Intellectual Disability Services Are Facing Significant Challenges

What's Going On?

On October 14, 2011 the Office of Developmental Programs sent a communication to all providers in Pennsylvania that their rates would be slashed. Calls and emails began streaming into the PAR office immediately with several providers notifying PAR that if DPW carried out this decision, some providers would not be able to survive this blow and most will have to make severe cuts to survive.

Members of PAR's executive and board leadership met with ODP Deputy Secretary Friel the following week, but learned there would be no relief from the -6% Rate Adjustment Factor that would begin November 15, 2011.

Short of any other explanation of root causes, it appears to PAR that since the changeover in 2009 from a county-based to a statewide system managed by ODP, ODP has failed to manage authorizations and utilization which has resulted in ODP authorizing services in the range of $100,000,000 to $200,000,000 for which they do not have funding. Now, ODP is imposing cuts to Pennsylvania's most vulnerable citizens instead of accepting the responsibility for closing the gap

This was confirmed in a January 30, 2012 article in the Lancaster Intelligencer when a spokesperson for the Department of Public Welfare stated: "We did not properly account for increases in changing needs of people receiving services.

Governor Corbett's human service policy statement contains a

precious commitment that services to persons with intellectual disabilities and autism is a core responsibility of government, and we have had confidence that this Governor meant what he said. This issue was not caused by a bad economy and we will seek the Governor's support, legislative supports, and other partners in setting this right.

ODP’s rate letter for FY2012 details two rates for this fiscal year:

• Providers will continue to be paid at last year’s (FY2011) rates, which were based on the Year 2 Cost Reports, and included a 2.5% RAF, for the first four and a half months of this fiscal year.  There will be no retroactive changes to rates paid from July 1^st through November 14^th of this fiscal year. 
• Beginning on November 15^th, rates will be based on the Year 3 Cost Reports, and will include a 6% RAF. 
• The rates beginning on November 15^th were adjusted by ODP to eliminate the continuing participation allowance expenses in the Year 3 Cost Reports. 

Here is a copy of the letter sent by the IDA Coalition to Budget Secretary Zogby, copied to Secretary Alexander and Deputy Secretary Friel, strongly objecting to the use of the Rate Adjustment Factor to deal with DPW’s under-budgeting for the costs of the “changing needs” entitlement within the waiver.  ODP believes that since the rates are being adjusted prospectively, they meet CMS requirements; on the other hand, CMS officials have previously expressed concern with a rate-setting methodology that is based on the state’s refusal to provide the resources necessary to fund utilization increases created by the state’s agreement with the federal government.

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On December 13, 2011, the House Human Services Committee chaired an informational meeting to hear concerns raised by PAR, the IDA Coalition, families and providers regarding current ODP fiscal practices.

• IDA Coalition Press Release
  
• Testimony of Shirley Walker, President and CEO of PAR
  
• "War on the Weak" editorial from the Lancaster Intelligencer referenced by Shirley

That same morning, members of the IDA Coalition received this letter from ODP defending their recent actions, including the use of the RAF.

 Here is the IDA Coalition's response to Kevin Friel.

And here is a copy of the letter the IDA Coalition set to the Centers for Medicare and Medicaid Services (CMS) disputing the use of the RAF.

We are currently awaiting a response from CMS.

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Meanwhile, providers continue to struggle through a midyear year rate cut. Families and individuals in service continue to worry about the future of their services. The nearly 16,000 people on the Waiting List for Intellectual Disability services will continue to wait.

Please use the materials found in this section and in PAR Mails to let Governor Corbett, you legilsators and your community (via the press) know how concerning this is to you.