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1 HOUSE OF REPRESENTATIVES COMMONWEALTH OF PENNSYLVANIA 2 * * * * 3 Department of Human Services * * * * 4
5 House Appropriations Committee
6 Main Capitol Building 7 Majority Caucus, Room 140 Harrisburg, Pennsylvania 8
9 Wednesday, March 25, 2015 - 1:35 p.m.
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11 COMMITTEE MEMBERS PRESENT: 12 Honorable William Adolph, Majority Chairman 13 Honorable Karen Boback Honorable Jim Christiana 14 Honorable Gary Day Honorable George Dunbar 15 Honorable Keith Greiner Honorable Glen Grell 16 Honorable Seth Grove Honorable Warren Kampf 17 Honorable Fred Keller Honorable Tom Killion 18 Honorable Jim Marshall Honorable Kurt Masser 19 Honorable David Millard Honorable Mark Mustio 20 Honorable Mike Peifer Honorable Jeffrey Pyle 21 Honorable Marguerite Quinn Honorable Curt Sonney 22 Honorable Mike Vereb
23 1300 Garrison Drive, York, PA 17404 24 717.764.7801
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Key Reporters [email protected] 2
1 COMMITTEE MEMBERS PRESENT:
2 Honorable Joseph Markosek, Minority Chairman Honorable Matthew Bradford 3 Honorable Tim Briggs Honorable Michelle Brownlee 4 Honorable Mike Carroll Honorable Scott Conklin 5 Honorable Mary Jo Daley Honorable Madeleine Dean 6 Honorable Maria Donatucci Honorable Edward Gainey 7 Honorable John Galloway Honorable Stephen Kinsey 8 Honorable Michael O'Brien Honorable Kevin Schreiber 9
10 NON-COMMITTEE MEMBERS: 11 Honorable Gene DiGirolamo 12 Honorable Kathy Watson Honorable Joe Hackett 13 Honorable Harry Lewis Honorable Kristin Hill 14 Honorable Russ Diamond Honorable Dave Zimmerman 15 Honorable Rick Saccone Honorable Tim Hennessey 16 Honorable Kerry Benninghoff Honorable Judy Ward 17 Honorable William Kortz Honorable Kevin Boyle 18 Honorable Dom Costa Honorable Vanessa Lowery Brown 19 Honorable Eddie Pashinski Honorable Mike Schlossberg 20 Honorable Peter Schweyer
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1 STAFF MEMBERS PRESENT:
2 David Donley 3 Majority Executive Director
4 Ritchie LaFaver 5 Majority Deputy Executive
6 Curt Schroder, Esquire 7 Majority Chief Counsel
8 Miriam Fox 9 Minority Executive Director
10 Anne Baloga, Esquire 11 Minority Chief Counsel
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1 INDEX OF TESTIFIERS
2 DEPARTMENT OF HUMAN SERVICES 3
4 Ted Dallas Acting Secretary 5
6 David Spishock, Director Office of the Budget 7
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12 INDEX OF REQUESTED DOCUMENTS OR INFORMATION 13
14 Page Line Page Line Page Line
15 13 9-15 41 3-7 41 24-
16 51 1-4 69 13-16 73 23-
17 76 6-9 95 17-25 103 12-
18 118 19-23 119 18-19 120 10-11
19 128 14-19
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1 MAJORITY CHAIRMAN ADOLPH: Good
2 afternoon, everyone. I'd like to reconvene the
3 House Appropriations Committee budget hearings.
4 The afternoon hearing will be with the Department
5 of Human Services.
6 But before we get going, I just want to
7 go over a couple House rules, ground rules, if I
8 may. Believe it or not, you are in the second
9 biggest room in this Capitol. The only larger room
10 is the House Chamber itself. But it's certainly
11 overwhelming for us to see you folks here today,
12 because it means an awful lot to us to see the
13 residents of Pennsylvania, how much support there
14 is for the services that are provided you. So we
15 thank you for being here.
16 Keeping with that, it's important that,
17 at this time you just check your iPhones and your
18 iPads. I see all these little devices out, and
19 turn them off because it interferes with the
20 broadcast. Thank you.
21 We have a lot of members on this
22 committee. We have invited the Chairmen of the
23 standing committees of the House that are related
24 to the Department of Human Services, and we're
25 going to give them an opportunity to ask some
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1 questions.
2 At this time, I would like to welcome
3 Acting Secretary Dallas. Good afternoon.
4 ACTING SECRETARY DALLAS: Good
5 afternoon.
6 MAJORITY CHAIRMAN ADOLPH: The
7 Department of Human Services, obviously, is an area
8 of great importance because of the type of
9 essential services you provide to some of
10 Pennsylvania's most vulnerable citizens. DHS is
11 also an important agency in the context of these
12 budget hearings, because of the magnitude of the
13 agency's total budget. The Department of Human
14 Services' proposed budget is nearly $12 billion,
15 which represents 35 percent of all state funding.
16 I look forward to this hearing and
17 working together to ensure we are able to serve the
18 residents of Pennsylvania that depend on DHS in a
19 fiscally, responsible and sustainable way.
20 So without further ado, Mr. Secretary,
21 would you like to introduce the gentleman, who's
22 certainly no stranger to this committee, and
23 yourself.
24 ACTING SECRETARY DALLAS: He just
25 followed me here. I'm not really sure.
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1 MAJORITY CHAIRMAN ADOLPH: I'm sure.
2 ACTING SECRETARY DALLAS: To my left is
3 Dave Spishock, who is the esteemed Budget Director
4 at the Department of Human Services.
5 MAJORITY CHAIRMAN ADOLPH: Nice to see
6 you, Dave.
7 DIRECTOR SPISHOCK: Thank you.
8 MAJORITY CHAIRMAN ADOLPH: Do you have
9 some opening comments for the committee? We'll get
10 right into questions if you don't.
11 ACTING SECRETARY DALLAS: Sure. Just
12 very briefly.
13 Thank you for the opportunity to appear
14 before the committee today to talk about the
15 department's budget. During my time here, I hope
16 that we'll be able to keep the department focused
17 on its primary mission, which is helping vulnerable
18 -- the most vulnerable citizens in Pennsylvania.
19 For me, that means putting people first. The folks
20 that we serve are among the most vulnerable in the
21 state and they need our help.
22 One of the things I try to stress in
23 every discussion I have about the department is,
24 when we're making decisions, we need to think about
25 them as if they were members of our own family. We
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1 have some very tough decisions we have to make in
2 our department, but one of the things I believe is
3 you at least think about that. If this was your
4 brother or your sister or your cousin, that you'll
5 probably make the right decision.
6 So what does that mean on an everyday
7 basis? An everyday basis -- DHS, Mr. Chairman, you
8 were right. It's a huge place; it's a big
9 bureaucracy. And for us, big bureaucracies, they
10 do black and white okay, but they don't do gray all
11 the time so well. Unfortunately for us,
12 understanding and doing the right thing by the
13 people we serve is understanding that gray. Issues
14 aren't always black and white, and we have to be
15 nimble enough to address the individual needs of
16 the people we serve.
17 Realistically, that means we have to do
18 things like Medicaid expansion, which will simplify
19 the way we provide health care; allow people to get
20 health care in this state. We need to look at ways
21 to pay for quality. Right now Medicaid focuses too
22 much on paying for services rendered. Until we
23 start making that shift to paying for outcomes and
24 paying for quality and making people well as
25 opposed to merely running tests or providing
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1 certain services, we'll never have enough money to
2 provide all the services that we need.
3 And what it also means is, we need to
4 find ways to serve folks in the community wherever
5 we can. Kids, everybody we serve, all the way
6 through seniors, everybody has a better quality of
7 life, I believe, if we can serve them in the
8 community. Now, that's not always immediately
9 possible for everybody, but I do think it's a goal
10 that we should go for. I think when we look at the
11 services we provide, we should always look at the
12 people we serve first, and we should always try to
13 find ways to serve them in the community whenever
14 we can.
15 MAJORITY CHAIRMAN ADOLPH: Thank you.
16 I'll start this conversation off on a
17 good note.
18 ACTING SECRETARY DALLAS: Sure.
19 MAJORITY CHAIRMAN ADOLPH: This time
20 last year I had been notified by many of my
21 constituents regarding the yearly application for
22 recertification of Medical Assistance benefits.
23 Starting with, the applications seemed to always
24 arrive about two days after the due date; some
25 questions on the form that, you know, really not
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1 needed, et cetera, et cetera, and sent to the
2 people that, you know, take these applications very
3 serious and tie up their benefits and so forth and
4 so on.
5 I'm happy to say that, in the past year,
6 through a lot of effort from your department, we
7 have been able to improve the system. I know
8 there's a lot of federal requirements that go on
9 those forms, but I want to thank all the employees
10 of DHS that worked on that form to make it simpler
11 and arriving on time. I'm a deadline-type guy.
12 It's bad when you get a form that was due Monday
13 and it's now Wednesday. So, that upsets a lot of
14 people, so that's a good thing. We can still make
15 it a little better.
16 I want a little shout-out here to a
17 wonderful woman who worked for your department in
18 Delaware County, Bonnie Gallagher. She's
19 unbelievable. She does the work of about 20
20 people. She's overworked and underpaid. If it
21 wasn't for her, I don't know what in the world we
22 would do down there in Delaware County. She just
23 does a fantastic job. So, keep an eye out on
24 her.
25 ACTING SECRETARY DALLAS: I absolutely
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1 will.
2 MAJORITY CHAIRMAN ADOLPH: She's a
3 keeper.
4 ACTING SECRETARY DALLAS: I think that
5 -- Most of the folks that work at our department
6 don't do it for the money. I think they got into
7 this business to try to help people; Bonnie
8 included. I'd love to take credit for any or all
9 of that, but I think the credit goes to all the
10 people who've worked here for years.
11 MAJORITY CHAIRMAN ADOLPH: Okay. I told
12 you I was going to start off real good.
13 ACTING SECRETARY DALLAS: Is it over
14 already?
15 MAJORITY CHAIRMAN ADOLPH: I'm a little
16 disappointed in the proposed budget's elimination
17 in certain state-funding items: Hospital-based
18 burn centers, MA critical access hospitals, MA
19 obstetrics and neonatal services. I think they
20 total about $11.3 million.
21 In the budget, with all the new taxes
22 proposed and all the increased spending, what was
23 the Governor's thinking or your thinking of why
24 these line items were completely eliminated out of
25 the budget?
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1 ACTING SECRETARY DALLAS: I think that
2 even with the revenue enhancements the Governor
3 proposed, there is still -- it's a tough budget
4 year and there were some tough decisions we had to
5 make. These are ones that we did not -- that were
6 very difficult for us to make. And when the
7 Governor gave his budget speech, I think he
8 mentioned that it would be the start of a
9 discussion. I think these are items in particular,
10 that if we had a little more money, we would like
11 very much to fund.
12 I look forward to a conversation with
13 the General Assembly about possibly restoring some
14 of the funding for these line items.
15 MAJORITY CHAIRMAN ADOLPH: Okay. Well,
16 it's very important to many of us that these line
17 items be restored. I don't know if it's going to
18 be possible to increase the spending in order to
19 get there. So, we're going to be looking in other
20 areas through this whole budget system in order to
21 do it.
22 My next question, really, is, over the
23 years I have been an advocate for folks with
24 epilepsy, for many reasons; friends, family, okay;
25 gotten to know the Epilepsy Foundation from
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1 Philadelphia to Pittsburgh very well. There's a
2 treatment called Vegas Nerve Stimulator.
3 ACTING SECRETARY DALLAS: Okay.
4 MAJORITY CHAIRMAN ADOLPH: And
5 currently, Medical Assistance covers the cost of
6 the stimulator. But the fee-for-service rate is
7 about $9,000, while Medicare is currently paying
8 approximately 26,000.
9 I understand that you don't have any
10 answer right now, but I would appreciate it if you
11 would get back to me and see how this can be
12 straightened out, because those that suffer from
13 epilepsy, it's very important for them. So, if you
14 would get back to me when you find out that answer,
15 the cost is exceptional, and it really works.
16 ACTING SECRETARY DALLAS: Of course, I
17 will.
18 MAJORITY CHAIRMAN ADOLPH: Okay. Thank
19 you.
20 At this time I'm going to turn the mike
21 over to Chairman Markosek.
22 MINORITY CHAIRMAN MARKOSEK: Thank you,
23 Chairman Adolph.
24 Acting Secretary, welcome. Mr.
25 Spishock, welcome.
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1 First of all, Mr. Acting Secretary, you
2 have roots here in Pennsylvania, and I just -- I'm
3 so happy that you were appointed by the Governor
4 for this position.
5 ACTING SECRETARY DALLAS: It's good to
6 be back home.
7 MINORITY CHAIRMAN MARKOSEK: It's great
8 to have you back home. I know you had been with
9 the Rendell Administration a few years back and had
10 left and done great work in another state, and
11 we're really glad to have you back here in
12 Pennsylvania.
13 ACTING SECRETARY DALLAS: Thank you very
14 much.
15 MINORITY CHAIRMAN MARKOSEK: I had a
16 question relative to autism and autism services.
17 And if some of this -- I don't have all my facts
18 straight, but feel free to correct me. But, if I'm
19 not mistaken, the General Assembly passed Act 62 in
20 2011, which requires insurance carriers to pay for
21 autism services as a primary coverage. And beyond
22 that, if that coverage is either not there or is
23 used up, Medical Assistance kicks in.
24 It's my understanding that in a lot of
25 cases, the Medical Assistance is kicking in ahead
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1 of the private coverage. For whatever reason, the
2 private carriers, in spite of Act 62, or perhaps
3 the enforcement of it, are not covering that. As a
4 result, it kicks into Medical Assistance, which, of
5 course, costs a whole lot more, or at least costs
6 the state more to provide that.
7 Can you comment on that? If that, in
8 fact, is the case, what can we do as a Commonwealth
9 and as a Department of Human Services to correct
10 that and to ensure that the provisions of Act 62
11 are followed?
12 ACTING SECRETARY DALLAS: You are
13 correct about Act 62. It was passed late in my
14 first tour of duty here at the Commonwealth. Since
15 then, I can't speak exactly to the implementation
16 of it over the last few years or so, but my
17 understanding is that it did not move as fast as
18 was expected. When I returned here, I would have
19 thought that we were a little further ahead than we
20 are at this point.
21 I had a conversation or two with the
22 Insurance Commissioner about Act 62. I think it's
23 a question of working with her to figure out how is
24 the best way to implement it. I think that it's
25 something that -- it's a matter of moving forward
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1 now. I think that both the Insurance Commissioner
2 and I are committed to making sure that that law is
3 fully implemented.
4 MINORITY CHAIRMAN MARKOSEK: Okay, thank
5 you. The Insurance Commissioner will be in front
6 of this committee tomorrow, so that's good timing
7 and I'll --
8 ACTING SECRETARY DALLAS: I'll give her
9 a head's up.
10 MINORITY CHAIRMAN MARKOSEK: If she's
11 listening, she's probably jotting down the answers
12 right now. But I want to, again, welcome you back
13 to Pennsylvania and wish you well in your
14 confirmation over in the Senate.
15 ACTING SECRETARY DALLAS: Thank you very
16 much, sir.
17 MINORITY CHAIRMAN MARKOSEK: Thank you.
18 MAJORITY CHAIRMAN ADOLPH: Thank you,
19 Chairman.
20 I just want to make an announcement in
21 case more folks arrive. We have made arrangements
22 to have monitors set up in the rotunda with chairs
23 so you can, you know, if you don't have a seat. I
24 saw some folks standing over there. You can go out
25 into the rotunda, and there's a monitor set up and
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1 you can watch the hearing out there and be
2 comfortable. So, thank you.
3 Before we take the next question, I just
4 want to acknowledge some other state
5 representatives that are present at this hearing
6 because of their interest: Representative Ed
7 Pashinski; Representatives Lewis, Zimmerman,
8 Phillips-Hill, Ward, Diamond, Chairman Tim
9 Hennessey and Representative Joe Hackett. Thank
10 you for joining us.
11 First question is going to be by
12 Chairman DiGirolamo. The chairmen are invited when
13 we have a hearing that is related to their
14 committee. It's certainly my pleasure to introduce
15 the Chairman.
16 CHAIRMAN DiGIROLAMO: Thank you, Bill.
17 Acting Secretary, Ted, welcome. Dave,
18 welcome, and to all your staff here from the
19 Department of Human Services, welcome, and also to
20 our guests that are here. I see many familiar
21 faces in the audience. I see you up in Harrisburg
22 a lot advocating on behalf of the people that we
23 all care about the most. So, thank you all for
24 being here.
25 Ted, I've always said your job is the
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1 toughest job of anybody in Harrisburg. So, all the
2 best and good luck to you. I'm looking forward to
3 working with you and your staff in the months and
4 years ahead, so welcome.
5 ACTING SECRETARY DALLAS: Thank you.
6 CHAIRMAN DiGIROLAMO: I'm going to start
7 out with Medicaid expansion.
8 ACTING SECRETARY DALLAS: Okay.
9 CHAIRMAN DiGIROLAMO: It's an issue that
10 has been near and deer to my heart for a number of
11 years. I want to thank you and I want to thank
12 Governor Wolf for the decision to expand Medicaid
13 here in Pennsylvania. I think it's absolutely the
14 right thing to do for all of the right reasons.
