Since the Post-Gazette Editorial Board began writing about the struggles of Pennsylvania’s system of care for people with intellectual disabilities and autism (ID/A) exactly two years ago, the crisis has only deepened. Now, only weeks after the embarrassingly late final passage of the 2023-2024 budget, it’s time to plan for the 2024-2025 budget — and to beg Harrisburg leaders once again to take seriously their responsibilities to the most vulnerable Pennsylvanians.

We wrote in January 2022 that 12,000 Pennsylvania families were on an interminable wait list for services the state is obligated by law and human decency to provide. That figure has now climbed above 13,000. And still roughly 5,000 of those on the wait list have an “emergency” need the state cannot meet.

We wrote then that the state’s hourly reimbursement rate for direct service providers (DSPs) was scandalously low, making it impossible for disability service organizations to hire and to retain competent and compassionate employees. While rates have increased since early 2022, they have not kept up with inflation. The state reimbursement rate of $14.25 cashes out to average wages of $16.90, barely enough to keep up with what teenagers make at fast food restaurants. As a result, the system has a 23% vacancy rate, and turns over DSPs at a 33% clip, hamstringing its ability to serve enough people, and to serve them well.

And we wrote then that, above all, the governor and state legislature needed to budget more state money to shore up the ID/A care system. But last year, the General Assembly slashed $170 million from Gov. Josh Shapiro’s proposed appropriation, further forfeiting $200 million in federal matching funds. The reason? The previous year’s appropriation hadn’t been completely used. But that was only because service organizations couldn’t hire enough staff at the paltry rates set by the state.

The best news Pennsylvania’s disability advocates received in years came last September, when Mr. Shapiro ordered an early review of the state’s DSP reimbursement rates. And we urged — and continue to urge — that the review take into account not just inflation, but the wage rates needed to maintain a robust, sustainable system of care.

Further, Mr. Shapiro’s agreement to increase state workers’ wages 22% over the next four years will increase pay for workers in the state’s institutional care facilities, but not for community-based DSAs. The least the state can do is maintain wage parity between the two kinds of service provider — especially when families and experts generally prefer community-based care.

The Provider Alliance, which represents the state’s disability service providers, is renewing last year’s request for $430 million to fund wage increases for the dedicated workers who keep Pennsylvania’s most vulnerable citizens safe and healthy. Mr. Shapiro has demonstrated his openness to their cause. Now, legislative leaders must stop looking the other way, and save the state’s system of care for people with ID/A.

First Published: January 16, 2024, 10:30 a.m.