One proposed change and one implemented change in the proposed state budget could affect the independence of seniors and those with disabilities - even though home-care providers are fighting back.
There are 37 providers across the state that perform administrative responsibilities such as paying taxes and buying workers compensation insurance for the participants, known as the employers or consumers. The program is known as consumer-directed care, said Renee Sluzalis, CEO of Roads to Freedom Center for Independent Living in Northcentral Pennsylvania.
The proposed state budget calls for cutting those providers to no more than three, with each provider being responsible for a specific region.
"It's causing a lot of providers to closing up shop and laying off people," she said.
The state has suggested using an agency model, which would reduce the consumer's control. Currently, they are in charge of hiring, training and firing those who work for them.
If the agency model is used, the consumers might not be able to select their own employees or what tasks those employees do because the model is not as flexible.
"It could potentially disqualify current staff from continuing to provide services," Sluzalis said. "The unemployment rate would go up. It's a snowball effect that keeps growing and growing."
The procedural changes began more than a year ago when the state unbundled the rates used to operate the home-care provider systems, Sluzalis said.
While rates already were not sufficient, by not allowing the bundled money to pay for both the fiscal management system and the supports coordination side, there is an unbalance. The money for fiscal management system grows and the supports coordination side cannot keep up.
"It caused the system to financially fail," Sluzalis said. "It's not being able to carry the costs of the program ... The unbundled left one side bleed very heavily, while the other side pools," Sluzalis said.
At the House Human Services Committee hearing to be held at 9:30 Thursday morning, provider organizations will ask for a percentage of the funds from the management system to be released to pay for the other side.
People are attending the hearing to ask the state to stop moving forward with the request for applications to select a provider and involve stakeholders in the conversation with how to better do business without taking away the consumer choice.
"We're truly concerned about consumers being able to have the same level of support they've had for the past 10 years," she said.
Because it is the consumers who are most affected, it is the consumers the providers sought to give testimony of how they will or have been affected.
"We've been involving a lot of consumers who have the most powerful voice," Sluzalis said.
With a combination of not being able to afford the supports coordination side of the bills and a looming chance that the majority of agencies will close, many already are just closing their doors.
"Why would anyone stay in business?" she said. "We're financially bleeding. We're being told we're going to be put out of business."
As the providers try to stay open, they cannot accept new consumers because they cannot afford them.
"We're leaving people with disabilities without a provider at this time," Sluzalis said.