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New agreement proposes to cap MCO profits to ensure taxpayer dollars benefit Pennsylvanians

A new profit-sharing agreement between Pennsylvania and its Medical Assistance physical health (PH) managed care organizations (MCOs) has been proposed to ensure taxpayer dollars benefit vulnerable citizens, Governor Tom Wolf announced. 

Under the proposed agreement, which would take effect in 2023, PH-MCOs will be capped at annual profits of 3 % and be required to invest additional profits in approved initiatives and projects aimed at benefiting individual health and well-being. 

“At a time when managed care organizations are seeing incredible returns, it is only right that excess dollars be funneled back into helping the very people those organizations serve,” Wolf said. “This agreement is a responsible use of public money and will put a cap on annual profits to allow the wealth to be shared among those who need it most.” 

MCOs will be able to maintain 3 % profit annually under the proposed profit-sharing agreement. Each MCO will have an opportunity to submit proposals to retain these profits to be used to support initiatives in line with the goals of the Department of Human Services (DHS).  

These goals include achieving health equity, employment supports, food security, housing, and programs focused on community development. The DHS’ Office of Medical Assistance Programs will approve and track each proposal’s measurable goals. All or a portion of the profits may be recouped by DHS should approved programs fail to meet their goals. 

“Managed care organizations are important partners in our work to help Medical Assistance recipients access the care and services necessary to achieve the health and quality of life they deserve,” Acting Secretary Meg Snead said. “This profit-sharing agreement will allow us to ensure that taxpayer resources for this program can be used to further invest in the program’s mission or be returned to offset program costs.” 

MCOs work with the DHS to negotiate and establish rates paid on a monthly basis based on how many members they have. To ensure the program remains financially solvent while allowing for profit of 2-3 %, capitation rates are developed. 

Over the last three years, an overall increase in the physical health program’s profits have exceeded 3 %. As this trend is expected to continue, an opportunity exists to require investments by the PH-MCOs in the Medical Assistance population. The excess profit would be spent on people the funding is intended to benefit. 

More than three million Pennsylvanians are covered by the Medical Assistance program. This profit-sharing agreement is intended to leverage Medical Assistance to ensure taxpayer money aids lower income and vulnerable Pennsylvanians.

UPMC assesses the most pressing midstate health care needs

Behavioral health, access to health care and prevention are the three most pressing health care needs in Central Pennsylvania in the post-pandemic world.

Tina Nixon, vice president, Mission, Effectiveness and Diversity, Equity and Inclusion, UPMC in Central Pennsylvania, said a health needs assessment outlined what people are facing after being homebound and, in many cases, isolated since the pandemic hit in 2020.

The assessment, which looks at the needs for 2022 through 2025, shows an increase in the need for behavioral health due to mental health issues and addiction.

The study also showed there are barriers to people seeking care as they try to navigate the health care system, and a lack of awareness around programs that offer preventative care.

The UPMC study, conducted every three years, surveyed community stakeholders, patients, community leaders, physicians, the faith community, and anyone using UPMC services, Nixon said.

“We need to improve access to and awareness of mental health services,” she said. The main issues – transportation and a shortage of providers.

“We were able to quickly move to telehealth during COVID so we can offer that platform,” she said. “But there is still a waiting list.”

A state report, conducted by the Wolf Administration, released last week, also showed a need for increased mental health services.

A Behavioral Health Commission for Adult Behavioral Health, established by Act 54 of 2022, which made $100 million in one-time American Rescue Plan Act (ARPA) funding available to support adult behavioral health needs, is charting a path for investments, said Acting Human Services Secretary Meg Snead.

Nixon said the UPMC survey showed the lack of mental health providers is partially because many people changed careers during the pandemic.

The state commission, seeing similar statistics, recommends $37 million should be directed to recruitment and retention initiatives to attract qualified professionals and assist those who do this work, so they are not overly stressed and burning out.

Nixon said UPMC is actively recruiting, letting people know the opportunities that exist both in person and via telehealth. Recruitment teams are reaching into the schools, as early as middle school, to promote the vocation, she said.

“We are not alone. All the (health care) systems in Central Pennsylvania are experiencing this, so the impact is great,” Nixon said. “We have to go above and beyond to attract and retain providers.”

While the state and UPMC, along with others in the field, are looking to recruit providers, Nixon said the demand for services needs to be addressed now. Specifically, she said, the UPMC survey shows a spike in demand from teens and African-Amercian males.

“There has been an overall increase in all populations,” she added, “stemming from isolation and adjustments. The pandemic created the inability to interact with friends and a loss of employment.”