15 I also want to thank you, because in
16 this transition between Healthy PA and Medicaid
17 expansion starting in the first of December, there
18 was an enormous problem especially on the
19 behavioral health side of Medicaid with people who
20 had lost their benefits. I'm not quite sure how
21 many people in the state. I think it's in the tens
22 of thousands. But you have worked really closely
23 with the providers.
24 I know -- I don't know if it's
25 completely resolved, but I know it's a long way to
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1 being resolved, and I want to personally thank you
2 for doing that. It was really, really important.
3 Thank you.
4 ACTING SECRETARY DALLAS: That was very
5 kind. Thank you.
6 CHAIRMAN DiGIROLAMO: Could you just
7 give us a short update on what's going on with the
8 Medicaid expansion and the transition? I'm
9 particularly interested in the private coverage
10 option and when those folks are going to get
11 transitioned over into the expanded Medicaid.
12 ACTING SECRETARY DALLAS: Sure. When
13 the Governor announced the transition to a
14 traditional Medicaid expansion, the first thing
15 that happened was, and that was the day he made the
16 announcement, I sent a letter to CMS withdrawing
17 the Healthy option. Healthy PA, which was the
18 previous program, was divided into, basically,
19 three pieces. It was Healthy, the Healthy -- the
20 Healthy Plus option and the Private Coverage
21 option, or the PCO. What the Medicaid expansion is
22 going to do is take those three pieces and
23 consolidate it into one streamlined adult package.
24 That package will look a lot like the
25 traditional HealthChoices package with a few tweaks
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1 along the way, the traditional HealthChoices
2 package that has served Pennsylvania for many
3 years. We think this will make the program a lot
4 simpler, a lot more streamlined, and it will help
5 folks get in touch with doctors when they need
6 them, and get a lot of the bureaucracy that was
7 there out of the way.
8 In terms of doing that, the next step in
9 the process will occur on April 27th, and that will
10 be -- There will be some I.T. changes to our
11 systems, and there will be some changes to our
12 policy that will start to move the first group of
13 folks from the Private Coverage Option to
14 HealthChoices; to the new streamlined adult
15 package. So there are about --
16 And this number changes on a day-to-day
17 basis. Some folks come in; some folks leave.
18 There are folks in the general assistance category,
19 and folks who are in a plan called and something
20 called Select Plan. There's about 115 to 120,000
21 of those folks. They will move over to the
22 HealthChoices plan. That leaves about 90,000--it
23 might be a little more by the time we get
24 there--that will still be in the Private Coverage
25 Option.
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1 After April 27th, we'll begin a process,
2 and I've tried to stress an orderly and efficient
3 process to move these folks from the Private
4 Coverage Option to HealthChoices. That will occur
5 over a period of time and will be done by
6 September. So our hope is that we'll have the
7 whole process done by September. We're trying to
8 do it in pieces for a couple of reasons.
9 When we implemented Healthy PA, I think
10 some of the speed at which it was implemented
11 caused some confusion, and I think you had
12 mentioned the drug and alcohol folks, and caused
13 some disruption in people's lives. We're trying to
14 make this change with a minimum amount of
15 disruption for people going forward, and we want to
16 try to make it as clear as possible to people what
17 is happening.
18 So, for most people what we've said is,
19 and for everybody is, until you hear from the
20 department, you don't have to do anything. Your
21 health care coverage doesn't change. You can go
22 see your doctor. When we start notifying you,
23 that's when we'll start making the switch to
24 HealthChoices. And in most cases, you'll go from
25 the PCO coverage from a provider to the MCO or the
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1 Medicaid coverage for that provider. That will
2 hopefully happen all the way across in September.
3 The reason we can do this in a
4 relatively short period of time is because of the
5 infrastructure that was built for Healthy PA. So I
6 know some folks had questioned, well, what happened
7 to the investment that we made in Healthy PA? We
8 had spent a lot of money on I.T. systems. And the
9 reason why I can say that we're going to make that
10 switch on April 27th this year and not next year
11 is, we're going to be using a lot of that I.T.
12 infrastructure, that investment. We're going to
13 leverage that investment to the changes we have.
14 The I.T. changes that we're making will
15 cost us, in state funds, only cost us, you know,
16 relatively small amount of $800,000. That will be
17 matched with some federal funds. But compared to
18 the, I think it was $95 million invested in
19 building the system, the reason that we can move as
20 quickly as we can is, we're taking that system that
21 was built for Healthy PA and making some changes to
22 the eligibility logic. So that allows us to move
23 quickly and also with a minimum amount of expense.
24 CHAIRMAN DiGIROLAMO: And I'm sure, I
25 trust that when this transition takes place, the
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1 same problems that popped up with the Healthy PA
2 will not pop up with the transition into expanded
3 Medicaid?
4 ACTING SECRETARY DALLAS: Right. Every
5 implementation will have its hiccups, but our
6 process is designed to inform people as many times
7 as we can. We have a website, Health Choices pa
8 dot com that we update with the information that is
9 there, and we're trying to get the information out
10 to stakeholders, to recipients, to providers, to
11 everyone so they know what's happening. We've met
12 with every MCO along the way. We've talked to them
13 about the transition. They're well aware of what's
14 going on, and the steps they need to take on their
15 end to make sure that they're complying with the
16 change set by the Governor.
17 CHAIRMAN DiGIROLAMO: One problem I'm
18 seeing on the short term with the PCO coverage,
19 that's Act 106 coverage for drug and alcohol. My
20 understanding is that some of the insurers are not
21 covering the people under Act 106. I don't know if
22 you got any complaints, but my understanding is
23 you're going to get some today and in the coming
24 week. Some of the Private Coverage Option
25 insurance companies are not honoring the 106
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1 benefit, so --
2 ACTING SECRETARY DALLAS: So, part of
3 the issue we dealt with is what you mentioned
4 before, and thank you again for the kind words, was
5 moving some of the folks that were put in the wrong
6 place under Heathy PA to what was then the Healthy
7 Plus Option, which is now HealthChoices, moving
8 folks to that to get them the coverage they need.
9 As folks are still enrolling in the
10 program right now, before we make that switch on
11 April 27th, we may still have that problem. We're
12 working through those on a case-by-case basis as we
13 become aware of them. I got a couple of them today
14 in my e-mail and that we made sure we're taking
15 care of.
16 CHAIRMAN DiGIROLAMO: And just to remind
17 everybody, with this Medicaid expansion, we're
18 going to insure five to 600,000 Pennsylvanians. I
19 think the important part about this is that there
20 are people who are in the workforce that have no
21 coverage; they're working. And everybody is
22 concerned about veterans. In the State of
23 Pennsylvania right now, there are probably about
24 50,000 of our veterans who are uninsured. Medicaid
25 expansion will cover at least half of the 50,000
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1 veterans who have no insurance. Absolutely the
2 right thing to do.
3 Just a couple more questions --
4 ACTING SECRETARY DALLAS: Sure.
5 CHAIRMAN DiGIROLAMO: -- and comments.
6 There was a number of years ago an
7 autism advisory board in the office of ODP. I
8 believe Secretary Alexander disbanded that board.
9 I would like for you to seriously consider starting
10 that board again. I think it was really
11 beneficial. I think all the providers liked the
12 assistance that the board provided, so I would like
13 you to consider taking a look at that and doing it.
14 ACTING SECRETARY DALLAS: Actually, I've
15 already met with the autism advocates, and they
16 brought up the same issue with me. At that meeting
17 I asked our deputy secretary for developmental
18 programs, and Nina Wall-Cote, who's our autism
19 director, to come up with a plan to increase the
20 number of times I get to meet with autism
21 advocates.
22 CHAIRMAN DiGIROLAMO: Okay. One final
23 note. I'm going to hand you this. I know we have
24 a meeting next week. This is my House Bill 183.
25 It deals with the human service block grant that we
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1 now have in 30 counties in the state. It's kind of
2 like my idea for an alternative to the block grant.
3 ACTING SECRETARY DALLAS: Okay.
4 CHAIRMAN DiGIROLAMO: I'd like you to
5 take a look at it. I think it makes an awful lot
6 of sense. It allows the counties at the end of the
7 fiscal year, instead of being able to move the
8 money around; if they have unspent money at the end
9 of the fiscal year, they be able to carry that
10 money over into the following fiscal year and then
11 be able to use it and move it around in any way. I
12 think this makes all the sense in the world.
13 I'm going to hand this to you, give it
14 to you, and if you'll just take a look at it and we
15 can discuss it next week.
16 ACTING SECRETARY DALLAS: I'll take a
17 look at it after the hearing.
18 CHAIRMAN DiGIROLAMO: All right.
19 Thank you, Mr. Chairman.
20 MAJORITY CHAIRMAN ADOLPH: Thank you,
21 Chairman.
22 You'll probably hear that throughout the
23 hearing, legislators promoting their own
24 legislation. But they're all good legislation to
25 somebody out there. And Gene -- Gene's not taking
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1 any chances. He's going to walk it right up to
2 you.
3 It's my pleasure now to introduce
4 Representative Kathy Watson. Kathy is the
5 Chairperson of the Children and Youth Committee.
6 Representative Watson.
7 CHAIRMAN WATSON: Thank you, Mr.
8 Chairman.
9 Good afternoon, and certainly welcome,
10 though. Acting Secretary Dallas was very kind.
11 And we had a meeting in my office to talk about
12 what I call the voiceless Pennsylvanians, and they
13 are the children of Pennsylvania because, we all
14 know, as I was told when I first started in
15 politics, kids don't vote and they don't have
16 lobbyists.
17 I said to you, I'm announcing that I
18 have turned into the voice of children and I guess
19 their lobbyist. And no, ladies and gentlemen, I'm
20 not paid for that, but it's just something that I
21 have a great passion for and believe.
22 Chairman Adolph, I will not be handing
23 out a bill, because what I'm going to do is thank
24 the committee publicly once again, the committee
25 that I have the pleasure of serving as their
Key Reporters [email protected] 28
1 Chairman. And I know I've told you, because I had
2 to bring you up to speed I felt was my job, that,
3 indeed, the House Children and Youth Committee, of
4 the 23 bills that were recently passed and started
5 on December 31st, of the 23, 15 of those came
6 through our committee, and we certainly had direct,
7 I would say more than responsibility, but pride of
8 authorship in what went through.
9 So my committee certainly cares that the
10 implementation goes as well as the creation had
11 done, because these people, amazing people did a
12 lot of very good work, and I truly believe are as
13 passionate about protecting our children to the
14 best of our ability as I am.
15 I want to give you a chance to say,
16 then, because you and I talked, that there have
17 been articles in the paper and there has been a
18 whole crush of people, I call them the good
19 Pennsylvanians who said, background checks, I've
20 got to get one. Okay. So they have, indeed,
21 flooded DHS with the application.
22 Do you want to talk briefly about -- I
23 know you put something out there. We did have some
24 problems. We know it's, I'll call them severe, but
25 growing pains that we're doing something new and
Key Reporters [email protected] 29
1 different and a bit more involved. Where are we
2 now because, it's only March and we started
3 December 31st. And lucky you, you came right in at
4 the beginning. So, where are we now? That would
5 be my first question.
6 ACTING SECRETARY DALLAS: Thank you.
7 First I'd echo, I think some folks had a concern
8 that when these laws got passed, it might
9 discourage people from wanting to volunteer or
10 wanting to help kids. By looking at the number of
11 clearances that we have to do, I think I can tell
12 you that's clearly not the case; that folks are
13 interested in helping kids in Pennsylvania, which
14 is a great thing.
15 It is true that we saw an uptick, or
16 actually a big increase in the number of clearances
17 that we had to perform. The department was caught
18 a little off guard by the size of the increase. I
19 think that since I got here, we tried to address
20 that and working with Deputy Secretary Kathy Utz
21 and her team to get the department on a little
22 sounder footing in responding to all those
23 clearances. So, we tried to address it in four
24 ways.
25 The first thing we wanted to do was look
Key Reporters [email protected] 30
1 at the number of staff that we had there. Right
2 now we've added about 19 staff to the cause, and
3 there are folks who are -- which almost doubles the
4 number of folks that are doing clearances to help
5 deal with the influx of clearances that we have.
6 The second thing that we did was, we're
7 making some changes to our I.T. systems. There's a
8 release that's coming out this month in March and a
9 release that's coming out in July that will make
10 the system a little easier to use, and will also
11 give the folks who are working on the clearances a
12 little more information to complete their work more
13 timely.
14 Third, we're looking at our practices
15 and policies to make sure that we're being as
16 efficient as possible. Just this week we sent our
17 chief of staff of the Children, Youth and Families
18 over to ChildLine to review those policies and to
19 make sure that every worker over there is doing
20 their fair share of the work, and that the burden
21 of getting all these clearances done don't fall on
22 just a few employees.
23 And lastly, we're promoting the ability
24 to do these clearances on-line. There's a website
25 called keep kids safe dot PA dot gov., which allows
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1 you to go through the process on-line. If you can
2 complete the application on-line, it will auto
3 clear. That means you'll get an e-mail back almost
4 instantly telling you that you've been cleared.
5 Good news is, last week we had about 65
6 percent of our applications went through that
7 website. It's a much, much simpler process. It
8 also takes some of the stress off of the hard-
9 working staff at ChildLine. I think since we
10 started, it's been about 50 percent of those cases
11 have gone through the website and have been auto
12 cleared.
13 Now, the impact of all of that has been
14 good so far. We're not where we need to be, but
15 we're headed in the right direction. The statute
16 calls for 14 days to process. When I got here in
17 early January, we were at 26 days to process.
18 Since we put that plan into place, we're down to
19 18. Eighteen is not 14, and we're committed to
20 getting to 14, but it's definitely a step in the
21 right direction.
22 CHAIRMAN WATSON: Thank you very much.
23 And, Mr. Chairman, if I could beg your
24 indulgence, I have maybe two more questions; might
25 morph into a third, but I'm going to really try.
Key Reporters [email protected] 32
1 Let me say that with those, I'll
2 constantly refer to the people who did a great job.
3 With the 23 bills that passed in our child
4 protection legislative package, our whole goal was
5 to improve the ability, really; to recognize, to
6 report and to investigate child abuse and child
7 neglect. We certainly coined the phrase, child
8 protection is everybody's business. But
9 particularly, sir, it's your business as the
10 Secretary.
11 How are you going to commit the
12 resources of your department, then, to review the
13 funding streams; to work with these funding streams
14 in an effort to maximize the amount of dollars for
15 what we particularly care for; for child abuse and
16 neglect, prevention services, because really,
17 ladies and gentlemen, that's where we want to
18 focus. We would like that we don't have to do so
19 much investigation because we work to prevent that
20 and children are kept safe.
21 So, recognizing that we all have
22 constraints, I recognize that we're talking about a
23 proposed 12-billion-dollar budget; 35 percent of
24 the total budget as it's proposed. But assuming
25 that we have to work within some constraints that
Key Reporters [email protected] 33
1 we always do, how do we do this and how can you
2 redirect, and what can we do so that we get the
3 money where we need it the most right now?
4 ACTING SECRETARY DALLAS: So I think,
5 first I would say, it's important to remember when
6 you're talking about a child welfare system, right,
7 that it encompasses all kinds of issues. You can
8 talking everything from very serious cases of
9 physical and sexual abuse to cases that are things
10 that sometimes are the result of people dealing
11 with poverty.
12 You can get calls in the child welfare
13 system for anything from those very serious cases
14 to calls about a child unattended in the front yard
15 or walking out in the street. Now certainly those
16 are serious things that we have to deal with, but I
17 think you have to have a system that is
18 sophisticated enough to deal with those in
19 different ways.
20 The more serious cases they deal with--
21 formal investigations, finding of fault--could
22 result in the removal of a child from a home. Some
23 of the less serious cases are better dealt with by
24 providing services to the family in the home.
25 Now, when you make that distinction and
Key Reporters [email protected] 34
1 the system gets as sophisticated as it can about
2 that, that also has a budget impact, because
3 serving children in the home is a lot cheaper than
4 taking them out of their home and putting them in a
5 group home or some other type of community
6 placement. So, for us I think we need to make sure
7 we have got the right balance here.
8 The other thing is, a lot of the money
9 we get for child welfare, it comes from the federal
10 government. And when we get money from the federal
11 government, it usually comes with some strings
12 attached. Now, one of the biggest pots of money we
13 get is called IV-E money; so Roman Numeral 4 E.
14 Pennsylvania, my predecessor here, was
15 successful in getting a IV-E waiver from the state.
16 It only affects certain jurisdictions in the state.
17 But what the IV-E waiver does is, it gives us the
18 flexibility to use that money for other things.
19 Right now IV-E money is used for
20 out-of-home placements. So IV-E money almost pays
21 us when we take kids out of the home, so that's not
22 a great incentive. A IV-E waiver gives us that
23 flexibility to spend that money on how we think
24 will best serve that child and best keep that
25 family together, if that's the appropriate thing to
Key Reporters [email protected] 35
1 do. So, with that IV-E waiver, I'm hopeful that
2 will be exactly the flexibility that you're looking
3 for that will help us serve kids in a better way
4 than we can now.
