COMMONWEALTH OF PENNSYLVANIA HOUSE OF REPRESENTATIVES APPROPRIATIONS COMMITTEE HEARING STATE CAPITOL HARRISBURG, PA MAIN BUILDING ROOM 140 MONDAY, FEBRUARY 11, 2019 3 P.M. BUDGET HEARING FOR THE DEPARTMENT OF AGING BEFORE: HONORABLE STANLEY SAYLOR, MAJORITY CHAIRMAN HONORABLE ROSEMARY BROWN HONORABLE LYNDA SCHLEGEL-CULVER HONORABLE SHERYL DELOZIER HONORABLE GEORGE DUNBAR HONORABLE JONATHAN FRITZ HONORABLE MATT GABLER HONORABLE KEITH GREINER HONORABLE SETH GROVE HONORABLE MARCIA HAHN HONORABLE DOYLE HEFFLEY HONORABLE LEE JAMES HONORABLE FRED KELLER HONORABLE JOHN LAWRENCE HONORABLE JASON ORTITAY HONORABLE CLINT OWLETT HONORABLE CHRIS QUINN HONORABLE GREG ROTHMAN HONORABLE JAMES STRUZZI HONORABLE JESSE TOPPER HONORABLE RYAN WARNER HONORABLE MARTINA WHITE HONORABLE MATT BRADFORD, MINORITY CHAIRMAN HONORABLE DONNA BULLOCK HONORABLE MORGAN CEPHAS HONORABLE MARIA DONATUCCI HONORABLE ELIZABETH FIEDLER HONORABLE MARTY FLYNN HONORABLE EDWARD GAINEY HONORABLE PATTY KIM 2 1 BEFORE: (cont.) HONORABLE STEPHEN KINSEY 2 HONORABLE LEANNE KRUEGER HONORABLE BENJAMIN SANCHEZ 3 HONORABLE PETER SCHWEYER 4 ALSO IN ATTENDANCE: HONORABLE TOM MURT 5 HONORABLE JAKE WHEATLEY HONORABLE STEVE SAMUELSON 6 COMMITTEE STAFF PRESENT: 7 DAVID DONLEY, MAJORITY EXECUTIVE DIRECTOR RITCHIE LaFAVER, MAJORITY DEPUTY EXECUTIVE DIRECTOR 8 MIRIAM FOX, MINORITY EXECUTIVE DIRECTOR TARA TREES, MINORITY CHIEF COUNSEL 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 * * * * * Pennsylvania House of Representatives 25 Commonwealth of Pennsylvania 3 1 I N D E X 2 TESTIFIERS 3 * * * 4 NAME PAGE 5 ROBERT TORRES ACTING SECRETARY, DEPARTMENT OF AGING..........4 6 THOMAS SNEDDEN 7 DIRECTOR, BUREAU OF PHARMACEUTICAL ASSISTANCE CONTRACT FOR THE ELDERLY (PACE)...............19 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 * * * * * * Summer A. Miller, Court Reporter 25 [email protected] 4 1 P R O C E E D I N G S 2 * * * 3 MAJORITY CHAIRMAN SAYLOR: We'll call the 4 Appropriations hearing back to order. And I will ask 5 Secretary Torres -- or Acting Secretary Torres, Department 6 of Aging, and Tom Snedden, who is the Director of the Bureau 7 of PACE for the Department of Aging, if you would both rise 8 and raise your right hand. And after I do the comments, if 9 you would say "I do." 10 11 ROBERT TORRES AND THOMAS SNEDDEN, called as 12 witnesses, being duly sworn, testified as follows: 13 14 MAJORITY CHAIRMAN SAYLOR: Thank you. 15 And we will start right away with questions. 16 The first person to ask questions today on Aging is 17 Representative Culver. 18 REPRESENTATIVE SCHLEGEL-CULVER: Good 19 afternoon. 20 ACTING SECRETARY TORRES: Good afternoon. 21 REPRESENTATIVE SCHLEGEL-CULVER: Thank you 22 for being here. 23 I have had the privilege of serving on the 24 Aging Committee here for about six of eight years and 25 learned quite a bit over those years. And I think one of 5 1 the things I'm concerned about is the Penn Care waiting 2 list. 3 For those in the room that don't know what it 4 does, it's the appropriation that provides funding for the 5 52 Area Agencies on Aging, for their administration and to 6 provide home- and community-based social services, including 7 home-delivered and congregate meals, home health, personal 8 care, senior support, and protective services. 9 But according to the department, there are 10 approximately 3,800 seniors on the waiting list for these 11 services. Is that an accurate number? 12 ACTING SECRETARY TORRES: That's correct. 13 REPRESENTATIVE SCHLEGEL-CULVER: And is that 14 across all 52 or is that more localized in certain areas in 15 the state? 16 ACTING SECRETARY TORRES: Well, it varies 17 because the agencies have some discretion on how they set up 18 the services that they provide. Some may provide a smaller 19 mix of services so they can serve a broader population. 20 Others may have more comprehensive services, and as a 21 result, end up with a waiting list. So it varies. 22 REPRESENTATIVE SCHLEGEL-CULVER: So what 23 would you estimate, I guess, across the Commonwealth, then, 24 what are the top three services that seniors are waiting 25 for? 6 1 ACTING SECRETARY TORRES: Well, in terms of 2 all services, it's the 3800. But again, what I would like 3 to clarify is that even though that number is high, that 4 doesn't mean that they're not receiving any services. Some 5 may receive, some of that 3800, the 3800 individuals may be 6 receiving some services and waiting on others. In terms of 7 in-home meals, we have 404; and caregiver support, 14. 