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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.

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The Office of Long-Term Living (OLTL) has issued Bulletin 59-21-03, which pertains to the Home and Community-Based Settings (HCBS) Heightened Scrutiny process. Also included are the following bulletin attachments:

  • Attachment A: Final Rule Heightened Scrutiny checklist for Day Settings
  • Attachment B: Final Rule Heightened Scrutiny checklist for Employment Skills Development Settings
  • Attachment C: Final Rule Heightened scrutiny checklist for Residential Settings

OLTL is currently working to develop a training for providers on this topic and will host training sessions sometime in early 2022. Questions about the bulletin and/or the attachments should be sent via email. The bulletin is effective December 29, 2021.

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A Financial Management Services (FMS) Stakeholder meeting has been scheduled for January 7, 2022, from 1:00 pm–2:30 pm. The purpose of this public meeting is to discuss upcoming changes for the administration of FMS under the Community HealthChoices (CHC), OBRA Waiver, and Act 150 programs. Representatives from both the Office of Long-Term Living (OLTL) and the CHC Managed Care Organizations (MCOs) will be in attendance to discuss the upcoming changes. The meeting information is provided below:

Meeting Link

Meeting Number:
Meeting Number Access Code: 2631 798 3447
Meeting Password: Stakeholders

Join by Phone:
408-418-9388 (U.S. Toll)
202-860-2110 (U.S. Toll — Washington, D.C.)

Join from a Video System or Application
Dial 26317983447@pa-hhs.webex.com
You can also dial 173.243.2.68 and enter your meeting number.

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The Centers for Medicare and Medicaid Services (CMS) has released guidance on the Omnibus COVID-19 health care staff vaccination interim final rule that was published on November 5, 2021. The emergency regulation helps safeguard health care workers and the people they serve from COVID-19 and its variants for all individuals seeking care. This is done by imposing requirements regarding vaccinations for eligible staff at health care facilities participating in the Medicare and Medicaid programs.

This guidance provides important information on implementation as well as guidelines to assess and maintain compliance with the COVID-19 vaccination requirements for health care workers at facilities participating in the Medicare and Medicaid programs.

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The Office of Long-Term Living (OLTL) has outlined its plan to the Centers for Medicare and Medicaid Services (CMS) to strengthen the workforce and assist Adult Day Services (ADS) providers. This plan is in response to the American Rescue Plan Act of 2021 (ARPA), which provides a temporary 10 percent increase to the federal medical assistance percentage (FMAP) for certain Medicaid expenditures for home and community-based services (HCBS). The funding must be used to enhance, expand, or strengthen HCBS.

The OLTL ARPA plan directs $46.5 million to Personal Assistance Service (PAS), Community Integration (CI), and Residential Habilitation (Res Hab) providers to assist with recruitment and retention of direct care workers. The plan directs an additional $13 million to ADS providers to strengthen ADS. To qualify for these payments, providers must have been in operation as of November 1, 2021.

OLTL sent letters to providers with details about the payments, including information about the approved use of and reporting on these funds. For reference, samples of the letters, a list of qualifying entities and payment amounts, and a blank copy of the Provider Attestation Form are available on the DHS Long-Term Care Providers page under the heading “American Rescue Plan Act (ARPA) Funding.”

To receive a Strengthening the Workforce or Adult Day Services payment, providers must complete the OLTL Provider Attestation form and return via email or fax it to the OLTL Bureau of Finance at (717) 787-2145.  Providers who return completed forms by January 7, 2022, will receive payment in February 2022.

Strengthening the Workforce Payments

  • The total available for a one-time payment to PAS, Res Hab, and CI providers is $46,500,000. Of that, $44 million is allocated to PAS and CI, and $2.5 million is allocated to Res Hab. Amounts allocated to providers in each category were based on fee-for-service claims and managed care encounters for services provided between July 1, 2020, and March 30, 2021.
  • To calculate each PAS and CI provider’s Strengthening the Workforce payment, OLTL first divided the $44 million allocation by the total number of fee-for-service and managed care PAS and CI units billed between July 1, 2020, and March 30, 2021, to determine a per unit amount. Each provider’s payment was then calculated by multiplying the per unit amount by the provider’s number of fee-for-service and managed care PAS and CI units billed during the same period.
  • To calculate each Res Hab provider’s Strengthening the Workforce payment, OLTL first divided the $2.5 million allocation by the total number of fee-for-service and managed care Res Hab units billed between July 1, 2020, and March 30, 2021, to determine a per unit amount. Each provider’s payment was then calculated by multiplying the per unit amount by the provider’s number of fee-for-service and managed care Res Hab units billed during the same period.

Strengthening ADS Payments

  • The total funds available for a one-time payment to ADS providers is $13 million. Amounts allocated to ADS providers were based on fee-for-service claims and managed care encounters for services provided between January 1, 2019, and December 31, 2019.
  • To calculate each ADS provider’s Strengthening Adult Day Services payment, OLTL first divided the $13 million allocation by the total number of fee-for-service and managed care ADS units billed between January 1, 2019, and December 31, 2019, to determine a per unit amount. Each provider’s payment was then calculated by multiplying the per unit amount by the provider’s number of fee-for-service and managed care ADS units billed during the same period.