5 CHAIRMAN WATSON: Thank you very much.
6 And yes, you and I talked a great deal about
7 flexibility. I use the example that I have seen
8 folks in a situation where I knew that if we could
9 even if she was a working woman, but a single
10 mother and made just a little bit more. But if we
11 could help her for a year, I knew that if we could
12 make this system, I believe, flexible enough; give
13 her the help she needs right then and there, we
14 won't see her ever again, and we will not see her
15 children. And there is a part of me that says,
16 however the family is configured, that's what I
17 really want; that we get folks up and running, and
18 we kind of spin them off, and they --
19 ACTING SECRETARY DALLAS: And that's my
20 hope --
21 CHAIRMAN WATSON: -- go to be a good
22 family and they don't need us, and then we have the
23 money for those who absolutely, positively do need
24 our help.
25 If I may, Chairman, I do have one last
Key Reporters [email protected] 36
1 question. I would like to also follow your lead,
2 Mr. Chairman, and give a shout-out because you
3 mentioned a name there. And I cannot -- I have to
4 say this publicly, that I don't think DHS would
5 function, and certainly the Office of Children and
6 Families, if it didn't have -- now I have to get
7 the title correct, Acting Deputy Secretary; is that
8 right? I just know her as Kathy Utz. I refer to
9 her and have said to people, this is like the
10 Wikipedia of DHS for Pennsylvania. She did start
11 when she was 12, ladies and gentlemen, because
12 she's been there for 27 years. So, it may get her
13 upset when I reveal, and you can do the math and
14 the age. But, her dedication and concern, from my
15 perspective, showing us the pitfalls of, well,
16 yeah, you can do this, but if you do that and set
17 something in statute or create legislation, you'll
18 create this problem over here; and all with the
19 idea of protecting children and keeping families
20 together, which is what we all hope for.
21 One of the things we also did in those
22 23 bills, we have expanded both the role and the
23 number of mandated reporters. And as I said, I
24 sort of worked on my own, what I call my own
25 personal PR campaign, which is, child protection is
Key Reporters [email protected] 37
1 everybody's business. And I thank you for that
2 website because, indeed, you can go to that
3 website, ladies and gentlemen, and learn all the
4 things you need to know; frequently asked
5 questions. It's all there. It's very, very
6 helpful.
7 But, how are you then going to --and
8 will the department ensure the best possible
9 training that we can give all these folks? It's
10 important that we created and said, look, for what
11 you do you are a mandated reporter, and we need you
12 to be our eyes and ears to help children so there
13 isn't neglect, and heaven knows, not to get to the
14 point of abuse. But then, again, we
15 need to train these folks, and what I hear, that's
16 the concern. So, what will the department be
17 doing? We have some things I think in place, but
18 it would be good to explain or how are you going to
19 expand them? How do we account for all these
20 people?
21 ACTING SECRETARY DALLAS: So I think,
22 first, I just want to echo what you said about
23 Kathy. I've known Kathy for years from my first
24 time here, and we've kept in touch. Despite the
25 fact she's known me this long, she still takes my
Key Reporters [email protected] 38
1 phone calls, which I'm very appreciative of, Kathy,
2 every once in a while that you pick up the phone.
3 CHAIRMAN WATSON: She does mine, too,
4 which is really --
5 ACTING SECRETARY DALLAS: She does.
6 She's fantastic.
7 For training, the department has offered
8 free training for folks as part of this process. I
9 have here -- I can't seem to find it right now, but
10 there are several -- Oh, here we go. There are
11 193,000 folks who have completed the training on-
12 line. That's free. We're also working on a work
13 group to get some more advanced training together.
14 We hope to have a solicitation out sometime in the
15 next few months that will provide the opportunity
16 to get even more training for the folks that we
17 have.
18 CHAIRMAN WATSON: Would you define
19 advanced training, sir? Is that more where it's
20 really a trainer meeting with the people? I
21 appreciate -- I see the first go-around when I
22 don't know anything would be sitting in front of
23 the computer and learning. I get that.
24 But I also know, probably because I am a
25 former teacher, that the best training of all is to
Key Reporters [email protected] 39
1 have the trainer right there with a group of people
2 so there's more of the give-and-take. Is that your
3 definition for advanced training?
4 ACTING SECRETARY DALLAS: I think a good
5 training program encompasses all types of training.
6 I think some folks will learn well in front of a
7 computer. Some learn better face to face. I think
8 a good training program will be multi-faceted and
9 have different levels of training.
10 I think the ultimate composition of
11 that, I think there's still some discussion about
12 that. Once we have that put together and
13 finalized, I will be happy to share that with you.
14 CHAIRMAN WATSON: Thank you very much.
15 Mr. Chairman, thank you for your
16 indulgence. And on behalf, if I can, of certainly
17 the children and the families of Pennsylvania, we
18 wish you well in your tenure, and happy to work
19 with you and make things better for those children.
20 Thank you.
21 ACTING SECRETARY DALLAS: Thank you.
22 MAJORITY CHAIRMAN ADOLPH: Thank you,
23 Chairman.
24 I'd like recognize Representative
25 Schlossberg who has joined us.
Key Reporters [email protected] 40
1 The next question will be offered by
2 Representative Gainey.
3 REPRESENTATIVE GAINEY: Good afternoon.
4 Representative DiGirolamo--I almost
5 messed his name up--he asked a lot of what I wanted
6 to ask with regard to the Medicaid expansion. I'm
7 so happy that we're moving in that direction.
8 I just wanted to give a little context
9 of the difference between that and Healthy PA and
10 why this will serve the state -- the Commonwealth
11 of Pennsylvania better. How many jobs will
12 actually be created?
13 Let me get all my questions out now
14 because I know the Chairman will definitely let me
15 know.
16 With dyslexia in school, what type of
17 funding are we looking at when we continue to do
18 things around that for kids that are dealing with
19 dyslexia?
20 And then thirdly, I wanted to talk about
21 the Act -- I wanted to talk about the Act 150. I
22 needed to know, will there be a waiting list for
23 the Medicaid waiver such as the Act 150, attendant
24 care, autism independence, and OBRA and Comcare, if
25 there will be a waiting list for that. And if
Key Reporters [email protected] 41
1 there is going to be a waiting list for that, how
2 do people get to it? Thank you.
3 ACTING SECRETARY DALLAS: So, we can
4 certainly provide the details of some of those
5 questions to you. But, generally, for the waivers,
6 all of them had increases this year. There were no
7 reductions in them.
8 The only one that may have a bit of a
9 waiting list, depending how you define it, is the
10 Act 150 waiver. There is just some transition that
11 we need to go through to get folks through that
12 process. There are some folks who are waiting, but
13 there is funding in the budget to move them.
14 And I'm trying to remember the rest of
15 the questions.
16 REPRESENTATIVE GAINEY: The other one on
17 that one right there. But even though they'll have
18 a time right now waiting, they will be -- Do we
19 have a period of time, because some people in my
20 community are saying that they've been waiting,
21 waiting, and waiting and they haven't heard
22 anything. Do we have a period of time that they'll
23 be moving through the system?
24 ACTING SECRETARY DALLAS: I don't know
25 the exact period of time. I can get back to you on
Key Reporters [email protected] 42
1 that. But I know that there are some folks that
2 were just getting through the process of making
3 sure we move them.
4 REPRESENTATIVE GAINEY: Okay. And
5 dyslexia in school, is there any type of funding
6 increase to deal with that?
7 ACTING SECRETARY DALLAS: I'm sorry.
8 With what?
9 REPRESENTATIVE GAINEY: Dyslexia. I can
10 pronounce it wrong sometimes.
11 ACTING SECRETARY DALLAS: Oh, dyslexia?
12 You know, I don't know the answer. Dave, do you
13 know?
14 DIRECTOR SPISHOCK: Not specifically,
15 no. Not for dyslexia.
16 REPRESENTATIVE GAINEY: Just the
17 difference between moving into the federal Medicaid
18 program.
19 ACTING SECRETARY DALLAS: It will be a
20 much simpler program. It will be one that will
21 allow us to realize some additional federal
22 dollars. I think that, you know, there's some
23 programs that are paid for with state dollars right
24 now that will be able to claim federal dollars.
25 That would have been true as well under Healthy PA.
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1 Overall, the switch will be basically
2 cost neutral or actually produce some level of
3 savings. In this year's budget, it will be about
4 $35 million in savings as compared to Healthy PA.
5 REPRESENTATIVE GAINEY: Thank you.
6 MAJORITY CHAIRMAN ADOLPH: Thank you,
7 Representative.
8 Representative Seth Grove.
9 REPRESENTATIVE GROVE: Thank you, Mr.
10 Chairman.
11 Mr. Acting Secretary, Dave, good to see
12 you both.
13 First I want to ask about the school-
14 based access program. For about maybe one to two
15 years now school districts have had issues with
16 coordination of payment between the department and
17 the Department of Education. I understand that
18 there's a new contract for a vendor going out for
19 RFP.
20 Can you kind of go into a little bit of
21 detail about how you're trying to better the
22 program for school districts and make it easier and
23 kind of coordinate a little better.
24 ACTING SECRETARY DALLAS: I think there
25 were two things going on. I think that when some
Key Reporters [email protected] 44
1 of the concerns were raised about the program,
2 there was a change in vendor, and a lot of folks
3 associated the change in the program with the
4 change of vendor; while there was a transition
5 going on, the other thing that occurred was, there
6 were changes in federal rules that made the program
7 a little more complicated. So regardless who the
8 vendor was, there were going to be some issues
9 there. And there are some absolute growing pains
10 associated with that, and it's been tough for
11 everyone.
12 We have tried to be clear about, in the
13 process going forward, the RFP is actually out on
14 the street right now; that we put some new clauses
15 into the contract that we will sign with a vendor
16 that will give us a little more control and allow
17 us to, whoever the vendor may be, have a little
18 more accountability for the services that are
19 provided.
20 So, as we go through that process and
21 the RFP is available on our website for anybody who
22 wants to take a look at it, we're hopeful that
23 those changes that we make will make it so that
24 we'll be able to better manage the program through
25 the vendor that is providing the service.
Key Reporters [email protected] 45
1 REPRESENTATIVE GROVE: That is some good
2 news.
3 In York County we have seen many
4 personal care homes closing due to their inability
5 to care for their residents at their lower
6 reimbursement rates. These homes serve low-income
7 Pennsylvanians with disabilities. I've heard from
8 personal care homeowners throughout Pennsylvania
9 the same message.
10 How will you ensure these barely
11 surviving homes stay afloat with the proposed 10.10
12 minimum wage tax -- or not tax, but 10.10 minimum
13 wage possibly coming?
14 ACTING SECRETARY DALLAS: Well, I think
15 an increase in the minimum wage will help get
16 better workers there. But I think, ultimately, the
17 long-term answer for personal care homes, for
18 assisted living, for nursing homes, for the
19 long-term care system in the state is, we have to
20 begin the process of moving to manage long-term
21 care.
22 Right now the system is not managed. As
23 a result of it, there are many folks who aren't
24 getting the appropriate level of service, and they
25 don't have the quality of life that they need. If
Key Reporters [email protected] 46
1 we're going to have a true continuum of services
2 and we're going to have care that's managed, we
3 have to go to long-term care.
4 Right now we're working with the
5 University of Pittsburgh on best practices. We
6 hope to put a proposal that will encompass the
7 entire range of services that are provided to folks
8 with -- to seniors and to folks with disabilities a
9 proposal, or I'll say a discussion paper out there
10 for folks to react to. We hope to do that in May.
11 And then after going through some stakeholder
12 meetings and discussions, I think it's time to move
13 forward and try to implement those things so that
14 we can get to managed care.
15 So, there's all kinds of folks who are
16 caught in the system. They go to a nursing home
17 when they don't have to. They're served in an
18 inappropriate setting. If we can get those systems
19 right where we can get those cost balances, we can
20 get our costs under control. And that's the only
21 way that we're ever going to be able to provide a
22 better rate for things like personal care homes and
23 every type of provider in the system.
24 REPRESENTATIVE GROVE: Are you looking
25 for a specific rate increase to cover it within
Key Reporters [email protected] 47
1 your budget for personal care homes?
2 ACTING SECRETARY DALLAS: Not a specific
3 rate increase, no.
4 REPRESENTATIVE GROVE: Okay. Have you
5 analyzed the plain cost of a minimum wage increase
6 into your budget?
7 ACTING SECRETARY DALLAS: Right now our
8 budget does not include the effects of a minimum
9 wage increase. I think should the General Assembly
10 see fit to work with the Governor on his proposal,
11 we'd be happy to engage in that process, and I
12 think it would be something that would have a great
13 benefit to many of the people we serve. I know
14 there are about 40,000 folks who receive SNAP
15 benefits right now, or what used to be called food
16 stamps, who will be lifted out of poverty if there
17 was an increase in the minimum wage. There's about
18 60,000 folks who get the child care subsidy who
19 would also see their income rise if the minimum
20 wage was raised. So, I think there's an
21 impact on real families' lives. I hope that the
22 General Assembly and the Administration can work
23 together to make that happen.
24 REPRESENTATIVE GROVE: I had a meeting
25 two Fridays ago with some advocates for the minimum
Key Reporters [email protected] 48
1 wage. They have said that the welfare budget will
2 be reduced if we do an increase. In past practices
3 when we've done minimum wage increases, has the
4 Department of Welfare's budget been reduced because
5 of that?
6 ACTING SECRETARY DALLAS: I think
7 there's always folks that will get off -- will be
8 no longer eligible for certain benefits when the
9 minimum wage kicks in. Sometimes that's hard to
10 see because, if you have an overall growing
11 population, as you do in Pennsylvania, and that
12 happens for a lot of reasons, sometimes you don't
13 see that. But yes, there are absolutely folks who
14 will no longer be eligible or will require benefits
15 from the department with an increase in the minimum
16 wage.
17 REPRESENTATIVE GROVE: Since you have
18 the opportunity to be the head of the largest state
19 department in the entire country, do you know the
20 cost of any new potential employee contracts, union
21 contracts that are being negotiated right now? Are
22 they built into your budget as well?
23 ACTING SECRETARY DALLAS: I think -- I
24 think those contracts are still being negotiated,
25 right?
Key Reporters [email protected] 49
1 DIRECTOR SPISHOCK: Yes, there is
2 nothing specific built into the budget right now.
3 ACTING SECRETARY DALLAS: Nothing in the
4 budget now.
5 REPRESENTATIVE GROVE: Yes. So a GGO
6 line item --
7 MAJORITY CHAIRMAN ADOLPH: Dave, if you
8 would -- That's it. Thank you.
9 DIRECTOR SPISHOCK: Yeah, there's
10 nothing specific in there right now. I mean, we do
11 work with the Administration as we're going forward
12 with this. We do put in increases for our salary
13 increases, benefit increases, but nothing as far as
14 anything above and beyond --
15 REPRESENTATIVE GROVE: So the GGO line
16 item for this year is predicated on current
17 employees, current structure of contracts?
18 DIRECTOR SPISHOCK: Yes, and whatever we
19 had in there for it.
20 REPRESENTATIVE GROVE: Okay. I'm going
21 to ask these questions just because I've gotten I
22 don't knows every time I've asked them.
23 DIRECTOR SPISHOCK: Okay.
24 REPRESENTATIVE GROVE: Has anybody in
25 the Administration advised you to not discuss the
Key Reporters [email protected] 50
1 sales tax expansion?
2 ACTING SECRETARY DALLAS: To not?
3 REPRESENTATIVE GROVE: Do not discuss
4 it.
5 ACTING SECRETARY DALLAS: No.
6 REPRESENTATIVE GROVE: Has anybody from
7 the Administration advised you to say I don't know
8 to the questions about sales tax expansion?
9 ACTING SECRETARY DALLAS: The only time
10 I've been advised to say I don't know the answer to
11 a question is when I don't know the answer to a
12 question.
13 REPRESENTATIVE GROVE: Okay. Good.
14 That's good to know.
15 So, I do have the sales tax plan in
16 front of me. It's right here, 144 pages, over 550
17 new taxes. Have you analyzed this to see the
18 impacts on your stakeholders and those receiving
19 under DPW's care?
20 ACTING SECRETARY DALLAS: I think I've
21 seen a spreadsheet developed by the Secretary of
22 Revenue about the impact that it might have on some
23 of the folks that we serve, yes.
24 REPRESENTATIVE GROVE: What is that
25 total amount?
Key Reporters [email protected] 51
1 ACTING SECRETARY DALLAS: Total amount,
2 I think I can refer you to Secretary McNulty's
3 spreadsheet. I don't have it with me right now,
4 but we can provide it.
5 REPRESENTATIVE GROVE: When did you see
6 that from the department?
7 ACTING SECRETARY DALLAS: The last
8 couple weeks have been a little bit of a blur, but
9 it's been -- It's been in the last couple of weeks.
