Governor Wolf Announces Initiative to Improve Home, Community-Based Care Services for Seniors in Pennsylvania

PHILADELPHIA, Pa. – Yesterday Tom Wolf unveiled a package of legislative and budgetary actions to provide choice and protections for seniors as they age.

Governor Wolf, the Department of Human Services (DHS) and the PA Department of Aging (PDA) are committed to increasing opportunities for seniors to receive care in a home or community-based setting.

“My actions today are just the first step in rebalancing our long term care system and increasing opportunities for home care workers,” said Governor Wolf. “This package is designed to provide choices for seniors, efficiencies in home- and community-based care delivery, and protections so that seniors receive the high quality level of care that they seek in their homes.”

This initiative is comprised of the following combination of budget, legislative and executive actions:

Expand Services for Older Pennsylvanians and Reduce Long Term Care Costs. The upcoming 2015-2016 budget expands home- and community-based long term care programming by allowing more than 5,500 additional individuals to obtain care in their home this year. With this expansion, more than 50 percent of residents receiving long term care will do so in a home or community setting. For every month a resident receives care in the community as opposed to a nursing facility, the Commonwealth is able to save $2,457 per month. In expanding home- and community-based services to more than 5,500 residents, the Commonwealth is offsetting more than $162.2 million in nursing care costs.

Phase in Medicaid Managed Long Term Care. DHS in partnership with PDA will pursue the implementation of managed long term care through engaging stakeholders to ensure that the system is person-centered, breaks down barriers, and fills in the gaps that currently exist in the long term care services and supports system. This initiative, which was recommended by the Pennsylvania Long Term Care Commission, will result in a more strategic care delivery system and improved health outcomes for seniors.

Improve Long Term Living Waiver Enrollment and Service Plan Development Process. The current process of enrollment into the Commonwealth’s Medicaid-sponsored home- and community-based care services is a paper process and has numerous areas of duplication and inefficiencies that delay services being provided to these consumers. DHS and PDA are currently developing a work plan to automate and streamline this process so that services are delivered in timely manner and unnecessary nursing home stays are prevented.

Home Modifications through Selective Contracting. A major barrier to individuals remaining in their homes is accessibility. Under the DHS home- and community-based services waivers, enrolled consumers are eligible for modifications to their homes to prevent admissions to nursing homes, and allow individuals to age in place.

Unfortunately, current program barriers occasionally make it difficult for modifications to be made in a timely manner, forcing consumers into nursing care while waiting for the modifications to be made. DHS is proposing to establish a coordinated program to manage the home modifications across all of the home- and community-based waivers, through a comprehensive selective contracting model that will establish a team of specialists to allow for more timely services, improved quality and greater accountability for waiver consumers.

Implement Online Homecare Registry. According to PHI PolicyWorks (PHI), Pennsylvania’s direct care workforce in 2013 consisted of 194,670 workers. Between 2012 and 2022, the direct care workforce is projected to grow by 33 percent. PDA is currently working to develop an online tool to make it easier for workers to find stable employment opportunities and for consumers to find competent care.

Ensure Seniors have Choices about Where to Age. Ensuring that the home care sector is able to attract qualified and competent caregivers so that seniors have the option to age at home or community-based setting is a top priority of the Wolf Administration. Governor Wolf is signing Executive Order 2015-05 to form the Governor’s Advisory Group on Participant-Directed Home Care and direct the Secretary of the Department of Human Services to regularly meet and discuss issues of mutual concern with a representative for Direct Care Workers. These actions will ensure that home care workers have a voice in shaping the future of their industry in Pennsylvania and seniors have choices about where to receive care.

“This package will also provide home care workers with the opportunity to meet and contribute to discussions about improving wages and employment conditions,” added Governor Wolf. “As the workers on the front lines of delivering care to seniors and our most vulnerable, they should have a voice in the future of their industry in Pennsylvania.”

Over the next few months, DHS Secretary Ted Dallas and PDA Secretary Teresa Osborne will work with key stakeholders to develop an action plan that addresses the current income and health barriers that prevent seniors from being able to age in place.

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