In addition, “People don’t know how to find the resources they need so we have to bring awareness to what providers are available,” she said.

To that end, UPMC is creating a “one-stop shop” by imbedding specialists in primary care facilities and community health clinics.

Providing that service has helped, but Nixon said many people have difficulty getting to the facilities due to lack of transportation, especially in rural areas.

The health system has a mobile unit that travels to those areas offering medical assistance and addiction services. Nixon said they also have coordinated care teams that visit the homebound and those recently released from the hospital.

“Our visit teams provide education, medication and safety checks,” she said. “They also provide a bridge between the time a patient is released from the hospital until their follow-up visit with the doctor,” providing wound care, medication checks and education.

Education, she said, runs the gamut from teaching people to monitor their blood pressure to teaching people how to use phones, computers or tablets for telehealth visits.

“People didn’t go to the doctor during COVID and now that they are seeking care, many are sicker than they would have been,” Nixon said.

“We need to look at ways to address the barriers and we can’t do that alone,” she said. “We have to work with other community organizations to provide all the services.”

Those services include prevention. “We want to promote wellness by looking at health related social needs,” she said.

The health system offers community-based health programs for blood pressure and diabetes care and exercise programs with instructors that look like the population they are working with.

Nixon said the programs are not only informative, but they create connection, reducing the feeling of isolation.

“This is not a one-size fits all issue,” Nixon said. “We need to meet people where they are and provide the services necessary to get them the help they need.”

SNAP expanded to assist nearly half-million Pennsylvanians

More than 420,00 Pennsylvanians and 174,000 households in the commonwealth are receiving increased food assistance due to expanded eligibility through the Supplemental Nutrition Assistance Program (SNAP).

Updated October 1, 2022, those newly eligible for SNAP will receive an average of $63 per month to aid in the purchase of produce, meats, dairy, and additional groceries.

“Being able to eat and nourish yourself every day is one of the most essential building blocks to living well and doing everything else in life,” said Pennsylvania Department of Human Services (DHS) Acting Secretary Meg Snead. “It’s easy to take for granted, but for too many people, being able to afford your next meal isn’t a given. SNAP helps to make that possible. Expanding eligibility for SNAP allows us to extend a reprieve to people who may be struggling so we can help more Pennsylvanians meet this most essential need that literally fuels us to live, work, grow, and thrive, and I strongly encourage Pennsylvanians not currently using this program to apply and see if SNAP can help them make a little extra room in their monthly budget.”

SNAP eligibility is being expanded through Broad-Based Categorical Eligibility (BBCE). A federal program, SNAP’s benefits are funded through the federal budget with states administering eligibility and the issuance of benefits.

BBCE allows states to determine income thresholds that are appropriate and extend SNAP benefits to families and individuals whose low income causes them to struggle to purchase food.

“For years, we’ve gotten calls on a daily basis from folks who are hoping to qualify for SNAP but don’t,” Ann Sanders, Public Policy Advocate for Just Harvest, said. “They include parents who are trying to feed their kids, people who are struggling between skyrocketing rents and rising food prices. Often, they’re just a few dollars over the limit, so we’re thrilled that the Wolf Administration found a way to allow more of these households to qualify for some help.”

More than 2 million Pennsylvanians, including one in seven children, experience daily chronic hunger and food insecurity. Increased risks for disease, hospitalization, and increased health care costs can result from chronic nutrient deficiencies. SNAP and other programs help provide access to food for working adults, individuals with disabilities, older adults, and children. Expanding purchasing power means individuals will not have to choose between eating a meal or paying for a doctor’s appointment.

Grocery stores, food retailers, and various farm markets across the commonwealth accept SNAP. Applications for SNAP and additional public assistance programs can be submitted online at www.compass.state.pa.us.

York’s Susquehanna Riverlands one of three new state parks

Susquehanna Riverlands in York County is one of three new parks added to the 121-state park system, Gov. Tom Wolf announced Tuesday.

Vosburg Neck in Wyoming County and Big Elk Creek in Chester County are also part of the $45 million investment aimed at conserving close to 3,500 acres of crucial natural and cultural resources while also meeting the demand for new recreational opportunities.

The names of the three new parks are temporary. Final names will be determined during the planning process.

“Our beautiful state parks are among the finest in the nation,” Wolf said. “I’m proud to have secured funding in my final budget to make this investment in our park system which will not only preserve invaluable natural resources and habitats for wildlife but provide in-demand access for Pennsylvanians to enjoy the beauty of nature and recreational opportunities.”

Wolf in 2016 added Washington Crossing to the commonwealth’s state park system. Including the three new parks, he has added four parks in eight years, the most of any governor in the last 40 years. His final budget includes an historic $696 million investment in conservation, preservation, and recreation.

