PIE Info: State Budget Analysis: The Governor’s Proposed Budget for July 2013 Through June 2014

Forwarded by the Disability Rights Network of Pennsylvania –

Friends –

PIE Info: State Budget Analysis
February 7, 2013

Below is a preliminary analysis of items of interest to the Disability Community by the Policy Information Exchange (PIE).

On February 5, 2013, Pennsylvania Governor Tom Corbett delivered his budget request for the 2013-14 fiscal year. The Governor devoted significant attention in his budget address to the need for increased funding to serve more people with intellectual and physical disabilities in the community. He spoke of his visit to Vision for Equality and introduced two young women with intellectual disabilities who were in the House Chamber for his speech. Here are some excerpts from that speech:

“They were put on a waiting list – a waiting list that delays their access to the help that would allow them to work, to live at home, to enjoy a full measure of life’s experiences. … All Brittany wanted was a chance to work, to have the same opportunity as the rest of us. She might have needed our help, but because we gave her that help last year, she is ready to chart her own course. … That waiting list is a powerful metaphor for what has gone wrong in our society. We need to act now and we must not turn our backs on all the other Brittanys who are out there currently on the waiting list. That is why I am counting on the general assembly to join with me to make certain we pass this next round of funding for expanded services for people with intellectual disabilities. … This budget reaffirms this commitment to helping individuals with intellectual and physical disabilities. … I am determined that by the time Chloe, and the thousands of other young people with disabilities, have reached adulthood, they will be able to step into a full and active life as citizens of this state. These young people and their families have waited long enough. We will find a way to erase this waiting list. I asked Chloe and her family to be here today so I could make that promise in person. And I hope you in the General Assembly will help me keep that promise. My budget will dedicate $40 million to provide critical services to an additional 3,000 men, women and children with physical and intellectual disabilities. This will allow them to live independently in their homes and communities. It means we will help more people with autism and Down syndrome and serve more people living with physical disabilities.”

Below PIE summarizes some items of interest to the disability community in the Governor’s budget. Remember that this is not the final budget. Attention now focuses on the General Assembly which will hold hearings over the next month. After that, a budget bill(s) will be moved. Any of the Governor’s proposals can be changed before the budget bills are signed, probably in late June. For more information, contact PIE at The Arc of Pennsylvania office at 717-234-2621 or pie@thearcpa.org.

Department of Public Welfare

Intellectual Disability Waivers: State funding increased by $19,867,000 to serve 380 additional people from the waiting list, 700 graduates of special education and 100 people out of State Centers. Neither an increase nor a decrease is intended for provider rates.

Medical Assistance Expansion: The Governor will not accept the federal government’s offer, under the Affordable Care Act, to expand Medicaid eligibility. Both the Governor and Secretary Alexander seemed to leave the door open for the possibility in the future.

Autism: Increase in state funds of $1,497,000 to serve an additional 118 people.

State Centers: Institutions for people with intellectual disabilities will receive a $12 million increase for maintenance of current program.

Community Base Funding Intellectual Disabilities: There’s a small reduction in base funding.

Services to Persons with Disabilities: This line item includes funding for the Independence, OBRA and Commcare Waivers as well as specialized services in nursing homes. The line item would receive an additional $15,758,000 in state funds to serve an additional 1,280 people.

Attendant Care: The Attendant Care line item, which includes both the waiver and Act 150, would receive an additional $4,125,000 to serve an additional 400 people. It is not clear from the budget materials, but according to DPW Secretary Gary Alexander, this increase is intended only for the Attendant Care Waiver and not for the state funded Act 150 which has a growing waiting list.

Adult Protective Services: The Governor’s budget book lists $2,197,000 in the General Government Operations line to annualize funding for Adult Protective Services. Since APS does not yet have its own line item, it’s hard to tell what the total available would be. It may contain as much as $2,391,000 in state funds and an additional $1,304,000 in federal funds.

Human Services Block Grant Pilot: This block grant pilot was created in the 2012-13 fiscal year and currently exists in 20 counties. It combines funds for a number of programs — Community Mental Health, the Behavioral Health Services Initiative, Intellectual Disability Base funds, County Child Welfare, Homeless Assistance, the Human Services Development Fund and Act 152 Drug and Alcohol-into one block grant and gives the county flexibility on how the money is spent. The Governor proposes a statewide expansion allowing any county in the state to voluntarily participate in 2013-14.

