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
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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
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24 * * * * * Pennsylvania House of Representatives 25 Commonwealth of Pennsylvania 3
1 I N D E X
2 TESTIFIERS
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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
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24 * * * * * * Summer A. Miller, Court Reporter 25 [email protected] 4
1 P R O C E E D I N G S
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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:
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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. And shortly after the
21 investigation started, the department was already working on
22 updating some of our policies. And in particular, we
23 updated one to standardize and have a more uniform process
24 for how to do report of needs, which are reports that come
25 in from individuals looking to get protective services or 10
1 alleging that there's a case where protective services may
2 be needed.
3 That policy also instituted new monitoring
4 and oversight procedures. So if we, as a department, went
5 out to the AAAs and found that there were deficiencies,
6 noncompliance, depending on the severity of those issues, we
7 would go out again, either three months -- I'm sorry, 90
8 days from the time that we site visited or maybe six months,
9 again, depending on the level of severity. So again, rather
10 than waiting for an annual site visit, the frequency of
11 monitoring visits have increased, again depending on the
12 nature of any issues of noncompliance.
13 Part of the report talked about training in
14 terms of updating the content, increasing the frequency.
15 We've hired a Director of Education and Outreach. And those
16 are issues that are also being addressed in terms of looking
17 at our training content, increasing seeing what we could do
18 to improve delivery.
19 At the Department of State, we were looking
20 at piggybacking off an investigator's training academy,
21 something that's being spearheaded by the Attorney General's
22 Office. And several agencies are looking at leveraging
23 that. That's something that I want to look into because it
24 would be a fairly comprehensive course for investigators.
25 So that's something I have an upcoming meeting to help, to 11
1 assess whether we can take advantage of that.
2 We're also looking at how report of needs are
3 being classified. If they're classified as "no need,"
4 meaning there's no issue here and they could be closed,
5 we've been -- just slightly before the report was issued, we
6 started receiving any "no needs" from all the AAAs. And
7 again, that's our attempt to review them, to see if we agree
8 with their categorization of those reports and make sure
9 that if there's any issues, something is being missed that
10 requires technical assistance or maybe a clarification in
11 terms of policies or procedures, that we can be proactive on
12 that front, as well.
13 And personally I sat, within the last two
14 weeks, to look at the data that's coming in to see how the
15 data is coming in, how it's being used to establish
16 monitoring reports. Because one of the things I'm
17 interested in is making sure that the data is being used
18 effectively so that we have good oversight, that we're not
19 waiting a year to see that there's a problem. And I want to
20 make sure that if there's a trend or pattern that we can
21 address it a lot faster than during at an annual site visit.
22 MINORITY CHAIRMAN BRADFORD: My understanding
23 is that there were 12 recommendations, which require quite a
24 bit from the department. Is there a request or requirement
25 in your budget submission for additional staffing, and how 12
1 is that being handled?
2 ACTING SECRETARY TORRES: The budget does
3 have a 2.8 million increase proposed, and it's specifically
4 to support capacity increases at the AAAs because the demand
5 for service has increased so much with protective services.
6 MINORITY CHAIRMAN BRADFORD: Thank you,
7 Secretary.
8 ACTING SECRETARY TORRES: You're welcome.
9 REPRESENTATIVE DUNBAR: Next will be
10 Representative Grove.
11 REPRESENTATIVE GROVE: Thank you.
12 Good afternoon, gentlemen. How are you?
13 ACTING SECRETARY TORRES: Good afternoon.
14 REPRESENTATIVE GROVE: Good.
15 I want to talk about the federal
16 disallowances. There was $27.3 million Aging got hit with
17 to repay the federal government for the aging waiver, case
18 management activities performed by the AAAs, because it was
19 not included in Pennsylvania's Public Assistance Cost of
20 Allocation Plan. Who's responsible for preparing that plan?
21 ACTING SECRETARY TORRES: Are you talking
22 about the disallowance that goes back to 2008 and 2009?
23 REPRESENTATIVE GROVE: Yes, the
24 $27.3 million.
25 ACTING SECRETARY TORRES: Yes. 13
1 REPRESENTATIVE GROVE: Yes.
2 ACTING SECRETARY TORRES: That was a result
3 of an audit finding in 2008 and 2009. The Commonwealth has
4 been fighting that in court, but we lost. And what you're
5 seeing in our budget is some tobacco settlement dollars and
6 Lottery Fund dollars that are needed to repay that
7 disallowance from the source of the funding that was used.
8 REPRESENTATIVE GROVE: I take it -- it was a
9 single audit finding?
10 ACTING SECRETARY TORRES: Yes.
11 REPRESENTATIVE GROVE: Was that corrected,
12 the audit finding? The issue with that, was that corrected?
13 ACTING SECRETARY TORRES: Yes, it was.
14 REPRESENTATIVE GROVE: Do you know more about
15 this?
16 (No response.)
17 REPRESENTATIVE GROVE: He's looking at you
18 and you're shaking your head. The gentleman back here
19 (indicating) with --
20 ACTING SECRETARY TORRES: He's our finance
21 director.
22 (Inaudible.)
23 REPRESENTATIVE GROVE: Okay. All right.
24 Mr. Vice-Chairman, would it be all right if
25 he came forward and discussed this a little bit? 14
1 REPRESENTATIVE DUNBAR: It's all right if --
2 did we swear everybody in or did --
3 ACTING SECRETARY TORRES: No, he isn't sworn
4 in.
5 (Inaudible.)
6 REPRESENTATIVE DUNBAR: You figure as soon as
7 the chairman leaves, you're going to start playing games
8 with me, Seth. Is that what this is?
9 If he's okay with coming forward, we're okay
10 with hearing him testify. I don't --
11 ACTING SECRETARY TORRES: Can we follow up
12 with you?
13 REPRESENTATIVE GROVE: If you have the
14 answers now, I'd rather get them now. I've had a history of
15 not getting answers back.
16 ACTING SECRETARY TORRES: I'll have to follow
17 up with you, Representative.
18 REPRESENTATIVE GROVE: But you're saying, it
19 was correct, that whatever the issue originally was, it was
20 corrected.
21 ACTING SECRETARY TORRES: Yes.
22 REPRESENTATIVE GROVE: What was the original
23 issue that you were facing with that?
24 ACTING SECRETARY TORRES: As I understand it,
25 it was a Medicaid disallowance, so the feds came in on an 15
1 audit and disallowed. We took exception to that. We were
2 in the courts. And a district court ruled against us and we
3 had money in this year's budget to pay that.
4 REPRESENTATIVE GROVE: Okay.
5 The audit, did it specify -- was it DHS? I
6 assume this is a state plan change under Medicaid; is that
7 correct?
8 ACTING SECRETARY TORRES: Yes.
9 REPRESENTATIVE GROVE: I mean, no offense,
10 Mr. Secretary --
11 ACTING SECRETARY TORRES: If you'll allow me,
12 I don't have enough of that background detail.
13 REPRESENTATIVE GROVE: You've been on the job
14 for three weeks, I don't expect you to have the details of
15 this, but if your finance director has been here longer, I
16 would rather just get the information right here from him.
17 I mean, these are factual-based questions.
18 REPRESENTATIVE DUNBAR: Again, Mr. Secretary,
19 that's totally up to you. If you don't --
20 ACTING SECRETARY TORRES: I'll have to get
21 back to you on that, if you don't mind.
22 REPRESENTATIVE GROVE: Are you aware of any
23 other federal disallowances coming down the pike from the
24 Department of Aging?
25 ACTING SECRETARY TORRES: I am not. 16
1 REPRESENTATIVE GROVE: You're not. All
2 right.
3 So this is what I want to know: Number one,
4 state plan change. I assume it was DHS as primary, what is
5 the Department of Aging's role in that? Do they provide
6 oversight, guidance, dealing with Department of Aging
7 dollars going into that? Do you provide input into that
8 plan moving forward? Was there an issue with the AAAs or
9 was it an issue with how the Commonwealth was administering
10 it? Was it a DHS problem, AAA issue, or Department of Aging
11 issue?