“Each new park is unique in its value to a great system,” said Department of Conservation and Natural Resources (DCNR) Secretary Cindy Adams. “All of the new parks are steeped in cultural pre-and post-colonial history, centered around important water resources and represent fantastic natural resource value.”

Situated in Hellam Township, the Susquehanna Riverlands site warrants conservation as it occupies 1,110 acres of natural resources already preserved and protects important water and forest resources. The wooded tract is located within 30 minutes of a heavily populated area where land for recreation use is at a premium. It Is adjacent to Hellam Hills and Wizard Ranch nature preserves, which combine to protect the spacious tract along the Susquehanna River between Harrisburg, York, and Lancaster.

“By working side by side with DCNR, we are creating a conservation landscape that future generations will benefit from,” Lancaster Conservancy president Phil Wenger said. “Conservation needs both public and private organizations to partner to offset the impact increased development has on water and air quality, as well as ecological decline, to ensure our natural world doesn’t disappear before our eyes.”

Final stretch of 14-mile Northwest River Trail dedicated

Department of Conservation and Natural Resources Deputy Secretary Mike Walsh helped cut the ribbon Wednesday on the final section of the 14-mile Northwest River Trail that spans five municipalities in Lancaster County.

Development of the trail has produced significant reinvestment in and creation of local businesses that support outdoor recreation, a release from the department said.

The trail provides access to the Susquehanna River Water Trail for walking, pedaling and paddling. It links the river towns and villages of Marietta, Wrightsville, Columbia, Bainbridge and Falmouth, and provides wayfinding signage to users identifying local businesses.

“We started our outfitting business in Columbia because we bought into the vision of local leaders that the river is a resource that should be protected yet capitalized on to bring people to town and expand the economy through ecotourism,” said Jim Cox, owner of Chiques Rock Outfitters.

The Department of Conservation and Natural Resources supported the project with more than $3 million in Community Conservation Partnerships Program grants.

“Trails connect places,” Walsh said. “They connect people to the outdoors. They bring visitors to communities to help keep economies vibrant, and in the case of the Northwest River Trail also connect people to the river. So, it’s a great day when we can celebrate a trail being complete, moving us closer to our goal of a trail within 10 minutes of every Pennsylvanian.”

The trail, which has industrial archaeological remains such as abandoned canal locks and iron furnaces, follows the route of the historic Pennsylvania Main Line Canal and uses some of the original towpath. The Northwest River Trail is in the Susquehanna Riverlands Conservation Landscape, the Susquehanna National Heritage Area and in the Chesapeake Bay Gateways and Watertrails Network.

Paula Wolf is a freelance writer

New state program will fund home repairs

The 2022-2023 state budget just signed by Gov. Tom Wolf includes $125 million to fund a new program to pay for home repairs and other improvements for those with limited incomes.

Pennsylvania legislators and housing advocates praised the Whole-Home Repairs Program – believed to be the first of its kind in the country – as a step toward addressing the commonwealth’s housing affordability crisis.

The legislation to establish the initiative was proposed by Democratic Sen. Nikil Saval from Philadelphia but earned bipartisan support.

Saval, the Democratic chair of the Senate’s Urban Affairs and Housing Committee, introduced the legislation in the Senate with the full Democratic Caucus and five Republican senators as co-sponsors.

Homeowners with household incomes not exceeding 80% of area median income are eligible for grants up to $50,000 in the program. Forgivable loans for landlords who meet certain requirements are available as well.

The money can be used for habitability concerns, energy or water efficiency improvements, or accessibility for people with disabilities.

In addition, the $125 million covers staff to assist people in cutting through red tape, and pays for training to expand the skilled local workforce needed to make the improvements, through pre-apprenticeship and other programs.

The commonwealth has some of the oldest housing stock in the country.

“One out of every four Pennsylvania voters lives in a home that needs a critical repair, while one out of every three describes their utility bills as ‘unaffordable,’ ” a release from Saval’s office noted. “And if confronted with the need to make a critical repair to their home, nearly half of Pennsylvanians say they would struggle to afford it.”

With the Whole-Home Repairs Program the first of its kind in the nation, Saval hopes it becomes a model for other states in how to preserve aging housing stock while adding jobs.

“Every person has a right to a home that is safe – a home that is healthy,” he said in the release. “But right now, across our commonwealth, hundreds of thousands of households are denied this right simply because they don’t have access to the resources they need to repair their homes.”

Saval said the program starts to reverse the disinvestment urban, suburban and rural communities have experienced for decades at the hands of government.

