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Mental Retardation Update #04-10
March 31, 2004

PCPA Lobby Day
May 25 is PCPA’s Lobby Day at the Capitol in Harrisburg. Activities will include a breakfast briefing, legislative visits, and press conference. Watch for details! SAVE THE DATE!

PCPA has developed its FY 2004-05 state budget position. It available in the Legislative Affairs section of the web site. The position concurs with the Mental Health/Mental Retardation Coalition's budget position. The MH/MR Coalition will hold a Capitol Rally scheduled May 11. For a copy of the coalition position contact Linda Drummond at PCPA.

Accessing Housing
PCPA is sponsoring two seminars, “Accessing Housing For Those We Serve," HUD and Social Security Administration officials will provide information regarding housing initiatives in Pennsylvania, Social Security/SSI eligibility, housing first model, and how PCPA can assist members. Dates are May 13 at the Philadelphia Downtown Marriott and May 27 at the Pittsburgh Sheraton Station Square. For details contact Lynn Cooper.

CMS Review
The Office of Mental Retardation is due for its consolidated waiver review by the federal Center for Medicare and Medicaid Services (CMS). CMS will conduct statewide meetings with counties, providers, consumers, and families in Pittsburgh, Erie, Scranton, Harrisburg, and Philadelphia. The reviews are scheduled for June 14 - 30 and July 12 - 30.

CMS Ruling
The Center for Medicare and Medicaid Services (CMS) has issued a regulation addressing physician referrals to entities with which they have a financial relationship. The physician self-referral law prohibits a physician from referring Medicare and Medicaid patients for certain health services to facilities where the doctor has a financial ownership or investment. An entity is prohibited from billing for prohibited services. Prohibited services include clinical laboratory services, physical therapy, speech-language pathology, occupational therapy, radiology, durable medical equipment/supplies, equipment/supplies, prosthetics, home health services, outpatient prescription drugs, and inpatient and outpatient hospital services. Hospitals not subject to this moratorium are psychiatric, rehabilitation, children’s, long-term care, and some cancer facilities. For details access www.hhs.cms.gov and select Press Releases.

OMR Updates

  • PROMISe: new version (V3.51) of the Provider Electronic Solutions software is now available. This version is required to submit any electronic transaction to the PROMISe system. For download information access www.dpw.state.pa.us/omap/provinf/PESV2.asp.
  • On February 26 OMR sent a letter to counties regarding the maintenance of field notes as records for billing of Targeted Service Management (TSM) by supports coordinators. OMR is not requiring the retention of notes such as these if the TSM information is noted in a case comment in HCSIS. The case comments do not require the signature of the supports coordinator. However, if the provider is directly billing Medical Assistance for these services, they must follow all MA appropriate regulations (1101).

Workshops/Seminars

  • April 14: Housing Fair for Counselors, Case Managers and Program Staff at Temple University’s Mitten Hall, Philadelphia, PA. Features organizations focusing on shelters, transitional housing, subsidized housing, ownership assistance and housing advocacy. For details contact Natalie Williams at 215-685-5411.
  • May 16-19: Employment, Medicaid and Social Security: Collaborations at Work at Hilton, Minneapolis, MN. National conference focusing on removing barriers to Medicaid and Social Security funding for effective workplace supports. For informationaccess www.apse.org or call 804-278-9187.

Resources

  • Family Village Web site (www.familyvillage.wisc.edu) integrates information, resources, and communications opportunities on the Internet for persons with cognitive and other disabilities, their families, and service providers. Operated by the University of Wisconsin at Madison, the site offers information on specific diagnoses, adaptive products, technology, and health issues.
  • Quality Jobs/Quality Care is a free email newsletter from the National Clearinghouse on the Direct Care Workforce (www.directcareclearinghouse.org). Available on line is the annual state-by-state survey of initiatives concerning direct-care workers in long-term care. According to Results of the 2003 National Survey of State Initiatives on the Long-Term Care Direct-Care Workforce, most states are experiencing serious problems in trying to maintain a stable workforce.
  • New edition of Opening Doors that addresses proposed funding cuts to the Section 8 Housing Voucher program can be accessed at www.c-c-d.org.

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