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PCPA Meets With Secretary Nardone
October 19, 2010

On October 15, PCPA and other members of the MH/MR Coalition met with Department of Public Welfare (DPW) Acting Secretary Mike Nardone and Office of Developmental Programs (ODP) staff to address issues regarding waiver funding and the ODP budget. Mr. Nardone indicated that the department had avoided year-end reductions in revenue targets for 2009/10.  He also reported that the department was going to be $35 million over the 2009/10 allocation, but made a one time accounting adjustment that avoided reductions.  Acting Secretary Nardone further indicated his strong concern that the overage of 2009/10 is carrying forward into 2010/11 and, along with other increases, will result in an even greater budget problem this year.  Nardone acknowledged that the shift in payment models had created some problems in managing the system. He feels he must take steps to better manage funds and provide firm recommendations to the next administration on how to handle projected overages.

Mr. Nardone commented that the average cost of services from 2008/09 to 2009/10 increased by 20 percent, much of that due to the increase in authorizations for additional services. The extension of the enhanced Federal Medical Assistance Percentage (FMAP) is due to expire June 30, 2011. This will be an additional loss of revenue for the state. When asked why DPW has not requested a supplemental budget to address ODP funding issues, Nardone indicated that he has to substantiate to the governor and legislature the need for the additional funding request.

Deputy Secretary Kevin Casey indicated the increases in 2009/10 were due to increases in therapeutic leave paid with state-only dollars, vacancies, increased service authorizations, and ineligible costs for room and board. ODP Fiscal Director Joe Church provided a chart showing the percentage changes by services.  Noted are the following increases:

  • 3%  in waiver capacity/growth,
  • 20% in community homes with one resident,
  • 17% in community homes with two residents,
  • 14% in residential ineligible costs,
  • 24% in community habilitation (one-to-one), and
  • 34% in licensed day habilitation (one-to-one).

“Individuals in Lifesharing” is another ODP chart showing a steady four year decrease in the use of Lifesharing as a residential option. Casey indicated that Pennsylvania has a very substantial service options system and feels Lifesharing needs to be used more.  Also available are the charts showing the “Authorized Budgets for Consolidated Waiver SFY 08-09 to 09-10.” The average cost increased from $86,000 in 2008/09 to $103,000 in 2009/10. All three charts are available here.

The coalition asked for details on the percentage of authorizations actually used and the services billed. Casey indicated that many consumers asked for increased services, but ODP unsure if was actually due to changing needs. He was asked for ODP’s criteria for reviewing service requests and managing authorizations. The need to effectively manage the system was addressed at the October 14 ODP Planning Advisory Committee and is one of the work groups developed to make recommendations to the incoming administration.

 

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