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DPW Highlights Kirk T. Implementation
January 25, 2001

The Pennsylvania Department of Public Welfare (DPW) has issued highlights (see below) for the implementation of the Kirk T. settlement. Providers are encouraged to forward questions or concerns regarding the implementation process to Lisa Lowrie at PCPA. The Association is compiling a list of questions requiring further clarification from the Department. Additional information will be provided during the TSS Prior Authorization Training hosted by PCPA on January 31 - February 1. Additionally, PCPA members can use the Electronic Bulletin Board in the "Members Only" section of the web site to post questions to be included in those submitted to the Department.

HIGHLIGHTS OF KIRK T. SETTLEMENT

The Department Will Require that Behavioral Health Services be Delivered within Sixty Days of a Request for Service.

  • A request for service is the first request made to a county (including base service units), a behavioral health maintenance organization ("BH-MCO"), or a BHR service provider.
  • The sixty-day standard will be considered to have been satisfied if the prescribed service is offered to the recipient, even if the recipient delayed initiation of service, or if the actual amount of services that are offered is the amount the family agreed was appropriate.
  • Psychological and psychiatric evaluations must be conducted promptly and may not be delayed for any reason, including the possible lack of staff to provide BHR services.

The Department Will Require that Interagency Team ("IT") Meetings for Some Recipients be Held No More than Once Per Year.

  • For recipients receiving services from two or fewer delivery systems, IT meetings will be required to be held no more than once per year.
  • Any member of the IT team can request that the IT be convened more frequently based on the needs of the recipient.

The Department Will Change the Minimum Staffing Qualifications for Therapeutic Support Staff Worker.

  • The minimum qualifications for Therapeutic Support Staff workers ("TSS workers") will be changed to include:
    1. Persons with a Bachelor's Degree in a human services field;
    2. Persons with a Bachelor's Degree in any other field and one year of paid work experience with children or adolescents;
    3. Persons with an Associate's Degree or sixty college credits who have three years of paid work experience with children or adolescents;
    4. Licensed registered nurses with one year of paid work experience with children or adolescents; and
    5. Licensed practical nurses with three years of paid work experience with children or adolescents.

The Department Will Require Training for TSS Workers.

  • TSS workers without TSS experience must receive at least fifteen hours of training before working alone with children or adolescents and an additional twenty-four hours of training within the first six months.
  • TSS workers must receive at least twenty hours of training each year after the first year.

The Department Will Specify Minimum Supervision Requirements of TSS Workers.

  • All TSS workers with less than six months TSS experience must receive at least six hours of on-site supervision by a qualified supervisor before working alone with recipients.
  • All TSS workers who are newly hired by a different agency, regardless of the amount of TSS experience, must receive at least three hours of on-site supervision by a qualified supervisor before working alone with recipients.
  • All TSS workers must also receive ongoing supervision. TSS workers employed twenty hours per week or more must receive at least one hour of supervision per week. TSS workers employed less than twenty hours per week must receive at least thirty minutes of supervision per week. Some of this supervision must be on-site supervision while the TSS worker is providing services to a recipient.
  • The Department will establish a new procedure code to be billed for the initial six hours of on-site TSS service by and supervision of each new TSS worker and the three hours of on-site TSS service by and supervision of each TSS worker who is newly hired to an agency.

Reporting Requirements

  • Providers will be required to report on the time within which services are delivered and whether the services were delivered at the level authorized.
  • BH-MCO's will be required to submit reports to the Department that contain information on the time within which services are delivered and whether the services were delivered at the level authorized.
  • The Department will collect and record the information contained in the forms submitted with requests for prior authorization of TSS services to the fee-for-service Prior Authorization Unit.

Miscellaneous

  • The Department has designated certain persons to receive and resolve complaints and problems associated with access to services that are not resolved in a timely manner. The Department will advise class members how to reach these persons.
  • The Department will assure that the BH-MCO's use out-of-network providers if BHR services cannot be provided within the sixty-day timeliness standard by using network providers.
  • The Department will remind providers of the availability of the mechanism by which they may request a rate adjustment for BHR services.

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