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IDD Update #09-05:  ODP Cost Report and SCO Trainings, Direct Service Recognition, States Autism Updates, “Good to Go” Process, Billing Webcasts, HHS Rescinds Medicaid Regulations, and DRN Lawsuit
July 22, 2009

ODP Cost Report Trainings
The Office of Developmental Programs (ODP) is offering Cost Report trainings in preparation for the submission of cost reports for rates effective FY 2010/11 for waiver programs. Separate trainings are being offered across the state during the last two weeks of July for direct service providers and supports coordination organizations (SCO). Details are available at www.odpconsulting.net under both the Provider Information Center and the SCO Information Center.

ODP SCO Required Trainings
Supports coordinators and supervisors may register until July 24 for OPD required trainings “Enhancing Your Everyday Work Life.” The series, ,scheduled in August, include both online and face-to-face trainings which count toward the 27 hours of required training for calendar year 2009. Details and registration are available at www.odpconsulting.net under Supports Coordination Curriculum.

Direct Service Staff Recognition
The American Network of Community Options and Resources (ANCOR) has selected September 13-19 as Direct Support Professional Recognition Week. This offers an opportunity for agencies to recognize their direct support workforce and the tremendous difference they make each day in the lives of persons with disabilities. PCPA encourages providers to take this opportunity to thank direct support staff. ANCOR will provide suggestions on recognition options through their web site at www.ancor.org.

Autism Update
Other states are following Pennsylvania’s lead in signing into law bills requiring health insurance companies to cover autism diagnosis and treatments. Colorado’s Senate Bill 244 goes into effect July 1, 2010 and requires insurance companies to cover children up to age eight for up to $34,000 per year, and children ages nine – 19 up to $12,000 per year. Connecticut’s Senate Bill 301 requires coverage for children under age nine for behavioral therapy and psychiatric and psychological services up to $50,000 per year and children ages nine – 12 for up to $35,000 per year. Montana’s Senate Bill 234 requires insurance companies to cover up to $50,000 per year for autism diagnosis and treatment for children up to age eight and up to $20,000 per year for children ages nine – 18, effective January 1, 2010.

ODP “Good to Go” Process
In order to provide uniform procedures for the establishment and maintenance of Vendor Fiscal/Employer Agent Financial Management Services through the statewide contractor, Acumen Fiscal Agent, the Office of Developmental Program is implementing a “Good to Go” process which became effective July 1. The process information is available to Administrative Entities and Supports Coordination Organizations to assist individuals and families that have selected a participant directed service option and are using this fiscal model for service payment. Forms for both fiscal management service options (Vendor Fiscal and Agency with Choice) are available at www.odpconsulting.net under Participant Directed Services.

Billing Webcasts
Direct service providers funded through the ODP prospective payment system now have three webcasts available through www.odpconsulting.net. Each webcast provides information regarding billing PROMISe for services provided in the community. Webcasts include:

  • Managing for Successful Billing,
  • Fiscal Year 2009/10 Service Definitions, and
  • PROMISe Billing 2009/10 and Forward.

HHS Rescinds Medicaid Regulations
The US Department of Health and Human Services (HHS) has rescinded all or part of three Medicaid regulations previously issued. HHS Secretary Kathleen Sebelius stated that by rescinding these rules children will continue receiving services through their schools, people will be able to access all available case management resources, and outpatient hospital and clinic services will continued to be covered. The rules rescinded include:

  • Restricting beneficiary access to case management services and limiting state flexibility in determining efficient and effective delivery systems for case management services, and
  • Eliminating reimbursement for school-based administrative costs and costs of transportation to and from schools, which would have impacted schools’ ability to offer Medicaid services to students.

DRN Files Lawsuit
The Disability Rights Network of PA (DRN) has filed a lawsuit against the Department of Public Welfare regarding the practice of housing adults with intellectual disability at state psychiatric hospitals. The plaintiffs are among the 115 individuals with this disability housed at the state’s seven psychiatric hospitals. The purpose of the litigation is to require the state to develop policies and programs that focus on moving individuals into community-based programs where they will also receive mental health services.

 

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