being told the DHS Blue Book should be available with this specific information at the end of February or the first week of March. Once RCPA obtains the Blue Book and reviews it, we will provide members with a more detailed summary and analysis.

As a reminder, the Governor’s Proposed Budget is just that: a proposal. The General Assembly will now hold budget hearings; a complete hearing list can be found here. The General Assembly and the Governor will conduct budget negotiations after the House and Senate budget hearings conclude to hopefully finalize the Commonwealth’s 2022/23 budget by June 30. If you have any questions, please contact Jack Phillips.

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As someone on the frontlines, you already know that the workforce crisis affecting Pennsylvania’s human services is worsening. Unless lawmakers act swiftly, vital supports for individuals and families will be in jeopardy. Without additional state funding for human service professionals, providers may have no choice but to cut services or eliminate programs due to this increasing shortage of workers.

State government currently has billions of federal dollars and “rainy day” funds that could increase wages to help retain workers and attract and train a new workforce. Yet, even amid this worsening crisis, the money remains unspent as the needs of our most vulnerable residents go unmet.

That’s why we’re taking action — and we hope you’ll join us.

RCPA is partnering with other associations to urge lawmakers to increase funding and support human services professionals, so individuals and families in need get the assistance and care they deserve. View our official press release.

You can help.

  • Visit the coalition’s website to learn how you can help.
  • Follow us on Facebook and Twitter to stay informed of our progress.
  • Share this message with your own network of providers, professionals, and families and encourage them to do the same, using the hashtag #DirectCarePA.
  • Most importantly, TAKE ACTION TODAY. Tell lawmakers to release funding to address the workforce crisis facing Pennsylvania’s health and human services.

As always, thank you for all you do – for the support and care you provide to our most vulnerable residents. If you have any questions, please do not hesitate to contact us. We appreciate your support.

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