Pa. House Human Services hears update on performance-based contracting for developmental services

Deputy Secretary Kristen Ahrens of the Pennsylvania Office of Developmental Programs told the House Human Services Committee on an informational hearing that the department has begun implementing performance-based contracting for residential services for people with intellectual disabilities and autism and has submitted federal amendments to extend the model to supports coordination, with an expected Jan. 1 effective date if the federal government approves the amendments.

Ahrens said the performance-based contracting initiative aims to improve four areas: sustainability, access, workforce and clinical capacity. "We have 15,000 people receiving residential services, we have 11,000 people on a waiting list," she told the committee, and the department is using alternative payment methodologies under its 1915(b)(4) authority to tie payment to measurable outcomes.

The initiative, Ahrens said, folds about three residential service models — licensed community living arrangements (one-to-four residences), life sharing, and supported living — into a tiered contract system. Providers were evaluated and placed into tiers; higher-performing providers receive rate add-ons and pay-for-performance opportunities. Ahrens said the department assigned tiers to residential providers after public comment and a phased submission process and that the department published an online directory showing provider performance tiers to help families compare options.

Why it matters: Committee members were told performance-based contracting is intended to hold providers accountable for quality measures while building system capacity, expanding less staff-intensive…