Dear Editor,

As retired Area Agency on Aging Administrators in the northwestern Pennsylvania region, we are writing to express our deep concern over a change being executed by the Pennsylvania Department of Human Services (DHS) that will eliminate the local Area Agencies on Aging from the Medicaid assessment/eligibility process for older adults and persons with disabilities.

The state is currently preparing for negotiations with Maximus US Services, Inc. (Maximus) to expand its scope of work as the Independent Enrollment Broker to include the assessment responsibility.

For over 30 years, the 52 Area Agencies on Aging in Pennsylvania have been performing the assessment/clinical eligibility determination for seniors and persons with disabilities who are seeking to access Medicaid-funded services and supports.

Local Area Agencies on Aging have been trusted community resources who have assisted individuals and their families and caregivers with navigating through a complex, multifaceted and often confusing Medicaid enrollment process in order to receive services.

Nothing can replace the highly specialized and personalized assistance provided by the Area Agencies on Aging who have trained and experienced staff who excel at understanding the unique needs of vulnerable populations.

The Area Agencies on Aging have both the skill and experience necessary to appropriately assess an individual’s eligibility for services and have consistently achieved an impressive 99.75% on-time completion rate for assessments.

Maximus has a history of poor performance in Pennsylvania and in other states (1). According to the Office of Long-Term Living, OLTL (2021, June 8) LTSS Subcommittee meeting, Maximus failed to meet its contractual performance obligation for timely completion of enrollments within the 90-day time-frame for seventeen (17) consecutive quarters.

Why would the Commonwealth of Pennsylvania consider awarding a larger contract to a company that has repeatedly failed to meet critical performance standards as a replacement to Area Agencies on Aging who have an undeniable record of performance and reliability?

We fear it is a classic case of the ends justifying the means. By any reasonable performance standard, Maximus has failed miserably yet continues to be rewarded. Could it be that a bureaucracy so intent on achieving a specific outcome is willing to overlook the trampling of the consumer’s interests? Or could it be the elected officials with whom oversight is charged, have become so overwhelmed they simply let the bureaucracy do as they please regardless of how it impacts their constituents? Or is the federal government pushing an agenda that best suits them and the state is merely playing along, caught up in the backwash of federal efforts to dictate to the states.

At the end of the day, it ultimately boils down to right and wrong. What is occurring with Maximus, regardless of the reason, is simply wrong. Wrong for our seniors, wrong for our persons with disabilities, and wrong for Pennsylvania.

We strongly urge the Pennsylvania Department of Human Services to withdraw the RFA and to continue utilizing the community-based Area Agencies on Aging located in all 67 counties in the state. They have a proven record of success.

Bill Orzechowski,

Retired Executive Director, Office of Human Services, Inc., Area Agency on Aging,

Elk/Cameron and McKean Counties

Farley E Wright,

Retired Administrator Experience Inc.,

Warren/Forest Counties Area Agency on Aging

Stephanie Wilshire is Retired Executive Director,

Clarion County Area Agency on Aging

Jim McQuown,

Retired Executive Director, Aging Services, Inc.,

Indiana County Area Agency on Aging, Inc.

Donna Stimpson Trevey,

Retired Executive Director, Active Aging, Inc.,

Crawford County Area Agency on Aging