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MR Update #04-30: System Redesign, 30-Hour Rule, Mini-Grants, HIPAA Privacy Rule, Forums, and Meetings
October 13, 2004

System Redesign
PCPA’s System Redesign Work Group has completed development of its guiding principles and is moving forward with six subcommittees addressing specific topics geared toward the established principles. The mental retardation issues will be addressed from the standpoint of researching implications of the creation of an Office of Disabilities, moving from a state focusing on mental retardation to developmental disabilities, and the costs and services needed with these changes. Persons interested in serving on this subcommittee may contact Linda Drummond at PCPA for information.

30-Hour Rule Change
The office of Mental Retardation (OMR) has issued a new Mental Retardation Bulletin (#00-04-12) that rescinds bulletin #00-03-09 regarding the "30-Hour Rule." The 30-hour rule found in state regulations 6400.3(f)(7) states that "...residential homes for three or fewer people with mental retardation who are 18 years of age or older and who need a yearly average of 30 hours or less direct staff contact per week per home..." do not have to be licensed. The new bulletin offers the following clarifications:

1. Home needs to be licensed if:

  • Person owns the home and has one or more renters with mental retardation who require 30 hours or more supports per week;
  • If the home or apartment is owned/rented/leased by an agency and one or more residents needs more than 30 hours weekly support; or
  • If the person leases/rents under own name and needs 30 hours or more weekly.

2. Home does not need to be licensed if:

  • Person owns home and is only resident and needs any amount of supports, or
  • If the person owns the home and the agency is only the representative payee.

SC Forums
OMR is conducting public information sessions on county supports coordination services across the state. Topics include: recommendations from the OMR PAC, roles and responsibilities, improvement of communications with consumers/families, and development of a handbook and training. Sessions available include:

  • October 26 and 27 at Woodlands Inn, Wilkes-Barre
  • November 4 and 5 at PaTTAN, Harrisburg
  • November 9 and 10 at Crowne Plaza, Valley Forge
  • November 15 and 16 at Four Points Sheraton North, Mars

To register or for additional information contact Rebecca Roberts, 814-542-2501 or ocs_registrationsrr@tiu11.org.

Provider Users Group
OMR is holding its second networking meeting for providers who are currently utilizing the courses in the College of Direct Support to enhance their direct support professional’s job skills. Scheduled for November 4, 11:00 a.m. - 3:00 p.m. at PaTTAN in Harrisburg, registration is required by October 27 to ocs_registrationsmh@tiu11.org.

EI Rate Setting
OMR is establishing a work group for early intervention rate setting policies and procedures to make recommendations to Deputy Secretary Casey. The priorities of this group will be to recommend policies to ensure that early intervention rates and travel reimbursement are applied consistently across the state. The work group will consist of four provider representatives. If interested in additional information contact Connell O’Brien at PCPA.

MAWD Mini-Grants
The Department of Public Welfare (DPW) has received a grant from the Centers for Medicare and Medicaid Services (CMS) to address issues related to employment and healthcare coverage for persons with disabilities. One of the initiatives is to complete an education and outreach effort regarding workers with disabilities and the Medicaid optional group called Medical Assistance for Workers with Disabilities (MAWD). A request for proposal has been issued to address educating transition age youth with disabilities, parents and others regarding MAWD, benefits planning assistance and outreach programs, and Ticket-to-Work. Proposals, not to exceed $7500, are due by October 29. For details contact Linda Drummond at PCPA.

CMS Grant
The Governor’s Office of Health Care Reform has received a federal CMS grant to address integrating long-term supports with affordable housing. This three-year $893,000 grant will allow the state to focus on housing issues for those needing long-term community care.

Recertification Courses
Two certified investigator recertification courses for the southeast region are now posted on the Learning Management System. The courses are being held in February 2005. Only those investigators with certifications expiring within four months of the training date will be able to enroll (www.humanservices-r.state.pa.us/HCSISLMS).

Community Choice
Community Choice is a new program for people with disabilities of all ages and older adults to expedite their enrollment in home and community-based services within three days. Being piloted in Fayette, Greene, Philadelphia, Washington, Chester, and Delaware counties the program will help those living in their homes or moving from nursing homes back into the community to have faster access to services such as attendant care and community services program for persons with physical disabilities. For additional information access the DPW web site at www.dpw.state.pa.us.

HIPAA Privacy Issues
The US Department of Health and Human Service’s Office of Civil Rights (OCR) has released a letter responding to questions regarding the application of federal medical privacy laws through HIPAA to services for persons with developmental disabilities. Addressed are issues such as:

  • Legality of communications between MR/DD agencies and other providers that service adult consumers and their families and friends who have traditionally assisted in health care decision making even if not formally a legal guardian.
  • The privacy rule generally allows health care providers and plans to share information about the patient’s treatment or payment for health care with spouses, other family members, close personal friends, or any other person identified by a patient as directly involved with them.
  • The health care provider may disclose information to a family member or friend if the individual is present and agrees or does not object to the disclosure or the doctor or plan reasonably infers from the circumstances that the patient does not object.
  • OCR’s privacy rule does not affect state laws governing the legal responsibilities relating to consent, legal capacity, or exercise of such legal rights.
  • For additional information access OCR’s web site at www.hhs.gov/ocr/hipaa.

Federal Issues

1. The Assistive Technology Act of 2004 (HR4278) passed on October 8 and is awaiting the president’s signature. This is a five-year reauthorization of the act that has an array of programs in all states. An additional component is a new focus on school to community transition and funding for research and development for new devices and telecommunications technology.

2. Congress missed its schedule for adjourning on October 8 and will return in mid-November to finalize fiscal year 2005 appropriations and IDEA reauthorization. The House passed the Labor, Health and Human Services (HHS) and Education Appropriations bill, and the Senate Appropriations Committee approved its spending bill for these services. A brief overview:

  • $63.2 billion for HHS discretionary program
  • $177.5 billion for Medicaid
  • $119.1 billion for federal share of current state Medicaid costs
  • $11.6 million for developmental disabilities projects of national significance
  • $119.2 million for Centers for Disease Control and Prevention for birth defects, developmental disabilities, disability, and health program including studies on Down Syndrome, Spina Bifida, and autism
  • $12.2 billion for special education
  • $466.6 million for grants to states for infants and families under IDEA
  • $47.6 million for Office of Disability Employment Policy
  • $40 million for CMS Real Choice Systems Change Grants.

To read the bills access: House bill at http://thomas.loc.gov/cgi-bin/bdquery/z?d108:HR05006 and Senate bill at http://thomas.loc.gov/home/thomas.html and search for S2810.

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