10 REPRESENTATIVE GROVE: Okay. Because we
11 had her first. When I asked her questions, she had
12 no idea, and that worried me because she's supposed
13 to collect it. So --
14 ACTING SECRETARY DALLAS: I wouldn't --
15 I wouldn't take my date to the bank. I've had a
16 lot of meetings over the last couple of days, so
17 I'm not a hundred percent sure when I've seen it.
18 REPRESENTATIVE GROVE: I can definitely
19 believe that. But what we're looking to tax --
20 I'll go through some of them here:
21 Home health care services; providing
22 skilled nursing services in the home, personal care
23 services, homemaker and companion services,
24 physical therapy, medical STET services,
25 medications, medical equipment and supplies,
Key Reporters [email protected] 52
1 counseling, 24-hour home care, occupation and
2 vocational therapy, dietary and nutritional
3 services.
4 I apologize to you (looking at court
5 stenographer). I have this. I'll give this to
6 you.
7 Speech therapy, audiology, high-tech
8 care including intravenous therapy, other
9 ambulatory health care services, nursing health
10 care facilities.
11 Residential, intellectual and
12 development disability, mental health and substance
13 abuse facility services. Services provided by
14 group homes and intermediate care facilities
15 providing residential care services for persons
16 diagnosed with intellectual and developmental
17 disabilities and mental health and substance abuse
18 illnesses.
19 Continuing care retirement community and
20 assisted-living facility services for the elderly.
21 Providing residential and personal care services,
22 with or without on-site nursing care. Individuals
23 who are unable to fully care for themselves; do not
24 desire to live independently.
25 Individual and family services,
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1 including non-residential social assistance
2 services for children and youth, such as adoption
3 and foster care, drug prevention, life skills
4 training and positive social development,
5 non-residential social assistance services to
6 improve the quality of life for the elderly;
7 persons diagnosed with intellectual and
8 developmental disabilities or persons with
9 disabilities in such areas as day care, non-medical
10 home care or homemaker services, social activities,
11 group support.
12 Community food and housing and emergency
13 and other relief services.
14 Collecting, preparing and delivering
15 food for the needy; distributing clothing and
16 blankets to the poor. Preparing and delivering
17 meals to individuals who, by reason of age,
18 disability or illness, are unable to prepare meals
19 for themselves. Collecting and distributing
20 salvageable or donated food. Preparing and
21 providing meals at fixed or mobile locations, such
22 as food banks and soup kitchens.
23 Providing community housing services,
24 such as short-term emergency shelters for victims
25 of domestic violence, sexual assault or child
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1 abuse; temporary residential shelters for the
2 homeless, runaway youths and patients and families
3 caught in medical crises, and transitional housing
4 for low-income individuals and families.
5 Providing volunteer construction or
6 repair of low-cost housing in partnership with the
7 homemaker, who may assist in construction or repair
8 work.
9 MINORITY CHAIRMAN MARKOSEK: Excuse me,
10 Representative. Is there a question?
11 REPRESENTATIVE GROVE: We'll get to it.
12 Providing shelter, clothing, and medical
13 relief; resettlement and counseling to victims of
14 domestic or international disasters or conflicts.
15 And I believe it completely removes the sales tax
16 on non -- Here it is. An entity which is
17 authorized to do business in this Commonwealth as a
18 non-profit corporation or unincorporated
19 association under the laws of this Commonwealth,
20 which includes youth, sports, volunteer fire,
21 ambulance, religious, charitable, fraternal,
22 veterans or civic associations and a separately
23 chartered auxiliary of the association operated on
24 a non-profit basis.
25 It's a lot. That's just a short blurb
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1 of what is actually new taxable under the sales tax
2 plan.
3 Is that going to be beneficial for
4 Pennsylvania residents moving forward?
5 ACTING SECRETARY DALLAS: I think at the
6 end of the day, you know, I think both the Governor
7 and Secretary Albright have made clear that it's a
8 comprehensive plan that you look at as a whole.
9 Sure, would I always want to look at the
10 folks that I serve first and try to exclude them
11 from any change? Of course, I would. But at the
12 end of the day, I know my department is part of a
13 bigger picture in this state. And I know that when
14 you're looking at the fiscal challenges that this
15 state has, the time for gimmicks and excuses is
16 over, and you need to find a way to plug the
17 revenue hole that we have.
18 I think the Governor's plan is one that
19 will comprehensively address those holes. And I
20 think that -- As I was listening to you list all
21 those things there and, presumably, you would be
22 against including them in any tax increases, to
23 come up with an alternate plan in a way that we can
24 plug the revenue hole that we have if we are not
25 going to do those things.
Key Reporters [email protected] 56
1 REPRESENTATIVE GROVE: I appreciate
2 that. And I think it shows a difference between
3 governing of adding those 550 taxes on some
4 individuals that barely are able to survive on a
5 day-to-day basis. To add that, you know, one's
6 Cable TV, not the premium channels, but the
7 regular. I know a lot of individuals have that,
8 too.
9 It's just a compounding effort that
10 we're going to drive money into these programs, but
11 we're going to take it from them on the front end.
12 So I appreciate that.
13 Thank you, Mr. Chairman.
14 MAJORITY CHAIRMAN ADOLPH: Thank you.
15 We may not all agree on what will be
16 taxed and what won't be taxed, but it is a budget
17 hearing, and it's necessary for the residents of
18 Pennsylvania to understand what is going to be
19 taxed under the proposal. There will be a lot of
20 debate on the floor of the House, on the floor of
21 the Senate, in committee meetings and so forth.
22 But, it's a comprehensive plan. It's a
23 complex plan. There's a lot of taxes. And those
24 services, obviously, are needed in Pennsylvania.
25 The gentleman was just trying to make sure that he
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1 was on the record of stating that these services
2 under this plan would be taxed at 6.6 percent.
3 Sensitive to all of us.
4 I happen to have a loved one going into
5 a home in April; going to pay about $3,000 a month.
6 I wasn't expecting 6.6 when they applied. So, it
7 is personal, it is financial, and it is important
8 that we talk about it.
9 Representative Daley.
10 REPRESENTATIVE M. DALEY: Thank you, Mr.
11 Chairman.
12 And, Secretary Dallas, thank you for
13 being here today. A key to your department's
14 mission is to move Pennsylvanians to independence.
15 So, can you just outline what your department is
16 doing to link your recipients to jobs that would
17 increase their independence and, thereby,
18 decreasing their dependency on the system?
19 ACTING SECRETARY DALLAS: I think across
20 the system there are several initiatives that are
21 in the Governor's budget to help people make that
22 transition. There are a variety of populations
23 that we serve in that regard. Is there one in
24 particular you'd like to talk you about, or do you
25 want me to just --
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1 REPRESENTATIVE M. DALEY: Just if you
2 can give us a general overview, and then see if
3 there's anything I want to ask more questions
4 about.
5 ACTING SECRETARY DALLAS: I think one of
6 the things that I've had some success in my time in
7 government is helping folks who are receiving cash
8 assistance make the transition to employment. In
9 the state that I worked in previously, we were able
10 to set three consecutive records for the most
11 people moved from welfare to work in the state's
12 history, and I'm very proud of that.
13 I think to do that you need to get to,
14 what I was talking about before, looking at the
15 differences and people and the circumstances that
16 they're under. One of the e-mails I got on my last
17 job was a woman -- a woman who said, my husband is
18 in -- lost his job. He worked for 20 years. His
19 unemployment ran out, and he was at the door of my
20 department in my previous job for the first time;
21 never expected to be getting benefits from the
22 government in his life. And she said, you have him
23 in a job -- you have him in a training class for
24 how to dress successfully for work. That is a
25 complete -- And she took me to task. She said,
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1 that's a complete waste of his time, to which my
2 response was, that's right. It is a complete waste
3 of his time.
4 So when we make changes to our systems
5 here or in my previous state was, we need to look
6 at the individual circumstances. There are some
7 folks who need just a little bit of help from us
8 and some folks who need a lot more help from us.
9 There are folks who are dealing with very serious
10 issues of mental health and substance abuse, and
11 there are some folks who just maybe need to be put
12 in contact with employers who are hiring.
13 So, for us it's finding ways to engage
14 those folks and getting them where they need to go.
15 It's a much more efficient use of resources, and it
16 also gets them back into the work world as quickly
17 as possible.
18 REPRESENTATIVE M. DALEY: So the idea is
19 to be able to customize the plans to the groups of
20 people or the individual people who need them is
21 what --
22 ACTING SECRETARY DALLAS: Absolutely.
23 Otherwise, it's just an inefficient use of
24 resources, and it also doesn't particularly help
25 people.
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1 REPRESENTATIVE M. DALEY: No, you're
2 absolutely right. So I'm glad to hear that that's
3 the approach you're taking. Thank you.
4 MAJORITY CHAIRMAN ADOLPH: Thank you,
5 Representative.
6 Representative Mark Mustio.
7 REPRESENTATIVE MUSTIO: Good afternoon.
8 Thank you for being here, and thank you for all
9 that you do and your department does for
10 Pennsylvanians.
11 ACTING SECRETARY DALLAS: Thank you.
12 REPRESENTATIVE MUSTIO: A couple weeks
13 ago Attorney General Kathleen Kane was here and
14 testified as far as her budget request, that she
15 would like to fund an additional 18 individuals for
16 fraud investigators because, as she stated, the
17 cost of Medicaid fraud is out of control in
18 Pennsylvania and nationwide. I assumed that she
19 wanted these additional investigators because of
20 the expansion of Medicaid in Pennsylvania.
21 Do you agree that Medicaid fraud is out
22 of control in Pennsylvania?
23 ACTING SECRETARY DALLAS: That's out of
24 control? I think it's something that is a very
25 important part of what we do; making sure that
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1 folks who receive benefits are those who truly
2 deserve those benefits. I think that when you look
3 at the size of the Medicaid program, it is
4 certainly inviting for folks who might want to try
5 to take advantage of the system to do so. We spend
6 billions of dollars every year.
7 The department regularly engages in
8 activities to control costs and also to root out
9 waste, fraud and abuse. For example, for many,
10 many years the department has operated a
11 third-party liability program. By far, the biggest
12 improper payments we make are to providers. And
13 those providers, sometimes we will pay -- Medicaid
14 will pay for folks who have third-party insurance.
15 And by working through those cases, we are able to
16 save a great deal of money. Last year we saved
17 $368 million in payments that were initially made
18 by Medicaid, but those folks had third-party
19 insurance. And we also were able to avoid
20 $256 million in costs.
21 REPRESENTATIVE MUSTIO: Do you
22 anticipate increasing those efforts to drive those
23 numbers higher?
24 ACTING SECRETARY DALLAS: Yes. I think
25 one opportunity that I'd really like to pursue here
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1 in Pennsylvania is looking at the growth in data
2 analytics. I think that when you look at the
3 traditional approach to deal with fraud and abuse,
4 a lot of time folks do -- they increase the number
5 of inspectors; they do more random samples. A lot
6 of times it's like fishing in the ocean. You just
7 take a random sample regardless of who those folks
8 are and you're investigating them.
9 Through folks who are really good at
10 this, they can use data to start finding patterns
11 that look suspicious, so that when it's either
12 Attorney General Kane's investigators, the OIG's
13 investigators, or investigators in the department,
14 that when we send them out to investigate things,
15 there will be things that the data tells us are
16 suspicious patterns. So that when they go out
17 there, they're much more likely to find things, and
18 they're much more likely to not waste time on folks
19 who are doing nothing wrong.
20 REPRESENTATIVE MUSTIO: So you're
21 bringing Moneyball to the department?
22 ACTING SECRETARY DALLAS: I never
23 thought about it that way, but that was a good
24 movie. Maybe I'll start using that as a line.
25 REPRESENTATIVE MUSTIO: So, if that's
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1 the case, do you anticipate technology needs as far
2 as your budget goes?
3 ACTING SECRETARY DALLAS: I think that
4 there are some things that we'll have to make some
5 smart investments in technology. I think they'll
6 pay off for us in the long run.
7 One thing that we're looking at right
8 now is, there are a lot of big companies out there
9 that have a lot of data on folks, right, so they
10 can do something called identity proofing. So
11 sometimes when you see waste, fraud and abuse, it's
12 simply just a data entry error; the last four
13 digits of your Social Security number is 1234.
14 Someone types in 1243, then that person, you know,
15 there's a whole bunch of issues that occur.
16 If you can do that identity proofing
17 upfront and you can look at those things, you can
18 catch those things from happening, and those
19 improper payments are never made in the first
20 place. Those are the kinds of things that I think
21 are smart investments. They are. They don't
22 require a whole lot more staff. They're done
23 automatically, and they help lighten the load for a
24 lot of those CAL workers out there who are dealing
25 with rising caseloads. If we can make those
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1 investments, I think that's the smart way to go
2 after fraud.
3 REPRESENTATIVE MUSTIO: One of my
4 colleagues, Representative Quinn, provided a
5 report, an audit that was done in New York State.
6 Basically, they audited 22 providers and found that
7 20 of those providers were routinely submitting
8 inflated claims.
9 So I guess my question is, if you feel
10 that you can drive those numbers up to multiple
11 hundreds of millions of dollars more, would that be
12 a strong consideration, perhaps, in removing some
13 of the laundry list of taxes that my other
14 colleague just got done reading on the most
15 vulnerable citizens of the state that your
16 department represents?
17 ACTING SECRETARY DALLAS: There is no
18 doubt that increased recoveries would help reduce
19 the amount of revenue that we need.
20 REPRESENTATIVE MUSTIO: And it would be
21 nice if you can somehow, as far as this budget
22 process goes, up to the middle of June, come up
23 with a more concrete number on how high that can go
24 so we can adjust some of those revenue enhancers.
25 ACTING SECRETARY DALLAS: I think when
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1 you do those things, you have to be very careful.
2 It's very easy to start thinking of bigger and
3 bigger numbers out there of waste, fraud and abuse
4 that may not be there. Sometimes it's like the eat
5 chocolate cake and lose weight plan that we say --
6 REPRESENTATIVE MUSTIO: I'm on that.
7 ACTING SECRETARY DALLAS: -- if we just
8 got rid of waste, fraud and abuse, we wouldn't need
9 to provide for services. The reality of it is,
10 there's a growing number of citizens out there who
11 need our help. While program integrity is
12 certainly going to be part of the puzzle, it is not
13 the only answer to the issue we have out there.
14 REPRESENTATIVE MUSTIO: I would agree
15 with that, and you're a very talented individual.
16 And I think that Kathleen Kane probably hit the
17 nail on the head, too, with the amount of fraud
18 that she feels that's rampant in the state. And by
19 expanding the program, I think that just means that
20 we're going to have more.
21 So, with your talent, your ideas about
22 implementing Moneyball matrixes, I think we've got
23 a lot of opportunities here to look at other ways
24 that we can improve. Thank you.
25 MAJORITY CHAIRMAN ADOLPH: Thank you,
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1 Representative.
2 Representative Kinsey.
3 REPRESENTATIVE KINSEY: Thank you, Mr.
4 Chairman.
5 I want to welcome Mr. Secretary, as well
6 as Mr. Director. Thank you for being here this
7 afternoon.
8 I want to talk about developmental
9 program funding. In the General Fund, 14.1 percent
10 of the 11.9 billion is dedicated towards
11 developmental programs. For the fiscal year, that
12 includes providing supports for home and
13 community-based options for 1,000 individuals with
14 intellectual disabilities. It also includes
15 providing supports for home and community-based
16 options for 50 individuals with autism, and
17 providing an opportunity for individuals with
18 mental illnesses and intellectual disabilities to
19 transfer from institutional placements to home and
20 community-based placements as well.
21 I guess the question I want to ask is
22 that, the dollars that are being used towards the
23 developmental program, is there -- And, actually,
24 let me just backtrack.
25 I've gotten calls from a lot of provider
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1 agencies in the City of Philadelphia. What they
2 shared with me is the fact that they support the
3 expansion of services, but, by the same token,
4 there's a concern in regards to the current rate of
5 pay for the current services being provided. One
6 organization actually informed me that for the
7 current services, and when you compare with
8 inflation, they're basically not receiving enough
9 dollars for the current services that are being
10 provided to individuals who are in need.
11 I guess the question is, is there a plan
12 for the Administration to address that in regards
13 to additional dollars being put in to increase
14 maybe the current rate of pay for services
15 currently being provided? Then I have another
16 question as well as that, but I'll let you address
17 that one first.
18 ACTING SECRETARY DALLAS: First, I would
19 say the folks that you're talking about are
20 probably among the most vulnerable Pennsylvanians.
21 I think we have a special duty to make sure that
22 we're doing all we can for them. That's why, even
23 in a relatively tough budget year, there's an
24 expansion of the level of services for those who
25 are on the waiting list.
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1 That being said, I think we do face some
2 tough budgetary challenges. I'd loved to have been
3 able to do more in that area.
4 With regard to providers, I certainly am
5 sympathetic to their complaints, but we don't have
6 any increases built into the budget for them at
7 this time. I know that everyone has had during
8 this budget time the need to do more with less, and
9 we're going through a regulatory process to change
10 the way that we fund these services and the
11 regulations that are around that. My hope is that
12 will provide some relief for folks if we can
13 streamline the process a little bit; make the
14 process maybe not so burdensome on an
15 administrative basis. But, it is certainly
16 something that's a tough thing. The providers who
17 do that job do some very good work.
18 REPRESENTATIVE KINSEY: Well, I would
19 offer to have you join me maybe in Philadelphia
20 with a group of providers maybe to discuss future
21 strategies that might lessen the burden. So I'd
22 like to invite you down for that.