“At this time of protracted hardship … we have a program to preserve housing across the commonwealth, to stabilize our communities, to prevent blight and abandonment and displacement, to build a skilled workforce to keep our state at the forefront of the industries of the future, and to protect the place that is most dear to all of us: home.”

Paula Wolf is a freelance writer

Pair of Lebanon County farms get state ag loans

Gov. Tom Wolf announced Friday the approval of $2 million in funding for five agricultural projects in four counties through the First Industries Fund.

The projects, two of which are in Lebanon County, will help farms expand their operations and bring in additional revenue.

Local recipients of loans are:

• Dalton, Dale and Kynel Himmelberger, through the Lebanon Valley Economic Development Corp., who were approved for a $400,000 FIF loan. The money will be used to construct of two 31,500-square-foot broiler houses. The project site is at 10837 Jonestown Road, Jonestown.

• Clyde, Carolyn, Michael and Rodney Meyer, through the Lebanon Valley Economic Development Corp., who were approved for a $400,000 FIF loan. The funds will be used to construct a pair of 31,500-square-foot broiler houses as well. The project site is on Thompson Avenue in North Annville Township.

“Pennsylvania’s economy is deeply rooted in the agriculture industry and supporting projects that spur growth in these communities is important,” Wolf said in a release. “The funding provided by the First Industries Fund helps farmers in the commonwealth grow their operations. Ensuring our farmers thrive is an investment in Pennsylvania’s future.”

Paula Wolf is a freelance writer.

Through May, state’s general fund revenue sets record pace

With the May totals now in, Pennsylvania has collected a record $43.9 billion in general fund revenue for the first 11 months of the current fiscal year, Gov. Tom Wolf announced
Wednesday.

The $3.2 billion in general fund revenue that came into the state’s coffers last month was $402.4 million, or 14.2%, over estimate. Year-to-date general fund collections are 12.5% above
estimate.

Here are more May numbers from the release:

• Sales tax receipts were $1.2 billion, or $129.1 million above estimate.

• Personal income tax revenue was $1.1 billion, or $126.9 million more than expected.

• The corporation tax revenue totaled $510.9 million, or $129.5 million more than
anticipated.

• Inheritance tax revenue was $132.3 million, or $15.6 million above estimate.

• Realty transfer tax revenue was $69.3 million, or $13.9 million more than expected.

• Other general fund tax revenue, including cigarette, malt beverage, liquor and gaming taxes, totaled $176.3 million, or $3.1 million less than anticipated.
• Non-tax revenue was $29.7 million, or $9.4 million below estimate.

Outside general fund collections, motor license fund collections – which include gas and diesel taxes, as well as other license, fine and fee revenues – were $301.1 million in May, or $10.7
million more than expected.

Also, the state’s rainy day fund, a separate account to protect Pennsylvania against emergencies, now contains a record $2.8 billion.

“We have the money in the bank to pay for the historic investment I want to make in K-12 education, as well as the corporate net income tax cut and reforms I have proposed to bolster
Pennsylvania businesses, and still have $1.8 billion left over,” Wolf said in the release. “At a time when Pennsylvanians are hurting and state government is not, there is no excuse not to
use this huge pot of money to improve education, lower costs for taxpayers, and build a stronger economy.”

Paula Wolf is a freelance writer.

Deadline approaches to apply for Hurricane Ida disaster loans

The U.S. Small Business Administration is reminding businesses in Pennsylvania that were affected by the remnants of Hurricane Ida from Aug. 31 to Sept. 5 of last year to apply for working capital loans before the June 10 deadline.

The federal Economic Injury Disaster Loan program is available to small businesses, small agricultural cooperatives, small businesses engaged in aquaculture, and private nonprofit organizations, an SBA release said.

The loans, not intended to replace lost sales or profits, are for working capital needs caused by the disaster and are available even if the business did not sustain physical damage. Loan amounts range up to $2 million with interest rates of 2.855% for small businesses and 2% for private nonprofits, with terms up to 30 years.

In Pennsylvania, the disaster declaration covers the counties of Adams, Bedford, Berks, Blair, Bucks, Cambria, Carbon, Chester, Cumberland, Dauphin, Delaware, Fulton, Huntingdon, Lancaster, Lehigh, Monroe, Montgomery, Northampton, Philadelphia, Somerset and York.

Also falling under the declaration are New Castle County, Delaware; Allegany, Baltimore, Carroll, Cecil and Harford counties in Maryland; and Burlington, Camden, Gloucester, Hunterdon, Mercer and Warren counties in New Jersey.

