RCPA - Rehabilitation and Community Providers Association


DPW Declines to Apply for Dual Eligible Grant
February 4, 2011

In mid-January the Departments of Public Welfare (DPW) and Aging requested stakeholder input for a grant offered from the Center for Medicare and Medicaid Innovation to integrate physical health, behavioral health, and long-term living services for persons dually eligible for Medicare and Medicaid. PCPA provided comments on two occasions on the draft prepared for submission by the February 1 deadline. PCPA’s primary concerns were:

  • that the intent was to include all dual eligible individuals and that persons receiving comprehensive services through waivers may lose eligibility and access to
    needed services and supports if they participate in demonstration projects and should not be included in the planning and demonstration project should Pennsylvania receive the grant, and
  • although there is need for behavioral and physical health services to be coordinated or integrated, funding integrity must be maintained. The carve-out for behavioral health services must continue.

Acting DPW Secretary Gary Alexander issued the following statement February 1:

After careful consideration, the Commonwealth of Pennsylvania has decided not to submit a proposal for a design contract under the “State Demonstrations to Fully Integrate Care for Dual Eligible Individuals.”

While we recognize the dual eligible population is an important constituency, we believe there is considerable need to integrate care and services across multiple populations and delivery systems, including those individuals who are not dual eligible. As such, we have decided to look at this initiative from a broader perspective rather than focusing only on the dual eligible demonstration proposal request. We have received significant stakeholder feedback to support this position.

We appreciate all of the suggestions, recommended changes and letters of support submitted by those who participated in the stakeholder engagement process. You can rest assured that the input will be part of our planning and implementation effort as we move forward.

The Corbett administration sees person-centered, coordinated care for all eligible medical assistance populations as an extremely important priority. Our goal is to move quickly to identify broad-based working solutions to address these needs. We also are committed to continuing to solicit your feedback and input in this process.

Acting Secretary Alexander was a strong proponent of Rhode Island’s Global Medicaid Waiver, which placed a ceiling on federal funding for Medicaid in exchange for flexibility in how funds were used. The global waiver agreement placed a five-year, $12 billion cap on Rhode Island's Medicaid spending. By using home and community-based services instead of institutional care and by other means, the waiver was intended to create cost savings over time. There is some debate whether significant cost savings were achieved.

PCPA thanks members who reviewed the request for information and the draft application and submitted comments.

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