23 ACTING SECRETARY DALLAS: Of course.
24 REPRESENTATIVE KINSEY: Great.
25 The other quick question is, just to
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1 sort of pick up where Representative Grove, when he
2 was talking about personal care homes. Again, the
3 section of Philadelphia that I represent, there's
4 quite a few personal care homes in my legislative
5 district. I guess my first question is, are
6 personal care homes licensed under the Department
7 of Human Services?
8 ACTING SECRETARY DALLAS: Yes, they are.
9 REPRESENTATIVE KINSEY: They're
10 licensed, but they do not receive any type -- Are
11 they included in this budget for the 2015-16 year
12 in regards to some type of funding for --
13 ACTING SECRETARY DALLAS: I don't know
14 if there's a separate line item. If you let us get
15 back to you, we'll give you a breakdown of the
16 funds that go to personal care homes.
17 REPRESENTATIVE KINSEY: Great. If you
18 can give it to --
19 ACTING SECRETARY DALLAS: Sure.
20 REPRESENTATIVE KINSEY: -- the Chairman.
21 I guess the third part is, I noticed
22 that -- Again, in my legislative district there are
23 individuals who were veterans, and a lot of them
24 have sort of matriculated towards these personal
25 care homes. So I know that there are some
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1 additional dollars. I believe that there's a
2 million dollars -- an additional million dollars
3 under the human service enhancement. Is that used
4 towards -- That is used towards homeless
5 individuals, correct?
6 ACTING SECRETARY DALLAS: Yes. There's
7 a million dollars in the budget to try to find new
8 ways to help veterans who experience homelessness.
9 Too many of our veterans, when they come back from
10 overseas, wind up homeless. For us the idea here
11 is to take that million dollars and work with
12 Military and Veterans Affairs to put out a
13 competitive grant process for folks to show some
14 innovative ways that we might be able to have more
15 success helping veterans who become homeless and
16 keeping veterans from becoming homeless.
17 REPRESENTATIVE KINSEY: Do we believe
18 that that million dollars is enough? Is that
19 million dollars on top of additional funding
20 already that's proposed in this budget?
21 ACTING SECRETARY DALLAS: I think the
22 million dollars is a start. My hope is that we can
23 find ways that are cost-effective and successful
24 through that million dollars that will help pave
25 the way for future increases.
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1 REPRESENTATIVE KINSEY: Okay. Then the
2 last part of my question is, what impact will the
3 Medicaid expansion have on individuals living in
4 personal care homes? How will that impact those
5 individuals?
6 ACTING SECRETARY DALLAS: How will it
7 impact individuals in personal care homes? I think
8 to the extent it makes -- If they're receiving
9 Medicaid, they'll be largely unchanged. They'll
10 continue to receive Medicaid.
11 For folks that maybe didn't qualify
12 before or had trouble navigating the system, and we
13 get more folks enrolled, having that private health
14 insurance will allow them easier access to a doctor
15 and, hopefully, help them get more healthy than
16 they are now.
17 REPRESENTATIVE KINSEY: Okay, great.
18 Thank you, Mr. Secretary.
19 Thank you, Mr. Chairman.
20 MAJORITY CHAIRMAN ADOLPH: Thank you.
21 Representative Jim Marshall.
22 REPRESENTATIVE MARSHALL: Thank you, Mr.
23 Chairman.
24 Acting Secretary, good to see you again.
25 ACTING SECRETARY DALLAS: Good to see
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1 you, too.
2 REPRESENTATIVE MARSHALL: Twice in one
3 week. I hope to have a lot of questions for you as
4 we develop and go through this budget. I
5 appreciate the opportunity to speak with you.
6 Today I'll just make a -- I have a short question
7 for you.
8 I'm asking if you can provide me an
9 update on Adult Protective Services? It was Act 70
10 of 2010. Any thoughts on that? How's it been
11 implemented? Who's doing the investigations and so
12 on?
13 ACTING SECRETARY DALLAS: So, I believe
14 there's -- I think there's about $3.5 million in
15 the budget this year for that. We are moving
16 forward with -- we've selected a provider that is
17 going to do those investigations. They start April
18 1st. That provider has -- We met with them a week
19 or two ago. We met the executive team that's going
20 to be providing those investigations.
21 Also, I should say Secretary Osborne
22 also was present at that meeting. They had a
23 pretty impressive management team they had put
24 together. They're including folks who had
25 protected the President of the United States, which
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1 was unexpected, but nonetheless, impressive. Those
2 folks will start April 1st. We're hopeful that
3 will greatly increase our ability to provide those
4 investigations and those services.
5 The act you mentioned was passed in
6 2010. This previous year was the first year that
7 it was fully funded, and with that funding I think
8 we'll be able to finally initiate the
9 investigations that we need to.
10 REPRESENTATIVE MARSHALL: Could you go
11 into any more detail about the provider at this
12 time?
13 ACTING SECRETARY DALLAS: I'm not sure
14 exactly how you mean? What other things would you
15 like to know about the provider?
16 REPRESENTATIVE MARSHALL: Well, for
17 instance, you said they begin to take effect this
18 coming month, April 1st.
19 ACTING SECRETARY DALLAS: April 1st,
20 yeah.
21 REPRESENTATIVE MARSHALL: Is it a
22 provider that you've had a lot of dealings with?
23 ACTING SECRETARY DALLAS: The provider
24 is called Liberty, and they're -- We can get you
25 more detailed information on that provider and
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1 provide it to the Chair. I'll be happy to give it
2 to you.
3 REPRESENTATIVE MARSHALL: Thank you very
4 much.
5 ACTING SECRETARY DALLAS: Sure.
6 REPRESENTATIVE MARSHALL: Thank you, Mr.
7 Chairman.
8 MAJORITY CHAIRMAN ADOLPH: Thank you,
9 Representative.
10 Representative Brownlee.
11 REPRESENTATIVE BROWNLEE: Over here, Mr.
12 Secretary. Good afternoon.
13 ACTING SECRETARY DALLAS: Oh, there we
14 go.
15 REPRESENTATIVE BROWNLEE: Over here.
16 It's kind of like playing tennis.
17 Recently your department announced two
18 grant initiatives received from the federal
19 government. I believe one is in conjunction with
20 PHFA. Your department was awarded 8.5 million
21 grant to provide permanent homes and services for
22 low-income individuals with disabilities.
23 Can you give us how the two agencies are
24 going to work together to provide that grant for
25 those individuals to help them get to self-
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1 sufficiency in their own homes?
2 The second grant I believe was a little
3 over 12 million that was awarded from the U.S.
4 Department of Health and Human Services. Can you
5 also kind of explain what that grant is for as
6 well, and how would that help the residents of
7 Pennsylvania?
8 ACTING SECRETARY DALLAS: So I think
9 that when you've been doing this for a while, one
10 of the things you see is, one of the primary
11 barriers for people making it from poverty to self-
12 sufficiency, housing is a big piece of that, so
13 we're very happy that we got that money. It's a
14 step in the right direction for us.
15 I think the one that's in conjunction
16 with PHFA, as you probably know, the department
17 sits on the PHFA board, and we coordinate with them
18 closely on those grants. I think as we work with
19 them, we're going to try and find ways to use that
20 money to supplement and leverage other funds that
21 are out there, but also to make sure that, where
22 appropriate, we can provide services to those and
23 provide housing to those that I think will have the
24 most need and help them make that transition to
25 self-sufficiency. I can get you the details of
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1 those particular grants and provide you much better
2 details than I can give you here at the hearing.
3 But I'll give you the details of exactly how that
4 money will be spent and the process for going
5 forward.
6 REPRESENTATIVE BROWNLEE: Thank you. If
7 you can get that information to the two Chairmen we
8 would be much appreciative.
9 ACTING SECRETARY DALLAS: Sure.
10 MAJORITY CHAIRMAN ADOLPH: Thank you.
11 Representative Marguerite Quinn.
12 REPRESENTATIVE QUINN: Thank you, Mr.
13 Chairman.
14 And thank you, Acting Secretary. We
15 really appreciate you being here today.
16 ACTING SECRETARY DALLAS: Thank you.
17 REPRESENTATIVE QUINN: I think it was
18 said a couple of times today the enormity of the
19 job that you have. We take it very seriously, and
20 we thank you for the work that you do on behalf of
21 our constituents.
22 I have some questions; a couple of them
23 in the line of Representative Grove. I just want
24 to assure you, when we're asking questions like
25 this, we're trying -- It's often said the biggest
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1 vote we have each year is our budget. It's our
2 greatest responsibility. And it's just a matter of
3 really trying to make sure that we fully understand
4 just what is in this budget.
5 You know, we're told that it's something
6 you've got to look at it as a whole. So in order
7 to do that, we'll just start peeling layers. So
8 thanks for your indulgence.
9 As you know, Pennsylvania has one of the
10 oldest populations in the nation. There's a 2010
11 AARP article that I read, a survey that said about
12 95 percent of seniors would prefer to live in their
13 house. As a daughter of a senior, I'd say when
14 they poll this generation, too, or my age, we
15 prefer that the seniors live in their house, and I
16 hope to be able to live in my home until I go out
17 feet first. That survey is in line with what the
18 Governor's initiative is and his goals.
19 But, as I'm looking at the taxes that
20 are being offered here, the new taxes that are on
21 personal hygiene products, non-prescription drugs,
22 personal care service, social assistance services,
23 home health care services, ambulatory health care
24 service, then I started scratching the surface to
25 see what they involved. I just missed nursing and
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1 residential care services.
2 My understanding is that these are home
3 health care aides, RNs or LPNs typically, that go
4 into the home and provide things like medication
5 therapy, immunizations, drawing blood, tracheotomy
6 care, wound care, tube care, nutrition. They
7 change bandages, help out with catheters,
8 respiratory care, removal of sutures, stitches and
9 staples, help bathe people, even dialysis these
10 days. There's some components of that at home.
11 That work, by estimate from the
12 Pennsylvania Home Care Association, to have 40
13 hours of home health care a week for a family, or
14 for a senior, a household I'll say, it's at $22 an
15 hour. That work comes to about 880 per week. With
16 this tax on it, that's another $58 per week, which,
17 my rough math, that's just under three hours of
18 care; 232 bucks a month, another $2,800 more per
19 year. That's a lot of money coming out of it.
20 I just have to ask you, don't you think
21 -- I believe, and I'd like you to comment, that
22 implementing a tax on nursing home increases and
23 the things that I just mentioned, it's going to
24 make those private payers -- those individuals are
25 going to spend down their assets much more quickly
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1 at 6.6 percent more a year and put them into MA and
2 just costing the state even faster.
3 ACTING SECRETARY DALLAS: Again, I think
4 that when you look at this proposal, it's easy to
5 -- it's easy to single out this piece or that piece
6 that you don't want. I think Secretary Albright
7 was clear that we're trying to look at this as a
8 combined whole. And that if there are other
9 thoughts out there, I believe both the Governor and
10 Secretary Albright and everyone in the
11 Administration has been clear we're more than happy
12 to have that conversation.
13 But I think the challenge is, if we're
14 going to take away this piece or that piece, what
15 are we going to replace it with? Are we going to
16 replace it with something else? Are we going to
17 cut some other service? How are we going to
18 provide those services?
19 You had mentioned at the start of what
20 you had to say about home and community-based
21 services. I am a big believer in home and
22 community-based services. You said, I think what
23 you said, 95 percent or above of folks want to be
24 served in the community. It's hard to get 95
25 percent of the American public to agree that
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1 Tuesday comes after Monday, right? But they agree,
2 right, that they want that. To do that, it's going
3 to take some resources to do that.
4 So, I think the Governor has been clear
5 that it's the start of a discussion. If there's a
6 way that we can find a way to provide those
7 services and do all those things and change some of
8 those things around, I think that's part of the
9 great discussion that we're here for today, right?
10 So, to me, if there are alternative proposals,
11 we're more than happy to have that discussion.
12 REPRESENTATIVE QUINN: Okay. Thanks.
13 First, Secretary Albright has not yet been in front
14 of this committee. So, you know, I haven't heard
15 it. So I'm hearing it's the start of the
16 discussion, but then I'm also hearing you've got to
17 take it as a whole.
18 I believe we will be coming up with a
19 proposal. I don't have one generated yet on my
20 desk. I'm still in a fact-finding mode. Do you
21 know of any other states that tax these services
22 and items?
23 ACTING SECRETARY DALLAS: That would be
24 a question I think better directed for Secretary
25 Albright. I'm not as familiar with that -- with
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1 that. That's not my area of expertise.
2 REPRESENTATIVE QUINN: Well, if he's
3 listening, he's going to get that question
4 tomorrow.
5 ACTING SECRETARY DALLAS: Okay. I might
6 give him a call and let him know.
7 REPRESENTATIVE QUINN: Okay. If you
8 give me his cell. I'd be happy to save you a trip.
9 ACTING SECRETARY DALLAS: For everyone
10 watching on TV, it's -- Okay.
11 REPRESENTATIVE QUINN: Okay. So, if you
12 don't know that, maybe you don't know this.
13 Involved in this whole budget -- And that's
14 W-H-O-L-E; not H-O-L-E. Involved in this whole
15 budget is about $3.2 million in new property tax
16 relief. Do you know if it's been estimated what
17 percent or how much of that $3.2 million in new
18 property tax relief is going to be generated by the
19 taxes on the items that we're speaking about today?
20 ACTING SECRETARY DALLAS: Again, that's
21 a question that I think there are probably folks a
22 little better qualified than I to answer that
23 question.
24 REPRESENTATIVE QUINN: Okay. Thank you
25 very much. I look forward to getting to know.
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1 Again, I'll thank you for the good work you do for
2 our constituents.
3 MAJORITY CHAIRMAN ADOLPH: Thank you.
4 Representative Dean.
5 REPRESENTATIVE DEAN: Thank you, Mr.
6 Chairman.
7 Good afternoon, Director; Mr. Secretary,
8 welcome. And I welcome all the families and
9 advocates in the room, for those who might be
10 watching on TV. We've been here three weeks for
11 budget hearings, Appropriations hearings. This is
12 definitely one of the most crowded days. To me,
13 that's a reflection of what you do, the importance
14 of what you do, and the families that it touches.
15 So, it's no surprise to me that the size of your
16 budget is quite large, and the responsibility is
17 very large too. I admire your work.
18 I want to examine, the Governor's budget
19 reflects in the area of your department a
20 restoration of funds, but also an increase in funds
21 in a couple areas that I'd like to ask you about.
22 ACTING SECRETARY DALLAS: Sure.
23 REPRESENTATIVE DEAN: So I'll ask you
24 what those increases will be meaning, what will
25 they provide. But then I also thought maybe,
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1 Mr. Director, you might be able to say that while
2 we increase over here, isn't that in the long term
3 going to save us somewhere else?
4 So, in the areas I was thinking about,
5 number 1 was, could you tell us about the people
6 who are still in state hospitals, mental health
7 hospitals, how many people are we still serving in
8 state hospital settings? I note that there's an
9 increase budget request of 4.7 million in order to
10 begin serving those folks in home and community-
11 based places. So, could you tell us something
12 about that?
13 ACTING SECRETARY DALLAS: So, I think
14 when you look at state hospitals or state centers
15 or any of the facilities that DHS operates, the
16 populations generally are declining there. I think
17 there are ways that there are folks who are in
18 those facilities we can serve better in the
19 community.
20 A lot of times when you're talking about
21 government funding for things, you can either say,
22 well, we're going to spend more money to provide
23 more services or we're going to save money by
24 cutting services. Either one of them are not
25 particularly easy choices to make. I think the way
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1 that you need to get out of that is, you need to
2 look at paying for quality. You need to look at
3 serving people in the most appropriate setting.
4 We have a continuum of services out
5 there. We have it ranging from state hospitals and
6 state centers to serving people, and group homes
7 are serving them in their own homes and
8 communities. I think the more that we can get
9 folks in those appropriate settings, those
10 investments we make will pay off for us big time in
11 the long run, because there's very few things you
12 can do that improve the quality of life for folks,
13 but also cost less money, and serving people in the
14 community is one of those things.
15 I think that we are always looking at
16 our state home populations and looking at reducing
17 those populations over time and serving people,
18 where appropriate, in the community. So my hope is
19 that the money that's invested in the budget for
20 that will yield those results. Not only will it
21 save us money, but more importantly to me, it will
22 help improve the quality of life for a lot of the
23 folks that we serve.
24 REPRESENTATIVE DEAN: And do you have
25 any sense, as we transition folks through this
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1 investment in trying to move people from state
2 homes--I don't think it's that many any longer--
3 what that will save down the road?
4 DIRECTOR SPISHOCK: When we look at any
5 transition of people out of the state hospital or a
6 state ID center, in the budget you'll see there's
7 actually a reduction in the complement positions in
8 both the mental hospitals and the ID centers, which
9 one -- And the mental health side is reflective of,
10 I think we transferred maybe 30 recipients out of
11 Torrance Hospital into the CHIP program. Taking
12 them out of the facility and moving them back into
13 the community where they are more appropriately
14 served ends up being a reduction. We were able to
15 close a wing at Torrance, be able to save some
16 staffing costs.
