Budget Hearing Wrap with PA Department of Human Services
3/6/2024
Pennsylvania Department of Human Services (DHS) Secretary Dr. Val Arkoosh, Fiscal Management Director of the Office of the Budget Gloria Gilligan, Deputy Secretary of the Office of Administration Stephanie Shell, Deputy Secretary of the Office of Long Term Living Juliet Marsala, Deputy Secretary of the Office of Mental Health and Substance Abuse Services Jen Smith, Deputy Secretary of the Office of Income Maintenance Hoa Pham, Deputy Secretary of the Office of Developmental Programs Kristin Ahrens, Deputy Secretary of the Office of Child Development and Early Learning Shante’ Brown, Deputy Secretary of the Office of Medical Assistance Programs Sally Kozak, and Chief of Staff for the Office of Children, Youth and Families Natalie Bates, testified today before the House Appropriations Committee.

House Republicans focused their questions on the DHS's core functions and their inability to address basic access to care. Questions were asked about the failing children and youth system, lack of access to maternity care, and overall hospital sustainability across the entire Commonwealth. Additionally, Republicans probed the Secretary about new initiatives and continued growth in spending.


Key Takeaways

· Access to healthcare in Pennsylvania is a serious concern. The issues plaguing our hospitals across the Commonwealth include workforce shortages, emergency room boarding, difficulties discharging complex cases, regulatory challenges and more. These issues are further exacerbated in our rural communities. House Republicans cited the growing maternal health deserts across the state and asked the Secretary what the department’s plan was to address this concern. We were informed that a strategic plan is under development and to be released soon. · Program Integrity measures continue to be a priority for the Appropriations Committee. Ensuring tax dollars are working as intended and without waste, fraud, and abuse is critical. House Republicans were again dismayed DHS is pushing back on using National Provider or State Provider Identification Numbers to ensure proper billing with service providers.

· Program Integrity measures continue to be a priority for the Appropriations Committee.  Ensuring tax dollars are working as intended and without waste, fraud, and abuse is critical.  House Republicans were again dismayed DHS is pushing back on using National Provider or State Provider Identification Numbers to ensure proper billing with service providers.  

· House Republicans also asked questions about the struggle of children and youth agencies to adequately address general protective services reports, especially given the growing number of county agencies operating under a provisional license, including Blair, Clearfield, Lackawanna, Indiana, and Delaware. Republicans remain concerned that the County Child Welfare appropriation does not address the issues counties are experiencing, especially those with a provisional license.

· As with other agencies who testified before the Appropriations Committee, the DHS budget includes unrealistic out-year projections. House Republicans pressed DHS to improve their budgeting practices to reflect future budgetary obligations more accurately.

· The DHS budget will increase by over $1 billion in state funds under Governor Shapiro’s budget proposal. While this is mostly due to cost-to-carry increases in Medicaid, the proposal also includes significant new spending. This is exactly why House Republicans questioned the ability of DHS to expand programming when many of its core functions are suffering.

· When asked about the use of zero-based budgeting as a former Montgomery County Commissioner Sec. Arkoosh stated that it was “very successful at the county level and could be helpful in certain areas.”  House Republicans believe it could be a very useful tool to help state agencies focus on what they should be investing in to meet their core functions.  



Notable Q&A


Rep. Clint Owlett addresses budget gimmicks used by DHS to show unrealistic low future budget growth. 



Rep. Eric Nelson asks what measures DHS can take to ensure hospital sustainability in rural Pennsylvania, specifically for maternal health. 



Rep. Mike Cabell asks DHS about his Program Integrity bill, HB 876, which requires a National Provider Identification Number for all Medicaid service providers in the Commonwealth. 



Rep. Lou Schmitt asks about children and youth agencies operating under provisional licenses. 


Chairman Grove asks Sec. Arkoosh about her experience with zero-based budgeting as a county commissioner.  




Full Hearing

Watch the two-parts of the hearing here:
Part 1.
Part 2.



Rep. Seth Grove, Republican Chairman of the PA House Appropriations Committee
196th Legislative District
Pennsylvania House of Representatives