Authors Posts by Melissa Dehoff

Melissa Dehoff

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Melissa Dehoff is responsible for all medical rehabilitation and brain injury service issues. Ms. Dehoff attends multiple state-level meetings to advocate on behalf of members on brain injury and rehabilitation issues and is a member of the Department of Health Traumatic Brain Injury Advisory Board.

The Office of Long-Term Living (OLTL) will conduct their next Community HealthChoices (CHC) Third Thursday webinar on July 16, 2020 from 1:30 pm – 3:00 pm. During this webinar, OLTL’s Deputy Secretary, Jamie Buchenauer, will be providing updates on COVID-19. To participate in the webinar, registration is required. Once registered, an email will be sent that contains the information about joining the webinar.

Questions about the webinar should be directed to the OLTL Bureau of Policy Development and Communications Management at 717-857-3280.

The next Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting will be held on August 5, 2020 from 10:00 am – 1:00 pm via remote streaming. Members interested in participating in the meeting must register in advance. After registering, members will receive a confirmation email that will contain the information about joining the webinar.

Remote captioning and streaming services will be provided. If you require these services, please use this remote captioning and streaming services link.

The Office of Long-Term Living (OLTL) recently issued bulletin 17-20-02, “Employment and Employment Related Services,” that shares Pennsylvania’s “Employment First” policy to the Community HealthChoices (CHC) Managed Care Organizations (MCOs) and Service Coordination Entities (SCEs), and updates the obligations of and the resources available under this policy. This bulletin specifically notes the changes to the CHC and OBRA waivers which allow employment and employment-related services to be authorized through the waivers when the Office of Vocational Rehabilitation has a closed order of selection or has not made an eligibility determination within 120 days. The revisions reflecting these changes are detailed in the Procedures section of the Bulletin.

OLTL also included a document, “Guidance on Conversations about Employment for OLTL Participants,” for additional information.

This bulletin rescinds OLTL’s Bulletin 59-16-07, “Employment and Employment Related Services,” issued on July 26, 2016, and any other OLTL policy documents or parts of policy documents that are inconsistent with this bulletin’s contents.

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The Centers for Disease Control and Prevention (CDC) released a new report, “Trends in Emergency Department Visits for Contact Sports-Related Traumatic Brain Injuries Among Children – United States, 2001–2018,” that shows the rate of emergency department (ED) visits among children for contact sports-related traumatic brain injuries (TBI) decreased 32 percent from 2012 to 2018. This decrease is notable after more than a decade of increasing rates. The CDC attributes this reduction due to a 39 percent decline in the rate of football-related TBI ED visits from 2013–2018 (which had previously increased more than 200 percent from 2001 to 2013. This decrease was likely due to a decrease in participation in tackle football, the implementation of contact limitations, and the use of tackling techniques to reduce concussions. Even with this reduction in TBIs, football remains the sport with the highest incidence of sports and recreation-related TBIs.

Some additional key findings noted in this report include:

  • Between 2001 and 2018, there were over 3.8 million ED visits for sports- and recreation-related TBIs among children under 18 years old. Contact sports accounted for approximately 41 percent of these ED visits.
  • Football had the highest rate of TBI ED visits in 2018 for contact sports, with basketball and soccer following. TBI ED visits from basketball and soccer did not show a significant decline over the study period.
  • The rate of contact sports-related TBIs declined among both sexes, with a 31 percent decrease among males from 2012 to 2018 and a 38 percent decrease among females from 2014 to 2018.
  • The rate of ED visits from TBIs in non-contact sports (for example, playground activities and bicycling) declined 24 percent from 2011 to 2018.

These findings highlight the continued need to expand efforts to prevent football-related TBIs among children and call attention to the need to identify effective prevention strategies for other contact sports.

The Pennsylvania Department of Aging will host a Virtual Community Conversation on July 7, 2020, from Noon to 1:30 pm to discuss their State Plan on Aging for 2020–2024. During this virtual meeting, feedback is encouraged from the public and community stakeholders. The State Plan on Aging is designed to help Pennsylvania meet the objectives of the Older Americans Act and will be submitted to the Administration for Community Living (ACL) containing a vision and direction for Pennsylvania’s network of aging services. This plan is required to be submitted every four years, with this next plan due by October 1, 2020.

Individuals interested in participating can be an observer only or can make comments for up to two minutes on aging issues that are important to them. Questions can also be submitted on aging-related topics in advance and have them answered during the discussion by registering online.

Registration is required to participate via WebEx. If you choose to participate by phone, you must still register through the link to obtain your Attendee ID.

