Home And Community-Based Service Recipients, Providers Warn Against State Proposal

Image by Brendan Scanland

HARRISBURG, Pa. (ErieNewsNow) – Home and community-based care providers and recipients spoke out against a proposed care model that they say would limit care options and quality.

“Agency With Choice” (AWC) is essentially the ability for a consumer or care recipient to choose who they want to work for them and take care of them so that they may live independently.  

The idea of this care model has been utilized by home and community service recipients and providers for decades. The concern among advocates today stems from a new AWC model being proposed by Pennsylvania’s Department of Human Services (DHS). The model utilizes a single vendor method for the entire state. 

“This Agency With Choice model is totally unnecessary,” said Thomas Earle, CEO of Liberty Resources. “We don’t need a new model. We invented these services.”  

For advocates and providers outside the Capitol today, the DHS proposal is not the right choice.  

According to Shona Eakin, CEO of Voices for Independence in Erie, the single-vendor method is unnecessary and will add a heavier burden on local care agencies that are already struggling. 

“We’re shocked that that they’re bringing in an outside entity – a single vendor – to provide this service when it doesn’t need to be done,” said Eakin. “So, by doing this, they’re just creating one more methods of competition for the existing service providers, but they’re also not really giving consumers choice,” she added. 

Eakin’s colleague, Kelly Barret echoed similar remarks.  

“Given the smaller agencies that myself, or other folks may use, are going to have a smaller pool of workers to pull from to provide care,” said Barrett. 

Barrett worries that the single vendor care model will not only hurt local providers, but also the quality of care she relies on, especially if it’s not in close proximity. 

“I do think the model as proposed could negatively impact the quality of care,” said Barrett. “For example, living in Erie County, for myself, if I can’t get out of bed and I’m in Harborcreek, and I call this Agency With Choice vendor and they’re in Philadelphia, or even out of state somewhere, and I say ‘my attendant called off and I’m stuck in bed,’ there’s no one locally to say, ‘okay, we know what your needs are, or we know where someone is down the road from you that can come and assist you,’” said Barrett. 

Eakin says the new model could restrict consumers with less options. 

“You should have the ability to say, I don’t like that policy or procedure, so I’m going to go through another entity. They don’t have that with this model,” said Eakin. “People with disabilities who need this kind of intimate care should never feel trapped by the vehicle that offers it,” she added. 

Providers say the proposed model would cost more and that the process has been rushed with limited stakeholder input.  

“We do not need to waste taxpayer money on an unproven and rushed agency with choice model when we desperately need it for our current programs and our caregivers,” said Carl Berry, Executive Director of Community Resources for Independence. “The Department of Human Services has stated to the Medical Assistance Advisory Council that the proposed agency with choice program will not save the Commonwealth money, and they said it is expected to cost more,” Berry added. 

Thomas Earle and other speakers spoke about the rushed timelines with the proposed model and what they call a lack of stakeholder input. 

“When you don’t include people with disabilities at the table and develop your policy, develop the model with their input that you’re going to make mistakes. We know what we’re doing, please include us. You should be here today listening to us and following our advice,” Earle added, referring to DHS. 

“We’re just asking them to slow down and think before they rush this through,” said Eakin. 

“We don’t want $280,000 only to disrupt everything that we’ve spent 35 years building in Pennsylvania. This has been a long haul, and we don’t want to turn it around,” said Fady Sahhar, President and CEO of ProVantaCare. 

ErieNewsNow reached out to Department of Human Services Tuesday afternoon regarding the proposed model, and received a statement which reads in part: 

“It is important to note that this is model of service that will be in addition to, not replacing, any other models of service for the participant-directed population that the department currently offers. There is no requirement that participants and their direct care workers currently working with home care agencies need to switch and use the Agency with Choice (AWC) option, it is simply another option for participants and their workers to consider. The department’s goal with AWC is to further support the direct care workforce and participants by offering an option in which participants can choose and manage a direct care worker and still benefit from the back-end administrative and payroll functions of an agency.” 

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