PCPA Legislative Alert: Visit Legislators and Advocate for Community Services!

Governor Corbett will present his proposed 2012/13 state budget on February 7 and it is anticipated that the Department of Public Welfare budget may be cut. The budget will not be finalized until much later, usually by the end of June. There is significant opportunity to impact the final budget numbers by strong and effective advocacy in the districts. In the current economic climate it is more crucial than ever that community providers reach out to local legislators to educate them regarding the importance of maintaining the community safety net for constituents in need of mental health, intellectual disability, or substance use disorder services.

It is imperative that members contact legislators in their district offices to urge them to support funding mental health, intellectual disability, and substance use disorder services at a level that enables community agencies to continue to provide quality services. Visits are most effective if framed by:

  • educating legislators about your agency and the important role it plays in his or her district as both an employer and as a resource for constituents in need of services;
  • advocating for the key role of community services as a more effective and less costly modality for the provision of mental health, intellectual disability, and substance use disorder services; and
  • most importantly, how possible budget cuts impact your agency and, consequently, their constituents.

For supporting material, please review the talking points document referred to below.

Important information to highlight concerning your role as an employer includes the following.

  • The number of consumers/persons your organization serves annually.
  • The number of individuals employed by your organization. Remember that you are an employer – besides salaries, consider other rising costs (for example, increasing health care costs) at your organization. Be specific.
  • Remember that you are a business and purchaser of services – think about the amount spent on utilities (including vehicles, gasoline, phones, computers, furniture, food, postage, supplies, training, etc.). Make it clear to your legislator that your organization is vital to your community’s economy.

When contacting legislators the following materials should be shared:

It is important to note that PCPA members agree with the necessity of a balanced state budget, but not on the backs of individuals served. If services to Pennsylvanians in need of mental health, intellectual disability, autism, or addiction care are to remain accessible and effective, funding must be preserved and Pennsylvania’s safety net must be protected.  To avoid the implementation of cuts to community services, it is crucially important that members take action.

Questions and comments may be directed to George Kimes (george@paproviders.org) or Anne Leisure (anne@paproviders.org).

 

September Implementation of Act 22 Co-Payments

Act 22 of 2011 provides the Department of Public Welfare (DPW) the authority to address current fiscal challenges and budgetary limitations by imposing a co-payment on services for certain children enrolled in the Medical Assistance (MA) program. The Office of Medical Assistance Programs (OMAP) has announced that this co-payment for services will be implemented in September. It will affect approximately 38,000 children with disabilities living in a family with income in excess of 200 percent of the federal poverty level. OMAP is in the process of finalizing plans. Notices will be sent to affected families 30 days prior to implementation.

Providers will be responsible for collection of co-payments and may do so at the time of service or set other arrangements for payment. The yearly cost of co-payments for service may not exceed five percent of the family’s income and may not be in excess of 20 percent of the cost of the service. The MA claims processing system will be used to regulate the family income cap so that the ceiling of five percent on a monthly or quarterly basis is not exceeded. Co-payments will not be applied to school-based services, preventative services, and other items or services that are currently excluded from MA co-payment. It is unclear whether providers will be required to provide services if the co-payment is not paid. MA representatives have stated that the law does not establish an exception process for co-payments.

PCPA will continue to update members as new information is received.

Changes to Medical Assistance Prescription Coverage

Changes are being made to the Medical Assistance/ ACCESS program regarding prescription coverage. The links below contain valuable and helpful information if you or a loved one are affected by these changes.

 

Medical Assistance Bulletin from the PA Department of Public Welfare

Medical Assistance Prescription Coverage Limit Fact sheet