HR 134 — A Resolution directing the Joint State Government Commission to conduct a study and issue a report on home and community-based services provided to individuals with physical disabilities, intellectual disabilities, autism and other developmental disabilities with a focus on streamlining the application process and improving service delivery.

PRIOR PRINTER'S NO.

1045 THEPRINTER'S GENERALNO. ASSEMBLY OF PENNSYLVANIA HOUSE RESOLUTION Session of No.

3294 THE GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE RESOLUTION Session of No.

MILLER, KHAN, SANCHEZ, HILL-EVANS, WAXMAN, GUENST, HARKINS, GIRAL, PROBST, McNEILL, MADDEN, OTTEN, HOWARD, HANBIDGEHANBIDGE, AND DEASY, MARCHKAZEEM, 19,CEPEDA-FREYTIZ, 2025RIVERA, REFERREDD. TO COMMITTEE ON HUMAN SERVICES, MARCH 19, 2025 A RESOLUTION Directing the Joint State Government Commission to conduct a study and issue a report on the programs administered by the Office of Long-Term Living and the Office of Developmental individuals with disabilities that receive a Home and Community-Based Services waiver.

WILLIAMS, STEELE, DALEY, GREEN, FLICK, O'MARA AND CIRESI, MARCH 19, 2025 AS REPORTED FROM COMMITTEE ON HUMAN SERVICES, HOUSE OF REPRESENTATIVES, AS AMENDED, APRIL 28, 2026 A RESOLUTION Directing the Joint State Government Commission to conduct a <-- Office of Long-Term Living and the Office of Developmentalhe Programs focused on how to improve the experience of individuals with disabilities that receive a Home and Community-Based Services waiver.

and 20250HR0134PN3294 - 2 - WHEREAS, Home and Community-Based Services waivers give the 20250HR0134PN1045 - 2 - Commonwealth the flexibility to offer care that is not typically available under Medicaid so that vulnerable individuals can continue to live in the community rather than an institution;

and WHEREAS, Supporting access to Home and Community-Based Services waivers, medical assistance and other public assistance is important to the Commonwealth's commitment to health equality 20250HR0134PN3294 - 3 - and equal participation in our communities;

and 20250HR0134PN1045 - 3 - WHEREAS, The concerns and needs of the individuals who use these programs should be the foremost priority for legislators in delivering assistance to those individuals;

20250HR0134PN3294 - 4 - (4) Examine challenges faced by waiver participants to 20250HR0134PN1045 - 4 - avoid institutionalization and to be supported to remain actively engaged in their community.

(10) Evaluate ways in which other states have 20250HR0134PN3294 - 5 - accommodated the diverse needs of individuals with 20250HR0134PN1045 - 5 - disabilities and altered their public assistance programs as a result, including the utilization of the Federal definition of "developmental disabilities." (11) Report on barriers and facilitators to accessing direct care services for individuals with disabilities on Home and Community-Based Services waivers, including the differing standards for authorizing direct care services among different waivers.

20250HR0134PN3294 - 6 - (2) The Secretary of Human Services or a designee.

20250HR0134PN1045 - 6 - (3) One member of the Senate designated by the President pro tempore of the Senate.

(17) A consumer representative from the Long-Term Services and Supports subcommittee of the Medical Assistance 20250HR0134PN3294 - 7 - Advisory Committee.

20250HR0134PN1045 - 7 - (18) A representative of the Long-Term Care Council.

20250HR0134PN1045DIRECTING -THE 8JOINT -STATE GOVERNMENT COMMISSION TO CONDUCT A <-- STUDY AND ISSUE A REPORT ON HOME AND COMMUNITY-BASED SERVICES PROVIDED TO INDIVIDUALS WITH PHYSICAL DISABILITIES, INTELLECTUAL DISABILITIES, AUTISM AND OTHER DEVELOPMENTAL DISABILITIES WITH A FOCUS ON STREAMLINING THE APPLICATION PROCESS AND IMPROVING SERVICE DELIVERY.

WHEREAS, IN THIS COMMONWEALTH, ALMOST 3 MILLION INDIVIDUALS 20250HR0134PN3294 - 8 - HAD A DISABILITY AS OF 2022, AND, AS OF 2024, APPROXIMATELY 166,356 INDIVIDUALS RECEIVED SERVICES THROUGH HOME AND COMMUNITY-BASED SERVICES (HCBS) WAIVERS;

AND WHEREAS, HCBS WAIVERS ARE WAIVER-FUNDED SERVICES OR WAIVER PROGRAMS UNDER WHICH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES WAIVES CERTAIN MEDICAID RULES FOR INSTITUTIONAL CARE, ALLOWING STATES, INCLUDING THIS COMMONWEALTH, TO USE MEDICAID FUNDS TO HELP INDIVIDUALS WITH DISABILITIES REMAIN IN HOME AND COMMUNITY-BASED SETTINGS RATHER THAN BE ADMITTED TO LONG-TERM CARE FACILITIES;

AND WHEREAS, THE DEPARTMENT OF HUMAN SERVICES ADMINISTERS HCBS WAIVERS THROUGH MULTIPLE PROGRAM AREAS;

AND WHEREAS, THE DEPARTMENT OF HUMAN SERVICES ADMINISTERS THE COMMUNITY LIVING WAIVER, THE CONSOLIDATED WAIVER, THE PERSON/FAMILY-DIRECTED SUPPORT WAIVER AND THE ADULT AUTISM WAIVER, WHICH PROVIDE ESSENTIAL SERVICES TO CHILDREN AND ADULTS WITH INTELLECTUAL DISABILITIES, DEVELOPMENTAL DISABILITIES AND AUTISM;

