There are about 200 clients in the two counties, said Claire Hornberger, the counties' mental health/mental retardation administrator.
"Letting decisions that should be local drift away to Harrisburg (Pa.) or (Washington), D.C." will further remove the decision-making process from the people receiving the services, said Human Services Director Rick Wynn.
"I don't know of any county that says it makes sense," Wynn said.
The mental-retardation program could be "the guinea pig," with the state exercising more control over other human-service programs in the future, he said.
The CCAP letter to counties stated that the Pennsylvania Department of Public Welfare's goal is to create a more uniform mental-retardation program statewide.
"The Department claims that these changes are required by CMS (the federal Centers for Medicaid Services), but the changes proposed in Pennsylvania reach far beyond what has been required by CMS in other states," the letter reads.
Problems CCAP foresees include:
· Counties losing leverage in monitoring service providers.
· Loss of interest revenue to reinvest in programs.
· Delays in getting authorization and payment from the state, particularly in emergency cases where needs "often have to be addressed in hours."
· The Department of Public Welfare would have access to the same information as counties, but would lack familiarity with individual recipients' needs, families' concerns and operations of the providers.
CCAP's letter encourages county officials to work with members of the General Assembly to address these concerns.
The state also has an auditing company studying rates paid for services, with the goal of developing a statewide rate schedule, she said.
The county is working with providers, preparing them for the new regulatory requirements, McMichael said.
While there could be significant financial repercussions, Commissioner Bob Thomas said he was more concerned about the effect the change could have on the quality of services to mentally retarded residents and families.
