February 23rd, 2009

Department of Aging House Appropriations Hearing

February 23, 2009

John Michael Hall, Acting Secretary of Aging

President Obama’s proposed health stimulus money is being appropriated to Medicaid, Nursing and Office of Long Term Living. A large portion of federal support will go towards senior nutrition and senior employment. John Michael Hall, Acting Secretary of Aging was confident that the department has the capacity to allocate these resources appropriately and timely.

Had the stimulus money not come, a 4.5% increase provider cut would have been implemented.

House (question): Can you ensure that no senior citizens will have cuts to already existing benefits and programs within the Department of Welfare?

Hall (reply): Within the Office of Long term Living, there will be no reductions, it is simply the landscape that will be changing.

Legislation has not yet been passed for the Department of Welfare and the Department of Aging to merge, however, employees within the departments with similar tasks have relocated to work side by side in the same environment.

Hall proposed the merging of the Department of Welfare and the Department of Aging.

Rationale for merger voiced by Hall:

1.)    Working to create a holistic solution that works for individuals striving to remain independent and families in need of assistance to keep loved ones home and exercise their freedom of choice.
There will be no budget increase.

2.)    the current system is too fragmented and there is a higher risk for individuals to “fall through the cracks”

3.)    32 overlapping positions could be eliminating by consolidating

4.)    Merging the departments creates the best hope for maintaining momentum so that in the future, Pennsylvania can invest in home and community services.

5.)    Before the initial phases of this process had begun, Pennsylvania was ranked 48^th nationally as a result of poor Medicaid and disability funding.

a.       In the last few months, Pennsylvania has moved up, now ranking 43^rd nationally.

6.)    15 prior states have experienced success with bringing together these programs

a.       Consolidating budgets is the sensible choice in managing budget and also balance expenditures.

Concerns voiced by the House:

1.)    The states who have implemented this plan prior, did not have the same fragile system or number of seniors as Pennsylvania.

2.)    Currently, 15% of Pennsylvania is 65 or older. With the baby boomers getting older, in 2020, it will increase to 22% of the state population. Is now the right time to abandon a program (The Department of Aging) dedicated solely to aging adults?

a.       Statewide there are 162,000 with disabilities and 2.8 million seniors

                                                               i.      Can both be served adequately without diluting the services and choices already existing with one voice?

Hall (reply): The program and constituents will not be abandoned. While it is true the number of people we will be serving will explode with the combination of baby boomers becoming seniors, life expectancy being longer and those with disabilities, the current proposal strengthens and coordinates this program to better serve. One focal place is likely to serve them better.

Budget:

House (question): As a result of Medicare Part D, $20 million per month is being saved. Currently across the commonwealth 2700 are on the waiting list for healthcare, with a large number allocated within certain counties. Why are we not spending any excess money to help those most in need?

Hall (reply): Pouring money into a flawed formula will only exasperate an already problematic system.

Looking Forward:

A stronger balance between facility and home based care needs to be maintained

• This is a year to:
  • Strengthen infrastructure
  • Maintain programs already in place
  • Maintain aggressive stance on shifting cots away from commonwealth and back to Medicare.
  • 2008 was the lowest fiscal year since 1999, time to rebuild reserve to what is has been historically
• Not a year to:
  • Propose new legislation

Negotiations:

• Medicare/Aid – How regulations turn out will determine what is in the waiver
• Assisted Living – process will be slowed down to do a thoroughfare on the comments and suggestions to make revisions
  • Hope to have advised regulations by the beginning of March