Please Note: This is a revised version of the PACA MH/DS Newsletter
ELECTION LEADS TO CHANGES IN GENERAL ASSEMBLY, CONGRESS
A quarter of the Pennsylvania General Assembly will be made up of new faces when the 2019-2020 session convenes next January, based on unofficial results as of the writing of this newsletter.
The Senate filled five vacancies, and two incumbents were unsuccessful in their re-election bids, for a total of at least seven new members of the Senate. However, several races were within a one percent margin at press time, including the 6th district in Bucks County between incumbent Sen. Tommy Tomlinson (R) and challenger Rep. Tina Davis (D) and the race between Jeremy Shaffer (R) and Lindsey Williams (D) to fill the seat formerly held by Sen. Randy Vulakovich (R) in the 38th district in Allegheny County. If the unofficial results hold, Democrats will have picked up five seats, narrowing the margin from a 33-16 Republican-Democratic split (with one vacancy based on the Scott Wagner resignation) to a 28-21 split, with one vacancy in the 37th district in Allegheny and Washington counties created by the election of Sen. Guy Reschenthaler (R) to Congress.
Several close races in the House at press time could also affect the balance in that chamber. Two House races were within a one percent margin - incumbent Rep. Bud Cook (R) and challenger Steven Toprani (D) in the 49th district in Fayette and Washington counties, and incumbent Alex Charlton (R) and challenger Jennifer Omara (D) in the 165th district in Delaware County - with three others within a two percent margin. In addition, at least one vacancy remains in the 114th district in Lackawanna County following the October death of Rep. Sid Kavulich (D); another vacancy would occur in the 141st district if Rep. Tina Davis (D) is ultimately successful in her bid for the state Senate while a third is pending following the recent conviction on political corruption charges of Rep. Vanessa Brown (D) in the 190th district in Philadelphia. Should the unofficial results hold, Democrats will pick up 12 seats, shifting the balance from a 120-79 Republican majority, with four vacancies, to a 110-92 Republican majority with one current vacancy.
or counties, this means 24 counties will see at least one new House member in their delegation, and 12 will see at least one new member of their state Senate delegation, with nine seeing both new House and Senate members.
In the Governor's race, current Gov. Tom Wolf (D) won a second term over Republican Scott Wagner.
Pennsylvania will see a shift in its Congressional delegation next year as well, with Democrats picking up three seats to hold nine of the state's 18 districts. Further, eight members will be newly elected to their positions, including four women for the state's first female U.S. Representatives since 2014. On the Senate side, incumbent Bob Casey (D) won a third term over Congressman Lou Barletta (R).
SUNSHINE LAW AMENDMENTS
Following the unanimous approval of the House on Oct. 11, Gov. Wolf has signed SB 1078, into law as Act 156 of 2018. The legislation amends the Sunshine Law to add an executive session option, which will allow governing bodies to have confidential discussions regarding safety and security plans and protocols to afford protection of during public gatherings.
SOCIAL SECURITY INCREASES ANNOUNCED
The Social Security Administration (SSA) announced a 2.8 percent cost-of-living adjustment for Social Security and Supplemental Security Income (SSI) benefits in 2019. According to SSA, the average monthly benefit for a Social Security disabled worker beneficiary will increase from $1,222 in 2018 to $1,234 in 2019. In addition, the SSI Federal Payment Standard will increase from $750 per month in 2018 to $771 per month in 2019. Important work incentive thresholds for Social Security and SSI beneficiaries with disabilities will also increase, including the Substantial Gainful Activity level and the Trial Work Period earnings level.
CONGRESS REACHES AGREEMENT ON OPIOID LEGISLATION
A comprehensive federal opioid legislative package, H.R. 6, is Public Law No: 115-271 as of October 24.
The omnibus bill, known as the SUPPORT for Patients and Communities Act, serves as the vehicle for a number of smaller bills that had been under consideration in both chambers. The final package focuses on improving the federal response to the opioid epidemic via changes to Medicare and Medicaid, expansion of treatment resources for health care providers, and enhancement of recovery supports for patients.
Of particular interest to counties, the law requires state Medicaid programs to suspend, rather than terminate, Medicaid benefits for justice-involved juveniles, and directs the Department of Health and Human Services to issue best practices around providing health care for justice-involved individuals returning to their communities from county correctional facilities. The Centers for Medicare and Medicaid Innovation are also directed to incentivize demonstrations of health information technology for behavioral health providers, and Medicaid's Institutions for Mental Diseases' (IMD) exclusions are partially lifted to allow states to receive federal Medicaid payments for substance use disorder services provided in IMD facilities. Federal programs that support counties addressing substance abuse disorders are also reauthorized.
GAO STUDY HCBS PROGRAM STRUCTURE AND CHALLENGES
In October, the U.S. Government Accountability Office (GAO) released their study Medicaid Home- and Community-Based Services: Selected States' Program Structures and Challenges. The report reviews five states Home- and Community-Based Services (HCBS). Regardless of managed care, number of waivers or limits on benefits or number of beneficiaries, three challenges rose to the top: workforce, complex needs of beneficiary and limitations on funding. The study is available online.