12 And if you could pull that single audit and
13 send it to us, that would be great, as well, so we know
14 specifically what the issues were.
15 Thank you.
16 REPRESENTATIVE DUNBAR: And again, Mr.
17 Secretary, we would appreciate if you can get back to
18 Representative Grove and the committee with the answers of
19 those questions.
20 ACTING SECRETARY TORRES: We will.
21 REPRESENTATIVE DUNBAR: And next up will be
22 Representative Krueger.
23 REPRESENTATIVE KRUEGER: Thank you,
24 gentlemen. Thanks so much for joining us here today.
25 Yesterday in Delaware County, I was at our 17
1 courthouse, the Media Courthouse, with about 50 grandparents
2 and grandchildren who had gathered together to recognize the
3 fact that these grandparents were raising their
4 grandchildren largely due to having lost loved ones to the
5 opioid crisis. And this is an issue that a number of my
6 constituents have brought to my attention.
7 We've got a great-grandmother who is now
8 raising two great-grandchildren who's come to us for help
9 and has shared how challenging it has been for her to get
10 help and services. Her household went from two to four
11 overnight and she hasn't been able to get the support
12 services that she really needs to support this new family,
13 this new household.
14 So can you tell me, first, is this an issue
15 that the Department of Aging is seeing?
16 ACTING SECRETARY TORRES: It is an issue and
17 it's an issue that we're addressing.
18 One of the -- you may have seen, we have
19 about four commercials promoting our Caregiver Support
20 Program. That program was underutilized and it's a program
21 that grandparents in the situation that you described can
22 take advantage of. So we want to make sure that there's
23 awareness, public awareness, of those programs.
24 It's a program that can give grandparents an
25 opportunity to take a break from the caregiving 18
1 responsibilities. It reimburses for certain out-of-pocket
2 costs associated with caregiving and any related services.
3 It also provides education, training, counseling, if needed.
4 Again, it's been underutilized, so over the
5 past several weeks you may have seen different commercials
6 out there by the Department of Aging really trying to raise
7 the awareness of the program.
8 The other thing we have done related to
9 grandparents or grandfamilies -- before my arrival at the
10 department, there was a listening tour. There were about
11 three forums where the concerns of grandparents raising
12 children were discussed. And out of that effort, there was
13 a grandfamilies work group that was launched. So we have 11
14 grandfamilies that have been identified. We are going to
15 engage them over the next six months, from March through
16 July. And that will be a process where we'll be looking for
17 actionable recommendations that we can implement.
18 REPRESENTATIVE KRUEGER: So I saw a report --
19 and it's now two years old -- that said that there were
20 90,000 grandparents here in Pennsylvania who are raising
21 grandchildren, who are the primary caregiver for at least
22 one grandchild. And it estimated that there was about
23 195,000 grandchildren under their care. This was two years
24 ago, so I imagine the numbers have grown.
25 Is there more that you think we can be doing 19
1 in this building? Are there any solutions that would
2 require legislative authority that you would encourage us to
3 look at?
4 ACTING SECRETARY TORRES: Well, I think,
5 again, the Caregiver Support Program is one program that we
6 can take advantage of and help these families.
7 Tom, is there anything on the Opioid Command
8 Center with the families?
9 DIRECTOR SNEDDEN: Not specifically at this
10 time, no.
11 ACTING SECRETARY TORRES: I can get back to
12 you with any specific suggestions we might have.
13 REPRESENTATIVE KRUEGER: Okay.
14 And would your office be open if we hear
15 proposed solutions from the grandparents on the ground, is
16 your office open to us coming to you with ideas, as well?
17 ACTING SECRETARY TORRES: Absolutely,
18 absolutely.
19 REPRESENTATIVE KRUEGER: Okay. Thank you so
20 much. It's an issue we're seeing so much in Delaware
21 County, and I appreciate your help.
22 ACTING SECRETARY TORRES: Yeah.
23 MAJORITY CHAIRMAN SAYLOR: Secretary Torres,
24 if you would, Representative Grove's questions, get those
25 answers to us as soon as possible. 20
1 ACTING SECRETARY TORRES: Will do.
2 MAJORITY CHAIRMAN SAYLOR: I know -- send
3 them to me as chairman and I will disseminate them to the
4 rest of the committee members, but it's critical that we
5 have answers to the questions that Representative Grove
6 asked earlier.
7 ACTING SECRETARY TORRES: Okay.
8 MAJORITY CHAIRMAN SAYLOR: Before we start
9 the next question, I wanted to announce, for tomorrow, to
10 everybody that we will not have a morning session. Chairman
11 Bradford and I have discussed it. Due to the ice issue, we
12 will start at one o'clock tomorrow afternoon.
13 PSERS and SERS will move to another day at
14 this point in time.
15 So we will start at one o'clock tomorrow.
16 The morning session is canceled due to weather
17 considerations.
18 And at this point, PEMA cannot fill us in on
19 exactly what they expect. So we are going to play it safe
20 for people to come in here first thing in the morning and
21 give us light to lie.
22 With that, we will move to Representative
23 James.
24 REPRESENTATIVE JAMES: Thank you, Mr.
25 Chairman. 21
1 Gentlemen, I'm over here. Thank you for your
2 testimony today.
3 I wanted to spend a few moments talking about
4 one of the issues du jour, which is the proposal out there
5 to increase the minimum wage and how that's going to affect
6 some of the folks that work in your industry.
7 I see that the budget team has proposed an
8 increase of $226,000 to Penn Care for attendant care
9 services. So it would be very helpful for me and others if
10 you would describe what services will be covered, please.
11 ACTING SECRETARY TORRES: Attendant care
12 services are the services that we provide for individuals
13 age 60 and over who need those services. Those services are
14 being transitioned through Community HealthChoices, so
15 again, there's some adjustments in the budget as the rollout
16 of Community HealthChoices proceeds.
17 Our budget is being decreased. So the
18 226,000 that you're referencing is what we anticipate we'll
19 need to support direct care workers in the Attendant Care
20 Program, at least through the next year until the full
21 rollout of Community HealthChoices occurs. And then that
22 won't be our responsibility anymore.
23 REPRESENTATIVE JAMES: Okay. So we've
24 identified there may be some people working at minimum wage
25 in the industry. And so that is intended to cover 22
1 everything that they do?
2 ACTING SECRETARY TORRES: Well, as you said,
3 the individuals there, we can estimate a number of
4 individuals that fall into that category and that's what
5 that amount of money covers, and that will be for the next
6 fiscal year. And then for 2020, that would be transitioned
7 under Community HealthChoices.
8 REPRESENTATIVE JAMES: Okay.
9 What impact do you think, then, that the
10 Governor's proposed increase to the $12 per hour minimum
11 wage would have on the cost of services in any of the
12 facilities?
13 ACTING SECRETARY TORRES: Well, I think the
14 direct care workers are an important part of the system in
15 terms of caring for our elderly. In terms of the $12 per
16 hour and raising it even further, I think being able to
17 stabilize that workforce so they have a livable wage and we
18 don't see a lot of turnover in that industry, or in that
19 category of employees, is important to help maintain
20 continuity of care. But I think it's an important proposal
21 that should be considered.
22 REPRESENTATIVE JAMES: Okay.
23 Where does that leave, then, the senior
24 citizens who are covered that are paying their own way
25 through the system? Are they going to be expected to pay a 23
1 higher fee for the service in order to cover some of the
2 cost of their less fortunate neighbors; do you think?
3 ACTING SECRETARY TORRES: Well, I believe
4 they would. If the minimum wage is raised, they would have
5 to comply.
6 REPRESENTATIVE JAMES: Okay. Well, that's a
7 lot of pressure, I think, extra, on the private pay seniors.
