PA-HCBS Members, Consumers and Stakeholders,

As you know, rates for your services have not kept up with inflation, with significant wage and benefits pressures, and with unfunded mandates such as the COVID19 pandemic, Affordable Care Act, federal overtime increases, electronic visit verification systems, and program requirements like staff training, quality assurance, and compliance, all of which are unbillable overhead expenses. Travel time, mileage expense reimbursement, shift differentials, and overtime are facts of life in agency model home care, but these, too, are not billable.
Indeed, based on analyses provided by members, providers have determined that they would need rate increases to $32 per hour to just to stem the losses and account for additional expenses relating to COVID-19. These expenses include, but are not limited to, necessary pay increases, incentives for picking up additional client shifts, reimbursement for increased travel expenses, costs for personal protective equipment (PPE), cleaning supplies, sick leave, increased administrative burdens, and more. Due to the historically low provider rate, many Pennsylvanians with physical disabilities and older Pennsylvanians are going without in home supports due to the lack of direct care workers.  This lack of direct care workers is a result of the chronically low provider rate.  Costs have outstripped rates, and the supports to people with disabilities and the aged are now critically unsustainable.  Current hourly rates for PAS and HCBS Services are not at all competitive with pay rates that employees can easily obtain at Amazon, Sheetz, and other employers. This disparity in rates has only been exacerbated during the COVID-19 crisis, when grocery, drug, and other retailers are offering “hello” pay and significant hourly rate increases to fill openings and maintain their workforces. 

There is already a drain of direct care workers out of HCBS and other human services such as ODP into other lines of work to find higher wages, benefits, and stable schedules and an increase to the minimum wage without a corresponding rate increase will exacerbate this problem.  HCBS/PAS currently compete with big-box retailers, convenience stores, and a myriad of other employers for critical staff. Largely, these other employers can raise their prices to offset increases in costs, including wages and benefits.  Without a rate increase from the state, providers cannot do this.
Thus, PA-HCBS is requesting that an increase in PAS, HCBS and ODP/OLTL provider rates, to ensure that direct care workers have livable wages and that seniors and adults with disabilities have these workers to help them stay at home.
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