Thank you for your recent correspondence in which you express your support for maintaining the Berks Heim as a county-owned and operated long-term care facility and urging enhanced state support for the facility.  I appreciate you taking the time to contact me to apprise me of your concern.  I believe that the advocacy of concerned, caring, and involved citizens like you is critical to the present and future viability and success of the Heim.

          First, let me say that I wholeheartedly agree with you that the Berks Heim should be maintained as our county-owned nursing home.  The Heim is a wonderful facility staffed by dedicated professionals who care deeply for the health and well-being of our needy elderly and other citizens in need of skilled nursing care.  That reputation for high quality long-term care is well-known here and in Harrisburg.  Our local seniors deserve to be cared for in a top-notch, nurturing facility.  That is what the Heim provides, and that is why when I was a county commissioner I voted to invest local funds to construct the new Heim facility. 

          As you know, over the past year, there has been a lot of conversation and incomplete information presented to the public about state support for county-owned, long-term care facilities, like the Berks Heim.  For accuracy sake, I’d like to clarify some of this information:

• The Commonwealth does not mandate that counties operate long term nursing care facilities.
  
  
• Based on negotiations between the Commonwealth and counties, an agreement was reached to continue increasing the share of county funds from the IGT over a three-year period, beginning with FY 18-19. In doing preliminary projections of the value of a 75% share for the counties for FY 18-19, the negotiated goal was determined to be $54 million in county net gain in the third year. It is the intent of the Commonwealth to continue to honor that agreement and work toward increasing the county gain to that level within allowable federal regulations all while the Commonwealth’s gain remains flat. 
  
  
• The portion of the IGT funds that state retains helps pay for other human service needs, from which all counties, including Berks benefit.
  
  
• IGT funds will no be longer available to support the long-term care needs of needy Berks Countians if the county home is privatized.  
  
  
• While Medicaid reimbursements over the past handful of years may not have kept pace with inflation, the county has been able to keep the Heim operating in the black and working together, members of the Berks County legislative delegation and others were able to secure an unexpected 1% increase in Medicaid per diem reimbursement rate in this year’s state budget.
  
  
• Importantly, as of January 1, 2020, our region will be switched to a managed care funding model under Community Health Choices versus the fee-for-service model.  Under this system, counties will no longer be paid for care provided to long-term care patients on a fee-for-service basis.  Under the CHC model, well-run, high quality county-owned nursing homes, like the Berks Heim, will have the ability to negotiate with managed care organizations higher reimbursement rates for the care they provide.  I have been told by officials in Harrisburg that Berks County is well-positioned to benefit from this change in long term nursing care funding.  So contrary to some public statements, there is opportunity for increased state support going forward.
  
  
• DHS estimated in February 2018 that the Medicaid reimbursement rates for Berks Heim if privatized would be 5% lower than reimbursement rates as a county-owned facility.  This is on top of lost revenues under the IGT and potentially different results under the nursing facility assessment.
  
  
• Additionally, there are also other long-term care services, like the Options Program, that provide a range of support that allow seniors to stay in their homes, which are not now adequately-funded.  I have also reached out to the Administration to urge more funding for these programs.

                                                                                                                        Sincerely,

                                                                                                                        Judith L. Schwank
                                                                                                                        Senator—11th District