8 Thanks for your testimony. That's all my
9 questions, Mr. --
10 MAJORITY CHAIRMAN SAYLOR: Representative
11 Bullock.
12 REPRESENTATIVE BULLOCK: Thank you, Chairman.
13 Good afternoon, Secretary. How are you?
14 ACTING SECRETARY TORRES: Good afternoon,
15 Representative.
16 REPRESENTATIVE BULLOCK: Great.
17 My first question goes in regards to your
18 workforce and diversity. Could you share with me the
19 percentage or actual numbers of women and minorities and
20 other groups that are employed by your agency in comparison
21 to last year?
22 ACTING SECRETARY TORRES: Sure. Last year we
23 had four minority males, eleven minority females. This year
24 we're at about the same, but we dropped one minority male.
25 REPRESENTATIVE BULLOCK: You dropped one or 24
1 you --
2 ACTING SECRETARY TORRES: We decreased by
3 one, at least the numbers I'm looking at.
4 REPRESENTATIVE BULLOCK: Okay. I got you.
5 And women total -- or was that the 11 or is
6 that just minority females?
7 ACTING SECRETARY TORRES: That was minority
8 females, 11.
9 REPRESENTATIVE BULLOCK: So that includes all
10 of your women?
11 ACTING SECRETARY TORRES: Correct -- no.
12 REPRESENTATIVE BULLOCK: So -- and then,
13 other women, so nonminority women.
14 ACTING SECRETARY TORRES: Okay, I'm sorry.
15 So our staffing is 84 total.
16 REPRESENTATIVE BULLOCK: Okay.
17 ACTING SECRETARY TORRES: Okay. So let me
18 start over. So for last year --
19 MAJORITY CHAIRMAN SAYLOR: Mr. Secretary,
20 would you speak into the mic? I think they might have a
21 hard time hearing you.
22 ACTING SECRETARY TORRES: I'm sorry.
23 Okay. So white males, last year, 19; white
24 females, 50; minority males, 4; minority females, 11.
25 REPRESENTATIVE BULLOCK: What was the number 25
1 on white females? I'm sorry.
2 ACTING SECRETARY TORRES: Fifty.
3 REPRESENTATIVE BULLOCK: Fifty, thank you.
4 ACTING SECRETARY TORRES: Again, this year,
5 22 white males, 48 white females, 3 minority males, and 11
6 minority females.
7 REPRESENTATIVE BULLOCK: Thank you.
8 ACTING SECRETARY TORRES: You're welcome.
9 REPRESENTATIVE BULLOCK: And a separate
10 question in regards to adult protective services, this is an
11 issue that I know is occurring throughout the Commonwealth.
12 We want to make sure we're protecting our most vulnerable
13 citizens, particularly our elders.
14 The executive budget proposes a $2.8 million
15 increase for the AAAs to utilize for older adult protective
16 services. When combined with the current year increase of
17 2.2 million, there is an additional $5 million, but this is
18 about $3 million short of the identified need. Can you
19 please share with me your concerns, if any, about this
20 shortfall?
21 ACTING SECRETARY TORRES: Well, we have to
22 balance out the resources that we have. Last year, the
23 general assembly and the Governor added, as you said, the
24 2.1 million. 2.8 million will be used to help increase
25 capacity, the capacity of the AAAs, to deal with the 26
1 increase in the demand for those services.
2 During the three years of the Inspector
3 General report, we saw Reports of Need come in at a 42
4 percent increase. And then the reports that were
5 substantiated were 32 percent. So the need is there.
6 I think we have to just, you know, prioritize
7 and balance out the resources that we provide. So it's
8 something that we will continue to work on and look for
9 other ways to streamline operations, as well, to see if we
10 can, you know, stretch those dollars.
11 REPRESENTATIVE BULLOCK: It's important that
12 we put the dollars necessary there to support the work that
13 you're doing so that we can protect our seniors. And I'll
14 definitely be looking into that as we move forward with the
15 budget process.
16 Thank you.
17 ACTING SECRETARY TORRES: Thank you.
18 MAJORITY CHAIRMAN SAYLOR: Representative
19 Keller.
20 REPRESENTATIVE KELLER: Thank you, Mr.
21 Chairman.
22 And thank you, Mr. Secretary. I'm over here,
23 sort of in the back here.
24 ACTING SECRETARY TORRES: Oh, sorry.
25 REPRESENTATIVE KELLER: I wanted to follow up 27
1 on some of the earlier questions concerning waiting lists
2 and services for individuals, I would probably say, in their
3 homes. Now, other than the Family Care Program, do we
4 provide anything where people visit homes of seniors and
5 provide services?
6 ACTING SECRETARY TORRES: We have the Options
7 Program. Most of the programs provide home visitations to
8 assess the needs of the individuals.
9 REPRESENTATIVE KELLER: Other than assessing
10 the needs, we have people who visit homes for, I would say,
11 personal care, meals --
12 ACTING SECRETARY TORRES: Correct.
13 REPRESENTATIVE KELLER: -- housekeeping,
14 those kinds of things?
15 ACTING SECRETARY TORRES: Correct.
16 REPRESENTATIVE KELLER: Have we accounted for
17 the increase in the minimum wage and all the costs
18 associated with that -- the Social Security tax, the
19 workers' compensation insurance, and all those items -- have
20 we accounted for that in our budget request?
21 ACTING SECRETARY TORRES: Well, as it relates
22 to the Department of Aging, what I just explained a few
23 minutes ago, in terms of the direct care workers under the
24 attendant, that's what we've accounted for in our budget.
25 REPRESENTATIVE KELLER: So you would say 28
1 there's probably some people that we have that aren't
2 accounted for, or would that fall under DHS?
3 ACTING SECRETARY TORRES: (No response.)
4 REPRESENTATIVE KELLER: I mean, I guess I'm
5 trying to get at how big is that impact? And I'm concerned
6 that we're going to end up with more people on waiting lists
7 because we're not going to have enough funds to go around
8 and provide all those services. And I don't know if we've
9 considered that.
10 ACTING SECRETARY TORRES: I -- yeah, I'm not
11 sure. You know, I'm not sure about the response to the
12 question.
13 Like I said, in terms of the increase in the
14 minimum wage, as it relates to the Department of Aging,
15 we've accounted for it. We've accounted for it through what
16 remains of the Attendant Care Program that we're responsible
17 for through the next fiscal year.
18 REPRESENTATIVE KELLER: Are option services,
19 would they be currently paid above the $12 an hour, or what
20 are we paying for our option services?
21 ACTING SECRETARY TORRES: For option
22 services, well, option services -- I would have to get back
23 to you on that. I don't have financial figures in front of
24 me.
25 REPRESENTATIVE KELLER: Yeah. Again, it's 29
1 just the concern, you know, that everybody is talking about
2 what we do to help people. And I think that everything that
3 we do is going to have another layer to it and maybe create
4 some hardships on others when we look at that.
5 I guess I would ask, too, when we look at the
6 services that we provide for our seniors, do we provide them
7 or do we pay family members to take care of seniors also?
8 ACTING SECRETARY TORRES: We support family
9 members if they qualify as a caregiver.
10 REPRESENTATIVE KELLER: And would their pay
11 scale, as a family member, be the same as anybody else? If
12 we increase the minimum wage, would we be increasing the
13 family members' pay?
14 ACTING SECRETARY TORRES: Well, again, I
15 don't -- I don't know the answer to that.
16 But again, I don't know that we're paying
17 wages. We're just paying supplies, services, so it's not
18 direct wages in terms of like the Caregiver Support Program.
19 REPRESENTATIVE KELLER: But family members
20 can qualify as a caregiver for the support program?
21 ACTING SECRETARY TORRES: Correct.
22 REPRESENTATIVE KELLER: Okay. So they would
23 get wages.
24 ACTING SECRETARY TORRES: Not under this
25 program. 30
1 REPRESENTATIVE KELLER: The other thing is, I
2 just want to follow back on the services that we're waiting
3 for, the waiting lists. And I think it was asked by
4 Representative Culver, and you mentioned about how many, but
5 which services in particular are people on waiting lists
6 for? I know you said, "Well, somebody might be getting
7 services, and still might be on a waiting list." But what
8 services are we providing, would you say, are most of the
9 people waiting for?
