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03/19/2024 01:01 AM
Pennsylvania House of Representatives
https://www.legis.state.pa.us/cfdocs/Legis/CSM/showMemoPublic.cfm?chamber=H&SPick=20210&cosponId=37191
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House of Representatives
Session of 2021 - 2022 Regular Session

MEMORANDUM

Posted: April 11, 2022 11:51 AM
From: Representative James B. Struzzi, II
To: All House members
Subject: Helping to Ensure Homecare Patients get the Support They Need - Personal Assistance Services/Medical Assistance Program Sustainability
 

Pennsylvania is one of the fastest aging states in the country. The 85+ population is growing more than ten times the general population, and by 2030, nearly one quarter of Pennsylvanians will be 65 and older. Seniors and adults with disabilities have made it clear that they want to receive their care at home, where outcomes are better, and the cost is a fraction of facility-based care. In fact, demand for personal assistance services (PAS) through the state Medical Assistance program has increased dramatically in recent years.

Unfortunately, many individuals who are eligible for these services cannot find them. In a recent member survey, 98% of the Pennsylvania Homecare Association’s members providing PAS reported declining new cases and referrals because they do not have enough caregivers to staff the cases. Providers cite low wages as the top reason that employees are leaving the direct care workforce.

Today, the average hourly rate for home health aide/personal care attendant in Pennsylvania is $13.40/hour, well below hourly wages being offered by gas stations, fast-food restaurants, and big box stores for work that is far less demanding. Medical Assistance program providers, however, cannot simply increase wages and pass the cost along to consumers. These providers are severely limited by the reimbursement rates they receive from Managed Care Organizations (MCOs), which are directly impacted by the fee-for-service rates set by the General Assembly.

These rates must cover the cost of training, overtime, benefits, Personal Protective Equipment (PPE), transportation, background checks, health screenings, office staff, and more. Homecare providers are at their breaking point, and we must take meaningful steps to ensure that critical, quality home care services remain available to our most vulnerable Pennsylvanians. Home care is cost-effective, with better outcomes, and is strongly preferred by those receiving care.

To that end, I plan to introduce legislation that will do the following:
  • Increase the PAS reimbursement rate by 8%, with the goal of allowing providers to offer an average hourly wage of $15/hour to enable them to recruit and retain quality caregivers. Direct care worker wages must better reflect the immense value of the services they provide.
  • Set the legislatively-established fee-for-service (FFS) Medicaid reimbursement rates as the rate floor for PAS. Managed care organization would still be free to negotiate additional incentives/payments to providers.
  • Require an actuarial study to determine the cost of care to occur every three years, consistent with other Medical Assistance Programs.
  • Provide PAS agencies with reimbursement for overtime expenses, consistent with reimbursements currently being provided in the consumer-directed model.
Please join me in sponsoring this legislation to help ensure that Pennsylvania’s seniors and individuals with disabilities continue to have access to quality home and community-based care.
 



Introduced as HB2563