March 9, 2015

Former Pennsylvania Governor Tom Corbett accepted the recommendations of the Pennsylvania Long Term Care Commission, a commission created to address issues facing the long term services and supports system. The commission’s goal was to create a report that ensured older Pennsylvanians and individuals with disabilities will have access to quality long-term care while living with dignity, safety and respect through a system that is fiscally responsible and person centered while achieving better health and life outcomes.

In light of this report, we asked members of the Sellers Dorsey team who facilitated the committee about the experience and what this could mean for other states interested in examining their long term care systems.


Question: Can you describe some of the issues that Pennsylvania faces related to Long-Term Services and Supports?

Pat Brady: There are several issues Pennsylvania is facing. The primary one is the increase in the aging and physically disabled population, this and the fact that individuals are living longer are escalating the cost of care. There is also a need for efficiency within the system and a desire to continue to promote the “rebalancing” of the system which still relies heavily on institutional services. In addition, Pennsylvania has limited state financial resources to administer and monitor the system.


Question: Do other states face this same type of challenge?

Kris Blake: Yes, absolutely. The increase in the aging and physically disabled populations is definitely a factor across the country. With this comes the increase in the cost of care since there are more people in need of care and these individuals are now living longer. Each State will have its own obstacles to overcome within their individual systems so they should be evaluated and addressed on a per-state basis.


Question: Were there common themes the commission heard about in public meetings?

Kris Blake: Some of the common themes we came across were difficulties and delays in accessing the long-term care system, lack of affordable and accessible housing and a need for greater service coordination and care management. Issues dealing with long term care providers such as the level of reimbursements to personal care homes and focusing on the needs and abilities of direct care workers were also identified.


Question: Can you talk about how the public input fed into the process?

Fran Grabowski: Soliciting public input was an essential part of the process. The public comments we received were critical in identifying the aspects of the system on which the Commission focused its review and recommendations. To ensure that all public comments were considered, comments were recorded, categorized into topical areas, then each work group was assigned topical areas to cover and provided theme papers to review on their designated topical areas. Once this was complete we confirmed that we addressed all major topical areas.


Question: There’s been a lot of other reports done at the state and federal level. Did you use these and if so, how?

Kris Blake: We reviewed many reports from Pennsylvania, other states, and the federal government and eventually ten reports stood out as most applicable. We examined them in detail, and identified key accomplishments and the progress of the recommendations in those reports. We then shared them with each of the four workgroups in order to identify goals to address in the Commission’s report.


Question: The commission unanimously voted to accept the report, its recommendations and the supporting strategies. That is a great accomplishment. Can you talk about how that happened/the process that was used?

Pat BradyAn integral part of the process was the diverse group of individuals involved and the collaboration and compromise that took place. We used work groups and a work group steering committees and held commission discussion to openly address issues and make suggestions for the report. The commission membership included consumers and consumer advocates which assisted in ensuring the focus was on the needs of the population. The respect amongst the group for fellow commissioners’ knowledge and contributions allowed for open dialogue and frank discussions and helped to foster the collaboration and compromise. Another factor was the contribution of industry experts through presentations at meetings which exposed commissioners to what was out there in other states. There was also a clear definition of roles, responsibilities and expectations from the beginning, and having Sellers Dorsey as a neutral facilitator was essential.


Question: What suggestions would you make to other states and interested parties that want to undertake a similar process?

Fran Grabowski: I suggest they put together a broad based group of stakeholders to collaborate on the process. They should also include extensive public input to ensure that public concern on the needs of long-term care services are identified. They will also need to make sure they allow sufficient time for background education, discussion, and collaboration. Fostering open, frank and collaborative discussions will be vital to making the process work efficiently. Before anything else, the state should make sure they have the proper resources available to help direct, support, and guide the process and make sure the process is neutral in its approach and recognizes the value of all aspects of the long-term services and supports system.

To view the report the Pennsylvania Long Term Care Commission released, click here.

For more information about the report, please contact Sellers Dorsey at