10 ACTING SECRETARY TORRES: I would have to get
11 back to you on that.
12 In terms of the OPTIONS Program, there's four
13 types of services: Care management, in-home meals, adult
14 daily living services, and personal care. Those are
15 required, and then there's a list of other services that are
16 optional.
17 REPRESENTATIVE KELLER: I would like to know
18 who qualifies for each one of those, what we pay for each
19 one of those, what the impact would be to the minimum wage
20 increase on those, and which one of those we're most waiting
21 for, you know, we have the most people waiting for. Because
22 if we know the services, we definitely should know how many
23 people are waiting for those services.
24 ACTING SECRETARY TORRES: We'll get back to
25 you with that. 31
1 MAJORITY CHAIRMAN SAYLOR: Representative
2 Sanchez.
3 REPRESENTATIVE SANCHEZ: Thank you, Mr.
4 Chairman.
5 Thank you, Acting Secretary Torres.
6 I wanted to give you the opportunity to share
7 your vision on two things, what the department is doing to
8 support Pennsylvania's LGBTQ seniors, and then also, what
9 the department is doing to combat hunger among seniors.
10 ACTING SECRETARY TORRES: Well, last fall,
11 the department convened the first ever LGBTQ aging summit.
12 There were about, over 300 participants. I was not a part
13 of that summit, but I understand it went very well. There
14 were providers, attorneys, educators, members of the LGBTQ
15 community, and there was a lot of interest in learning what
16 the issues are.
17 So I have a meeting scheduled with the
18 executive director of the Pennsylvania Commission on LGBTQ
19 Affairs. I know that that commission has set up an aging
20 subcommittee. So as far as next steps, my intentions are to
21 meet with Mr. Snovel and really map out a strategy for, what
22 do we do after this summit to make sure we're taking
23 advantage and implementing some of the steps that were
24 discussed at that summit.
25 REPRESENTATIVE SANCHEZ: I know you have a 32
1 lot of follow-ups, but if there's any legislative fixes that
2 would come of that, please feel free to contact us and we
3 can try to make that happen.
4 And then the second part was the hunger.
5 ACTING SECRETARY TORRES: On the hunger,
6 hunger is very important. The Governor is definitely
7 committed to making sure that no senior goes hungry. We
8 have in-home meal programs and congregate meals, which are
9 meals that are given in a group setting, which helps seniors
10 to engage and socialize with peers.
11 Last year, just to give you an example, we
12 had over nine million meals that were served through our
13 programs. So again, it's something that we support and know
14 how critical it is for seniors to have a good, nutritious
15 meal as part of staying well.
16 REPRESENTATIVE SANCHEZ: Thank you.
17 ACTING SECRETARY TORRES: Thank you.
18 REPRESENTATIVE SANCHEZ: And I expect that's
19 something that touches, unfortunately, each district in the
20 Commonwealth, so we thank you for that.
21 DIRECTOR SNEDDEN: I would add to that,
22 through the PACE Program -- which does extensive outreach to
23 Pennsylvania residents who are eligible for benefits that
24 they're not enrolled in -- over the past two years, we
25 prepared 15,000 SNAP applications. And in concert with DHS, 33
1 submitted them to them and got most of them enrolled.
2 REPRESENTATIVE SANCHEZ: Thank you.
3 That's all I have, Mr. Chairman.
4 MAJORITY CHAIRMAN SAYLOR: Representative
5 Greiner.
6 REPRESENTATIVE GREINER: Thank you, Mr.
7 Chairman.
8 Good afternoon, Mr. Secretary.
9 ACTING SECRETARY TORRES: Good afternoon.
10 REPRESENTATIVE GREINER: I want to switch
11 gears a little bit, although I don't think for too long, to
12 talk about the Lottery Fund.
13 There was a written statement that included
14 the following, quote, "Thanks to the leadership and hard
15 work of Governor Wolf and the general assembly creating an
16 influx of new gaming options tailored to the next generation
17 of lottery players, the Lottery Fund is stable and thriving,
18 allowing us to serve more seniors." And we've heard today
19 that, you know, it's doing all right.
20 But here's the fact with the numbers,
21 financially. If you look at the Lottery Fund's financial
22 statement's net sales revenues and you analyze them, and if
23 you look and see that they're only off by about a half of
24 one percent for this year, then for '19-'20, the Lottery
25 Fund would actually have a negative ending balance. 34
1 And I was wondering, in light of that
2 comment, are you really that comfortable moving forward?
3 Should we be more conservative in our analysis when we look
4 at the Lottery Fund?
5 ACTING SECRETARY TORRES: Would I be
6 comfortable with -- I'm sorry?
7 REPRESENTATIVE GREINER: With whether there's
8 going to be enough money for the Lottery Fund to help
9 provide, you know, services inside the, you know, Department
10 of Aging?
11 ACTING SECRETARY TORRES: As far as the
12 information I have, as you said, with the changes that were
13 enacted last year to expand gaming, they're projecting an
14 increase in the revenue. So given the information, as I
15 understand it, I think --
16 REPRESENTATIVE GREINER: Let me follow up,
17 then, also to when you look at the '17-'18 budget and in the
18 proposed 2019-20 -- this is for DHS now -- DHS Lottery Fund
19 appropriations have increased by over $147 million, or
20 58 percent, while the Aging's Lottery Fund appropriations
21 have decreased by more than 41 million, or almost 8 percent.
22 My question to you would be, do you believe
23 that more lottery funds should be used to serve seniors
24 through your department's programs when you have waiting
25 lists for option services and increasing protective service 35
1 investigation costs instead of having it in DHS? What are
2 your thoughts on that?
3 ACTING SECRETARY TORRES: Well, again, the
4 funds that are allocated to DHS support seniors, as well.
5 We welcome, you know, any additional resources, but we're
6 serving the same population.
7 REPRESENTATIVE GREINER: Okay.
8 I have no further questions, Mr. Chairman.
9 Thank you, Mr. Secretary.
10 MAJORITY CHAIRMAN SAYLOR: Representative
11 Donatucci.
12 REPRESENTATIVE DONATUCCI: Thank you, Mr.
13 Chairman.
14 And thank you, gentlemen, for being here
15 today.
16 A lot of seniors take meds, a lot of
17 medications, especially to control pain. How is the
18 department working to address the opioid crisis specifically
19 related to seniors?
20 ACTING SECRETARY TORRES: Would you like to
21 take that one?
22 DIRECTOR SNEDDEN: Well, we're doing a number
23 of things. But specifically to your question, you know, in
24 the PACE Program this past year, there were 43,000 people
25 who got a prescription for an opioid. And what we have done 36
1 in the PACE Program is ensure that those people who are
2 getting a new prescription get that prescription for a very
3 limited period of time at a dose that's consistent with best
4 prescribing practices for opioids. We're able to do that
5 online, real time, at the point of sale. And it's a
6 mandatory effort that has real impact in terms of protecting
7 the enrollment in the program from misadventures with the
8 overuse of opioids.
9 Beyond that, the program has had a physician
10 education program since 2005, where we have approximately a
11 dozen people across the state that go to physician offices
12 and provide education in specific clinical topics. Last
13 year with respect to opioids, we visited with 1,972
14 different prescribers to review the best practices for
15 selecting opioids, in terms of patient care, and for
16 managing the dosing and duration of those opioids.
17 So we're doing a significant amount to help
18 not just people in the PACE Program, but people across the
19 state.
20 REPRESENTATIVE DONATUCCI: Thank you.
21 Also, Act 87 authorized the department to pay
22 part of the Medicare Part D, which is the prescription drug
23 benefit, delayed enrollment penalty. How many seniors did
24 this help and what was the impact on the program?
25 DIRECTOR SNEDDEN: Well, to date, going back 37
1 100 days ago since we implemented Act 87, we have enrolled
2 2100 people into the low-income subsidy. That has had a
3 tremendous impact in terms of reducing the spend for those
4 people, because these people were not in Part D until we
5 informed them we would pay for that late enrollment penalty.