IFO RELEASES SEPTEMBER REVENUE REPORT
The state's Independent Fiscal Office (IFO) released its monthly trends report for September, showing that the state's general fund revenue collections for the first quarter of FY 2018-2019 were $204.3 million (2.8 percent) greater than estimates. September's collections are primarily responsible, which came in $137.8 million (4.7 percent) greater than estimates, owing to higher-than-expected corporate net income tax payments and sales tax revenue collections. The IFO cautioned in its report, though, that it is too early to project those gains forward to the rest of the fiscal year, as it does not anticipate that growth can be sustained. In addition, personal income tax revenues have been slightly below estimate for the first three months of the fiscal year. The full IFO report is available at ifo.state.pa.us.
GOVERNOR VETOS MEDICAID WORK REQUIREMENTS
Governor Wolf vetoed House Bill 2138 which would have established work requirements for individuals enrolled for medical assistance. The bill called for the Department of Human Services to apply to the Center for Medicare and Medicaid Services for a demonstration grant in order to initiate work requirements for individuals applying and enrolled for medical assistance. The governor's comments on the veto are available online.
MENTAL HEALTH PROCEDURES ACT AMENDED TO INCLUDE AOT
A bill to amend the Mental Health Procedures Act was introduced as HB 1233 in April 17, 2017 in order to establish a basis for Assisted Outpatient Treatment. PACA MH/DS has worked with various stakeholders and legislative staff since the bill was introduced in an effort to make the legislation practical in terms of implementation. This effort was ongoing as various amendments were considered and incorporated as recommended by the various stakeholders. PACA MH/DS did not take a stance for or against the bill, but has remained vigilant regarding details and has provided feedback on each iteration of the legislation with the ultimate goal of ensuring that the issues outlined by the Board of Directors as critical to counties were in the forefront. A concurrent bill passed both chambers unanimously on October 17, 2018 and Governor Wolf signed it into law October 24. The law is in effect April 22, 2019.
ODP APPROVED WAIVER CHANGES WEBINAR SESSIONS AVAILABLE
Individuals who were not able to watch the webinars held by the Office of Developmental Programs to review approved changes to the three home and community-based waivers can access them at MyODP website.
The August 2018 59 page report documenting the outcomes from the various employment initiatives over the past two and one half years along and the outcomes for individuals receiving ODP services. The report contains critical information with status of outcomes by county/AE and Support Coordination Organizations. You can compare statistics between regions, counties and individual SCOs to see who has been the most effective. The "best" may surprise you and serve in promoting employment by sharing with peers.
PAR RELEASES IDA SYSTEM STRUCTURE CONCEPT PAPER
ACL & CMS OFFERS HCBS WEBINARS
The Administration for Community Living (ACL) and the Centers for Medicare and Medicaid Services (CMS) in conjunction with other national partners are hosting technical assistance webinars regarding effective implementation of the settings criteria for home and community-based services (HCBS). You must register for each webinar separately.
Thursday, November 29, 2:00 - 3:30pm ET
A review of promising practices states are using (in partnership with stakeholders) for provider transformation, as well as state strategies to build provider capacity to improve community integration and increase the availability of non-disability specific settings.
Thursday, December 13, 2:00 - 3:30pm ET
A review of creative examples of state policy reforms, reimbursement/rate restructuring, and meaningful stakeholder engagement activities to facilitate ongoing HCBS systems-change.
ODP HOLDING LISTENING SESSIONS FOR SELF-ADVOCATES AND FAMILIES
Acting Deputy Secretary Kristin Ahrens will be holding listening sessions throughout the commonwealth for families and self-advocates. Members are encouraged to send out the information for their local sessions to interested individuals. The schedule is:
November 27 from 11a.m. to 12:30 p.m. at Edinboro University in Edinboro
November 28 from 11 a.m. to 12:30 p.m. at Norwin Public Library in Irwin
November 29 from 11 a.m. to 12:30 p.m. at the Super Giant of Camp Hill in Camp Hill
December 3 from 11 a.m. to 12:30 p.m. at the Child Welfare Resource Center in State College
December 4 from 6:30 to 8 p.m. at Luzerne County Community College
December 5 from 6:30 to 8 p.m. at Vision for Equality in Philadelphia
December 5 from 6:30 - 8 p.m. at the Church on the Mall in Plymouth Meeting
And December 10 via webinar at 10-11:30 a.m. and 1-2:30 p.m. Link to be announced
DUAL DIAGNOSIS CONFERENCE 2018 - BROADENING UNDERSTANDING, STRENGTHENING SUPPORT
The Office of Mental Health and Substance Abuses Services and the Office of Developmental Programs are presenting the conference on November 13 - 15 at the Blair County Convention Center in Altoona. The intent is to increase the ability to support individuals with complex developmental and behavioral issues in the community. The schedule and registration information is available online.
PACA MH/DS TESTIFIES IN SUPPORT OF 6100 REGULATIONS AT IRRC
Dan Eisenhauer, PACA President, testified that the regulations are a culmination of an extensive process. PACA had four representatives involved in the drafting efforts. Eisenhauer commented that he believes the final recommendations are both fair and balanced, adding that they strengthen services and protections for individuals. Eisenhauer recommended approving the regulations, and hopes to work with the department as it moves forward to address additional changes.
JOB POSTING - SCHUYLKILL COUNTY MH/DS/D&A ADMINISTRATOR
Schuylkill County is posting the position as Dan McGrory is retiring at the end of 2018. A detailed job description is available online. The deadline for submitting applications to Paula Moucheron is December 31, 2018.