Hohenstein: Wolf's final budget proposal underscores complicated time for PA

(Photo caption): In 2018, as part of his work as a DSP in Philadelphia, my brother Frank worked with his residents to make clay pottery. This type of hands-on dedication is one of the reasons I support DSPs and other frontline caregivers.

Governor Wolf’s final budget proposal arrives during a complex time for the commonwealth. The pandemic continues to affect the lives of Pennsylvanians impacting their health, the health of their loved ones, their job prospects, the care and education available for their children, and their access to goods and services in the economy.

The economic recovery has fueled General Fund revenues that continue to exceed estimate by billions of dollars, but the disruption of the pandemic has shown widespread need and increased costs. With billions in remaining federal rescue dollars and a historic state surplus, simply banking these dollars and doing nothing for Pennsylvanians and our commonwealth’s economic growth is not an option.

The 2022/23 budget approaches the coming fiscal year by choosing opportunity over status quo and prioritizes our core ideals of investing in education at all levels; making Pennsylvania a better place to work and do business; supporting families and caregivers; and prioritizing seniors, veterans, and all vulnerable populations all without raising taxes.

I support the measures in the Governor’s budget that will increase the share of Fair Funding Formula dollars in education. The fair funding formula is essential if our schools in Philadelphia are going to improve and become the kind of places our children can build their future. Getting rid of old, dilapidated buildings and infrastructure is a win-win for everyone. Our kids and families benefit from better facilities and the jobs that are created benefit the economy as a whole.

Investment in infrastructure is another key component to the Governor’s budget proposal – to use the surplus and rainy-day funds from the American Rescue Plan to ignite economic recovery. We can rebuild crumbling bridges and roads, again benefiting communities and providing jobs at the same time.

I also want to focus on the final part of the Governor’s message: protecting the most vulnerable. The care of our seniors and the members of our disabled communities is at risk if we do not take the action proposed by the Governor. Those communities, and the people who work to provide their care, deserve support. Pennsylvania caregivers have been on the frontlines of the pandemic from the beginning, risking their lives, their health, and their families. Nurses and other caregivers are burning out, falling ill, and leaving the bedside for less dangerous and often better paying jobs that don’t come with the physical, mental, and emotional burden that healthcare jobs require.

The underpayment of our Direct Service Professionals (DSPs) is an issue that is long overdue to be addressed. The proposed budget would invest $280,000 to implement Agency with Choice, preserving the ability for home and community-based waiver participants to choose their worker while allowing workers to obtain the support of an agency. This helps ensure vulnerable Pennsylvanians can be appropriately matched with a caretaker who knows and understands their unique needs, while also allowing that caretaker access to things like training, health insurance benefits, and paid time off.  We also look to prioritizes those with autism and intellectual disabilities by investing $18.8 million to serve an additional 832 individuals currently awaiting services. The waiting line for those waiver services is still far too large – more than 11,000, but this would be a start. Supporting DSPs and the people they serve is a personal issue for me. My brother Frank was a DSP for more than 20 years, and I know that the job requires a level of dedication and skill that is undervalued in the current system. 

The Governor proposes a permanent, sustainable investment – $91.25M for the rest of the fiscal year, which is a $182.50M Medicaid rate increase – into our nursing home workforce so that every Pennsylvanian can receive person-centered care in the setting of their choice. This funding will stabilize the long-term care workforce and provide better care for our seniors and those who need nursing home care. Similar increases are planned for people who receive in-home care. We now face a catastrophic staffing crisis that puts residents and caregivers at risk. 

Pennsylvania has one of the highest COVID nursing home death rates in the entire country. Nursing home workers are often caring for 20 or more residents at a time, often for poverty wages and without benefits to be able to take care of themselves and their own families. Permanent investment will provide safe staffing standards, training, wages and benefits to grow the workforce and keep caregivers at the bedside, and protections from unethical nursing home owners. Investment in our caregiver workforce will provide much-needed relief to those who are entering their third year of the pandemic and are leaving healthcare in unprecedented numbers. It also will improve care and safety for the residents.

In 2020, the general assembly supported nursing homes and other long-term care providers by appropriating $295 million in critical stimulus dollars to help manage the skyrocketing costs of PPE, testing and staffing. Last year, it was $247 million from the American Rescue Plan. Those one-time payments simply ensured the survival of our nursing homes. Now, in one of the oldest states, in terms of population, in the country, we must look to sustainability.

Simply put, we must make 2022 the year for a substantial long-term investment in long-term care. Our message is simple: let’s make today’s proposal the beginning of a critical discussion – one that yields real support for nursing home providers, workers, and residents throughout the commonwealth. We have a real opportunity to ensure sustainability for those who need it most. And, above all, there must be transparency and accountability with all funding: Currently only 63% of PA nursing home revenue is spent on care for residents. We need to make sure that funding gets to the bedside and not go to CEOs or corporate offices.

If we make the wise investments that Governor Wolf proposes, we will be on the way to improving the lives of all Pennsylvanians.