6 On average, if you're not in Part D and
7 you're in PACE, we pay about 3,000 a year for your benefit.
8 When we get you into Part D, we drop that number by about
9 60 percent, and if we're able to get you into the low-income
10 subsidy, we can drop it even further. So those moneys that
11 we have saved as a result of this ongoing effort to move
12 people into Part D by paying for their LEP has afforded us
13 with the revenues that we needed to offset the cost of the
14 additional people that have been added as a result of the
15 income increase that was part of Act 87.
16 REPRESENTATIVE DONATUCCI: And do you think a
17 lot of people didn't go into Part D because of that penalty?
18 DIRECTOR SNEDDEN: Absolutely. We --
19 You know, the legislation does not mandate
20 that you be in Part D. However, over time since 2006, when
21 we started the Part D rap, we have managed to put about
22 90 percent of the enrollment into a Part D plan. Every year
23 we recommend to people a plan to go into, if they're not in
24 a plan.
25 So we have heard repeatedly, particularly in 38
1 recent years, from people who said, "I would go into Part D,
2 but I can't afford the late enrollment penalty." Now, what
3 has changed over time is, you know, when they started in
4 2006, the penalty was nonexistent. By the time you got to
5 2011, it was getting significant. And now we're looking at
6 people who have been eligible for Part D for 13 years, who
7 accumulate a one-percent-per-month penalty on their premium,
8 so it can cost them four or five hundred a year in added
9 out-of-pocket expenses, and some of these people just can't
10 manage it.
11 When we told them we were going to pay for
12 the penalty, most of them jumped and it helps us
13 tremendously.
14 REPRESENTATIVE DONATUCCI: Thank you.
15 Thank you, Mr. Chairman.
16 MAJORITY CHAIRMAN SAYLOR: Representative
17 Struzzi.
18 REPRESENTATIVE STRUZZI: Thank you, Mr.
19 Chairman.
20 Good afternoon. Thank you for being here.
21 Just as -- in looking at the Inspector
22 General's report, just a general statement, the numbers are
23 obviously very concerning to me. And I know that you're
24 new, but I trust that you will do everything you can to
25 correct these problems and rely on us for any assistance 39
1 that you need, because I believe, first and foremost, we
2 have to take care of senior citizens here in the
3 Commonwealth of Pennsylvania. But my question pertains,
4 building on that, to the well-being of seniors and how it
5 relates to real estate property taxes.
6 In our community, which is Indiana County, we
7 went through a property tax reassessment process several
8 years ago, and unfortunately, that resulted in dramatic real
9 estate property taxes for many property owners who had been
10 in their homes for the majority of their lives, and that
11 equates to senior citizens.
12 And I've met with numerous senior citizens
13 who, with tears in their eyes, are looking at losing their
14 homes. And my question, then -- and as it correlates, think
15 of the stress that's placed upon them, the health issues
16 that that can create with that stress. And then if they do
17 lose their homes, you know, where do they go?
18 My question is, is that something you're
19 looking at both from a mental health perspective, from a
20 physical health perspective, the impact of real estate
21 property taxes on senior citizens? Is your department
22 concerned about that? Is it something you're looking into?
23 Because I truly see it as a health issue for senior citizens
24 when they are threatened basically with losing their homes
25 over real estate property taxes. 40
1 ACTING SECRETARY TORRES: I am not aware that
2 we have an initiative looking at that specific issue.
3 Obviously, any issue that impacts seniors like that, it
4 would be of concern, as an agency that has to advocate for
5 seniors. So that's something that we can certainly take a
6 look at and see what our role should be in that.
7 REPRESENTATIVE STRUZZI: Thank you. I think
8 it is something that you should be at least aware of and
9 perhaps looking into. Because when it comes to, you know, a
10 minimal amount of money that's not going to increase for
11 them for the rest of their lives and their taxes continue to
12 increase, you know, how do they pay for medicine? How do
13 they pay for food? It's something that I think needs to be
14 addressed.
15 So thank you.
16 MAJORITY CHAIRMAN SAYLOR: Representative
17 Flynn.
18 REPRESENTATIVE FLYNN: Thank you, Mr.
19 Secretary.
20 We all know the value of senior centers in
21 our communities across the Commonwealth. They're a valuable
22 haven for many older Pennsylvanians. They are places where
23 education information are provided, meals are served. It's
24 a lifeline for key special and supportive services.
25 The senior center line item has been level 41
1 funded for years. Federal resources under the Older
2 Americans Act are also flat funded. So in real terms, these
3 resources are declining. And we have seen some centers
4 close in some cases.
5 What is the department's strategy for
6 supporting these centers and has there been any talk about
7 increasing the line item possibly?
8 ACTING SECRETARY TORRES: Well, the budget is
9 level funded, so at least we'll maintain the services that,
10 or look to maintain the services that we have.
11 We have a $2 million line item that is used
12 for competitive grants to support senior centers. Those
13 grants are used to support centers in terms of making sure
14 that they are safe, they may have some capital needs,
15 programming needs. So when we issue those grants, we're
16 looking to see what benefits the center is going to derive
17 through increased participation, increased programming, and
18 the safety of the actual facility for the seniors in
19 providing different programs that they do.
20 REPRESENTATIVE FLYNN: I've just been seeing
21 senior centers in my district struggling with this. You
22 know, they're not getting the support that they need from
23 the state to keep providing services as things go, and I've
24 seen some close. So I was very concerned.
25 ACTING SECRETARY TORRES: Yeah. 42
1 Well, there are a lot of needs. They are
2 contracted through the AAAs. So again, there's a lot of
3 different needs and the resources have to be balanced.
4 But senior centers play a critical role in
5 terms of supporting our seniors, like, you know, providing,
6 like I said, the congregate meals, giving them that ability
7 to socialize and take advantage of health and wellness
8 programs, those kinds of things. So I agree, they're a
9 critical part of the system to support our seniors.
10 MAJORITY CHAIRMAN SAYLOR: Representative
11 Delozier.
12 REPRESENTATIVE DELOZIER: Thank you, Mr.
13 Chairman.
14 Secretary, I'm over here. We're moving it
15 around on you to keep you busy.
16 Thank you both for being here. I appreciate
17 it. I just had some quick questions.
18 And I know, Secretary, that you just
19 started -- over there, sorry -- I recognize that and respect
20 the fact that you can't consume everything all at once. But
21 I do have some questions about the report, the OIG report,
22 and just really what the next steps are in many cases.
23 It was interesting to find out, in taking a
24 look, that in between '14 and '15 to '16 and '17, the
25 requests for services went up by 42 percent. I just think 43
1 that's a huge amount of increased services. But if you take
2 a look at the OIG -- and this is an executive summary.
3 Do you know, is there a full report coming
4 out with more detail or is the executive summary the extent
5 of what we will --
6 ACTING SECRETARY TORRES: The executive
7 summary is the extent of, as far as I understand, of what
8 will be issued, consistent with what past precedent has been
9 with the OSIG.
10 REPRESENTATIVE DELOZIER: Okay, so just the
11 executive summary. There will be no -- okay. This is it.
12 All right. I just wanted to clarify.
13 And then, some of the issues that the OIG
14 found, as you are well aware, are not providing timely
15 guidance to the AAAs, the AAAs not interviewing within a
16 72-hour requirement for possible abused seniors, the AAAs
17 not intervening, you know, the right information -- just
18 data collection, basically -- as well as doing it timely,
19 insufficient training, you mentioned that earlier. I know
20 that you did address that and everything. And as well as --
21 I guess my question is, you mentioned the
22 over $2 million request for more staff for the AAAs, but it
23 seems that there's also a need for additional staffing
24 within Aging to oversee the AAAs -- I mean, I guess it's
25 two-pronged. Do you believe that the staffing that you have 44
1 is adequate to oversee the AAAs and what is it that you
2 believe that oversight of the AAAs -- because it seems like
3 it's lacking in the sense of accountability to those AAAs.
