Funding main focus of Luzerne County Providers Association's annual Legislative Breakfast

Yahoo

22-02-2025

Feb. 21—PLAINS TWP. — The Luzerne County Providers Association held its annual Legislative Breakfast on Friday to discuss issues of concern, but the main focus was on the uncertainty of funding.
The morning-long event was held at The Woodlands Inn & Resort.
Attending the event were: Sen. Marty Flynn, D-Scranton; Rep. Eddie Day Pashinski, D-Wilkes-Barre; Rep. Jim Haddock, D-Pittston Township; Rep. Alec Ryncavage, R-Hanover Township; Rep. Jamie Walsh, R-Ross Township; and representatives of Sen. Lisa Baker, R-Lehman Township; Sen. Lynda Schlegel Culver, R-Northumberland; and Rep. Brenda Pugh, R-Pittston Township.
Richard Edley, president/CEO of RCPA — Rehabilitation and Community Providers Association — and Jack Phillips, director of government affairs for RCPA, co-moderated the event.
"This year, more than ever, getting a budget is going to be tough," Edley said. "Human services need to be funded, but the key is going to be federal support and whether there are significant changes to Medicaid.
Sen. Flynn said Pennsylvania is facing a $1.2 billion structural deficit.
"We need new revenue sources — we can't cut our way to prosperity," Flynn said, adding that he doubts the legislature will approve recreational marijuana legalization.
Legislative and administrative priorities for RCPA
—Advocate for increased funding and transparent models that reflect true "cost-plus"service reimbursement.
—Medicaid capitation, county-based funding, value-based payment programs.
—Workforce initiatives and funding that build the infrastructure for current and future-systems needs.
—Licensed professional staff, DSPs, DCWs, counselors, case managers, and peers Regulatory reform: decreasing administrative burden; reducing barriers to access for care.
Behavioral health
(Adult and children's mental health; Substance use disorder services)
—Ensure that the BH HealthChoices capitation issues related to the MA unwinding are appropriately addressed without negatively impacting the service delivery system.
—Ensure the expansion of telehealth flexibilities through a new bulletin, legislation, and practice policy.
—Utilize the opening of the OMHSAS State Plan Amendment bi-annually to address ongoing barriers to systems access and administrative burden (i.e., IBHS, family-based, outpatient psychiatric clinics).
—Reopen the IBHS regulations to address access barriers and payment equity.
—Ensure the promulgation of the PRTF regulations are contingent on the equitable funding of implementation.
—Support for expansion and funding of the ICWCs.
—Address redundancy and inconsistency among substance use disorder treatment audits and overseers.
—Support efforts to ensure opioid settlement funds are used with fidelity to the settlement agreement.
—Continued advocacy efforts to ensure proper funding for county-based services.
Intellectual and developmental disabilities (IDD)
—Advocate for restoration of the $93 million (state portion) reduction to the governor's budget and include a 3% inflationary adjustment factor in the SFY 2025/26 proposed budget.
—Support ongoing stakeholder involvement and input in the implementation of performance-based contracting.
—Continued advocacy for programs for the severely disabled (e.g., those with medical and behavioral needs).
—Focus on revamping CPS and respecting individual choices.
—Advocate for a broader, more inclusive interpretation of the CMS Settings Rule.
—Create an effective appeal process for the Supports Inventory Scale (SIS).
—Advocate for Standard Occupational Code (SOC) for DSPs.
Physical disabilities and aging
—Increase FFS rates for Personal Assistance Services and Residential Habilitation Services to reflect current market conditions and workforce challenges — a minimum of 15%.
—Mandate a rate refresh process for all OLTL services, including managed care, based on OBRA Medicaid FFS.
—Require consumer choice of providers in all consumer-directed services.
—Require CHC-MCOs to make VBP programs available for all segments of the waivers.
—Develop proactive partnerships with CHC-MCOs and BH-MCOs.
Medical rehabilitation
—Continued expansion of the 3-hour rule: advancing the Access to Inpatient Rehabilitation Therapy Act.
—Review Choice Demonstration — for year 2
Early intervention
—Interim rate increase while early intervention rate methodology is completed for 2025/26 budget.
—Improve system consistency across counties.
—Clarify/expand access and eligibility criteria.
Brain injury services
—Meaningful changes and increases to funding and models; an increase has not been provided since 2011.
—Create and develop a legislative package specific to brain injury issues.
—Work with OLTL/DHS to develop a system in which rates are reviewed annually.
—Develop a targeted plan to engage key providers, political leaders, and stakeholders to advocate for a legislative package addressing critical issues for BI services.
—Encourage an improved system of oversight of the CHCMCOs by OLTL/DHS.
Reach Bill O'Boyle at 570-991-6118 or on Twitter @TLBillOBoyle.