MEMORANDUM. Aging Network, Community Organizations, and Interested Consumers. Public Hearing on Meeting the Needs of Philadelphia s Elderly

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MEMORANDUM TO: FROM: Aging Network, Community Organizations, and Interested Consumers Holly Lange, President and CEO DATE: September 29, 2017 SUBJECT: Public Hearing on Meeting the Needs of Philadelphia s Elderly PCA is holding a public hearing to obtain comment on its proposed budget and programs for 2017-18. The hearing will take place on October 11, 2017, at 10:00 am at PCA, 642 North Broad Street, in the fifth floor auditorium. Attached is the preliminary budget information for fiscal year 2017-18. PCA just received its allocation from the state for the fiscal year beginning July 1, hence the delay in having a public hearing on the budget. We again received no increase in our various funding streams. Limited funding increases for many years have steadily eroded the capacity of the aging network to provide services and is resulting in program consolidations and reductions in the level of services provided. As a result, PCA has been exploring alternatives to bring in more funds. Many providers have been raising funds as well. The Public Hearing will include a review of the budget documents and a briefing on the impact of current funding levels and efforts to address the situation. An update will also be provided about the upcoming roll out of the Community Health Choices program, which will turn over management of many of Pennsylvania s Waiver programs to Managed Care organizations. The majority of the Public Hearing, however, is reserved for consumers, providers, community advocates and aging experts to comment on the budget and to share thoughts about the dire fiscal and programmatic challenges facing the aging network next year as well as ideas and insights into directions for the future. You may testify in person at the Public Hearing on Wednesday, October 11, 2017, or submit written comments to PCA by that date. Register to testify by calling 765-9000 ext. 5075 by October 9th. Where possible, those presenting testimony will be grouped by issue area, in order to provide more continuity in the presentations. Written comments can be mailed to PCA s Planning Department or emailed to lauren.ring@pcacares.org. We are continuing to advocate for increased funds but other voices in the community need to be heard as well.

Major Funding Sources FY 2017 FY 2018 Final Initial Funding Funding PDA AGING BLOCK GRANT Regular Block Grant $56,025,883 $56,025,883 Family Caregiver State 1,702,584 1,702,584 Family Caregiver Federal 2,431,642 2,431,641 Title V 944,800 865,433 NSIP 927,228 979,528 Apprise 212,278 195,756 Health Promotion 307,815 307,565 Block Grant Supplement 1,413,574 1,113,574 Additional Options Services 1,946,696 1,946,696 Other 58,703 21,105 65,971,203 65,589,765 Other PDA Grants and Title XIX grants Over 60 Waiver 17,329,602 17,000,000 Medicaid Assessments 12,325,746 12,325,746 1 Nursing Home Transition 345,067 300,000 ADRC 242,998 176,140 Cost sharing Options 681,738 450,000 Other Grants City of Philadelphia Office MH/MR 63,483 63,483 Corporation for National Service 274,916 232,497 PCA Waiver Provider 4,367,895 4,367,895 VA 743,474 743,474 Other Funds 1,283,851 971,224 Program Income 310,361 301,143 Subtotal Cash 103,940,334 102,521,367 In kind match requirement 117,181 117,181 Total $104,057,515 $102,638,548 Medicaid Assessments At the beginning of the year our base allocation was 5,384,503. In previous years the department supplimented this during the year. In FY 2016 they gave an additional 2,000,000 and in FY 2017 they gave us an additional 6,941,243. We are currently waiting for an assessment budget amount for FY 18. We have been asked to provide a revision for review in December or January.

Proposed Allocation FY 2017 FY 2018 Final Initial COST CENTERS LONG-TERM CARE Adult Day Care $ 546,413 $ 532,500 Assessments 10,307,621 10,307,621 Care Management 24,074,265 22,938,963 Consumer Reimbursement 2,287,714 2,275,000 Domiciliary Care 656,479 651,596 Guardianship 476,657 492,972 Home Delivered Meals 8,008,479 7,924,967 Home Health Home Support 169,011 179,874 Medical Equipment & Supplies 402,138 386,500 Ombudsman 525,764 462,883 Overnight Shelter 688 Personal Assistance 3,634,817 3,792,500 Personal Care 7,198,026 7,715,500 Professional Evaluation 633 2,500 Protective Services 7,764,592 7,604,177 Sub total 66,053,297 65,267,553 COMMUNITY SERVICES Congregate Meals 4,884,450 5,310,109 Counseling 1,762 2,000 Discretionary Services 552,800 500,000 Employment 1,275,645 1,193,219 In Home Support 2,451,825 1,983,175 Legal 471,345 430,209 Senior Companion 422,533 435,054 Senior Community Center Services 5,202,854 5,556,676 Volunteer Services 48,906 47,127 Sub total 15,312,120 15,457,569 ACCESS SERVICES ADRC 254,586 223,267 Attendant Transportation 1,335,574 1,119,549 Information and Assistance 5,153,975 4,715,207 Passenger Transportation 2,213,488 2,751,720 Sub total 8,957,623 8,809,743 Environmental Modifications 4,261,285 3,946,113 Administration 9,473,191 9,157,570 Total $ 104,057,515 $ 102,638,548

Proposed Allocation by Cost Center with Projected Levels of Service FY 18 Projected Initial Number of Projected Unit of Budget Clients Units Service COST CENTERS LONG-TERM CARE Adult Day Care $ 532,500 117 9,639 Service Day Assessments 10,307,621 35,404 35,404 Assessments Completed Care Management 22,938,963 20,400 N/A Consumer Reimbursement 2,275,000 830 N/A Domiciliary Care 651,596 199 N/A Guardianship 492,972 120 120 Guardianships Managed Home Delivered Meals 7,924,967 7,100 1,581,830 Meal Home Support 179,874 100 4,000 Service Hour Medical Equipment & Supplies 386,500 929 N/A Ombudsman 462,883 940 180 Closed Case Personal Assistance 3,792,500 675 213,062 Service Hour Personal Care 7,715,500 1,846 428,639 Service Hour Professional Evaluation 2,500 10 100 Service Hour Protective Services 7,604,177 4,251 4,100 Investigations Completed Sub total 65,267,553 COMMUNITY SERVICES Congregate Meals 5,310,109 10,025 494,424 Meal Counseling 2,000 5 50 Service Hour Discretionary Services 500,000 1,500 N/A Employment 1,193,219 2,100 168 Unsubsidized Placement In Home Support 1,983,175 2,700 N/A Legal 430,209 12,800 Service Hour Senior Companion 435,054 135 N/A Senior Center Community Services 5,556,676 22,743 715,000 Event Volunteer Services 47,127 N/A Sub total 15,457,569 ACCESS SERVICES ADRC 223,267 N/A Attendant Transportation 1,119,549 300 64,626 Attendant Assisted Transfer Information and Assistance 4,715,207 285,000 Contacts Passenger Transportation 2,751,720 4,232 310,448 One Way Passenger Trip Sub total 8,809,743 Environmental Modifications 3,946,113 1,053 1,053 Homes Modified Administration 9,157,570 Total $ 102,638,548

WAITING LIST FOR LTC SERVICE PROGRAMS Options PDA Waiver CSP October 14, 2016 1,904-8 September 15, 2017 1,787-4