4 ACTING SECRETARY TORRES: In terms of
5 accountability, we -- part of the policy change that we
6 made, we tightened that particular responsibility. We are
7 looking, we've seen improvements since we initiated that
8 policy change where --
9 REPRESENTATIVE DELOZIER: When was that?
10 ACTING SECRETARY TORRES: What's that?
11 REPRESENTATIVE DELOZIER: When was that
12 policy change?
13 ACTING SECRETARY TORRES: September of 2017,
14 so it was shortly after the OSIG started their
15 investigation.
16 REPRESENTATIVE DELOZIER: Okay.
17 ACTING SECRETARY TORRES: That was already --
18 REPRESENTATIVE DELOZIER: So you've had a
19 could of months, okay.
20 ACTING SECRETARY TORRES: Correct.
21 And so as part of the site visits and the
22 monitoring that we do, we have seen improvements throughout
23 the past year, year and a half. That continues, and again,
24 if we see a AAA that is noncompliant or has some
25 deficiencies, we will go out more frequently. That was one 45
1 of the concerns of the report, that an annual site visit was
2 not enough to see if things were, you know, if issues were
3 being remediated.
4 REPRESENTATIVE DELOZIER: And it mentioned,
5 of the 52, only half had been even reviewed, correct? That
6 was one of the issues that had been brought up within the
7 report.
8 ACTING SECRETARY TORRES: Right.
9 REPRESENTATIVE DELOZIER: And quickly, I'm
10 sorry, because with the time, was the AAAs that were
11 identified -- and I didn't see it in the executive summary,
12 so I didn't know if you had additional information as to the
13 fact of, with the AAAs that were looked at, is it just three
14 of them that caused this issue or is it across the state or
15 are all of them doing it incorrectly or is it a targeted
16 mistake?
17 ACTING SECRETARY TORRES: If I remember
18 correctly, the Inspector General's Office looked at about
19 18,000 records across the state, so it wasn't just limited
20 to a few counties.
21 REPRESENTATIVE DELOZIER: I'm sorry, so it
22 was limited to --
23 ACTING SECRETARY TORRES: No, it was not
24 limited to a few counties.
25 REPRESENTATIVE DELOZIER: Okay. So it was 46
1 statewide.
2 ACTING SECRETARY TORRES: Correct.
3 REPRESENTATIVE DELOZIER: So these findings
4 were applied, were applicable to all of the AAAs, not just
5 10 of them or something like that?
6 ACTING SECRETARY TORRES: Aggregate, yes.
7 REPRESENTATIVE DELOZIER: And my other
8 question kind of goes to the training because that's a
9 concern as to -- I mean, a lot of our seniors, obviously
10 being our largest population, the report in and of itself is
11 concerning, but one of the things that I really kind of
12 looked at was the training issue and that it was being done
13 incorrectly, but we were paying Temple University and the
14 AAAs to provide this training. Do you know the cost of
15 those contracts?
16 ACTING SECRETARY TORRES: I do not have it
17 with me. I can get that for you.
18 REPRESENTATIVE DELOZIER: Okay, I would
19 appreciate that.
20 The second kind of follow-up with that was,
21 in those contracts, were there -- and I asked this question
22 before, earlier today to another secretary -- as to the
23 performance measures as to the fact -- because I guess my
24 frustration is the fact that we had these two separate
25 contracts to do training and it was found to be 47
1 insufficient, and then on top of that, we were paying them
2 to do it. So that's kind of a frustration, which I'm sure
3 you have the same frustration. It's just a matter of making
4 sure we have the performance to say they have to be trained
5 correctly in order to provide the seniors the care that they
6 need.
7 ACTING SECRETARY TORRES: Yeah. We'll look
8 at that.
9 I guess what I would caution is, if we're
10 directing the contractor in terms of subject matter or
11 content, then -- we'll just have to see. I don't know the
12 exact reason why content was not updated, but I know it has
13 been since.
14 REPRESENTATIVE DELOZIER: Okay.
15 Well, and that's part of the question that
16 kind of goes back to my first question in the sense of the
17 oversight of what is happening and going out into our senior
18 population. We want them to have the best tools and the
19 best, you know, information to be able to protect our
20 seniors.
21 So I thank you for that, and I look forward
22 to the information.
23 ACTING SECRETARY TORRES: Thank you.
24 MAJORITY CHAIRMAN SAYLOR: Representative
25 Cephas. 48
1 REPRESENTATIVE CEPHAS: Thank you, Chairman.
2 And thank you for your testimony.
3 My question is specifically related to your
4 role in the workforce development conversation.
5 So when you have a series of trends -- a
6 series my colleagues talked about it today. You have an
7 increased population 65 and over coming into Pennsylvania,
8 you have an increased demand on the social services that are
9 provided through the AAAs, which is kind of a direct
10 correlation that some of our seniors are either retiring
11 into poverty, staying on longer at their jobs because they
12 need the resources in order to maintain their quality of
13 life, or to be honest, looking for encore careers again so
14 they're not making that decision between their health and
15 their heat.
16 So with those realities, how have you seen
17 the impact to your, the role that you play with workforce
18 development within our aging community? Has there been an
19 increase and an interaction in that part of your department?
20 ACTING SECRETARY TORRES: I know we have a
21 program that supports seniors that are looking to continue
22 working age 55 and older. I don't have specific details on
23 that, but I can certainly follow up with you.
24 REPRESENTATIVE CEPHAS: That would be great.
25 And if you can follow up with what industries you see them 49
1 going into, as well as if they are returning back to
2 post-secondary institutions or trade schools to do some
3 credential stacking, that would be good to know, as well.
4 Thank you.
5 ACTING SECRETARY TORRES: Okay.
6 MAJORITY CHAIRMAN SAYLOR: Representative
7 Gabler.
8 REPRESENTATIVE GABLER: Thank you very much,
9 Mr. Chairman.
10 And thank you, Mr. Secretary. I appreciate
11 the opportunity to ask you -- over here, sir.
12 ACTING SECRETARY TORRES: Oh, sorry.
13 REPRESENTATIVE GABLER: Thanks. I know we
14 keep changing it up on you.
15 I was interested in some of the questions
16 that Representative Delozier was asking. And I wanted to
17 kind of continue with that because in reviewing the
18 executive summary of the OSIG report, Finding 6 is
19 particularly concerning because it deals with the important
20 role of the Protective Services Department. And I just
21 wanted to make sure I understood some of the findings and
22 then some of the plan and some of the work that's being done
23 in the department to implement response to that.
24 So according to the executive summary, it
25 states that Pennsylvania Department of Aging records show 50
1 that 24 of the 25 monitoring reviews that were conducted in
2 2018 were completed after the target dates. Is that
3 something that you feel that you'll be able to rectify in
4 2019?
5 ACTING SECRETARY TORRES: Yes.
6 REPRESENTATIVE GABLER: Okay.
7 And -- but one thing I'm trying to make sure
8 of is, there are 52 AAAs, correct?
9 ACTING SECRETARY TORRES: Correct.
10 REPRESENTATIVE GABLER: So does that mean
11 that in 2018 there were 27 AAAs that were not reviewed at
12 all?
13 ACTING SECRETARY TORRES: I'm sorry, I'll
14 have to get back to you on that.
15 REPRESENTATIVE GABLER: I would appreciate
16 that, because I think it's important for us to understand
17 the trajectory of where the department is heading.
18 And you mentioned that there was a policy
19 change that was implemented in September 2017. And maybe
20 that might have been a start, but it appears, based on this
21 report, that if 24 of the 25 reviews conducted the following
22 year in 2018 were, in fact, completed late, then that shows
23 us that the policy change in 2017 hasn't quite caught up and
24 gotten us all the way there. And then, furthermore, if
25 there's 27 other AAAs that have not been reviewed at all, it 51
1 seems to me that we have a very large population of seniors
2 that are not having their cases reviewed to ensure
3 compliance with protective services.
