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RCPA is happy to share highlights of Governor Shapiro’s proposed budget that recognizes the needs of the ID/A community in a way that Pennsylvanians have not seen for many years.

Governor Shapiro is prioritizing investments in home and community-based service providers so that they can pay competitive rates to attract and retain staff who provide these life-changing services to Pennsylvanians. The governor is proposing an increase in reimbursement rates by 12%, which will invest a total of over $480 million. This will be divided by state ($217 million) and federal ($266 million) funding for programs that support ID/A.

This budget will invest $34.2 million in the Community Waiver and $1.85 million in the Community Base Program, which will allow the Department of Human Services (DHS) to expand the number of individuals participating in home and community-based services programs.

The 2024/25 executive budget invests $213 million toward the Community Waiver Program, $2.1 million in the Autism Intervention Program, and $1.1 million in the Community Base program. It also leverages $266 million in total federal funding to increase resources for providers of home and community-based services.

In addition, this budget invests $934,000 to add American Sign Language and English interpreter services to programs serving those who require these services in order to experience equality in communication.

In response to this announcement, Richard Edley, PhD, President and CEO of RCPA, stated, “Governor Shapiro is really living up to his mandate to ‘get stuff done!’ The disability community has waited decades for a governor that would make systemic fixes a key budget issue, and the day has finally come. This may not solve all the issues that nearly destroyed this critical system of care and support, but it’s a start, which is more than we’ve had in quite some time.”

Read the summary of Governor Shapiro’s proposed budget plan for ID/A services. RCPA will be sharing more analysis of the budget when additional information is released.

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On December 29, 2023, the Department of Human Services (DHS) issued to the CHC-MCOs a revised edition of “Operations Memo (#2019-05): Circumstances When Community Health Choices (CHC)-Managed Care Organizations (MCOs) Must Transmit the Home and Community-Based Services (HCBS) Eligibility/Ineligibility/Change Form (PA 1768).” The PA 1768 (included in the Operations Memo) is used to notify the County Assistance Office (CAO) when a CHC participant is determined clinically eligible for CHC HCBS or when a CHC participant, who is receiving HCBS, experiences a change affecting his or her eligibility for HCBS.

This revised operations memo describes situations where the CHC-MCO sends the PA 1768 to the CAO. The memo has also been revised to include Money Follows the Person (MFP) information to communicate on the PA 1768 (Attachment 8), and to update a participant letter (Attachment 4: CHC HCBS Termination Letter (No Response).

If you have any questions, please contact Melissa Dehoff.

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On January 10, 2024, from 2:00 pm – 3:30 pm, the Center for Medicaid and CHIP Services (CMCS) will be conducting an upcoming webinar that will focus on Person-Centered Service Planning (PCSP) in Home and Community-Based Services (HCBS): Requirements and Best Practices.

The webinar will include the following:

  • An overview of person-centered service planning;
  • A detailed discussion of the Home and Community-Based Services (HCBS) regulations pertaining to person-centered service plans provisions;
  • A detailed review of themes identified during CMS heightened scrutiny site visits regarding person-centered service plans;
  • Measures included in the 2022 HCBS Quality Measure Set that can be used to assess person-centered planning;
  • Section 9817 of the American Rescue Plan Act (ARPA) and state examples to support person-centered service planning;
  • Strategies to ensure comprehensive understanding and implementation of person-centered service plans; and
  • Indiana’s approach to person-centered planning.

Following the presentation, participants will have the opportunity to ask questions.

Register here to participate in the webinar.

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The Centers for Medicare and Medicaid Services (CMS) recently released two reports focused on Long-Term Services and Supports (LTSS). The reports are the Medicaid Long-Term Services and Supports Annual Expenditures Report, Federal Fiscal Year 2020, and the Medicaid Section 1915 (c) Waiver Programs Annual Expenditures and Beneficiaries Report.

These reports provide information on the LTSS rebalancing trends and patterns in expenditures for different home and community-based services (HCBS) and institutional care, both nationally and across states.

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Pennsylvania Senator Bob Casey, the Chairman of the Special Committee on Aging, will be introducing new legislation on the floor of Senate titled “The Home and Community-Based Services (HCBS) Relief Act of 2023.”

The HCBS Relief Act of 2023 would provide dedicated Medicaid funds to states for two years to stabilize their HCBS service delivery networks, recruit and retain HCBS direct care workers, and meet the long-term service and support needs of people eligible for Medicaid home and community-based services. States would receive a 10-point increase in the federal match (FMAP) for Medicaid for two fiscal years to enhance HCBS. Funds could be used to increase direct care worker pay, provide benefits such as paid family leave or sick leave, and pay for transportation expenses to and from the homes of those being served. The additional funds also can be used to support family caregivers, pay for recruitment and training of additional direct care workers, and pay for technology to facilitate services. The funds can help decrease or eliminate the waiting lists for HCBS in the states.

The HCBS Relief Act of 2023 will be introduced during the fourth week of October with a House companion bill expected to be released in the near future. Please join RCPA in supporting this critical piece of legislation to create a viable and sustainable pathway for HCBS.

If you have any questions, please contact your respective RCPA Policy Director.

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Senior woman with her caregiver at home

House Resolution (HR) 165, which was introduced by Representative Kim, directs the Legislative Budget and Finance Committee (LBFC) to conduct a study on the effect of workforce shortages on State-supported Medicaid home and community-based services (HCBS) waiver programs as well as the PA lottery-funded OPTIONS programs in the state. If the Resolution passes, LBFC will have 7 months to conduct the study. RCPA will keep members apprised on the status of the resolution.

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