February 25th, 2010

Dept. of Public Welfare Secretary Harriet Dichter

HB 1319

Rep. Siptroth: Right now, there is no active protective service law to protect those 18-59.

Dichter: Certainly shocked by such a gap. This needs to be closed and we as a department favor some version of this bill.

STATE SUPPLEMENTAL PAYMENT CUTS

Rep. Siptroth: Will these cuts be reconsidered?

Dichter: Unfortunately, all of the cuts we have had to make are very painful. We have made an effort to increase food stamps to those suffering from the cuts.

Rep. Manderino: The House shares in the responsibility of these cuts with the DPW. Why didn’t the DPW put the money back up in the budget after last years denial?

Dichter: $22mil is the amount of restoration.

Rep. Manderino: Who receives this money?

Dichter: 337,000 people are impacted…60,000 of whom are disabled.

TANIF

Rep. Manderino: I see that there is $360mil available in TANIF funds, but only $29 million is being utilized by PA. Why?

Dichter: Good news, that number is up to $46mil. There is a national problem in utilizing these funds. Also, the state must put up 20% of the money in order to receieve the other 80%.

This money is used for basic assistance, subsidized employment, etc. We are working with the DLI to create summer job opportunities for TANIF youth as well as more opportunities for adults and more food stamps as well. The President’s current budget calls for the extension of this to be more helpful to states.

ACCESS TO OB/NEONATAL UNITS

Rep. Manderino: How can DPW ensure access and make sure women aren’t waiting to long to be seen?

Dichter: There are many performance measures in place for the plans offered. We need offer early and continuous access to women. We have created rules that plans must offer at least 2 OB doctors within 30 minutes of the patient. In addition, we have added pay for performance measures which include frequency of care and seeing an OB early in pregnancy. We are looking to address disparities in areas.

DRUG REBATES UNDER MANAGED CARE

Rep. Manderino: Right now we are accounting for $102mil in savings based on federal level of assumption. This is part of Obama’s plan, but changes in the PhRMA agreement may not stand now. Where do we go for Plan B?

Dichter: This decision to account for these funds is based on analysis of the healthcare proposal. Managed care providers are enthusiastic about the plan.

WELFARE

Rep. Scavello: In your mission, you say you hope to break the cycle of dependency. What are we doing to break this cycle?

Dichter: 1,700 people per month are leaving the cash assistance program to work per month.

COMMUNITY MR WAIVER CUTS

Rep. Reichley: Right now, FMAP money is not included in the jobs bill that is moving through Senate. What is the department’s Plan B if this is not included?

Dichter: From our intelligence, there is bipartisan support for this. Other states are also relying on enhanced FMAP funds. Governors of 43 states have signed a letter about this, telling Congress how important these funds are. The plan right now is to do all we can to show our need to Washington.

We realize that the consequences without this money are severe and without it the cuts will go beyond the reductions on the current budget proposal. However, we felt it was prudent to rely on this put in the budget. We will only discuss other options later when we no longer feel relying on the FMAP money is no longer an option.

Rep. Briggs: With this proposed budget, you are adding $300mil for medicaid and other services, but cutting funding to hospitals. Why?

Dichter: The growth in the budget is to supply for rate increments. It is our goal to enroll all who qualify in the assistance programs.

COST SAVING/ELIGIBILITY ISSUES

Rep. Gingrich: We need to be as efficient as possible. We could be more efficient with eligbility issues and we should be seeing cost savings with compliance.

Dichter: There are ongoing efforts to improve accountability. We are making sure payments are processed correctly and we are letting the right people in. Some examples are the child care subsidy program where there has been unification and the workwear program which is being sure to make special allowances only as needed. We have also instituted a database for County Assistance Offices to track people.

ACT 54

Rep. Gingrich: Under Act 54, it is unlawful for people to buy liquor with the EBT card. How is this being monitored?

Dichter: We have issued notices to people through their county assistance offices of the limitations on use of the EBT card. We have also met with the LCB who have been notifying their employees of these rules as well.

PRE-K COUNTS

Rep. Stevenson: $6mil was cut from community retardation services. However, under child care assistance $3mil is being budgeted for PreK counts, shouldn’t this be funded through the Department of Education? This would then leave some money for the CRS.

Dichter: The money we fund for the PreK counts is for core accountability of children’s progress.

COMMUNITY RETARDATION SERVICES

Began billing the providers directly, removing the county as a middle man. The county is no longer involved in rate setting, but are they still providing a cost impact to the counties?

Dichter: We are still working to do rate setting with the counties.

FRAUD

Rep. Scavello: Do you agree with the $500mil line item for fraud?