17 The same on the ID side. We will be --
18 The ID population has been decreasing over the
19 number of years. More and more recipients are
20 being served in the community than in our
21 facilities. And as a result, the staffing in those
22 facilities, even though we may have funded
23 vacancies, we were able to eliminate a number of
24 those vacancies as part of the budget. So, until
25 -- When we see a declining population in both
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1 mental health and the ID centers, it's a slow
2 trickle-down because we do move them first to the
3 community, and we may see savings maybe a year or
4 two later on the facility side.
5 REPRESENTATIVE DEAN: Okay. Very good.
6 Another area that I care a lot about, and I know an
7 awful lot of people do, is the grave crisis of
8 heroin and opiate addiction in this Commonwealth
9 and across the country, of course. Secretary of
10 Health, Secretary of Drug and Alcohol were here.
11 The Secretary of Health named it the number 1
12 public health hazard issue in our state.
13 I see that the Governor wants to add
14 2.5 million to heroin and opiate addiction,
15 behavioral health services, what is that going to
16 get us? Is that on top of services we're already
17 providing? How's that going to help?
18 ACTING SECRETARY DALLAS: So that is in
19 addition to the services that we're providing. I
20 think we're looking at two primary areas to focus
21 on with that additional money. One is to expand a
22 pilot for a drug called Vivitrol. We're working
23 with the Department of Corrections on that. It's a
24 drug that has -- a lot of folks have hope will help
25 curb addiction. The idea I think here is to work
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1 with Corrections to get the first dose or the first
2 shot of Vivitrol while folks are still in a
3 corrections facility, and then work to make sure we
4 have the right wrap-around services to continue
5 those treatments once they leave prison.
6 There are a lot of folks who are in the
7 corrections system who has addictions to heroin or
8 other opioids and working with DDAP and the
9 Department of Health, our hope is that that
10 Vivitrol pilot can be expanded and we can make sure
11 we do it in a way that, as folks make that
12 transition out of jail, that we'll be able to make
13 sure that they keep using Vivitrol going forward,
14 and that will help them beat their addiction.
15 The other thing that we're looking at is
16 something called Nalaxone, or Narcan I think is the
17 common name of it; providing that that reverses the
18 effects of an overdose. I know that Department of
19 Health and DDAP are working together to put Narcan
20 in the hands of first responders. We are taking a
21 look at that as well, and seeing if there's places
22 like health clinics and other places where having
23 Narcan available would help save people's lives.
24 If the funds that we have allocated to
25 us aren't fully expended for those two ideas, I
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1 think there's other treatments out there that are
2 -- that folks have, hoping that we might want to
3 take a look at and see if they can be successful
4 here in Pennsylvania.
5 REPRESENTATIVE DEAN: By way of comment,
6 I just asked, and I'm sure you've got an awful lot
7 to focus on, but I ask that you do focus on the
8 heroin and opiate addiction problem. Ask for more
9 money if more money would be meaningful for
10 treatment, prevention, education.
11 Then the final question has to do with
12 jobs, following up on what Representative Daley
13 asked you about in terms of jobs initiative. It
14 certainly mirrors the ambition of the Governor and
15 it mirrors the mission of your department. How
16 about jobs for adults with disabilities? Is there
17 a focus on that, particularly full-time jobs for
18 folks with disabilities?
19 ACTING SECRETARY DALLAS: I think that
20 jobs, you know -- or jobs are therapeutic and good
21 for folks, whoever you are, whether you have a
22 disability or not. There are several initiatives
23 we have underway in the department in that regard.
24 One that I'll call attention to is, there's an
25 additional half a million dollars in the budget to
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1 work with the Department of Labor and Industry and
2 the Office of Vocational Rehabilitation, or OVR.
3 That money will leverage another $1.5 million in
4 federal funds. That will give us $2 million.
5 The hope there is that the expertise of
6 the folks at OVR can be used to help those with
7 disabilities find jobs, and that working together
8 we can find a better way to get jobs for folks
9 there.
10 REPRESENTATIVE DEAN: That's great.
11 Thank you. I wish you well with your work.
12 ACTING SECRETARY DALLAS: Thank you.
13 MAJORITY CHAIRMAN ADOLPH: Thank you,
14 Representative.
15 Representative Gary Day.
16 REPRESENTATIVE DAY: Thank you, Mr.
17 Chairman.
18 Thank you for being here today. I wish
19 you well in your future endeavors for the
20 Commonwealth.
21 ACTING SECRETARY DALLAS: Thank you.
22 REPRESENTATIVE DAY: Maybe you can get a
23 drink of water here while I'm going to open with a
24 little bit of a long question here.
25 Mr. Chairman, I look up there and I just
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1 think about sitting there and answering questions
2 for an hour and a half. I figure the guy needs a
3 little hydration.
4 You mentioned and the Governor has said
5 take this budget as a whole, so I take this
6 opportunity to share with you some of the people
7 that I represent and maybe people in my caucus
8 represent. The one thing we're trying to explain
9 about those people is that they're good people and
10 they're generous people. What I found is that,
11 when I describe and line out exactly what tax
12 dollars are going for, like we do in this budget
13 process, it's very helpful to get them on board to
14 say, yes, I do want to contribute my taxes or more
15 taxes toward that end.
16 So, when we sit here with the Medicaid
17 program, we have right now three Adult benefit
18 packages. Healthy Plus you mentioned in a couple
19 comments that you had answers: Healthy Plus,
20 Interim Health and the Private Coverage Option, and
21 that these three plans are going to be collapsed
22 into one. When that happens, that makes it --
23 that's back to the, take this budget idea in whole,
24 in total. That's what the Governor is saying about
25 the overall budget.
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1 The same thing happens here when we
2 collapse those all together. When they are
3 separated out, we have medically frail in one,
4 non-medically frail in another, and then the
5 private option. I can clearly say that's what this
6 is for; that's what these dollars are for.
7 Now, I understand being an administrator
8 that when you put those three together it gives us
9 more flexibility. And if I was sitting in your
10 chair, I would probably be asking for the same
11 exact thing; more flexibility. However, I'm over
12 here, and my job as a legislator is to try to have
13 clarity of where the dollars are going. So I have
14 a lot of questions about that.
15 Mr. Chairman, I'm going to try to
16 collapse my questions together the way these
17 programs are being collapsed together.
18 So, if we have this collapsing and we
19 put all three into one, how is it possible to --
20 You know, we're expanding services. How's it
21 possible -- If we expand the services offered and
22 remove service limits, how is it possible to save
23 money in that plan?
24 ACTING SECRETARY DALLAS: I think
25 there's a variety of things that save money. The
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1 35 million that I mentioned, off the bat that was
2 for the -- there was a system that would have had
3 to have been created to collect premiums under
4 Healthy PA. The elimination of that will save us
5 35 million this year, and it will go to SIDS for
6 half a year, so it will be 70 million the following
7 year.
8 I think that when you look at the
9 difference that was there, one of the problems with
10 Healthy PA -- You say you want transparency. One
11 of the things that also happened with Healthy PA
12 was, folks were going to the wrong category. They
13 were headed in the wrong category. Representative
14 DiGirolamo talked about, for example, folks who
15 were getting drug and alcohol services, that caused
16 a lot of problems.
17 When you look at the system the way it
18 was set up, there were folks who were relatively
19 healthy who were going into places that had higher
20 rates, and there were folks who were -- who
21 required more services who were in the wrong place.
22 By getting those folks into one common pool and
23 getting back to a HealthChoices package that the
24 state has been using for many, many years, that
25 will save money. That's not me saying it. That's
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1 the actuaries that do the rate review. That's the
2 federal government when they review the process
3 there. When you look at this, it will be either
4 cost neutral or actually cost less money than
5 Healthy PA over time.
6 REPRESENTATIVE DAY: So, I had another
7 question about MCOs. Are you looking to cut the
8 rates to MCOs or ask them to manage more
9 aggressively or --
10 ACTING SECRETARY DALLAS: The MCOs will
11 be using -- The rates are being determined right at
12 this time, but they will be in line with
13 HealthChoices and the traditional Medicaid rates
14 that were used throughout the Commonwealth for
15 years.
16 REPRESENTATIVE DAY: And does that --
17 Because we're putting everybody into the same
18 basket, does that make it cost more than, because
19 we have two other groups that will have more
20 services? That's what I'm trying to get at. It
21 seems like --
22 I'm trying to figure out if you figured
23 out a way not to make that cost more because, I
24 don't know how not to make that cost more with
25 expanding services.
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1 ACTING SECRETARY DALLAS: I'm not a
2 hundred percent sure I'm following you. I think
3 the key is, the PCO rates were higher rates, and I
4 think that they didn't necessarily need to be in
5 some regard. I think that when you look at the
6 combination down to that one rate, I think when you
7 look at insurance and you're pooling all those
8 folks there, I think there are efficiencies to be
9 gained there.
10 I think all the actuaries and the
11 federal government will tell you that as you do
12 that, that will ultimately allow us to serve more
13 people at a lower -- at a lower cost.
14 REPRESENTATIVE DAY: You stay in the
15 same category, but I'll ask you a question about
16 the public notice and the public notice period.
17 Your website indicates that the public notice will
18 be published in the Pennsylvania Bulletin -- on the
19 March 28 Pennsylvania Bulletin. It states that the
20 website notice begins the 30-day comment period.
21 And it also states that information will
22 be mailed to current recipients in the last week of
23 March, also, recipients will transition on April
24 27th. I'm trying to understand, when does the
25 public comment period begin? I think it's March
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1 19th or March 28th, but I don't know the answer.
2 ACTING SECRETARY DALLAS: The public
3 comment period began when we put the information up
4 on the website.
5 REPRESENTATIVE DAY: Would that have
6 been March 19th?
7 ACTING SECRETARY DALLAS: Yes, March
8 19th.
9 REPRESENTATIVE DAY: So, did you have a
10 legal review, you know, to determine that the
11 comment period can begin then before everybody is
12 notified?
13 ACTING SECRETARY DALLAS: Yes.
14 REPRESENTATIVE DAY: You do have a legal
15 review of that?
16 ACTING SECRETARY DALLAS: Yes.
17 REPRESENTATIVE DAY: Would you provide
18 that to the Chairman, please, so I can take a look
19 at that also?
20 ACTING SECRETARY DALLAS: Sure.
21 REPRESENTATIVE DAY: Thank you.
22 Mr. Chairman, I have a series of about
23 four or five other questions, and I'd like to
24 forward them to your office and ask you to respond
25 then to the Chairman, please --
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1 ACTING SECRETARY DALLAS: Of course.
2 REPRESENTATIVE DAY: -- just to save
3 time for today. I'd like to thank you for the
4 answers to my questions today and for your service
5 to Pennsylvania.
6 Thank you, Mr. Chairman.
7 MAJORITY CHAIRMAN ADOLPH: Thank you,
8 Representative.
9 Representative Matt Bradford.
10 REPRESENTATIVE BRADFORD: Thank you,
11 Chairman Adolph.
12 I wanted to begin kind of where some of
13 my colleagues have left off with the idea about
14 empathizing with, obviously, the expansion of the
15 sales tax in certain areas and the impacts that
16 would have. But I think that discussion would be
17 only half the discussion if we didn't talk about
18 the cuts that have been suffered over the last
19 couple of years.
20 As Chairman Adolph's admonition was,
21 this is a budget hearing and we have got to be
22 mindful of how the dollars have been spent and how
23 those services have been cut. The 10 percent cut
24 to human services that I guess was done about three
25 years ago now, what does this budget propose to do?
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1 We're all empathetic towards what those cuts meant
2 to real people. With an eye towards restoring some
3 of those cuts, what does this budget do in terms of
4 restoration to that 10 percent cut?
5 ACTING SECRETARY DALLAS: I believe
6 you're referring to what's normally called the
7 Human Services Block Grant?
8 REPRESENTATIVE BRADFORD: Yes.
9 ACTING SECRETARY DALLAS: So this budget
10 restores a third of that cut. I believe it's,
11 Dave, I have that right, it's $27 million?
12 DIRECTOR SPISHOCK: Yes. And it's not
13 just the block grant counties. It's all seven of
14 those appropriations within there. You could be in
15 the block grant or not.
16 REPRESENTATIVE BRADFORD: Just to be
17 clear, the seven, that's the mental health
18 services, intellectual disabilities community-based
19 services, county child welfare, behavioral health
20 services, homeless assistance, human services,
21 development fund and Medical Assistance?
22 DIRECTOR SPISHOCK: Yes. Act 150,
23 within the act. Yeah.
24 REPRESENTATIVE BRADFORD: So all of
25 those you'll restore the first third of the cut
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1 this year?
2 DIRECTOR SPISHOCK: Yes.
3 ACTING SECRETARY DALLAS: And the hope
4 is that over the next two years the remaining
5 two-thirds will be restored a third at a time each
6 year.
7 REPRESENTATIVE BRADFORD: Another
8 component of the cuts that have taken place -- And
9 again, when we talk about the impact of revenues,
10 and there's going to be impacts and there's no
11 reason to deduct them, but I think we should also
12 talk about some of the callous cuts that were made
13 in terms of how Act 22 was done. Obviously, that
14 was sold as cuts and waste, fraud and abuse, I
15 believe was the term. That was Secretary Alexander
16 at the time. I think what we really saw was
17 changes in services, benefits and eligibility.
18 I was just kind of going back looking at
19 one of the articles at the time. In the Inquirer
20 at the time, uncovering kids, 89,000 poor PA kids
21 slashed from Medicaid. It brings me to your very,
22 I think, valid point about saying that we need to
23 be intelligent when we look at cost savings. And
24 what we've seen in the past, I think, is a
25 willingness, a callousness, frankly, to make it
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1 seem like it's all okay; that we're doing program
2 integrity, and what we really were doing was
3 slashing and burning the DPW budget. I think that
4 was not Pennsylvania at its best over the last
5 couple of years.
6 So I'm glad to see us going in a very
7 different direction with this budget. I'm glad to
8 hear you say that it's important that we be mindful
9 in how we go about it. But the legacy of Act 22
10 still is there.
11 What does this budget propose to do, if
12 anything, in terms of how those regulations were
13 put in place?
14 ACTING SECRETARY DALLAS: For the block
15 grant?
16 REPRESENTATIVE BRADFORD: For the block
17 grant as well as the regulatory changes.
18 ACTING SECRETARY DALLAS: So I think for
19 the block grant, it leaves the block grant -- this
20 budget leaves the block grant intact. I think that
21 there needs to be a discussion about how we're
22 going to move forward, right? I'm of two minds
23 right now about the block grant. I believe that
24 affording flexibility to counties is a good thing.
25 I think some counties have done some interesting
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1 and innovative things with it as a result.
2 With that flexibility, I think we also
3 need to think about accountability and making sure
4 that those dollars are spent -- when they're flexed
5 that they're spent appropriately. So I think when
6 you look at how that's -- if we're going to expand
7 it or keep it in future years, I think we need to
8 make sure that there's also accountability.
9 I don't have -- One of the things we
10 don't have is good solid data about the results
11 that occurred in each of those counties with the
12 block grant. I think when you look at it you hear
13 some folks complain that some counties might have
14 spent more money on things that were favorite
15 programs and less money on things they
16 traditionally didn't like.
17 And I think, as we consider the future
18 of the block grant, my two cents would be that, if
19 we're going to keep it or expand it, that we need
20 to add accountability to it. There's a minimum
21 level of service and a common set of measures that
22 the public can have faith that even with that
23 flexibility, that a level of service is being
24 provided to those most in need under those seven
25 line items there.
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1 REPRESENTATIVE BRADFORD: And is it 30
2 counties right now that are in?
3 ACTING SECRETARY DALLAS: It's 30
4 counties out of the 67.
5 REPRESENTATIVE BRADFORD: And is there
6 any proposed expansion or not in this budget?
7 ACTING SECRETARY DALLAS: There's
8 nothing on the table now. The pilot -- I think it
9 technically was called a pilot. It was up to 30
10 counties. There are now 30 counties in there out
11 of the 67 in Pennsylvania.
12 I think that one of the discussions that
13 we should have is, is it something that should be
14 expanded and something that should be curtailed.
15 If we are going move forward, how exactly would we
16 do that.
17 REPRESENTATIVE BRADFORD: Thank you,
18 Secretary.
19 Thank you, Chairman.
20 MAJORITY CHAIRMAN ADOLPH: Thank you.
21 Representative Warren Kampf.
22 REPRESENTATIVE KAMPF: Thank you, Mr.
23 Chairman.
24 Mr. Dallas, Mr. Spishock, a couple of
25 questions on your personnel appropriation request.
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1 Maybe just to give it sort of a frame of reference,
2 the department actually has responsibility for
3 annually about $36 billion; is that right?
4 ACTING SECRETARY DALLAS: I think
5 it's -- That's about right.
6 REPRESENTATIVE KAMPF: Right. Which
7 just for folks watching, it's an amount larger than
8 the entire General Fund of Pennsylvania.
9 ACTING SECRETARY DALLAS: Including
10 federal funds, that's right.
11 REPRESENTATIVE KAMPF: Right. So big
12 job. How many employees in the department?
13 ACTING SECRETARY DALLAS: There are
14 about -- There's between sixteen and 17,000.