AND WHEREAS, HCBS WAIVER SERVICES FOR CHILDREN AND ADULTS WITH INTELLECTUAL DISABILITIES, DEVELOPMENTAL DISABILITIES AND AUTISM MAY INCLUDE COMMUNITY INCLUSION, TRANSITION SERVICES, COMPANION SERVICES, DAY AND RESIDENTIAL HABILITATION, HOME ADAPTATIONS, HOUSING AND TENANCY SUSTAINING SERVICES AND IN-HOME AND COMMUNITY SUPPORTS;

AND WHEREAS, THE DEPARTMENT OF HUMAN SERVICES ALSO ADMINISTERS THE OMNIBUS BUDGET RECONCILIATION ACT WAIVER, KNOWN AS THE OBRA WAIVER, WHICH SUPPORTS ADULTS WITH DEVELOPMENTAL DISABILITIES, AND COMMUNITY HEALTHCHOICES, WHICH SUPPORTS OLDER ADULTS AND ADULTS WITH PHYSICAL DISABILITIES;

AND WHEREAS, THE DEPARTMENT OF HUMAN SERVICES ALSO ADMINISTERS 20250HR0134PN3294 - 9 - THE INFANTS, TODDLERS AND FAMILIES WAIVER, WHICH SUPPORTS INFANTS AND TODDLERS FROM BIRTH TO THREE YEARS OF AGE WHO ARE EXPERIENCING CERTAIN DEVELOPMENTAL DELAYS, NEED EARLY INTERVENTION AND MEET AN INTERMEDIATE CARE FACILITY LEVEL OF CARE;

AND WHEREAS, IN 2024, 8,488 PARTICIPANTS WHO WERE 18 TO 64 YEARS OF AGE AND ENROLLED IN THE COMMUNITY LIVING WAIVER, THE CONSOLIDATED WAIVER, THE PERSON/FAMILY-DIRECTED SUPPORT WAIVER AND THE ADULT AUTISM WAIVER WERE EMPLOYED IN COMPETITIVE INTEGRATED SETTINGS EARNING AT LEAST MINIMUM WAGE, COMPARED TO 1,028 SIMILARLY AGED INDIVIDUALS ENROLLED IN COMMUNITY HEALTHCHOICES WHO WERE EMPLOYED IN COMPETITIVE INTEGRATED EMPLOYMENT;

AND WHEREAS, HCBS WAIVERS PLAY A VITAL ROLE IN EMPOWERING INDIVIDUALS WITH DISABILITIES TO MAINTAIN INDEPENDENCE AND ENGAGE MEANINGFULLY IN THEIR COMMUNITIES;

THEREFORE BE IT RESOLVED, THAT THE HOUSE OF REPRESENTATIVES DIRECT THE JOINT STATE GOVERNMENT COMMISSION TO CONDUCT A STUDY AND ISSUE A REPORT ON HOME AND COMMUNITY-BASED SERVICES PROVIDED TO INDIVIDUALS WITH PHYSICAL DISABILITIES, INTELLECTUAL DISABILITIES, AUTISM AND OTHER DEVELOPMENTAL DISABILITIES WITH A FOCUS ON STREAMLINING THE APPLICATION PROCESS AND IMPROVING SERVICE DELIVERY;

AND BE IT FURTHER RESOLVED, THAT, IN CONDUCTING THE STUDY, THE JOINT STATE GOVERNMENT COMMISSION MAY CONSULT WITH ORGANIZATIONS THAT HAVE EXPERTISE IN HCBS WAIVERS FOR INDIVIDUALS WITH PHYSICAL DISABILITIES, INTELLECTUAL DISABILITIES, AUTISM AND OTHER DEVELOPMENTAL DISABILITIES;

AND BE IT FURTHER RESOLVED, THAT, IN CONDUCTING THE STUDY, THE JOINT STATE GOVERNMENT COMMISSION CONSULT WITH ALL OF THE FOLLOWING:

20250HR0134PN3294 - 10 - (1) THE DEPARTMENT OF HUMAN SERVICES, INCLUDING COUNTY ASSISTANCE OFFICES.

(2) PROVIDERS OF HCBS SERVICES, INCLUDING COMMUNITY PROVIDERS OF LONG-TERM CARE SERVICES AND REHABILITATION SERVICES.

(3) ADVOCACY GROUPS IN THIS COMMONWEALTH THAT SERVE THE AFFECTED POPULATION.

(4) THE STATEWIDE INDEPENDENT LIVING COUNCIL.

(5) ORGANIZATIONS THAT PROVIDE HOMEMAKER AND CHORE SERVICES.

(6) ORGANIZATIONS THAT PROVIDE PERSONAL ASSISTANCE SERVICES.

(7) SERVICE COORDINATORS.

(8) SUPPORTS BROKERS.

(9) INDIVIDUALS ENROLLED IN HCBS WAIVERS.

(10) THE EMPLOYMENT FIRST OVERSIGHT COMMISSION.

(11) ANY OTHER REPRESENTATIVES THAT THE JOINT STATE GOVERNMENT COMMISSION DEEMS APPROPRIATE;

AND BE IT FURTHER RESOLVED, THAT THE STUDY, BY PROGRAM AREA AND BY EACH HCBS WAIVER, INCLUDE ALL OF THE FOLLOWING:

(1) AN ANALYSIS OF DELAYS AND DIFFERENCES IN THE APPLICATION PROCESS AND THE PROVISION OF SERVICES.