Mental Health: The proposed budget includes funding for 90 CHIPPs (people out of state hospitals and into the community).

Behavioral Health: BHSI is level funded.

Aging Waiver: While the Aging Waiver would receive the same amount of state general funds as in 2012-13, the Governor proposes $21 million from the lottery, including an $8.1 million initiative to serve an additional 1,550 people. The Governor seemed to tie these additional lottery funds to the privatization of the lottery.

Nursing Homes: Nursing homes are slated for a rate increase of 2% at a cost of $44.3 million. Over objections from advocates, the Governor again proposes using more than $309 million in lottery funds for nursing homes.

Early Intervention (Birth to age 3): DPW’s Early Intervention program is slated for a $4.3 million supplemental appropriation in 2012-13 and an increase in 2013-14.

Medical Assistance Transportation: Funding is increased to cover increased use and trip costs.

Medical Assistance for Workers with Disabilities (MAWD): While state funding would be reduced, the reduction is more than offset by an increase in Tobacco Settlement Funds, resulting in a net increase.

Cost Saving: The cost saving measures noted in the DPW budget include imposing time limits on payments to injured workers in state hospitals, state centers and youth development centers ($3.5 million to be saved); enhanced auditing of providers ($20 million projected savings); and outsourcing third party liability collections ($1.5 million to be saved). They include a projected $8.3 million saved by imposing premiums on families of one (sometimes called “loophole families”). Efforts last year to impose co-payments on these families were unsuccessful.

Supplemental Appropriations: As part of the budget package, the Governor asks for supplemental appropriations for the current 2012-13 fiscal year for a total of $69.3 million. Programs slated for an increase include: Long Term Living; Services to Persons with Disabilities; Attendant Care; Early Intervention; Aging Home and Community Based Services; Medical Assistance for Workers with Disabilities (MAWD); and Medical Assistance Outpatient. Programs which would be decreased include: MA Capitation; State Centers; and Supplemental Grants for the Aged, Blind and Disabled.

Federal MA Matching Rate: The federal share of Medicaid funds dropped from 54.28% to 53.52%, costing the state $109 million in 2013-14.

Department of Aging

Aging Services: The Governor proposes an additional $20 million from the lottery to take 5,400 people off the waiting list for OPTIONS home and community based services, $2 million for 193 people aging out of the attendant care program and $5 million for Area Agencies on Aging. There’s also $2 million in lottery funds which would go to Senior Centers.

Department of Labor and Industry

Transfer to Vocational Rehabilitation Fund Supported Employment, Centers for Independent Living (CILs), Assistive Technology Devices (alternative financing program) and Assistive Technology Demonstration and Training (lending library): All of these programs are level funded.

Department of Community and Economic Development

PA Accessible Housing Program: The PAHP program is part of the Keystone Communities line item which is level funded.

Department of Education

Special Education: Special education is once again level funded. Advocates note that this sixth year of flat funding for special education subsidy funding will force local school districts to cover the cost of living increases.

Early Intervention (for ages 3 to 5): Will receive a $10,800,000 supplemental appropriation in the 2012-13 fiscal year and an increase of $5 million in the 2013-14 fiscal year to serve 1,500 additional children.

Approved Private Schools: Approved Private Schools are level funded.

PA Charter School for the Deaf and Blind (sic): Charter schools for children who are deaf and blind would receive a small increase to continue the current program.

Department of Health

AIDS Programs, Services for Children with Special Needs and Sickle Cell: All of these programs are level funded.

AIDS Special Pharmaceuticals are level funded in state dollars, but an increase in Pharmacy Rebates is anticipated resulting in a net gain.

Epilepsy Support and Tourette Syndrome: The Governor proposes eliminating funding for these two programs.

Children’s Health Insurance Program (CHIP): Funding is increased to serve an additional 9,330 children.

Department of Drug and Alcohol Programs

Assistance to Drug and Alcohol Programs: State funding is level, but federal funding decreases, bringing total funding from $104,300,000 in 2012-13 to a proposed $103,211,000 proposed for 2013-14.

Department of Transportation

Shared Ride Program for Persons with Disabilities: There is no immediate threat to funding for the PWD program. But funding comes through Act 44 which may be repealed as part of the transportation reform package. So advocates need to pay attention to what happens to Act 44. Also, there is discussion about adding Allegheny County to the Counties that can participate in the PWD program.

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