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MR Update #08-02: Governor’s Proclamation, Cash and Counseling, Labor and Industry, Certified Investigators, Autism Updates, SIS Update, ODP Update, Participant Directed Services
February 25, 2008

Governor’s Proclamation 2008
Governor Rendell has proclaimed March as “Intellectual Disability Awareness Month.” The governor encourages “all citizens to support the efforts and hard work of Pennsylvanians with intellectual disabilities and their families as they strive to live self-determined lives and realize their own personal aspirations.” This awareness month is also recognized nationally and is an excellent opportunity to focus on the talents, skills, abilities, and successes of individuals with intellectual disabilities. Individuals, families, providers, and the community can work together to develop local human interest stories and plan special events.

Cash and Counseling Project
The state’s federally funded grant, Cash and Counseling, will now be known as “Services My Way.” This program is being added to the Aging waiver which was submitted to the Centers for Medicare and Medicaid Services (CMS) in early January. This program is also included in the Attendant Care waiver renewal. This project is coordinated by Virginia Brown, director, Bureau of Individual Supports (previously Bureau of Home and Community Based Services) at the Office of Long Term Living.

A notice of proposed rulemaking (NPRM) has been published by CMS addressing the new section 1915 (j) state option for self-directed personal assistance services known as “cash and counseling.” The new state option has been added to the Medicaid program under the Deficit Reduction Act of 2005. The proposed NPRM addresses the requirements that state must meet in offering this option to eligible beneficiaries. The NPRM can be viewed at http://a257.g.akamaitech.net/7/257/2422/01jan20081800/edocket.access.gpo.gov/2008/pdf/08-115.pdf.

Labor & Industry
Governor Rendell has named Sandi Vito as acting secretary of Labor and Industry and it is anticipated she will become the permanent nominee to the post. Vito has been deputy secretary of Labor and Industry for workforce development since 2003.

Certified Investigators
The Office of Developmental Programs (ODP) re-certification course for Certified Investigators is conducted online through the HCSIS Learning Management system. Investigators may register for the class within four months of their re-certification date. Information is available at www.omrinvestigators.com.

Autism Updates

  • ODP’s Bureau of Autism Services (BAS) has posted a draft of the autism waiver to their website (www.dpw.state.pa.us) and public comments will be accepted until February 27.
  • BAS has issued a Request for Proposals for Autism Service, Education, Research and Training Regional Centers for a two year period. Details are available at www.dpw.state.pa.us and proposals are due by March 28.
  • BAS is offering two-day trainings across the state to focus on “Functional Behavioral Assessment and Treatment Plan Development.” Details are available at www.autisminpa.org.
  • A recent Pittsburgh Post-Gazette article (February 6) provides information regarding a 2006 study in the Journal of Pediatrics that states the national increase in identified autism cases in school children between 1984 – 2003 has been paralleled by a similar decrease in the number of children labeled as mental retarded or learning disabled (www.post-gazette.com/pg/08037/854963-114.stm).

SIS Update
ODP’s implementation of a statewide assessment, Supports Intensity Scale (SIS), has begun with the training and certification of newly hired assessors. Part of this training includes practice assessments. Requests for volunteers to serve as responders have been disseminated for sessions scheduled in Harrisburg, Philadelphia, and Pittsburgh.

The contracting agency for SIS is Ascend Management from Tennessee. Nancy Shanely, Ascend director of advocacy and special populations, and ODP Deputy Secretary Kevin Casey have developed an introductory video, available online at www.odpconsulting.org.

As part of CMS compliance, OPD has announced that Supports Coordinators are expected to participate in all client/consumer assessments. This will be included in the newly developed supports coordinator leadership trainings. Since timing of these initial assessments will not allow for sufficient notification to supports coordinators, ODP will waive this expectation through May 9. In the future supports coordinators will have 60 days advance notice of scheduling.

ODP Update
ODP has issued several documents, letters, and notifications. Electronic copies are available from Linda Drummond.

  • The budget briefing on February 20 indicated the proposed budget shows no cost-of-living-adjustment for services, awaiting list initiativethat include special education graduates, funding for 30 state center residents to move to community programs, and an increase in the cap for the Person/Family Directed Supports waiver.
  • Costs that constitute “room and board” under respite services are not waiver eligible expenditures except when provided as Respite Care Services in a facility approved by the state that is not a private residence. Based on this interpretation, room and board costs may be incorporated into the service rate for Respite Out of Home (24 hour and 15 minute) if the respite setting is licensed and for respite overnight and accredited day camp.
  • Regulation revisions work groups are forming for Chapters 2380 – Adult Training, 2390 – Vocational Facilities, 6400 – Community Homes, and 6500 – Family Living Homes. An initial meeting is scheduled for April 4 in Mechanicsburg. For those unable to attend, information will be available to register for work groups.
  • The College of Direct Support now offers “Fire Safety” lesson to meet licensing regulations for providers licensed under Chapters 2380, 2390, 6400, and 6500.

Participant Directed Services
ODP’s Participant Directed Services (PDS) work group held their initial meeting to overview the purpose of these services and the rate setting approach. PDS offers the individual or their representative the ability to exercise decision making authority over some or all of his/her supports and services and accepts the responsibility for taking a direct role in managing these. Pennsylvania has identified 10 services that are eligible for PDS for individuals who live in their own private residence or the home of a family member. The fiscal management of these services will be available either by the Agency of Choice or Vendor Fiscal/Employer Agent options. The services are unlicensed home and community habilitation, supported employment, transitional work services, personal support services, transportation, home finding, homemaker/chore, respite, environmental accessibility adaptations, and adaptive appliances/equipment.

ODP has contracted with Mercer Consulting to assist in the establishment of state-set rates for seven of the 10 PDS. The rates will be used to develop individual budgets for persons using this option. Mercer is conducting a wage study based on several national data sources and reviewing rate setting done in other states. It is anticipated these rates will be developed and provided to CMS by July 2008 with the fee schedule effective July 2009.

PCPA is a member of this work group, Members may share any questions or recommendations with Linda Drummond. ODP’s coordinator of this initiative is Jeanne Meikrantz, Policy and Training (c-jmeikran@state.pa.us).

Keystone Human Services
Keystone Human Services has acquired Impact Systems, Inc., which has provided services to individuals with intellectual disabilities, autism, and mental illness in Dauphin, Cumberland/Perry, Luzerne/Wyoming, Lehigh, Chester, and Delaware counties.

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