The Pennsylvania Community Providers Association is a trade association representing over 200 community-based agencies that provide mental health, mental retardation, substance abuse, children’s, and other human services. Members cover all 67 counties in the Commonwealth and serve over 1 million Pennsylvanians each year. Founded in 1972, PCPA is the largest statewide behavioral health trade association in the country and represents providers on legislative, regulatory, policy, and planning matters.
Achieving Long-term Solutions to Funding Crises
• Include an Inflationary Adjustment Rate in the Budget (formerly COLA)
The Pennsylvania House of Representatives, in legislation introduced the end of last session, suggested the use of the Home Health Market Basket Index (HHMBI) as a mechanism for addressing an annual funding review for MH/MR/D&A programs thus allowing for a "cost-of-doing-business." The mental health/mental retardation/drug and alcohol (MH/MR/D&A) system has historically requested cost-of-living allowances (COLA) annually. By instituting an index, proper inflationary adjustments would be permanently established and an annual request for a COLA would be alleviated. According to the October 2004 Federal Register, the HHMBI is 3.1%. HHMBI legislation has not been introduced in the current Pennsylvania legislative session. Reference can be made to HB 3007 and HB 3008 from the 2003/04 session for additional information.
• Additional Long-term Solutions
In addition to the HHMBI inflationary adjustment rate, PCPA is working with other stakeholders to advance several proposals to assure the fair and appropriate use of taxes on beer, wine, and liquor. These proposals will help provide a permanent solution to the D&A budget crisis. PCPA supports the consumer and state government foci on recovery models and believes that a community-based system of care and treatment achieves those goals far faster than extended hospitalization or institutionalization. A strong and vital community-based MH/MR/D&A system is in place. PCPA supports reductions in waiting lists and institutional closures, but proper funding must transfer into the community system. Pennsylvania must support, enhance, and expand the community system through the allocation of sufficient financial resources.
Need for MH/MR/D&A COLA
• Fully Fund a 2005/06 COLA
The Department of Public Welfare (DPW) has included a 2% COLA in its 2005/06 budget for MH/MR/D&A – but only on certain line-items. A 2% COLA must appear on all related MH/MR/D&A service line-items. And, in order to maintain the cost-of-doing-business, the 2005/06 COLA must be 3.1% as stated in the HHMBI.
• Know the Status of the 2004/05 COLA
The Pennsylvania legislature included a 2% COLA for MH/MR/D&A in the 2004/05 state budget. In a January survey of PCPA members, less than half of those responding had received any COLA monies. Of those receiving some sort of COLA, it was generally less than 2% and was included only on certain service components. The January survey had a 25% response rate and represented feedback from providers in 43 counties. A follow up survey is planned for mid-April. Details from this upcoming survey and the January survey will be made available on the PCPA web site.
Restore MA Reductions
Behavioral health cuts must be restored to the Medical Assistance (MA) budget
as cost reductions (such as prescription and hospital limitations) will adversely
affect individuals served by the MH/MR/D&A system. As well, proposed cuts
to the fee-for-service lines of inpatient hospitalization, partial hospitalization,
and psychiatric outpatient services will affect many more people in treatment.
While some areas will experience a time of transition to other service modalities,
areas such as the state’s northeastern region will be disparately affected
as treatment alternatives are not readily available. Although specific reductions
in behavioral HealthChoices are not currently proposed, failure to increase
those resources based on adjustments for inflation also adversely affects
the ability of providers to do business. Additional information about
Medicaid-specific issues in the budget can be found in the Legislative Affairs
section of the web site.