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The Pennsylvania Department of Health (DOH) has announced that referrals are now being taken for the new Acquired Brain Injury Program (ABIP).

The ABIP will provide outpatient/day program or home- and community- based rehabilitation services. If eligible, an individual may receive up to $50,000 or a years’ worth of rehab services. The application will be a two-step process similar to the Head Injury Program (HIP) consisting of the application process and an assessment process.

In order to be eligible in the application process, an individual must complete the application forms, be 18 to 21 years old, have verification of an acquired brain injury (non-traumatic), be a Pennsylvania resident, and be within the income guidelines. For 2020 applicants, the ABIP will look at income from 2019. The income limit, which is based on 300 percent of Federal Poverty Income Guidelines, for one person is $37,470. Please be advised that only the applicant’s income will be considered.

The second phase of the application process will be conducted by our participating providers. Through an assessment, the ABIP providers will determine if the individual will benefit from rehabilitation and develop a service plan.

Participating providers for the ABIP are:

  • Acadia Acquisitions, Inc.
  • Moss Rehab
  • NeuroRestorative PA
  • ReMed Recovery Care Center
  • Success Rehabilitation, Inc.

In order to make a referral or for any questions regarding the program, please call the Brain Injury Helpline at 866-412-4755 or 717-772-2763. You may also email questions or referrals via email or fax to 717-265-7366.

If you have any questions, please contact Amy Deiderick.

Note:  This transition plan is intended to be used in conjunction with the April 30, 2020 Temporary Changes to the Community HealthChoices 1915(c) Waiver- (Revised) Guidance.  That guidance, attached to this email, contains complete descriptions of the temporary changes and guidelines for implementation.

The Centers for Medicare & Medicaid Services (CMS) approved temporary changes to the Community HealthChoices (CHC) waiver beginning March 6, 2020 in response to the COVID-19 pandemic.  Approval of these changes is covered under Appendix K, Emergency Preparedness and Response, which states may use during emergency situations to request amendments to their approved waivers.  These changes addressed potential staffing shortages and the need for service provision not included in approved service descriptions to ensure participant health and safety needs could be accommodated for the duration of the COVID-19 statewide emergency.  As described in the Temporary Changes to the CHC Waiver (Revised) Guidance, the changes were not intended to apply to all participants nor to be considered across-the-board changes that must be implemented for each participant.  These flexibilities were to be evaluated on a case-by-case basis in coordination with the CHC Managed Care Organizations (MCOs).

As we begin to ease restrictions on work and on social interactions, the temporary waiver changes can also be phased out, provided participants can be safely served and providers and service coordinators are taking proper precautions.  The attached transition plan provides guidance to the CHC-MCOs on phasing out the temporary waiver flexibilities.  The guidance is intended to be implemented at the county level as each county moves through the red, yellow and green phases of the Governor’s phased reopening plan for Pennsylvania.

If you have questions about the information in the attached transition plan, please contact the CHC-MCOs for guidance on implementation.

A listserv has been established for ongoing updates on the CHC program. It is titled OLTL-COMMUNITY-HEALTHCHOICES, please visit the ListServ Archives page at http://listserv.dpw.state.pa.us to update or register your email address.

Please share this email with other members of your organization as appropriate. Also, it is imperative that you notify the Office of Long-Term Living for changes that would affect your provider file, such as addresses and telephone numbers. Mail to/pay to addresses, email addresses, and phone numbers may be updated electronically through ePEAP, which can be accessed through the PROMISe™ provider portal. For any other provider file changes please notify the Bureau of Fee for Service Programs Enrollment and Certification Section at 1-800-932-0939 Option #1.

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The Centers for Medicare and Medicaid Services (CMS) has released a new inpatient rehabilitation facility patient assessment instrument (IRF-PAI) guidance document. The document was developed and based on questions submitted by stakeholders to the IRF Post-Acute Care (PAC) Quality Reporting Program (QRP) help desk.

In this guidance, CMS reiterates its prior instruction that it will delay the release of updated versions of the item sets needed to support the Transfer of Health (TOH) Information Quality Measures and new revised Standardized Patient Assessment Data Elements (SPADEs). As indicated in prior guidance, the release of the updated IRF-PAI version will be delayed until October 1st of the year that is at least one full fiscal year after the end of the COVID-19 public health emergency (PHE). An example provided by CMS: if the PHE ends on September 20, 2020, IRFs will be required to begin collecting data using the updated versions of the item sets beginning with patients discharged on October 1, 2021. No new information is provided on CMS’ planned approach for stakeholder education and training.

Included in CMS’ announcement, IRF-PAI questions and answers will be published on a quarterly basis.