Pushback against Pennsylvania’s Plans to Delegate Some Senior Services to a “For Profit Agency”

Right now there’s much ado as advocates for the elderly express concerns about Pennsylvania’s plan to transfer some senior services from the local Area Agencies on Aging to a for-profit company called Maximus which is based in northern Virginia.

Currently, older Pennsylvanians who need in-home care services through Medicaid have their eligibility for those services assessed-clinically and financially- by the local Area Agencies on Aging. The new regulations would shift that job to a private company.

This writer, an elder law attorney, is loath to proclaim our local agencies as a model of efficiency because that is not always the case. However, if a problem develops concerning an application for benefits, I can drive to the district office to meet in person with the caseworker or their supervisor. That option would drop when proceeding through Maximus. While the company is headquartered in northern Virginia, the employees who do the work are located in many different states and countries.

Maximus is not a new player in town. They’ve handled enrollment responsibilities for the program- though not the more complicated eligibility assessments- since 2016. There have been many complaints.

The argument against Maximus handling assessments is that many of the seniors who apply for these home based programs have serious medical or cognitive issues and cannot be expected to apply alone. In many cases the seniors who apply for these services have difficulty with daily activities such as dressing or feeding themselves.Under the current system, a DHS caseworker usually meets with the applicant in person to assist them. Under the new system, that service would be eliminated.

Maximus has not always done well in other states in which it operates. Kansas decided not to renew its contract with the company due to persistent failures. Click on the following link for an entire website devoted to the failures of the company. Click on the following link for Articles written revealing that Maximus workers do not even earn enough money to purchase their own health insurance.

The Pennsylvania contract with Maximus had not yet been renewed. State representatives have noted the Area Agencies on Aging (AAAs) have already filed a protest to the procurement. SEI Local 668, the
union for the caseworkers, has organized opposition to the move and has been holding webinars and issuing press releases. Groups of both Republican and Democratic state legislators have sent letters to Governor Tom Wolf, urging reconsideration. The Southwestern Pennsylvania Partnership for Aging is also opposed to Maximus handling the work. Click on this link to read their statement.

Obviously, one reason WEI Local 668 is opposed to the contract is because it will result in a loss of union jobs and members. Equally compelling for those who support Maximus is that the company has been doing this type of work since it got its first contract with Los Angeles, California in 1987 and is currently the largest provider of administrative services for Medicaid and CHIP (children’s services) in the United States, serving more than 50% of the market. You can read about the company and the good and bad parts of its history here.

The only problem this writer has with the current suggested contract is that one would expect a state’s government services to be performed within the state, rather than some company in a different state or country. As inefficient as they may be, our local AAA caseworkers have a stake in our community and they can be reached within a half hour’s drive. States have already had bad experiences when they outsourced prison and correctional facilities to private companies and reversed course on that idea. We do not outsource the police department’s job to Allied Securities and we should not discount the importance of senior services by delegating that responsibility to an out-of-state company. With that in mind, this writer is opposed to outsourcing the government benefits and has contacted Governor Wolf. If you wish to do so, you can use this link.

Bob Gasparro, Esq.

tags: new laws, medical