Billions of dollars in federal aid will soon be flowing to Pennsylvania as part of the Biden administration’s American Rescue Plan, and a number of human service providers in the state are calling for a multi-million one-time payment, as well as additional Medicaid funds, to help them cover increased costs from COVID-19 pandemic.
“To put it plainly, the safety net for our health and human services system is nearly disintegrated,” said Richard Edley, who heads the Rehabilitation and Community Providers Association. The group's members provide services in mental health, drug and alcohol addiction, intellectual and developmental disabilities, and other fields.
His organization is asking the state to use the federal dollars it will be getting for a one-time payment of at least $750 million. The organizations he represents say they were underfunded prior to the pandemic, and COVID-19 brought additional strain in the form of increased costs, staffing shortages, and – particularly for those in mental health and addiction – greater need for their services.
Costs were up at Acheiva, a Pittsburgh-based disability advocacy and service provider, for things like cleaning and protective equipment for workers, said president and CEO Steve Suroviec.
“We also paid out more a lot more sick time because we offered, not only for people who are getting sick, we had to make sure that someone who came into close contact with someone who had COVID potentially or in reality, we had to not have them come to work," he said. "And we were paying them to stay home even if they weren't sick. So, we had additional leave cost, sick time, cost, emergency, sick time costs. And, you know, there's just a lot of additional costs that were kind of placed on the providers after COVID hit."
Such agencies also faced existing pre-pandemic challenges due to low government reimbursement rates for the services they provide. Much of their work is reimbursed by Medicaid, a federal and state jointly-funded program that covers health costs for many low-income and disabled individuals. But low rates mean many staff earn earn low wages – leading to hardship for the staff, and high turnover for the agencies.
“We pay what we can pay, but it's almost exclusively driven by the rates we get from government,” Suroviec said.
Not being able to pay staff adequately means agencies can’t provide needed safety net services, said David Fath, assistant executive director of behavioral health and substance use disorders services at Milestone Centers. The nonprofit provides community mental health and intellectual and developmental disability services in Allegheny County.
"We have people caring for some people who absolutely need this service to survive. And we're paying the staff $12 an hour, which is just not adequate," Fath explained. "We pay them based on the amount of revenue that we get from the state."
The American Rescue Plan will send about $350 billion to various state and local governments.
Pennsylvania’s Department of Human Services said it is awaiting guidance from the federal government on how funds “can be used to support the programs, providers, and the people we serve. As we have done throughout the COVID-19 pandemic, DHS will make decisions on use of these funds that maximize their effectiveness in supporting Pennsylvania’s human services system and the people who depend upon it.”
While waiting for further federal guidance, some legislators have started to sketch out what they think the state should do with the money. A plan laid out by state House Democrats would provide funds to businesses that were not able to stay open, provide high-speed internet, childcare, public health infrastructure, hazard pay for essential workers and workers whose unemployment checks were delayed, among other priorities.
A spokesman for state House Republicans said their priority is crafting “a balanced budget that prioritizes good fiscal management” and said Democratic proposals would use “one-time funding for things needing recurring revenue. It is that sort of irresponsible spending that we must avoid.”
Officials said the state could have up to $7.3 billion dollars to spend over several years.
State Senator Minority Leader Jay Costa, a Forest Hills Democrat, said he has primarily heard from health and human service organizations, hospitals, and transit advocates lobbying for the funds.
"What it is not - it is not unfettered, $7.3 billion for us to do what we want with it. That's not the case and it won't be the case and we won't have it all in one year," he said.
