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House of Representatives
Session of 2021 - 2022 Regular Session


Posted: March 4, 2021 04:25 PM
From: Representative Eric R. Nelson and Rep. F. Todd Polinchock, Rep. Melissa L. Shusterman, Rep. Brandon J. Markosek
To: All House members
Subject: LEVEL UP for ID/A Act: Let’s Encourage Value in Everyone’s Life to Unite Pennsylvanians for Intellectual Disabilities and Autism Act
As bipartisan chairs of the Individuals with Disabilities and Autism (IDA) Caucus, we are proud to introduce legislation which will enhance operations and policies of the IDA community. This is not a tax proposal; it is an efficiency proposal where the cost savings can be re-invested to enable increased services for providers and wages for direct support professionals (DSPs).
The current ID/A system is focused on compliance as compared to outcomes. Service providers are subject to various requirements which do not add value to the lives of individuals with intellectual disabilities or autism and their families.
While the Department of Human Services (DHS) has started to utilize "Value Based Purchasing" (VBP) for acute and primary health care, it is not currently being used for ID/A services. In OHS' current payment system, providers are paid for each service they perform without regard to the impact on people receiving the service. VBP, in contrast, links provider payments to patient outcomes, aligning incentives to improve care and reduce costs.
That being said, our legislation would do the following:
1.            Require the Office of Developmental Programs (ODP) to issue an annual report to the General Assembly on the employment of people with disabilities such as rate of employment, barriers, and hourly wage.
2.            Require the ODP and Office of Vocational Rehabilitation within the Department of Labor & Industry to implement a two-year pilot program to better coordinate eligibility, supports, funding and oversight of employment services for the benefit of individuals with intellectual disability, developmental disability, or autism spectrum disorder.
3.            Provide authority for ODP to obtain necessary approval from the federal government to conduct pilot programs under the medical assistance program for alternative payment systems aimed at outcomes. Such pilot programs would require an agreement with stakeholders (i.e., PA Advocacy & Resources for Autism and Intellectual Disability; the Rehabilitation & Community Providers Association; The Arc of PA, Vision for Equality; and Disability Rights Pennsylvania).
4.            Require ODP to convene an advisory group consisting of providers, consumers, and client advocates to develop and propose recommendations to the Department of Transportation regarding improvements in access to public transportation by individuals with intellectual disability or autism.
5.            Require ODP to convene a group of stakeholders to simplify the ID/A system for individuals, families, providers, and the state; eliminate redundancies; and ensure a foundation of self-determined outcomes. The aim of these changes is to reduce costs and improve outcomes.
6.            Require ODP to complete a study on the long-term benefits of in-home and community supports, and companion services delivered to individuals enrolled in the ODP administered Home and Community-Based Services Waivers program.
7.            Provide that licensed facilities  shall qualify for compliance with licensure standards from the department  if they are accredited by a private non-governmental organization such as the Commission on Accreditation of Rehabilitation Facilities, provided that the accreditation standards meet or exceed applicable department licensing standards.
8.            Provide that licensed facilities shall be given the option to have differential or weighted licensure status based on the assessment of a licensee's level of compliance with applicable regulations. This would allow OHS to focus on the lowest performing facilities.
9.            Require OHS to assure for all OOP services with funding based on an assessment process, that the assessment shall be completed within 30 days of the request, and that any changes to rates triggered by reassessment be effective beginning on the date of request.
10.          Finally, provide for reinvestment of any savings realized from the above changes. Such savings shall be dedicated to increasing wages for Direct Support Professionals who render care and supports under OOP administered waiver programs that fund community-based services to individuals with an intellectual disability or autism and to fund services for individuals on the wait list for ODP administered waiver services.
Please join us in cosponsoring this legislation.