4 ACTING SECRETARY TORRES: I'm sorry, the time
5 frame that you're referencing for the reviews, what period
6 is that?
7 REPRESENTATIVE GABLER: According to Finding
8 6 in the executive summary, it says that these were the 25
9 monitoring reviews conducted in 2018. But it is my
10 understanding that the department should review all 52 of
11 the AAAs on an annual basis. So I'm trying to put that data
12 together.
13 And so my question is, does that, in fact,
14 mean that there were 27 AAAs that did not have a monitoring
15 review?
16 ACTING SECRETARY TORRES: I'll get back to
17 you.
18 REPRESENTATIVE GABLER: All right. I
19 appreciate that.
20 And then the other question that I have is
21 just, as we look at this, certainly there's a number of
22 logical responses that we could come up with as far as what
23 might we do to fix a problem with, fix a problem with this
24 oversight.
25 And so my question is, could you detail a 52
1 little bit of what the department is doing as far as
2 additional training to try to make sure that the oversight
3 gets better, but then also, is training sufficient? Has the
4 department asked for additional staff to try to make sure
5 that these reviews are done in an appropriate manner to make
6 sure that we're overseeing these cases in the appropriate
7 way to provide for seniors' safety?
8 ACTING SECRETARY TORRES: We have not asked
9 for additional staff. We're seeing how we can reallocate
10 staff to support the Protective Services Unit, and that's
11 something that I'm committed to looking, organizationally,
12 to what could be done.
13 Again, in terms of oversight, we are
14 providing oversight. In terms of the report of need,
15 particularly looking at how AAAs are categorizing Reports of
16 Need, at the beginning of this year, we started to actually
17 request all of the reports that were classified as "no
18 need," because there were some inconsistencies on how they
19 are being categorized.
20 So that's at least a first step in looking to
21 see if there's a training issue, if maybe there's
22 clarification that's needed, so that we can go back to the
23 AAAs with clear guidance on our expectations. So we are
24 providing oversight and we are looking to strengthen that,
25 as well. 53
1 REPRESENTATIVE GABLER: And I believe that is
2 an admirable step.
3 I think the concern, as I review this, is if
4 we look back over the last few years and we see that there
5 were monitoring reviews that were not completed, there were
6 cases that were not being followed up on previously, are you
7 going to be able to implement all these changes with the
8 same number of staff? And I just want to make sure -- and
9 we can have an ongoing conversation about the appropriate
10 level of oversight to make sure that seniors are protected.
11 ACTING SECRETARY TORRES: Yeah. It's my
12 intention to keep up with the appropriate oversight,
13 especially again, if we see AAAs that have some
14 noncompliance issues.
15 REPRESENTATIVE GABLER: Thank you.
16 ACTING SECRETARY TORRES: So we'll definitely
17 prioritize and stay on top of it.
18 REPRESENTATIVE GABLER: Thank you, Mr.
19 Secretary.
20 And, Mr. Chairman, I appreciate it.
21 MAJORITY CHAIRMAN SAYLOR: We'll now move to
22 the chairman of the House Aging Committee and the ranking
23 member, Chairman Murt.
24 REPRESENTATIVE MURT: Thank you, Mr.
25 Chairman. 54
1 Good afternoon, Secretary.
2 ACTING SECRETARY TORRES: Good afternoon, Mr.
3 Chairman.
4 REPRESENTATIVE MURT: Secretary, as you know,
5 I'm a veteran. I served in Iraq. And I am very concerned
6 about caring for our veterans.
7 And my question to you is, can you detail to
8 the best of your ability how the department is partnering
9 with other state and federal agencies to make sure our
10 senior veterans are getting access to care?
11 And I would just add that most of our Vietnam
12 veterans are now over 70 years of age. And this is a
13 population many of whom were exposed to Agent Orange and
14 other chemicals in Vietnam, and certainly are in need of the
15 services that the department provides.
16 ACTING SECRETARY TORRES: Yeah. I know the
17 department has done some work with DMVA. I have a very good
18 relationship with them in terms of all the work that we did
19 at Department of State. I've talked to General Carrelli
20 about collaborating on visiting veterans' homes and really
21 trying to understand the issues that we need to be aware of
22 as a department so we can better support veterans.
23 I know Tom has done some work, as well.
24 DIRECTOR SNEDDEN: Yeah.
25 Going back over a decade, we have worked with 55
1 the DMVA to ensure that all the patients in the six state
2 homes, that they have PACE coverage, if they're eligible.
3 And I would say, right now, probably half of the patients at
4 those homes are in the PACE benefit, which wasn't the case
5 if you go back 12, 15 years ago.
6 But more interestingly, actually, just last
7 week, I went over to the Gap and I met with the executive
8 leadership of the DMVA to talk about their new veterans
9 registry, something that was enacted early in the last
10 session. And they are in the process of trying to register
11 about 800,000 PA veterans in this registry. So far they're
12 up to 17,000.
13 Now, what we have offered them -- and they
14 are very excited about doing -- is, number one, providing us
15 with a listing of the 17,000 that are in the current
16 registry so that we can do targeted outreach to them, each
17 and every veteran individually, to make sure that they are
18 in all of the federal and state benefits that they might be
19 eligible for.
20 We have a great track record of that. We've
21 been doing it for 15 years. And I have no doubt we can help
22 many of those 17,000.
23 Secondly, and maybe more importantly, PACE
24 mails out about 750,000 outreach letters a year to
25 Pennsylvania residents who are qualified for benefits, but 56
1 not enrolled in them. And what we're going to do initially
2 is, with the mail people that are part of our outreach,
3 we're going to include a flier that will include the
4 registry form and a strong argument for completing it and
5 returning it to us or the DMVA.
6 I'm pretty sure we can get most of this
7 started this spring. And I think probably by the end of the
8 year, we'll have some pretty significant results to report
9 to you.
10 REPRESENTATIVE MURT: One other question.
11 Secretary, as you know, the Commonwealth has
12 been a leader in its approach to meeting the needs of older
13 Pennsylvanians for decades. One of the hallmarks of that
14 approach is our dedication of lottery revenues to services
15 for the elderly. Do you support that policy? And from your
16 perspective, do you believe the proposed budget is
17 consistent with that? And are there any instances where our
18 lottery funds are being diverted to other uses and can you
19 work internally to ensure that budget decisions remain
20 consistent with that policy?
21 ACTING SECRETARY TORRES: I think the Lottery
22 Fund has been a great benefit for Pennsylvania's elderly
23 population since its inception. It's 29 billion, last year
24 1 billion. Obviously it's important to us. It's 80 percent
25 of our budget. So I support the continued use of funding 57
1 for that.
2 Again, you know, there's a lot of demand for
3 services, a lot of different priorities, so in this
4 discussion, in terms of budget, we have to balance all those
5 different needs out.
6 REPRESENTATIVE MURT: Since I still have a
7 little bit of time, are you aware of lottery funds being
8 diverted to other missions, other than taking care of our
9 aging population?
10 ACTING SECRETARY TORRES: No, other than what
11 has been discussed in terms of the concerns of funds going
12 to the Department of Human Services.
13 REPRESENTATIVE MURT: Thank you, Mr.
14 Chairman.
15 MAJORITY CHAIRMAN SAYLOR: Representative
16 Samuelson.
17 REPRESENTATIVE SAMUELSON: Thank you, Mr.
18 Chairman.
19 Just a couple of questions and comments.
20 So we're talking about the Lottery Fund. And
21 I do know that there's some parts of this budget where
22 certain folks who are covered under the Department of Aging
23 are now going to be covered under Community HealthChoices
24 over in the Department of the Human Services. And that will
25 shift some of those costs from the Department of Aging to 58
1 the Department of Human Services in that particular line
2 item.
3 I do share the concern that we have to make
4 sure that our Lottery Fund is preserved for the core mission
5 of services for seniors and the traditional services for
6 seniors that have been funded under the Lottery Fund have
7 been the PACE and PACENET programs, the Property Tax Rent
8 Rebate Program, the transportation programs, and also the
9 funding for the 52 Area Agencies on Aging.