15 REPRESENTATIVE KAMPF: Okay. Which, by
16 my calculation, is about one-fifth of the entire
17 state workforce. Does that sound about right to
18 you?
19 ACTING SECRETARY DALLAS: It sounds
20 about right. I haven't done the math, but it
21 sounds about right.
22 REPRESENTATIVE KAMPF: Okay. What is
23 the overall personnel request, the budget request;
24 salaries, wages, benefits for '15-16?
25 DIRECTOR SPISHOCK: It's about 1.7
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1 billion.
2 REPRESENTATIVE KAMPF: And, just
3 generally, how is that broken down, wages, salary
4 to benefits?
5 DIRECTOR SPISHOCK: There's 848 million
6 are salaries, 26 million in wages, 27 million in
7 overtime, 738 million in benefits, as well as some
8 other payouts; about $1.657 billion.
9 REPRESENTATIVE KAMPF: All right. Have
10 you been able to just put a rough percentage on
11 that? What's the employee benefit factor?
12 DIRECTOR SPISHOCK: We can get you that.
13 REPRESENTATIVE KAMPF: Okay. The
14 calculations that we did have the employee benefit
15 factor at 89 percent. Does that sound about right?
16 DIRECTOR SPISHOCK: It sounds kind of
17 high, but we can verify something.
18 REPRESENTATIVE KAMPF: And do you know
19 what it was last year, for last year's budget?
20 DIRECTOR SPISHOCK: Last year we were at
21 $1.4 billion in salaries, with about 600 million of
22 that in benefits. So we grew from the
23 600 million to 738 million.
24 REPRESENTATIVE KAMPF: All right. Just
25 percentage-wise, what is the growth in your
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1 appropriation request for personnel from last year
2 to this year?
3 DIRECTOR SPISHOCK: We'd have to take a
4 look. We have our personnel scattered among a
5 number of appropriations, both county admin,
6 statewide and general government appropriations, as
7 well as the staffing that we have in the
8 institutions. We can break out what that overall
9 increase is. But in total dollars, we're going
10 from about 1.4 billion to 1.7 billion.
11 REPRESENTATIVE KAMPF: So, roughly,
12 about a 300-million-dollar increase?
13 DIRECTOR SPISHOCK: In total funds, yes.
14 REPRESENTATIVE KAMPF: And where is the
15 bulk of that increase coming from?
16 DIRECTOR SPISHOCK: As far as whether
17 it's salaries or benefits or --
18 REPRESENTATIVE KAMPF: Yes.
19 DIRECTOR SPISHOCK: Probably in the
20 benefit line item.
21 REPRESENTATIVE KAMPF: Just to put a
22 point on that, I see your retirement contribution
23 increased, by the numbers that you provided us, is
24 going up by 50 million; is that right?
25 DIRECTOR SPISHOCK: Yes.
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1 REPRESENTATIVE KAMPF: And your all-in
2 health care increase it looks like that's going up
3 by 80 or 90 million?
4 DIRECTOR SPISHOCK: Correct.
5 REPRESENTATIVE KAMPF: Okay. Two other
6 topic areas real quick. First of all, Acting
7 Secretary, the LIFE Program --
8 ACTING SECRETARY DALLAS: Yes.
9 REPRESENTATIVE KAMPF: -- there is, I
10 understand, in the budget proposal an expansion of
11 that. I presume you support that. Could you just
12 expand on it a little bit?
13 ACTING SECRETARY DALLAS: The LIFE
14 Program is one of the areas where we have
15 instituted some level of managed care into that
16 system, into the long-term care system. I think
17 it's a good inclusive approach and one that, my
18 hope is, that as we work with folks at the
19 University of Pittsburgh and stakeholders
20 throughout the system and move towards managed care
21 overall, the LIFE Program is something we can look
22 to use strategically and expand to help provide a
23 better quality of life for those folks and also to
24 help control costs.
25 REPRESENTATIVE KAMPF: Okay. Thank you.
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1 You just mentioned, I believe, the subject of
2 opiate dependence treatment and some money that was
3 going to go towards Vivitrol I think is the --
4 ACTING SECRETARY DALLAS: Yes.
5 REPRESENTATIVE KAMPF: -- is the
6 pharmaceutical. Sounds fine to me. I was handed a
7 document that shows that the pre-qualification
8 requirements, which I guess are being developed
9 right now, are pretty significant. So, I would
10 just ask you to take a look at those requirements
11 so that we don't make it too difficult to actually
12 get out into the potential patient population.
13 ACTING SECRETARY DALLAS: Of course.
14 REPRESENTATIVE KAMPF: Thank you. Just
15 back to the benefit factor, I'm absolutely not
16 picking on your department. This is something that
17 has been building and growing over a number of
18 years, as far as I can see, all the agencies, but
19 we are getting up into the 80 and 90 percent area;
20 meaning, for every dollar in salaries, 90 cents is
21 an equivalent amount that the taxpayers have to pay
22 for benefits.
23 That is quite out of whack with, I
24 submit to you, the rest of the private sector. If
25 you could, while you serve, look at whether that
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1 could be reduced, I would certainly appreciate it.
2 ACTING SECRETARY DALLAS: Certainly. I
3 certainly understand where you're coming from on
4 that. I'm not sure that our numbers line up as
5 high as 80 or 90 percent, but I certainly
6 understand your concern and I promise to work with
7 the General Assembly and with the Administration on
8 those costs.
9 REPRESENTATIVE KAMPF: I do think when
10 you go back and look, you'll find that they are 80
11 and 90 percent. Thanks.
12 MAJORITY CHAIRMAN ADOLPH: Thank you,
13 Representative.
14 Representative Keith Greiner.
15 REPRESENTATIVE GREINER: Thank you, Mr.
16 Chairman.
17 Thank you for being here today. I just
18 want to piggy-back real quickly Representative
19 Bradford. Actually, I want to get Chairman
20 DiGirolamo's bill back here, because I want to take
21 a look. Just give it back to me. I wish he was
22 here.
23 The block grants, I was actually the
24 county controller in Lancaster County just about
25 the time -- probably towards the end of that when
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1 this began. Lancaster County was one of the first
2 counties to implement this. I will say I worked
3 with a great team in the county, and I felt this
4 particular program worked exceptionally. I think
5 you'll see that the results if you do --
6 I agree with you about accountability.
7 Like I said, I worked with a great group of people
8 and it worked. There's no question it worked in
9 our county. We had the ability to put those funds
10 where we needed them, where the year before we
11 didn't have the ability to do so. If it was up to
12 me, I'd go to 67 counties with this plan.
13 But, you kind of answered the question,
14 though. I guess you're going to take a look into
15 that. You're going to evaluate how the counties
16 have done thus far. I'm telling you, maybe the
17 program is only as good as the people that you work
18 with, but in Lancaster County they were
19 exceptional. I just want to give a plug for that.
20 I do want to look at the chairman's
21 bill, because I do think there's a possibility,
22 really, that we can -- actually could save taxpayer
23 dollars. We talked today about the enormous tax
24 increases that we're going to have with this. This
25 is an opportunity maybe we can do something on the
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1 back end and do it from a savings perspective. So
2 I just wanted to give a shout-out for that.
3 The other issue I wanted to talk about
4 briefly, unfortunately, it's hit the news a lot in
5 the last year or so. I guess it's good that it's
6 being brought to light, is the domestic violence
7 that's occurring, and at times rape. And I notice
8 that there's a 10 percent increase for each of
9 those appropriations in the proposed budget.
10 What I'm wondering is, with every local
11 provider that's out there, how are you going to
12 allocate or divvy out that additional funding?
13 How's that going to be done?
14 ACTING SECRETARY DALLAS: You're
15 correct. It's a 10 percent increase for both. My
16 understanding is, there are funding formulas by
17 county for both domestic violence and for rape. I
18 suspect that the money will be allocated using
19 those funding formulas.
20 REPRESENTATIVE GREINER: I hope they're
21 nothing like our education funding formulas right
22 now. But the point is, I mean, I think that's
23 something that is going to be a concern because,
24 unfortunately, we're dealing with it more and more
25 in society; it's bring more to light, and we need
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1 to deal with it. I was just curious how that's
2 going to be done.
3 But, back to the block grants. I'm a
4 big proponent of it. Thank you.
5 ACTING SECRETARY DALLAS: I hear you on
6 that. To me, I want to be able to, folks who say
7 to me, well, they've underfunded this or that in a
8 particular county, I'd like to be able to look them
9 in the eye and say, well, let me show you what they
10 did with their block grant money. Here's how they
11 serve folks there. And I can be able to very
12 transparently show them what happened.
13 REPRESENTATIVE GREINER: Thank you for
14 your time.
15 Thank you, Mr. Chairman.
16 MAJORITY CHAIRMAN ADOLPH: Thank you.
17 Representative Mike Carroll.
18 REPRESENTATIVE CARROLL: Thank you, Mr.
19 Chairman.
20 Secretary, good afternoon.
21 ACTING SECRETARY DALLAS: Good
22 afternoon.
23 REPRESENTATIVE CARROLL: The question
24 related to the pension and the ratio, I'm not going
25 to rehash and recover that territory. I think when
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1 you do the calculation that was requested by the
2 gentleman from Chester, it would be at least
3 instructive, I think, to separate out the pension
4 obligation that we have for the normal cost and
5 then a separate calculation related to the cost
6 related to the unfunded liability going backwards
7 in time.
8 Secondly, I will congratulate the
9 department for the reconsideration, the re-issuance
10 of an RFP in the world of Access. The folks at the
11 Luzerne Intermediate Unit and my friends at the
12 North Pocono School District were at the forefront
13 of identifying problems related to the execution of
14 the last Access program and contract. I know for
15 certain they will, as I will, be thankful for
16 reexamination and, hopefully, a better
17 implementation going forward.
18 Mr. Secretary, as we contemplate, and
19 we've heard lots today about the sales taxes in the
20 Governor's proposal, as Representative Bradford
21 pointed out, I think it's important to remember
22 some of the things that brought us to where we are
23 today. And in the world of things that brought us
24 to where we are today, I recall last year's
25 exercise with respect to the use of one-time funds.
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1 To read just four that freed up
2 somewhere in the neighborhood of $650 million,
3 managed care payment delay that was pushed to July,
4 the use of lottery funds, the use of tobacco
5 settlement funds, and federal funds that are
6 non-recurring. That's $650 million, if we do
7 nothing else in terms of the other lines in your
8 budget, that will have to be replaced. Is that a
9 fair assessment?
10 ACTING SECRETARY DALLAS: For those
11 categories, yes.
12 REPRESENTATIVE CARROLL: Okay. So, when
13 we contemplate the world of your department, we
14 have to start with at least backfilling those lost
15 funds, if we were just going to maintain the level
16 of service that existed in the last fiscal year.
17 And so, when we consider and do the
18 handwriting relate to the sales taxes or the income
19 tax or the severance tax, I think it's important to
20 remember that the process that we have before us
21 must account for the budget that was passed last
22 year and the inability that we have to use the
23 funds that were exercised last year that are not
24 available to us this year; those being four
25 examples.
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1 Obviously, not a question here, Mr.
2 Secretary, but I think it's important that we
3 remember that we just simply cannot maintain the
4 status quo if we accept the reality of the fact
5 that there were one-time funding measures used last
6 year that had been admitted by almost all folks in
7 the Capitol that are not available to us this year.
8 So, when we consider our obligations as
9 a Commonwealth to provide services to folks that
10 are represented by the folks in this room, we have
11 to be honest with the fact that there's a
12 requirement for us to provide a level of funding
13 that, in all likelihood, requires some enhancements
14 at least if we're going to move forward with the
15 obligation to backfill the use of the one-time
16 funds, if not to go forward and try and backfill
17 some of the cuts that were made over the course of
18 the last four years. Thank you so much.
19 ACTING SECRETARY DALLAS: I guess I'd
20 add just one thing to that. I agree with
21 everything you said. I just think that, when I've
22 heard a couple of folks say, you know, you have to
23 take it as a whole or something; I think when folks
24 have said that, I think the idea is that it's a
25 comprehensive package and it works as a whole.
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1 I do think, though, that there's a
2 conversation to be had about pieces of it. I just
3 think that if you're going to say you're against
4 one piece of it, there's an obligation to say what
5 you would do instead if you're doing that. If
6 you're not going to implement that particular tax
7 and so on, what would you do instead? What would
8 be your plan if you don't like the plan the
9 Governor proposed?
10 MAJORITY CHAIRMAN ADOLPH: I'm sure
11 you're going to hear that.
12 ACTING SECRETARY DALLAS: I think we
13 might hear a few.
14 MAJORITY CHAIRMAN ADOLPH:
15 Representative Glen Grell.
16 REPRESENTATIVE GRELL: Thank you, Mr.
17 Chairman.
18 Secretary Dallas, thanks for being here
19 and taking all these questions. I have two areas
20 of questioning. I will confess I was a little
21 tardy getting here. So if you've already addressed
22 either one of these, let me know and I'll just
23 check the record.
24 And, Mr. Chairman, if I go too long,
25 I'll go into round 2.
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1 First area has to do with the attention
2 that's being put into the budget toward continuing
3 the work on reducing the ID waiting list. I'm
4 concerned that efforts in the past have been not as
5 successful as they could have been because of low
6 rates being paid to providers.
7 Is there anything in your budget, or in
8 your planning, that might address the rates that
9 are being offered to ID providers?
10 ACTING SECRETARY DALLAS: There's not a
11 rate increase per se, but I think there's a
12 regulatory process that's going on that I hope will
13 make the rules that we all have to play by a little
14 easier and less bureaucratic and that might help
15 folks save some money.
16 REPRESENTATIVE GRELL: Okay. A
17 corollary question to that is, if, in fact, the
18 minimum wage is increased, do you have any
19 information on what impact that would have on the
20 ability of whatever money is in that budget? How
21 many fewer people could be served, if that's the
22 case, if the minimum wage was increased?
23 ACTING SECRETARY DALLAS: Our initial
24 rough estimate is that there are approximately
25 40,000 folks who receive SNAP, which a lot of
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1 people call food stamps, who would be lifted out of
2 poverty by a minimum wage increase, and there are
3 about 60,000 or so folks who get the child care
4 subsidy who would see increases that would have
5 them not be eligible for the child care subsidy.
6 REPRESENTATIVE GRELL: I appreciate
7 those answers, but my question, I guess, wasn't
8 clear enough. I meant, in your ability to work on
9 the waiting list, if you had to increase the
10 minimum wage for providers and work that into your
11 compensation base, have you looked at what effect
12 that would have on your ability to whittle away at
13 the waiting list?
14 ACTING SECRETARY DALLAS: The budget
15 does not have -- The budget does not factor in a
16 minimum wage increase at this time. I'm sure if
17 the legislature and the Governor saw fit to
18 increase the minimum wage, we'd love to have that
19 conversation about some changes to our budget.
20 REPRESENTATIVE GRELL: Okay. But if we
21 just increased the minimum wage and kept that line
22 item the same, I assume that would mean fewer
23 people would be able to be brought off the waiting
24 list, in the first year at least?
25 ACTING SECRETARY DALLAS: I think that
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1 there are -- there would have to be -- there's
2 potentially some increases in the wages paid to
3 those folks. But I think that in the overall
4 scheme of things, that would be a small price to
5 pay for the benefit of the minimum wage increase.
6 REPRESENTATIVE GRELL: Okay. That is a
7 fair answer.
8 Shifting then to the second area. I've
9 been looking at the settlement agreement that the
10 previous Administration entered into with the
11 federal government back in January. This relates
12 to claims that were made -- Well, the settlement
13 agreement requires the Commonwealth to pay $48.8
14 million back to the federal government over the
15 next five years because of problems with the
16 Medicaid, the TANF and the SNAP program in terms of
17 paying non-citizens during a period from January
18 2004 to December 31st, 2010.
19 I want to ask you, are you familiar with
20 the settlement agreement and the --
21 ACTING SECRETARY DALLAS: Yes.
22 REPRESENTATIVE GRELL: Can you give us a
23 little idea of the circumstances related to --
24 ACTING SECRETARY DALLAS: There were
25 improper payments made for those category of folks.
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1 I think there were some problems with our processes
2 that got those folks moved into payment streams
3 where they shouldn't have been. We worked out a
4 settlement with the federal government to pay off
5 that, and moving forward we've corrected those
6 issues so those payments no longer occur.
7 REPRESENTATIVE GRELL: Okay. I want to
8 get into that a little bit more. Just so I'm
9 clear, the document, and it's their term, what is a
10 non-citizen as defined in the settlement agreement?
11 What population are we talking about?
12 ACTING SECRETARY DALLAS: Probably with
13 folks we call illegal aliens.
14 REPRESENTATIVE GRELL: Okay. All right.
15 Do you know how many individuals
16 received benefits during that period that were
17 later either deemed or agreed to by the parties to
18 not be eligible for the benefits?
19 ACTING SECRETARY DALLAS: I don't have
20 that number right in front of me, but I'm sure we
21 can get you something on that.
22 REPRESENTATIVE GRELL: That's something
23 you can get for us. Okay. Thank you.
24 You said that changes have been made.
25 Can you give us a little more detail on what those
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1 changes have been made; what quality control
2 measures have been put in place to make sure that
3 county assistance workers are not qualifying people
4 who shouldn't be qualified?