8 REPRESENTATIVE SCHLEGEL-CULVER: So one of my 9 other concerns, I think, is -- I unfortunately am in a 10 district where I had a senior pass away waiting for services 11 a few years ago. And you know, they called the office and 12 we made calls. 13 So we talk about this Silver Tsunami that's 14 coming upon us over the next decade. We had a report this 15 morning from the IFO trending the numbers of people we have 16 as seniors, as opposed to the number of working class that 17 can support the services. How are we preparing for -- in 18 light of the fact that we currently sort of have this long 19 waiting list, we have had some deficiencies pointed out -- 20 how are we preparing to provide services for -- from what 21 data I've been given -- probably the most medically needy 22 class of seniors to come yet? How do we prepare for that? 23 ACTING SECRETARY TORRES: We monitor and see. 24 If resources become available, we try to address the waiting 25 list. Again, it's trying to balance the resources that we 7 1 have in order to address that particular need. So it's 2 something that we will continue to monitor and work with the 3 agencies to see if we can address a reduction in the waiting 4 list. 5 REPRESENTATIVE SCHLEGEL-CULVER: And is there 6 something we as a legislative body can do to help you out 7 with that or is there something we can do back in our 8 districts to help out our local Area Agencies of Aging? 9 ACTING SECRETARY TORRES: Well, certainly 10 resources are always welcome. I mean, that's the crux of 11 trying to address the increase, as you said, with the 12 elderly population projected to continue to increase, the 13 demand for services increases, as well. So we have to try 14 to balance out the resources that we have, and additional 15 resources are always welcome to help the situation. 16 REPRESENTATIVE SCHLEGEL-CULVER: So there's 17 some that believe that the funding that's coming from the 18 Lottery Fund for the Medicaid is some of the problem -- the 19 reason we have a waiting list. Is there any fact to that or 20 is there a basis for that belief? 21 ACTING SECRETARY TORRES: I'm sorry, can you 22 clarify your question? 23 REPRESENTATIVE SCHLEGEL-CULVER: So we had a 24 policy committee last week and the belief of some of the 25 people there presenting was dollars going from the Lottery 8 1 Fund to pay for Medicaid is some of the issue with the 2 waiting list, that there would be enough money available for 3 the people on the waiting list if we weren't paying those 4 dollars over. 5 ACTING SECRETARY TORRES: I'm aware of the 6 concern. Dollars that are transferred over to the 7 Department of Human Services are used to support the 8 elderly. Again, I think it's a matter of trying to balance 9 the resources to meet the different needs that we have. 10 REPRESENTATIVE SCHLEGEL-CULVER: So I'm 11 assuming this is a much larger conversation than the five 12 minutes I have here. I just wanted to, I guess, express 13 that it is our job as a Commonwealth to make sure that our 14 seniors are aging with dignity and grace. And any way we 15 can help you, support you to do that, we'd be happy to do 16 that. But this is an issue, I think, that's critical in all 17 of our districts. 18 Thank you. 19 ACTING SECRETARY TORRES: Thank you. 20 MAJORITY CHAIRMAN SAYLOR: Representative 21 Bradford. 22 MINORITY CHAIRMAN BRADFORD: Thank you, 23 Chairman. 24 And thank you, Acting Secretary Torres. 25 It was a privilege working with you in the -- 9 1 during your time as Secretary of the Commonwealth. And I 2 had a question for you. 3 I know you've got a little bit of a big job 4 here at Aging and there's some concerns that a lot of us 5 have shared. Eugene DePasquale, our Auditor General and the 6 State Inspector General, I guess, actually did the report 7 that came out this past January about some of the issues 8 with oversight in our AAAs. And I just wanted to give you 9 kind of an open-ended opportunity to discuss about some of 10 the improvements that have taken place and what your office 11 is doing to make sure that these issues are being addressed. 12 ACTING SECRETARY TORRES: Are you referring 13 to the Inspector General report? 14 MINORITY CHAIRMAN BRADFORD: Yes. 15 ACTING SECRETARY TORRES: So thank you for 16 the opportunity, Mr. Chairman. 17 I want to clarify for the committee that the 18 investigation of the Office of State Inspector General, as 19 it related to protective services, started in May of 2017, 20 so it's quite a while ago.