10 So I know the practice of taking money from
11 the Lottery Fund and putting it over in the Department of
12 Human Services is a practice that's gone back seven
13 Governors, I think all the way back to Governor Thornburgh.
14 And we've had this discussion at our committee several
15 times, that we have a goal of seeing that that practice is
16 ultimately ended so that we can keep the Lottery Fund for
17 its core mission. Goodness knows we have a need to expand
18 some of these core programs, such as PACE and PACENET and
19 the Property Tax Rent Rebate Program.
20 So that's been a discussion at our Aging
21 Committee and we remain committed to that goal.
22 I have a question about the -- I'm listening
23 to the discussion about the Inspector General's report and
24 some of the logical responses we could take.
25 I know the funding was 2.1 million last year. 59
1 This year it's five million. The ask is actually
2 eight million. So one of the logical responses this
3 committee could take is we could give the Area Agencies on
4 Aging the full eight million they're asking for. So that's
5 just something to throw out as food for thought as we go
6 through this budget process. This budget funds it at five
7 million, a significant increase from last year, but the ask
8 from the 52 Area Agencies on Aging is actually
9 eight million.
10 And when you think about last year's 2.1
11 million, when you split it up around the state, it was only
12 about 50,000 per county Area Agency on Aging. So I'm glad
13 we're having the increase to five million. I think we
14 should talk further whether we can increase that to the full
15 $8 million level.
16 My question is actually about the PACE and
17 PACENET program. We did have that legislation last year. I
18 was able to work on that, a bipartisan piece of legislation,
19 to expand the PACENET income limits for the first time in 15
20 years. In October, the income levels went up $4,000. So
21 now, for a single person, it's 27,500, and now for a married
22 couple, it's 35,500, first increase in income since January
23 of 2004.
24 So my question is how -- what have you seen
25 overall in terms of the overall number of folks? I know you 60
1 talked about folks moving into federally funded programs,
2 but the overall increase that this $4,000 increase will
3 allow more seniors to sign up.
4 ACTING SECRETARY TORRES: Yeah. The total
5 impact has been to just over 17,000 individuals. And of
6 those 17,000, 12,574 became eligible to enroll in PACENET.
7 And the increase prevented 4,485 cardholders from becoming
8 ineligible. So that was the impact.
9 DIRECTOR SNEDDEN: That's correct.
10 REPRESENTATIVE SAMUELSON: So 17,000 since
11 October, since we've had that change in the law.
12 ACTING SECRETARY TORRES: Slightly over 17,
13 yes.
14 REPRESENTATIVE SAMUELSON: Okay.
15 I do want to mention that at the time, when
16 we had this legislation, we started asking for a higher
17 increase. We were trying to keep pace with inflation since
18 the 2004 level 15 years ago. And in order to do that, we
19 would have needed a higher income limit than we got. We
20 were very thrilled with the $4,000 increase, but I know we
21 have more work to do. And I want to revisit that to enable
22 us to further expand those income limits to enable us to
23 keep pace with inflation that our seniors are facing.
24 Just one last question about the outreach
25 efforts that PACE and PACENET do around the state to try to 61
1 get more people enrolled. What is the current enrollment in
2 PACE and PACENET, and how has that changed? Overall, not
3 just the PACENET we're talking about.
4 DIRECTOR SNEDDEN: Well, the overall
5 enrollment currently is about 235,000. But persons served
6 during last calendar year was about 270,000.
7 REPRESENTATIVE SAMUELSON: 270, okay.
8 DIRECTOR SNEDDEN: But the snapshot
9 enrollment today is 230. We will probably hit about 280,000
10 served this calendar year.
11 REPRESENTATIVE SAMUELSON: And we'll continue
12 to work together on that.
13 I just want to close by saying
14 congratulations to Secretary Torres. It's wonderful to have
15 you here.
16 ACTING SECRETARY TORRES: Thank you.
17 REPRESENTATIVE SAMUELSON: I know that early
18 in your career, you spent some time in Bethlehem working for
19 the former Bethlehem Steel Company, so I wanted to give a
20 shout-out to my hometown.
21 But thank you. And we're very glad you're in
22 this position.
23 ACTING SECRETARY TORRES: Thank you.
24 MAJORITY CHAIRMAN SAYLOR: Any comments from
25 the chairman? 62
1 Representative Gainey.
2 REPRESENTATIVE GAINEY: First of all, Acting
3 Secretary Torres, I want to thank you.
4 ACTING SECRETARY TORRES: Thank you.
5 REPRESENTATIVE GAINEY: I appreciate your
6 honesty today. We know you haven't been on the job long.
7 You answered the way you see fit, and what you didn't know,
8 you said you would get back to people. So I'm asking that
9 you make sure that you get the answers back to Chairman
10 Saylor and Chairman Bradford.
11 But again, I just want to thank you because
12 you came, you gave your testimony, and you said you would
13 get the people the information that they requested. And
14 again, thank you and welcome aboard.
15 ACTING SECRETARY TORRES: I appreciate that.
16 Thank you.
17 MAJORITY CHAIRMAN SAYLOR: Mr. Secretary, one
18 of the things, I'm actually going to ask you to return the
19 week of the 5th or the 6th. There were a lot of questions
20 on both sides of the aisle that did not get answered. You
21 didn't know, and again, I understand because you're brand
22 new. I can't expect you to know everything. But I think
23 it's important for members of both sides of the aisle to be
24 able to follow up on questions and answers, rather than just
25 submitting questions. 63
1 So I will ask you to return either March 5th
2 or 6th, we'll get in touch with your office to return to the
3 committee to answer some of those questions you were unable
4 to answer today, so that they can at least follow up. It's
5 only fair to the members to be able to follow up with some
6 of them, particularly when we're talking about our senior
7 population here in Pennsylvania.
8 The other thing -- I will reserve any
9 questions I have, but the biggest question I have that I
10 hear every day from -- and I will, again, not expect an
11 answer right now. And I've talked to the Governor about
12 this. The biggest problem we have today, if you want to put
13 your mother, grandfather, uncle, whoever, in a nursing home,
14 it's easy to get them in, within reason. But if you want to
15 keep them in their home where they are going to be
16 healthier, where they are going to be better off, it takes
17 forever, six months.
18 And I think we have to -- that is just
19 horrible. If you're wealthy, it's great. But if you're a
20 middle-class or low-income family, your mother, your father,
21 whoever it may be, your grandmother, is not being treated
22 fairly. And we have to do better at letting these people
23 stay in their homes.
24 I would welcome, when you return, comments as
25 to what we're doing to speed that up, because it's just not 64
1 right. It is really morally wrong for us to be doing what
2 we're doing. That's not a reflection on you or the
3 Governor. It's just something that's been going on way too
4 long. And I think it's something that we've talked about in
5 this committee. And probably the Aging Committee has talked
6 about it, as well. But we have to come up with an answer,
7 and I would welcome from your department recommendations on
8 how we can do it, whether it's legislation or something.
9 But I would welcome those comments when you return.
10 ACTING SECRETARY TORRES: All right.
11 MAJORITY CHAIRMAN SAYLOR: So with that, Mr.
12 Secretary, I do want to thank you.
13 ACTING SECRETARY TORRES: Thank you.
14 MAJORITY CHAIRMAN SAYLOR: And, Tom, I do
15 appreciate your comments today, as well.
16 And with that, we will reconvene tomorrow at
17 one o'clock with the State Chancellor of the State System,
18 and also with the Pennsylvania Higher Education Assistance
19 Agency.
20 Thank you. This meeting is adjourned until
21 one tomorrow.
22 (The hearing concluded at 4:23 p.m.)
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1 C E R T I F I C A T I O N
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3 I hereby certify that the proceedings are contained
4 fully and accurately in the notes taken by me on the within
5 proceedings, and that this copy is a correct transcript of
6 the same.
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