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MR Update#04-27: Quality Improvement, Child Development Office, Freedom March, PKU Group Home
September 14, 2004

Quality Improvement
The Centers for Medicare and Medicaid Services (CMS) has issued a new proposal for Quality Improvement Organizations (QIOs). QIOs are local organizations that by law contract with CMS to provide quality improvement assistance to health care providers such as physicians, hospitals, nursing homes, home health agencies, and health plans that contract with Medicare. This proposal aimed at these contractors, offers an eighth scope of work, a plan that represents significant enhancements to previous QIO contracts. For additional information access www.hhs.cms.gov.

Office of Child Development
The Department of Public Welfare (DPW) has created the Office of Child Development with Harriet Dichter as Deputy Secretary. This initiative is to link with the Department of Education to bolster early care and education. For details see the PCPA Info dated September 8.

Freedom March
Speaking for Ourselves and self-advocates across the state will hold the 5th Annual Freedom March on September 27 beginning at 11:00 a.m. in Harrisburg. The theme this year is “We Want the Keys to Set Our People Free.” People with disabilities want to make real choices and decisions, have control over their lives, and a place of their own to live in the community. For details contact Speaking for Ourselves at 610-825-4592 or info@speaking.org.

Call for Presentations
The 18th children’s interagency training conference scheduled for May 3-6, 2005 in State College has issued a call for presentations for those interested in addressing integrated planning for children’s services among the child-serving systems (MH/MR, child welfare, drug and alcohol, juvenile justice, regular and special education, and vocational rehabilitation). Information is available for “Building Bridges: Toward an Integrated System of Care for Children and Families” at http://pacassp.psych.psu.edu.

Class Action Lawsuit
On August 12, the United States District Court for Arizona issued an order requiring the state to offer a rate of pay to health care workers that is sufficient to attract enough workers to deliver all the services for which an individual qualifies. The case, Ball v. Biedess, is a class action litigation on behalf of Medicaid recipients who are disabled or elderly. The plaintiffs receive home based long-term services from Medicaid programs including attendant care, personal care, homemaker services, and respite services. The plaintiffs argued they were unable to receive some or all of the services needed due to low wages paid in the state’s Medicaid system. The court also found:

  • The state must pay a wage sufficient to attract enough health care workers to meet the Medicaid requirements for efficiency, economy, and quality of care;
  • the state must provide to qualified individuals those services required without gaps in service;
  • the state must develop alternative or contingency plans when a service is unable to be provided;
  • the state must monitor its entire program to detect gaps in services;
  • the state must implement a grievance process; and
  • the state must inform people of their rights.

This decision may serve as a blueprint for other states. For a copy of the decision contact Linda Drummond at PCPA.

HCSIS Update
HCSIS Release 3.3.3 will be released on October 2. Highlights include:

  • Service details screen to have funded amount
  • ISP state and end dates to be on service details screen
  • Multiple draft ISPs for one individual will be accepted in HCSIS, and
  • Unified Security will not be implemented on October 2, watch for further details.

PKU Group Home
California has opened its first group home devoted exclusively to treating adults with Phenylketonuria (PKU). Residents are provided with a special diet that has helped reduce their aggressive behaviors and the need for psychotropic medications. PKU is an inherited metabolic disease then if left untreated can cause mental retardation and other neurological disorders. Most states require newborn screening for PKU. For additional information access www.pkulatetx.com.

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