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MR Update #05-07: Consolidated Waiver Issues with CMS, HCSIS Update, Incident Management Changes, Federal Issues, Resources, Seminars and Employment
April 12, 2005

PCPA Sends Recommendations to OMR
The Office of Mental Retardation (OMR) recently received a letter from the Center for Medicare and Medicaid Services (CMS) requesting additional information regarding their review of the state’s Consolidated Mental Retardation Waiver. (See PCPA Info March 23). PCPA coordinated a response in cooperation with United Cerebral Palsy of PA, the Pennsylvania Association of Rehabilitation Facilities, and the Pennsylvania Association of Resoruces for Persons with Mental Retardation regarding what should be provider qualifications/criteria for licensed and unlicensed agencies. These included:

  • When required, obtain and follow relevant licensing and regulations based on services provided;
  • Meet waiver standards as indicated by CMS;
  • Assure computer capacity to access OMR required on-line components (i.e. HCSIS and PROMISe);
  • Develop a Quality Management Plan unique to the organization; and
  • Negotiate a service contract that is uniform and valid statewide.

On April 8, OMR held a conference call with CMS regarding the renewal issues, which are:

  • The state taking full responsibility for oversight of the waiver;
  • Concern that counties are operating independently and the state is not exercising control;
  • Necessary services identified in a person’s plan of care must be delivered;
  • Providers must enter into a direct agreement with the state as the Medicaid agency; and
  • Concern regarding rate-setting and how rate disputes are resolved.

OMR must finalizeand deliver its response to CMS by April 30.

HCSIS Update
HCISI Release 4.2.2 went live on April 7 and is posted on the Learning Management System HCSIS site at www.humanservices-r.state.pa.us/HCSISLMS. Highlights include

  • ISP pending approval alerts will be deleted automatically and
  • Confirmation messages in Provider Access will be enhanced for more descriptive information.

In May, the Case Transfer Wizard will be included with HCSIS Release 4.2.3 to enable counties to automate the transfer of individuals between counties. Also, providers will be able to access Individual Support Plans (ISP) in HCSIS. Once the ISP is approved all providers with services on the ISP will be able to view and print the plan. Providers will also receive alerts and be able to request the ISP aging report.

Incident Management Reports
In 2004 OMR developed a draft Provider and County Incident Management Report Template bulletin to develop aggregate incident management reports to be submitted to the state. After a trial period with this template the feedback from counties and providers was the need for OMR to develop user-friendly methods and format for delivery of the data. OMR worked with Deloitte Consulting to design a performance management system comprised of incident management trend and quality performance reports. These reports will replace the draft template and will be automatically generated with the HCSIS information and electronically delivered to OMR, regions, counties, and providers.

2003 Incident Statistics
OMR is currently preparing an incident management annual report for 2003. Nearly 54,000 reportable incidents were made. The top five categories, which represent 80% of the 53,849 incidents, include:

  • Restraint: 27%
  • Medication Error: 17%
  • Emergency Room Visit: 17%
  • Hospitalization: 11%
  • Abuse Allegations: 6%

Laurelton Center
Laurelton State Center (closed in 1998) is still on the market. There currently are five potential bidders for the property. Bid specifications require developers to guarantee a "fair consideration" of at least $1.75 million within five years, which includes job retention or creation, economic growth, community development, and expansion of the local tax base. Bidders are:

  • Firetree Ltd., of Williamsport for a drug and alcohol treatment facility;
  • Sports Management Group for an action sports facility, prep school, and golf course;
  • Randy Duncan for Laurelton Sports Village Resort with theater, museum, restaurants, and outdoor recreation;
  • James Saenger for Carillon Resort hotel, condominiums, and assisted living; and
  • RBIS Ltd., for a high tech business park.

Federal Issues
1. The United States House and Senate have passed competing versions of the $2.57 trillion federal budget for 2006. The Senate approved an amendment removing all Medicaid cuts from the budget and setting aside funding for a one-year commission to recommend changes to the program. More information about federal issues can be found in the Legislative Affairs section of the web site.

2. The National Governor’s Association has released a paper that looks at the issues, problems, and challenges facing Medicaid. For a copy access www.nga.org/cda/files/0502MEDICAID.pdf.

3. The Kaiser Family Foundation has released two resources related to the final regulations for the Medicare Part D prescription drug program. The summary document is available at www.kff.org/medicare/7283.cfm and the chart comparing the enrollment and appeal procedures is available at www.kff.org/medicare/7300.cfm.

4. The Kaiser Family Foundation has developed a fact sheet addressing intergovernmental transfers (IGTs). It reviews the key elements of Medicaid’s financing structure and the role of IGTs as a way in which states generate the state share of Medicaid financing. The brief is available at www.kff.org/medicaid/7282.cfm.

Resources
A new guidebook, Staff Recruitment, Retention and Training Strategies for Community Human Services Organizations, provides practical information to address the challenges of finding and retaining quality support staff. For information about ordering access www.brookespublishing.com.

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