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Gov. Shapiro Orders Rate Study, But Is It Just Business As Usual?

Picture of Steve Suroviec, President & CEO, Achieva

By Steve Suroviec, President and CEO

The National Alliance of Direct Support Professionals (NADSP) held their national conference in Pittsburgh a few weeks ago, and as the host state’s governor, Josh Shapiro videotaped a welcome message that was shown to the audience from around the country. In it, the governor talked about the importance of Direct Support Professionals (DSPs) and acknowledged the challenges facing the service system to pay DSPs competitive wages. His message culminated in announcing he was ordering his Department of Human Services to conduct a review of the state rates paid to organizations (like Achieva) providing services to Pennsylvanians with intellectual disabilities and autism (IDA). Since the IDA service system is essentially a single payer system, with the state government being the single payer, the level of state rates is a huge issue.

Initial reaction to Governor Shapiro’s announcement was very positive because it’s rare that a governor will even acknowledge the IDA population, their families, or the direct support professionals (DSPs) who care for them, much less acknowledge there’s a problem finding and keeping DSPs. So, the governor deserves credit for saying something publicly about the DSP crisis.

That said, it’s important that we not forget recent history. The governor’s announcement came only months after he failed to include a rate increase in his proposed budget and then failed again when he did nothing to restore a $170 million cut to the IDA budget imposed by the PA House of Representatives (controlled by his own party). But, while late, at least Governor Shapiro is now acknowledging there’s a problem – kudos to him.

A reason to celebrate? Well, maybe. The governor said in his announcement that the rate review would be used to inform his NEXT budget proposal in fiscal year 2024-25, the start of which is still over 9 months away.  Moreover, state regulations require that rate data be updated no less frequently than every 3 years, and so the state was going to be reviewing rate data anyway since it will have been 3 years NEXT fiscal year since the last rate increase. In short, a rate increase NEXT fiscal year was already likely – and based on the state’s past practice it’s expected to be implemented 6 months into the new fiscal year, which means not until January 2025 – a long 16 months away!

If a rate increase in early 2025 is the outcome of Governor Shapiro’s big announcement at the NADSP conference, then it’ll be nothing more than the status quo. Shapiro administration officials at the Department of Human Services (DHS) have had a number of chances to respond to IDA providers’ inquiries about the governor’s announcement in hopes of getting clarification that Governor Shapiro intends to move more quickly than 2025, but DHS officials have passed on every opportunity.

For the governor’s announcement to mean anything real, his rate review needs to be transparent, use current data (based on proper data assumptions and sources), and be completed within 90 days. Once done, the Shapiro Administration should propose a rate increase no later than December 31, 2023, with a retroactive effective date of July 1, 2023. If the governor does that, then he’ll be worthy of high praise. But if the IDA community doesn’t see a rate increase until 2025, then it’s just business as usual.

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