CORONAVIRUS (COVID-19) RESOURCE CENTER Read More
Add To Favorites

Disabled Pennsylvanians fear state plan for home health aides will backfire

Patriot-News - 6/14/2022

Pennsylvanians living with physical disabilities say one of their highest priorities involves choice.

This includes choosing the home care agency or aide that helps them with things like getting out of bed and getting dressed. It also involves being able to choose a different home agency or caregiver should they become unsatisfied.

But now they fear a proposal by the state intended to give them more choice will actually give them less. They fear it could also lead to problems such as having to rely on an out-of-state firm to provide a replacement if their regular caregiver calls off sick.

“Am I going to have to wait for someone to drive 12 hours from Vermont or Massachusetts to get me out of bed?” says Kelly Barrett, who uses a wheelchair.

Ed Pahula, who uses a wheelchair and advocates for people with disabilities, says “they prefer to talk to somebody in their own area code and they don’t trust outsiders. So it’s very important to have local support.”

About 115,000 Pennsylvanians with disabilities are potentially affected by the proposed change.

Most Pennsylvanians with physical disabilities are covered by Medicaid, which pays for home caregivers.

Pennsylvania has three Medicaid managed care organizations which receive state funding to pay for the caregivers. The organizations in turn contract with home health care agencies which employ the caregivers. That’s how more than 80% of Pennsylvanians with disabilities get home care.

But Pennsylvania also offers a “consumer-directed” option. This enables people with disabilities to hire and manage their own caregiver. Often, they hire a family member or someone they know. The caregiver is paid by the state, which contracts with a vendor to handle administrative tasks and payroll for people employed under the consumer-directed option.

Many Pennsylvanians with disabilities say the two options, while not perfect, allow a high level of choice in terms of being able to use an agency or hire someone on their own. Most importantly, they say it enables them to switch to a different agency or caregiver should they become unsatisfied.

But now the Pennsylvania Department of Human Services is proposing a third option it says combines the best aspects of the agency and the consumer-directed options.

Called “agency with choice,” it’s “simply another option” for people with disabilities, according to Brandon Cwalina, a spokesman for the human services department.

He says the department’s goal is to “further support the direct care workforce and participants by offering an option in which participants can choose and manage a direct care worker and still benefit from the back-end administrative and payroll functions of an agency.”

The state plans to hire a firm to provide the option, with the firm directly employing some caregivers. The state is also doing a study to determine an appropriate pay level and will pay for the caregivers’ benefits — something caregivers working under the existing consumer-directed option lack.

And that’s where assorted potential problems arise, according to Pennsylvanians with disabilities and advocates who recently gathered in Harrisburg.

For one, they argue the proposed option duplicates what’s already available.

Worse, they say the contracted agency will amount to a “preferred provider,” with many local caregivers flocking to the better pay and benefits it would offer.

The end result, they say, is an uneven playing field that will put some agencies out of business — thereby reducing their overall level of choice.

“With ‘agency with choice’ there is no choice. That’s real clear,” says Pahula, who lives in southwestern Pennsylvania. He says there’s “no support” for the proposal among southwestern consumers and agencies.

Pahula, who has been involved with the issue of home care for 25 years, also argues the proposal threatens to repeat mistakes of the past.

“We can’t keep rewriting the same story. One provider does not work. A bunch of providers does not work. History has proven this. It has proven we need a small number of providers in each region,” he says.

Even with that, numerous consumers and advocates stressed there are some things they like about the state’s proposal, including the plan to pay for benefits for caregivers.

However, they say the state should use the money they plan to spend on the third option to pay for benefits and better wages for caregivers working under the existing options.

They further contend the state is rushing forward with insufficient input from the people who will be impacted. They spent a recent day at the Capitol visiting legislators and asking them to slow down the plan, which they say is being rushed so it’s in place by the time Gov. Tom Wolf’s final term expires in January 2023. The state plans to have the proposal up and running by early next year.

Cwalina, the state humans services department spokesman, says consumers and advocates will have another formal chance for input this fall.

MORE FROM PENNLIVE:

Pa. promotes free needles to drug users to prevent disease, nudge recovery

Both sides in abortion debate preparing for a fight over Pennsylvania’s U.S. Senate seat

©2022 Advance Local Media LLC. Visit pennlive.com. Distributed by Tribune Content Agency, LLC.