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House approves Senate budget, cementing 7% cut to IDD waivers for 2023-24

There is no way to sugar coat the final outcome: we expect that advocates will feel that many state leaders turned their backs this year on the IDD community when key funding decisions had to be made. After a year-long campaign to secure badly needed investments in IDD services, caregivers and people with disabilities will be profoundly disappointed with the $172M in cuts that resulted. What advances were made? What impacts will we see this year? And what next?

The House voted on Wednesday to accept the Senate's budget - including $172M in cuts to the Governor's proposed budget that would have maintained levels of service to adults currently on IDD waivers. While the budget technically still requires the Senate's sign-off (including passage of other bills to establish specific details about how it will be implemented), any opportunity to restore the $172M in cuts to IDD waivers has passed for the coming year. Let's review some key facts and then look ahead to next steps.

Who voted "Yes" on the budget that included the cuts? Most of the voting followed party lines. Every Republican Senator (plus one Democrat), and every Democratic House member (plus 15 Republicans) ultimately voted in favor of the final budget that included these cuts. We doubt that many of the "No" votes were based primarily on the cuts to IDD services, and we spoke with many who voted "Yes" on the budget who did not support the cuts.

Why would someone who opposed the cuts vote in support of a budget that included cuts? We can imagine several factors at work here

  • Opposition to IDD cuts was simply not enough for any politician to break ranks with their party, especially for those who saw other elements as a "win" for their party. Unfortunately, the "win(s)" here required that adults with IDD lose.

  • We believe that some Democrats might have doubted claims by advocates that the system of services was collapsing because no such concerns had, to our knowledge, been clearly voiced by Governor Shapiro and the Department of Human Services. And once the potential for such cuts to support other "funding priorities" had been realized, lawmakers beginning to recognize the devastating impact of service gaps faced an uphill battle.

Regardless, this will be extremely frustrating for every constituent whose representative claimed to oppose the cuts. but then voted in support of the budget. We encourage every advocate to ask their Senator or Representative why they voted in favor of a budget that cut badly needed services, and what kind of legislation they would support (or not) and why.... we would love to hear what you learn!

Did any politicians express regrets that the budget fell short of what adults with IDD need? Many lawmakers expressed their frustration to us in private, and some wrote compelling letters of support to party leaders. So far, we have only seen a few lawmakers make public statements that the final budget left adults with IDD behind(some summarized here). Statements like those of Representative Kinsey offer some hope: " House Democratic Chairman of the Human Services Committee, I recognize that we as a state have more work to do and that we need to invest more dollars to ensure that many of our most vulnerable citizens get the support that they need as well as increasing the wages of those staff who work to provide such necessary services.” We wish that everyone was as supportive as Representative Delozier: "I am also discouraged by the lack of funding for the most vulnerable groups in our communities, like those with intellectual disabilities and autism. This budget cut $170 million from the intellectual disability and autism line item, leaving services for those Pennsylvanians in question". Advocates might consider encouraging their representatives to include a similar statement in their response to the budget.

But we suspect that advocates will feel that far more frequent statements simply claiming that "no budget is perfect" will ring hollow. Other statements of unrestrained support of the bill may feel like a slap in the face of people with IDD... like this statement (with an advocate's potential response in bold).

“The budget that passed the Senate and House makes historic investments in public education, safety, and economic development, and keeps us in good fiscal standing.” ... achieved by cutting $172M in services desperately needed by Pennsylvania's most vulnerable citizens

“A budget is a statement of our priorities – and with new investments in students, teachers, seniors, moms, families, farmers, workers, cops, emergency responders, business owners, and more, this is a budget for all Pennsylvanians,".... except those with IDD, who apparently do not count as true Pennsylvanians

Does this budget do anything to improve the lives of adults with IDD? There are some extremely marginal gains. One bill passed this session will increase property tax rebates by up to $350 for some people with disabilities. Governor Shapiro's budget also allocated $17.5M to support the creation of 850 new Community Living and Consolidated Waiver slots. While some will be tempted to trumpet this as a gain, other will point out that: (a) thousands more Pennsylvanians will continue to wait many years for more specialized services they desperately need right now; (b) the only way that these new slots can still be funded given the $172M in cuts will be to trim services already in place for other adults with IDD, and; (c) It is unclear whether providers could even find the Direct Support Professionals (DSPs) needed for these new services, given the difficulties that providers face recruiting new staff because the Department of Human Services has refused to ensure that rates paid for DSPs are competitive.

Does this budget address service gaps or the collapse of the service system? No, this budget does nothing to close service gaps or prevent system collapse. Without the rate increases needed to make wages paid to DSPs competitive, service gaps will continue if not increase. And adults with IDD are likely to exhaust the $2.33B in state funds allocated for 2023-24, despite the cushion created by underutilization rates of 10% or more. How? As noted elsewhere, Governor Shapiro's budget might have allocated enough funds to accommodate new enrollees before the cuts, but it was unclear if increased usage by last year's enrollees or inflation approaching 5% had been fully accounted for, when projecting needs.

Are there any other opportunities for legislation this session that might begin to close service gaps for adults with IDD, or at least prevent them from worsening? Yes. While we doubt that there is the appetite to pass stand-alone bills to ensure that rates paid for DSPs keep pace with inflation (e.g., HB 661 or SB 684), we have also recommended that the language in HB 661 or SB 684 be incorporated into the omnibus bills that must still be passed, including those for DHS. Codes bills are typically written by smaller groups of party leaders, making it more difficult for individual members to object to specific provisions like those which we recommend. We will continue to press legislators to consider this option. And we hope that you will too

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