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Senate of Pennsylvania
Session of 2019 - 2020 Regular Session


Posted: December 4, 2018 01:38 PM
From: Senator Judy Ward
To: All Senate members
Subject: Intellectual Disability/Autism Rate Transparency
I am reintroducing House Bill 1535 of last session, legislation amending the Human Services Code to provide transparency in Intellectual Disability and Autism Rate Development.

Presently, providers of services for intellectual disability and autism (ID/A) and the consumers and families who receive them have very little, if any, transparency in exactly how rates are set for these services and supports. They do not know the inputs into the rate calculations, they do not know the weighting of the inputs in the rate calculations, and they do not know the rate calculations themselves. Furthermore, they do not know how Area Designations are determined by the Department of Human Services (DHS) for purposes of applying rates for these services across the Commonwealth of Pennsylvania. Therefore, they do not know if the rates are being adequately set to meet the quality and efficacy of services threshold that they are required to meet. In a time of ongoing calls for transparency, this is unacceptable.

In addition, we must remember that the ID/A system in Pennsylvania is a partnership between the Commonwealth and service providers. A partnership where only one partner has the data and knowledge of the payments and reimbursements in the system is not truly a partnership. My legislation will enhance the nature of this partnership, at least in this one tangible way by ensuring all aspects of the rate setting calculations in the ID/A system are transparent.

The measure would require DHS to provide public notice regarding provider payment rates for home and community-based services delivered to individuals with an intellectual disability or autism and allow for public comment. The notice must be published annually (on or before March 31st) in the Pennsylvania Bulletin and include a detailed description of the precise methodology used to calculate the payment rates for services, as well as the data, inputs, assumptions, variables, calculations and any other information relied upon in establishing the rates. DHS must, within 45 days of the General Appropriations Act being approved, adopt the final provider payment rates for the fiscal year through notice in the Pennsylvania Bulletin and provide a detailed response to the public comments.

Please join me in co-sponsoring this important legislation.

Introduced as SB454