Pa. Plan on Home-Care Financing Worries Clients and Nonprofit Providers

A Pennsylvania effort to streamline the way the state supports home care for people who are older or disabled is raising concerns among participants in the program and among the dozens of mostly nonprofit firms that handle its financing, writes The Philadelphia Inquirer.

Gary Alexander, secretary of the state’s Department of Public Welfare, announced plans in January to reduce the number of entities that handle payroll, taxes, and other management services for workers in the direct-care program from the current 37 to no more than three. The deadline to apply for the three regional contracts is March 30.

Direct-care attendants are technically chosen and employed by the 22,000 Pennsylvanians enrolled in the program, who receive care at home as an alternative to institutionalization, but the workers are paid from Medicaid funds.

The consolidation poses a threat to the revenue streams of many smaller organizations that provide financial management as well as other direct-care services. Those groups, and disabled activists, say the change will reduce consumer choice and turn many customers over to for-profit, out-of-state providers.