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Mental Retardation Update #05-10: OMR Committee Volunteers, Provider Qualifications, Dual Eligibles, Autism “First Signs” Program, Cash & Counseling, Federal Issues, and Seminars
May 26, 2005

Providers Needed
Several committees within the Office of Mental Retardation (OMR) need direct support staff to participate. If your agency is interested in providing direct support staff to represent PCPA and advocate on behalf of the direct support profession on the OMR Planning Advisory Committee or the Independent Monitoring for Qualify Steering Committee, please contact Linda Drummond.

Provider Qualifications
The Office of Mental Retardation’s (OMR) Provider Qualifications Work Group continues to meet and address issues of criteria for agencies and individuals to be a provider of mental retardation waiver programs. Since OMR responded to the consolidated waiver review letter from the Centers for Medicare and Medicaid Services, the work group will redirect some of its efforts by addressing work activities that are identified in the official response.

Dual Eligibles
The Medicare Modernization Act’s Part D Prescription Drug benefit will impact individuals who are low income, elderly, and disabled. Medicare consumers who now get their prescription drugs through Medical Assistance (Medicaid) will be transitioned as "dual eligibles" to the new Medicare Prescription Drug benefit by January 1, 2006. This creates concern that rapid transition will cause a risk of a gap in prescription drug coverage, possibilities that the selected drug insurance plan will not provide the currently prescribed drug, and the need for providers to become knowledgeable on these changes to assist consumers in the enrollment process. PCPA’s June Mental Retardation Committee will feature an overview of this program and its impact on dual eligibles presented by David Gates, Pennsylvania Health Law Project.

CMS Notice
The Centers for Medicare and Medicaid Services (CMS) has issued a notice to those who receive both Medicare and Medicaid (dual eligibles) regarding their January 1, 2006 transition from Medicaid to the new Medicare drug benefit. It is estimated that approximately 50 percent of those who receive state mental retardation/developmental disabilities services are dual eligible. The notice is posted at www.cms.hhs.gov/medicarereform/11132DualLetter.pdf.

Autism Program
Pennsylvania’s Department of Public Welfare has started a new "First Signs" program to teach parents, teachers, and healthcare professionals about early symptoms of autism and other developmental disabilities in children. The program is geared to improve the frequency and quality of screening for infants, toddlers, and children who are starting school. Special continuing education credits are being offered to physicians, nurse practitioners, physician assistants, clinicians, and early childhood educators. For additional information contact Brenda Eaton at 484-237-5354. Download the brochure, A Pediatric Practitioners Guide, at www.firstsigns.org/downloads/ReferralBrochurePA.pdf.

Cash and Counseling
In October 2004 Pennsylvania was awarded a three-year grant of $250,000 to implement Cash and Counseling. This program allows people eligible to receive supportive services through Medicaid to direct their own care and live more independently. The program is funded through grants from the Robert Wood Johnson Foundation and the Centers for Medicare and Medicaid. Using a flexible monthly allowance based on the consumers’ individual care plan, money may be used to hire caregivers, including family members, or to purchase items to help with independent living. Each person’s budget is comparable to the value of services that he/she would have received from an agency.

The program will be available to participants in several home and community-based services waiver programs, including adults with physical disabilities, technology dependent persons, persons 60 and older, and those with mental retardation ages three and older. During the second year the OMR Persons/Family Directed Support Waiver will have the Cash and Counseling Program available in part of the state. It is expected that at least 1,500 consumers will enroll in the program by the end of the three year grant.

The new project director is Virginia Brown at the Governor’s Office of Health Care Reform, virbrown@state.pa.us. PCPA will be a member of the management committee for this grant.

Federal Issues

  • ? The House Energy and Commerce Committee’s Subcommittee on Health held a hearing on Long-Term Care and Medicaid: Spiraling Costs and the Need for Reform. Eleven witnesses testified including Dr. McClellan, CMS administrator. Many of the subcommittee members are concerned about the sustainability of the costs of Medicaid long-term care.
  • The Social Security Administration has started conducting educational efforts across the country to assist Medicare beneficiaries with disabilities (who do not receive services under Medicaid) in applying for extra help to pay for their prescription drugs. Application are available at www.socialsecurity.gov.
  • The proposed federal FY 2006 budget recommends cuts up to 50% in the Section 811 Supportive Housing Program for Persons with Disabilities. Section 811 provides affordable and accessible housing for people ages 18 and older with severe disabilities (physical, developmental and mental illness).

Seminars

  • June 7, 8, 9 (various 3 hours sessions) PA Academy for College of Direct Support Administrators Training at the OMR Computer Lab, Contract Consultants, New Cumberland, PA. This computer-based training will give CDS administrators an opportunity to enhance their skills and practice using the CDS Administrator features. To register email ocs_registrationsrr@tiu11.org. or contact Contract Consultants at 717-731-6770.
  • July 11-13, "Workforce Innovations: Integration, Transformation, and Innovation" at the Philadelphia Convention Center. For details access www.workforceinnovations.org.
  • July 27-29, "A Holistic Approach to Supporting People with Developmental Disabilities and Challenging Behaviors" at the Holiday Inn, Grantville, PA. For details contact Contract Consultants, 717-731-6770 or www.contractconsultantsinc.com.
  • August 1-5: National Autism Conference at the Penn Stater Conference Center Hotel, State College, PA. For details access www.outreach.psu.edu/C&I/Autism.

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