Pennsylvania HR 10: A Resolution directing the Joint State Government Commission to conduct a study of how Home and Community-Based Services waivers can be improved to meet the needs of individuals with disabilities, including programs administered by the Office of Long-Term Living and Office of Developmental Programs.

Bill Text

PRINTER'S NO. 146
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE RESOLUTION
No. 10
Session of
2025
INTRODUCED BY CERRATO, M. BROWN, HOHENSTEIN, D. MILLER, KHAN,
GIRAL, HILL-EVANS, SANCHEZ, PROBST, GUENST, SCHLOSSBERG,
CIRESI, McANDREW, SHUSTERMAN, FREEMAN, BOROWSKI, OTTEN AND
DALEY, JANUARY 16, 2025
REFERRED TO COMMITTEE ON HUMAN SERVICES, JANUARY 16, 2025
A RESOLUTION
Directing the Joint State Government Commission to conduct a
study of how Home and Community-Based Services waivers can be
improved to meet the needs of individuals with disabilities,
including programs administered by the Office of Long-Term
Living and Office of Developmental Programs.
WHEREAS, More than 2 million Pennsylvanians have a
disability, or approximately one-fourth of Pennsylvanians, which
includes mobility and cognitive disabilities; and
WHEREAS, Adults with disabilities are more likely to
experience other health issues, such as obesity, diabetes and
heart disease, than the average adult and they face barriers to
independent living and employment; and
WHEREAS, Home and Community-Based Services waivers offer
resources through a variety of Medical Assistance waivers which
support the particular needs of residents of this Commonwealth
in community settings, enabling recipients to live in their
communities rather than seeking care in an institutional
setting, such as an intermediate care facility for individuals
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with intellectual disabilities or a nursing facility; and
WHEREAS, Home and Community-Based Services waivers were first
created by an act of Congress in 1981 that amended the Social
Security Act to address a bias in the structure of Medicaid
towards providing benefits in institutional settings; and
WHEREAS, Congress created the waiver program to allow states
to apply for waivers that enable the state to target services to
areas of need and particular populations, especially to help
recipients remain in their community, rather than residing in an
institution; and
WHEREAS, Home and Community-Based Services waivers are
required to be cost-neutral and, by providing care equivalent to
Medicaid care in the community, costs are often lower than under
standard Medicaid; and
WHEREAS, There are multiple waivers available for home and
community-based services in this Commonwealth that vary in their
target population and the benefits provided, with waivers
available for residents with conditions, including autism and
developmental physical disabilities, and older Pennsylvanians;
and
WHEREAS, Home and Community-Based Services waivers are
administered by the Department of Human Services, and some of
the programs, like the Community HealthChoices Waiver and the
OBRA Waiver, are administered by the Office of Long-Term Living
(OLTL), and other programs, like the Community Living Waiver and
the Adult Autism Waiver, are administered by the Office of
Developmental Programs (ODP); and
WHEREAS, Home and Community-Based Services waivers give the
Commonwealth the flexibility to offer care that is not typically
available under Medicaid so that vulnerable individuals can
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continue to live in the community rather than an institution;
and
WHEREAS, In 1978, the Congress of the United States defined
developmental disability as a severe, chronic disability due to
a physical or mental impairment, manifesting before 22 years of
age, likely to continue indefinitely, and resulting in
substantial functional limitations in three or more major life
activities; and
WHEREAS, This definition was updated in 2000 by the
Developmental Disabilities and Bill of Rights Act of 2000,
emphasizing the need for lifelong, individualized support; and
WHEREAS, Pennsylvania has adopted eligibility criteria for
Home and Community-Based Services waivers that exclude some
individuals who meet the Federal definition of developmental
disability, thus preventing them from receiving the necessary
services; and
WHEREAS, Inadequate service availability and provision can
detrimentally affect an individual's health, ability to live
independently, work and have self-determined lives; and
WHEREAS, Data submitted by the Department of Human Services
to the Employment First Oversight Commission shows that in 2022,
16% of ODP's Home and Community-Based Services waiver
participants 18 to 64 years of age are employed in an integrated
setting and earning a minimum wage or higher; and
WHEREAS, Supporting access to Home and Community-Based
Services waivers, medical assistance and other public assistance
is important to the Commonwealth's commitment to health equality
and equal participation in our communities; and
WHEREAS, The concerns and needs of the individuals who use
these programs should be the foremost priority for legislators
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in delivering assista