Governor Shapiro Orders Immediate Review of Fee Schedule Rates for Providers of Services for Individuals with Intellectual Disabilities, Autism 

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Those who attended the family meeting include as attached from left to right: Nancy Murray, President of the The Arc of Pittsburgh; Sherri Landis, executive director of The Arc of Pennsylvania; Governor Shapiro, Cyndy Smith Jennings, parent of Matt Jennings, in foreground,  Judy Smith, Ruth Siegfried, President/Founder, InVision Human Services.

Harrisburg, PA –The Shapiro Administration today announced that the Department of Human Services (DHS) will begin updating the data used to set rates for home and community-based services for Pennsylvanians with intellectual disabilities and autism – a necessary first step for greater support for this essential field and the Pennsylvanians who benefit from and rely on this care.

“During the campaign and now as Governor, I’ve talked with so many families who are desperate to get their loved ones the care they need, but then they’re told to wait because the government hasn’t funded this enough. I’ve seen that exhaustion in their eyes, and even though they’re doing everything right – they still need help,” said Governor Josh Shapiro. “That’s why I’ve directed the Office of Developmental Programs, under DHS, to begin an immediate evaluation and assessment of the rates paid to intellectual disability and autism programs that employ Direct Support Professionals. These workers are called on to do so much, especially during a time when workforce shortages are putting additional strains on the industry. My Administration will continue to work with individuals with disabilities, advocates, families, and providers to improve the way we provide community-based services here in Pennsylvania.”

DHS, through its Office of Developmental Programs (ODP), establishes reimbursement rates for providers of Medicaid home and community-based service programs (HCBS). These HCBS programs serve individuals with intellectual disabilities and autism by helping them safely live in their community among their family and peers. DHS is responsible for establishing actuarially sound reimbursement rates for HCBS services, and with this announcement, DHS will immediately engage with its actuary to begin the process of rate setting ahead of the 2024-2025 budget process.

“This week marks Direct Support Professionals Week, an annual time to recognize the essential role DSPs play for both individuals with disabilities and their families. DSPs are the backbone of our work to support Pennsylvanians with intellectual disabilities and autism, and their work allows countless families and caregivers to live and work with the peace of mind that their loved one has the care they deserve,” said DHS Secretary Dr. Val Arkoosh. “DSPs work tirelessly to support an individual with disabilities with their most intimate needs, from helping people work and participate more fully in their communities, to preparing meals and medications. to transportation and personal care. By engaging in this rate setting process now, we can ensure that Pennsylvanians who rely on this system of care can continue to do so.”

“Governor Shapiro’s commitment to address the needs of people with intellectual disabilities and autism as a priority of his Administration, will provide tremendous relief and comfort to thousands of families across the Commonwealth. As the brother of an adult with an intellectual disability, I know all too well the anguish that families and people with intellectual disabilities and autism feel, because of the lack of attention and support they’ve experienced for so many years,” said Gary Blumenthal, vice president of InVision Human Services. “Governor Shapiro gives me hope that my brother – and tens of thousands of others with intellectual disabilities and autism – are being heard, and that the Commonwealth is going to better address their needs in the very near future.”

The rate-setting process and methodology for ODP’s HCBS programs is outlined in 55 Pa. Code §6100.571, requiring DHS to update the data used to inform the rate setting process at least every three years. The most recent increase to the fee schedule was effective January 1, 2022.

“We are grateful for Governor Shapiro’s leadership in directing the Department of Human Services to update the data used to establish the Home and Community Based Services fee schedule rates,” said Mark Davis, president and CEO of Pennsylvania Advocacy and Resources (PAR) for Autism and Intellectual Disability. “This is encouraging news for individuals who are waiting to receive supports and services, their families who depend on the availability of these services, and the direct support professionals who work tirelessly to deliver these services.  PAR stands with Governor Shapiro on delivering higher wages for direct support professionals, and quality supports and services for individuals with intellectual disabilities or autism.”

This announcement is just the latest effort by the Shapiro Administration to support and advocate for the ID/A community, after the Governor signed a budget into law earlier this year that will help an additional 850 individuals with an intellectual disability and/or autism get off waitlists for home and community-based services.

Additional specifics on the rate-setting process announced today will be made available later this fiscal year. Prior to updating any fee schedules for ODP HCBS, ODP will publish proposed rates in the Pennsylvania Bulletin for a 30-day public comment period as required by regulation. ODP will publish a final fee schedule prior to implementation of any changes in the fee schedule.

“We are grateful to Governor Shapiro for ordering an immediate fee schedule review of the rates affecting all intellectual disability and autism (ID/A) services across Pennsylvania. Announcing this at the annual conference of the National Alliance for Direct Support Professionals honors and recognizes the dedicated workforce that serves our ID/A community, which urgently needs our help and support,” said Patrick DeMico, executive director of the Provider Alliance.  

More information on ODP rates can be found here.

Information provided to TVL by:
Gary Blumenthal
Vice President, Governmental Relations/Advocacy
InVision Human Services
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