5 ACTING SECRETARY DALLAS: I think we can
6 give you some detail on that, and we'll provide it
7 to the Chair. But, I think they're along the lines
8 of, if there are folks who, sometimes there's
9 emergency medical services that folks qualify for.
10 Then that sometimes triggers through.
11 As you might imagine, in our system we
12 have things that trigger other events, and you get
13 enrolled in certain things by certain actions. I
14 think some folks got caught up in that. I think
15 that we've now corrected those issues, and
16 sometimes whether it's an emergency service or
17 something, got folks enrolled in other things.
18 Those are the kinds of things that we corrected,
19 but I can get more detail to the Chair about that.
20 DIRECTOR SPISHOCK: We do have a list of
21 that, because, as part of the settlement we had to
22 supply to the Department of Justice the list of
23 corrective actions that we have taken place since
24 that time to make sure prior to us entering into
25 that agreement.
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1 REPRESENTATIVE GRELL: Okay. Were any
2 personnel actions taken as a result of this whole
3 situation? Any people fired or otherwise
4 sanctioned for their conduct?
5 DIRECTOR SPISHOCK: Not to my knowledge.
6 These provisions were -- I'm guessing maybe in 2006
7 that these occurred.
8 REPRESENTATIVE GRELL: It says from
9 between 2004 and 2010.
10 DIRECTOR SPISHOCK: Yes. I'm not sure.
11 We'd have to check on that.
12 REPRESENTATIVE GRELL: Okay. As I read
13 the settlement agreement, the payment of this
14 $49 million is spread out over five years. And I
15 believe the first payment was due the end of March
16 -- or is due I guess next week.
17 DIRECTOR SPISHOCK: It was due the end
18 of March. We made the payment last week.
19 REPRESENTATIVE GRELL: So the first
20 payment of 2 million or so has been made, and I
21 think it's quarterly payments for 20 quarters until
22 it's paid.
23 DIRECTOR SPISHOCK: Yes.
24 REPRESENTATIVE GRELL: What fund is that
25 money coming out of? I mean, were monies set aside
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1 for that in the previous budgets?
2 DIRECTOR SPISHOCK: In our budget it's
3 listed under the MA Capitation Appropriation.
4 There's a line item in there for the settlement
5 provisions. We actually had some prior year
6 federal funds we were using to offset this. It's a
7 settlement that they've been working on for years.
8 When we had unspent money, we were able to set that
9 aside knowing that at some point we were going to
10 have to settle this provision.
11 REPRESENTATIVE GRELL: Okay. I think
12 that, sort of the bottom line of it is, that if
13 greater attention needs to be made at the time of
14 an eligibility determination, I think the committee
15 needs some assurance that those things are going to
16 be followed through.
17 I remember there was a period, and it
18 coincided with that period where we would hear, at
19 least anecdotally, of situations where caseworkers
20 were simply doing as much as they possibly could to
21 get people authorized for benefits. Again, at
22 least anecdotally, through some hearings we had
23 during that time, this sort of just get as many
24 people authorized, and that's our measure of
25 success. How many people are we providing benefits
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1 to? Maybe I'll just ask you to comment on, is that
2 the attitude of this Administration when it comes
3 to the Department of Human Services?
4 ACTING SECRETARY DALLAS: Of course not.
5 Our goal is to get benefits to those who are
6 eligible for those benefits. I think, going back
7 to 2004, some folks had made some mistakes. We are
8 correcting those mistakes. We made the settlement.
9 My goal is to make payments to only
10 those folks and not a penny more to those folks
11 that are eligible for those benefits. The measure
12 of our success is accurately determining
13 eligibility and paying benefits to those who are
14 eligible for those benefits.
15 REPRESENTATIVE GRELL: Okay. I
16 appreciate you saying that. And if you'll follow
17 up with the Chairman on providing that additional
18 information --
19 ACTING SECRETARY DALLAS: Of course.
20 REPRESENTATIVE GRELL: -- I'd appreciate
21 it very much.
22 Thank you, Mr. Chairman.
23 MAJORITY CHAIRMAN ADOLPH: Thank you,
24 Representative.
25 Representative Fred Keller.
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1 REPRESENTATIVE F. KELLER: Thank you,
2 Mr. Chairman.
3 And thank you, gentlemen, for being here
4 today. I had a question on our state centers for
5 intellectual disabilities, but I have to go back to
6 one thing prior to that, and I want to clear up
7 what a cut is.
8 A cut is when we spend a certain amount
9 of money this year, and the next year we spend less
10 money, correct? Because I have the 10-year history
11 for DPW spending. And in 2010-11, it was 10
12 billion 498 million. In '11-12, it was 10 billion
13 550 million. In '12-13, it was 10 billion 585
14 million. In '12-13 (sic), it was 11 billion 84
15 million. And in '14-15, it was 11 billion 208
16 million.
17 Now, can you tell me what cuts we're
18 restoring?
19 ACTING SECRETARY DALLAS: I think that
20 your analysis is missing a critical piece. I think
21 when you look at that and you put those numbers out
22 there, you're not looking at the number of folks
23 that are being served by the department.
24 REPRESENTATIVE F. KELLER: But the point
25 is, the cuts are not cuts unless we appropriate
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1 less money.
2 ACTING SECRETARY DALLAS: I think there
3 are many things that we appropriate less money for.
4 I think that if you simply do a simple analysis of
5 how much the department spends overall without
6 looking at the number of people who are served and
7 the number of people who receive those benefits
8 under the rules that are set up by the
9 Administration and the General Assembly, I think
10 it's an incomplete analysis and I think it doesn't
11 tell the whole picture.
12 REPRESENTATIVE F. KELLER: Like saying
13 we cut money before and restoring cuts doesn't tell
14 the whole picture because we did appropriate more
15 money. People are led to believe that we
16 appropriated less money. The point, we did not.
17 I want to get on to my question. I just
18 wanted to make sure that people understand watching
19 this because, at home when we do a budget, when we
20 cut something, we don't spend as much money as we
21 spent the previous year. But I want to get onto my
22 question.
23 ACTING SECRETARY DALLAS: Let's talk
24 about that a little bit more. When you talk about
25 the money that's being spent by the department, you
Key Reporters [email protected] 125
1 can look at the folks that we serve. About 30
2 percent of the folks we serve are the elderly and
3 the disabled. Pennsylvania has a growing elderly
4 population. The cost for providing services for
5 those folks is 60 percent of our costs.
6 So, when you talk about doing a budget
7 or reducing services, you're talking about cuts to
8 folks who are elderly or folks that are disabled.
9 So, when you look at that, I understand exactly
10 where you're coming from, but I'm just saying,
11 there's another dimension to that argument. It's
12 not quite as simple as you're trying to portray.
13 REPRESENTATIVE F. KELLER: I'm not
14 trying to make it simple. I'm just trying to
15 complete the argument on the other side of the
16 equation. There's two sides to the equation.
17 DIRECTOR SPISHOCK: Our budget would
18 normally grow by about $500 million each year, just
19 if we did nothing; just with the increase in
20 services to the benefits recipients, the elderly.
21 Plus, we have items out of our control; federal
22 matching rate. In one of those years you
23 mentioned, our federal matching rate dropped
24 considerably. We had a budget for $300 million in
25 state funds just to offset that change in FMAP. So
Key Reporters [email protected] 126
1 there are a lot of things that are just out of our
2 control when our budget is growing like that.
3 REPRESENTATIVE F. KELLER: Yeah,
4 understand. But let's understand the whole piece
5 of the puzzle. I wanted to get to our state
6 centers for intellectual disabilities was actually
7 my question.
8 I realize we have a lot of people that
9 work hard in state government, and particularly
10 those people who work in our state centers.
11 There's a center in my district, Selinsgrove
12 Center, and I don't know if you've been to the
13 Selinsgrove Center or not, but if you haven't been,
14 I would invite you to come up and see the work they
15 do.
16 ACTING SECRETARY DALLAS: Once I get a
17 chance through the budget process and I'm through
18 there, I'll be happy to visit Selinsgrove.
19 REPRESENTATIVE F. KELLER: Well, the
20 point I guess I wanted to make, and I was glad to
21 hear you recognize that we need to serve people in
22 the most appropriate settings. I realize the need
23 for community-based care, and I also realize the
24 need for state centers, because the people -- the
25 Benjamin decision has people being moved into the
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1 community, which is good if that's suited for those
2 people.
3 But looking at that, the people that are
4 remaining in our state centers are the ones that
5 probably are more -- require more care. And my
6 question comes to the complement of staff and how
7 that is determined. Maybe you can correct me if
8 I'm wrong on this. My understanding is, our
9 complement of staff is determined statewide amongst
10 the five centers; is that correct?
11 ACTING SECRETARY DALLAS: I'm not a
12 hundred percent sure, but I know there are staffing
13 ratios that you -- of folks that you use to
14 determine the staffing at any particular facility.
15 REPRESENTATIVE F. KELLER: So is it by
16 facility or is it just the population in a whole?
17 Are we --
18 ACTING SECRETARY DALLAS: I don't know
19 the answer to that.
20 REPRESENTATIVE F. KELLER: Okay. I've
21 heard it's within the whole system of state
22 centers. That would be my question as far as
23 getting answers on how we look at rectifying,
24 because there have been some Act 102 complaints
25 filed with the Department of Labor over the
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1 complement of staff and mandatory overtime. I
2 guess that's why I'm trying to get at that; to
3 bring the awareness up; that if we do need to give
4 these people care --
5 And these are truly people. I mean,
6 everybody gives the horror stories of abuse and
7 other things like that. The people living in our
8 state centers for intellectual disabilities are not
9 abusing the system. They need the care. They
10 deserve the care. And I just want to make sure
11 that we're looking at the complement of staff. So
12 if you guys can -- if we're not sure you can get me
13 the answers and we can work on that.
14 ACTING SECRETARY DALLAS: I will
15 absolutely look into that. I mean, it's -- I think
16 everyone can agree that we need to make sure those
17 centers are appropriately staffed.
18 REPRESENTATIVE F. KELLER: Thank you.
19 Appreciate it.
20 MINORITY CHAIRMAN MARKOSEK: Mr.
21 Chairman, just one thing. I think the gentleman
22 was just looking at state appropriations there, the
23 General Fund. I mean, there's a lot of other
24 sources that -- Ask any county if they got cut and
25 they would tell you yes.
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1 ACTING SECRETARY DALLAS: I think you
2 would not be hard to find some county
3 administrators who believe they have less money
4 now, yeah.
5 MAJORITY CHAIRMAN ADOLPH:
6 Representative Karen Boback.
7 REPRESENTATIVE BOBACK: Thank you, Mr.
8 Mr. Chairman.
9 Hello, gentlemen.
10 ACTING SECRETARY DALLAS: Hello.
11 REPRESENTATIVE BOBACK: I think I'm the
12 last one, so if you'll bear with me; if not, close
13 to the end. My question has to do with MA
14 transportation funding in the program.
15 If my numbers are correct, I'm going to
16 throw them at you, correct me if they're not,
17 please. That this upcoming year, '15-16, that
18 10.15 million one-way trips are anticipated with
19 the expansion. Does that sound right?
20 ACTING SECRETARY DALLAS: I don't have
21 the numbers right here in front of me, but --
22 DIRECTOR SPISHOCK: Yes. It sounds
23 right.
24 REPRESENTATIVE BOBACK: It sounds right.
25 So, the transportation, where are you
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1 going from and to? How is it utilized in your
2 department?
3 ACTING SECRETARY DALLAS: Most of the
4 time it's primarily for trips to see your doctor.
5 REPRESENTATIVE BOBACK: So it would pick
6 -- I'm in a rural area, so I would appreciate that
7 then. So it would pick up a constituent if they're
8 on the MA program and take them to their doctor?
9 ACTING SECRETARY DALLAS: Correct.
10 Particularly in rural areas. Sometimes
11 transportation is not the easiest thing and for
12 folks to get to see their doctor if there isn't
13 mass transit available, other arrangements have to
14 be made.
15 REPRESENTATIVE BOBACK: And that would
16 be the case in the area that I represent. But
17 here's a question.
18 Do you ever join with, like, the
19 Department of Aging and Older Adults, because there
20 are seniors that are in their 80's and 90's that,
21 perhaps, don't qualify through your program but by
22 their mere age would like to get to the senior
23 center. Do you hook up with them? Are they
24 allowed -- Because sometimes it seems we just put
25 everybody in a box. But wouldn't it be great if we
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1 could share services, or is that done?
2 ACTING SECRETARY DALLAS: I completely
3 agree with you. I know that there's an effort
4 underway to work with Aging and the Department of
5 Transportation to make those trips as -- you know,
6 get the most out of those trips as you can.
7 Sometimes it's difficult because people, it's very
8 hard to get to see your doctor sometimes and you
9 have to go when the doctor is available.
10 But, I think if we can find ways to make
11 those trips as economic as possible and pick up
12 multiple folks along the way and get them back, I
13 think if you balance that through a centralized or
14 an enrollment broker, I think there's ways that you
15 can achieve savings there.
16 My understanding is those discussions
17 are underway, and my hope is, moving forward, that
18 we'll find ways to do that, because you're right.
19 At the end of the day, we have budget hearings
20 about the Department of Human Services. You had a
21 budget hearing about the Department of Aging. But
22 for the taxpayers it's all the same dollar bill,
23 and it's all the same folks, right? So, for us, if
24 we can find ways to do that, I'm all for it and I'm
25 hopeful we can do that. It's not an easy thing to
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1 do, but I'm hopeful we can move in that direction.
2 REPRESENTATIVE BOBACK: If I can help
3 you, please call me. I appreciate your response.
4 Thank you for at least looking into that.
5 ACTING SECRETARY DALLAS: Absolutely.
6 Thank you.
7 REPRESENTATIVE BOBACK: Thank you, Mr.
8 Chairman.
9 MAJORITY CHAIRMAN ADOLPH: Well, I'm
10 going to put a smile on your face. That was the
11 last question --
12 ACTING SECRETARY DALLAS: All right.
13 MAJORITY CHAIRMAN ADOLPH: -- by the
14 Appropriations Committee members. I want to first
15 thank both of you for coming forward to testify
16 today. I appreciate your understanding of the
17 issues. We've had very tough budgets over the last
18 several years.
19 The one thing that this committee, in
20 putting together a budget over the last four years,
21 was not mentioned today and may -- may also bring
22 some more debate. But your department lost a
23 little over $4 billion in federal stimulus money.
24 That was spent over two and a half years, which we
25 didn't cut services for those dollars that we lost
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1 in federal stimulus money.
2 Some of the changes that were made --
3 And I'm very interested in that block grant
4 because, you know, you talk to some groups and
5 they're all in favor of it, and you talk to other
6 groups and they're not so happy with it. That's
7 why we did a pilot program.
8 My home county, those county
9 commissioners really think it works, because the
10 way it was explained to me, and I was never in
11 county government, is that there were several
12 silos, or whatever they were called. They were
13 filled up. And when they were not used in that
14 specific silo, that money would go back to the
15 Commonwealth. The county commissioners could not
16 move that money around to areas of need. And as a
17 result of the block grants, they were able to do
18 that. It was about putting the money to help the
19 people the most. Just a couple things.
20 We're going to be working with you. I
21 appreciate your expertise, and I know that Dave is
22 the numbers guy and he's been around. We're
23 looking forward to working with you. But there's
24 an awful lot of things that we have to put
25 together. I understand you don't like to talk
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1 about the tough things, but we have to. And paying
2 for it is the tough part of it, and we have to
3 explain to the people --
4 There's not one person on this committee
5 or elected that wants to harm the most vulnerable
6 people. And some of the waste, fraud and abuse
7 issues that we dealt with was actually recommended
8 by the Auditor General at the time. We cut his
9 recommendations in half so we wouldn't make a
10 mistake. So, I'm just giving you some history.
11 And being a Philadelphia Eagles' fan,
12 it's tough for me looking at Secretary Dallas all
13 day long.
14 ACTING SECRETARY DALLAS: You should see
15 what I go through on Sundays in Philadelphia.
16 MAJORITY CHAIRMAN ADOLPH: I can
17 understand that. But I certainly appreciate your
18 expertise and looking forward to working with you.
19 ACTING SECRETARY DALLAS: Thank you,
20 sir. I'm looking forward to working with you as
21 well.
22 MAJORITY CHAIRMAN ADOLPH: All right.
23 Thank you very much. Bye now.
24 Tomorrow morning for the members, we
25 will reconvene at 9:30 with the Secretary of the
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1 Budget. Thank you.
2 (At 3:50 p.m., the budget hearing
3 concluded).
4 * * * *
5
6 C E R T I F I C A T E
7
8 I, Karen J. Meister, Reporter, Notary
9 Public, duly commissioned and qualified in and for
10 the County of York, Commonwealth of Pennsylvania,
11 hereby certify that the foregoing is a true and
12 accurate transcript, to the best of my ability, of
13 a public hearing taken from a videotape recording
14 and reduced to computer printout under my
15 supervision.
16 This certification does not apply to any
17 reproduction of the same by any means unless under
18 my direct control and/or supervision.
19
20
21
22 Karen J. Meister Reporter, Notary Public 23
24
25
Key Reporters [email protected]