Business owners may apply online, under SBA declaration No. 17166, using the electronic loan application form at DisasterLoanAssistance.sba.gov/ela/s. Information and application forms can also be obtained by calling the SBA at 800-659-2955.

Paula Wolf is a freelance writer.

Pa. collected a record $6.5 billion in tax revenue last month

Gov. Tom Wolf announced Monday that Pennsylvania collected $6.5 billion in general fund revenue in April, the highest monthly total ever.

Fiscal year-to-date general fund collections are $40.7 billion, or 12.4% above estimate. The April figure was $1.8 billion, or 38.7% over estimate.

Revenue collections have met or exceeded estimates for 15 straight months. The Rainy Day Fund also contains a record $2.8 billion.

“Frankly, the most irresponsible thing we can do right now is hoard this money when we should use it to help lower costs for Pennsylvanians,” Wolf said in a release. “I want to make a historic investment in education so local districts have the ability to lower property taxes, and reduce and reform the corporate net income tax to make Pennsylvania a hub for innovative businesses that will drive further economic growth.”

Some revenue collection highlights from last month:

· Sales tax receipts were $1.2 billion. Fiscal year-to-date sales tax collections total $11.5 billion, or 8.4% more than anticipated.

· Personal income tax revenue was $4.1 billion, bringing fiscal year-to-date collections to $15.4 billion, or 15.4% above estimate.

· Corporation tax revenue of $676.1 million was $306.4 million above estimate. The fiscal year-to-date total of $5.8 billion is 23.7% more than anticipated.

· Inheritance tax revenue was $133 million. Through April, $144.2 million has been collected this fiscal year, or 12.5% more than expected.

· Realty transfer tax revenue was $77.6 million, bringing the fiscal-year total to $701.8 million, or 24.9% more than anticipated.

· Other general fund tax revenue – including cigarette, malt beverage, liquor and gaming taxes – totaled $39.8 million. Fiscal year to date, $1.4 billion has been collected, or 1.4% above estimate.

· The Motor License Fund – which include gas and diesel taxes, as well as other license, fine and fee revenues – received $247.2 million. Fiscal year-to-date collections are $2.3 billion, or 0.8 percent above estimate.

Central Pa., Lehigh Valley airport projects get state money 

Five airports in central Pennsylvania and the Lehigh Valley were among the recipients of $10 million total in state investments, announced Monday by Gov. Tom Wolf, through the Aviation Transportation Assistance Program. 

Overall, funds were earmarked for 12 projects at 10 airports. 

“Aviation plays a vital role in keeping our state’s economy moving,” Wolf said in a release. “These investments will help Pennsylvania’s airports operate safely, expand to meet current demands, and sustain growth well into the future.” 

Approved aviation projects included: 

  • Berks County, Reading Regional/Carl A. Spaatz Field – $3 million for air operations hangar complex infrastructure to accommodate the growth of an existing airport tenant.
  • Cumberland County, Carlisle Airport – $524,000 for design and construction of a terminal building to further continued economic development.
  • Lancaster County, Lancaster Airport – $750,000 to complete corporate hangar infrastructure to accommodate the growth of an existing airport tenant and provide space for a new operation relocating there.
  • Lehigh County, Lehigh Valley International Airport – $1.76 million to continue terminal connector and security checkpoint expansion and to enhance terminal commercial development connectivity.
  • York County, Capital City Airport – $150,000 for rehabilitation of airfield hangar roofs and structural reinforcement to repair rusted sheeting.

Ortega to step down as education secretary

Noe Ortega. PHOTO/PROVIDED

Department of Education Secretary Noe Ortega will resign his position April 29, Gov. Tom Wolf announced Friday.

The governor said he will name Eric Hagarty as acting secretary.

“Noe is a dedicated advocate for all students and I’m grateful for his service to our commonwealth,” Wolf said in a release. “He led the department through unprecedented times, ensuring a safe return to in-person learning and providing access to COVID-19 testing and vaccines. His successful efforts to diversify our educator workforce and improve opportunities for students to obtain postsecondary education opportunities will undoubtedly continue to impact our learners for years to come.”

 Prior to becoming secretary, Ortega was the Education Department’s deputy secretary and commissioner for the Office of Postsecondary and Higher Education. 

Eric Hagarty. PHOTO/PROVIDED

Hagarty currently serves as Wolf’s deputy chief of staff responsible for implementing the governor’s priorities and policies relating to education, including the “Level Up” program to invest more in Pennsylvania’s chronically underfunded schools, the COVID-19 vaccine initiative for teachers and the safe return to in-person learning, regulatory reforms to the state‘s charter school system, and generational investments in the Pennsylvania State System of Higher Education.