Acceptable Uses of ARPA Funding

ARPA funding must be used for things such as sign on bonuses, retention payments, COVID-19 related leave benefits and paid time off, vaccination incentives, or the purchase of personal protective equipment and testing supplies. Additionally, ADS providers can use the funding for retrofitting adult day centers, expenses to re-open the centers, and expenses to develop alternative models to provide ADS.

Questions about this information should be directed to the OLTL Provider Helpline at 800-932-0939.

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The Centers for Medicare & Medicaid Services (CMS) has approved the Office of Long-Term Living’s (OLTL) Community HealthChoices (CHC) Waiver amendment. The amendment is effective January 1, 2022.

The changes in the approved amendment include:

  • Revised service definitions, service limitations, and/or provider qualifications for the following CHC waiver services:
    • Adult Daily Living;
    • Home Adaptations;
    • Participant-Directed Community Supports;
    • Personal Assistance Services;
    • Personal Emergency Response System (PERS);
    • Specialized Medical Equipment and Supplies; and
    • Vehicle Modifications.
  • Revised waiver performance measures.
  • Revised number of unduplicated recipients for Waiver Years 3–5 and revised corresponding cost neutrality estimates.
  • Revised Service Coordinator selection or assignment time frame from 14 days to 7 days to be consistent with the CHC Agreement.

Questions about the 2022 CHC amendment can be submitted electronically.

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The Office of Long-Term Living (OLTL) has updated the Home and Community-Based Services (HCBS) Medical Assistance (MA) Fee Schedule. The updates reflect the fee schedule rates for Personal Assistance Services (PAS) procedure codes W1793, W1793 TT, W1792, and W1792 TU in the referenced Pennsylvania Bulletin below.

The updated OLTL HCBS MA Fee Schedule (effective January 1, 2022) may be found here. The new rates for the OBRA Waiver and Act 150 Program were announced in the Pennsylvania Bulletin on November 6, 2021, in the Volume 51, Number 45 issue and can be found here.

Questions related to this update should be directed to the OLTL Provider Inquiry Line at 800-932-0939, option 2, Monday–Friday between 9:00 am–12:00 pm and 1:00 pm–4:00 pm.

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The Office of Long-Term Living (OLTL) has issued additional guidance on the Enterprise Incident Management (EIM) Enhancements.

As stated in the ListServ communication sent on November 24, 2021, Critical Incident Report Extensions changes will be implemented in the EIM system on December 11, 2021. Once the maximum number of allowed extensions is reached, providers and service coordinators (SCs) will need to contact OLTL if additional extensions are needed.

When requesting incident report extensions, please follow these instructions:

  • Requests must be submitted to OLTL at least 5 business days prior to incident report due date, via email.
  • Reasons for prior extensions must be clearly documented in the incident report.
  • The reason for an extension request must be detailed, valid, and clearly documented in the incident report as well as in the Home and Community Services Information System (HCSIS) notes.
  • Incident report extensions will be approved for 30 days from previous report due date.
  • The following information must be included in the request for extension:
    • Participant’s Name
    • Participant’s Master Client Index (MCI) Number
    • EIM Incident ID
    • Incident Discovery Date
    • Incident Original Due Date Incident Primary Category
    • Reason for Extension Request (must be clearly documented in critical incident report and HCSIS notes)
    • Submission date (at least 5 business days prior to report due date)
    • Person submitting request (name and title)
    • Agency/Managed Care Organization (MCO) Name

OLTL staff will respond to extension requests within 3 business days by replying to the requestor to let them know if the request was approved or rejected. If rejected, the reason for the rejection will be included in the response. If approved, OLTL staff will enter the extension in EIM.

OLTL has drafted a form to use in the near future. Once the form is approved, providers will be notified. Any questions regarding the information should be directed here.

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The next Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting has been scheduled for January 5, 2022, from 10:00 am–1:00 pm via webinar. The information to participate in this meeting is provided below:

  • Webinar Registration Link : If you have trouble accessing the webinar registration through the Internet Explorer or Safari web browsers, please try accessing it through a different web browser, such as Chrome or Edge.
  • Dial In Number: The dial-in number is: 1 (415) 655-0052 Access Code: 592-813-305
  • Remote Captioning and Streaming Link

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Photo by Chris Montgomery on Unsplash

The Alzheimer’s Association will be conducting a virtual dementia caregiver symposium on December 14, 2021, from 10:00 am–2:00 pm. Please refer to the information below and the link to register.

VIRTUAL DEMENTIA CAREGIVER SYMPOSIUM 
Tuesday, December 14, 2021 
10:00 am–2:00 pm

Register Today!

Register today to join the Alzheimer’s Association for a special half-day Virtual Dementia Caregiver Symposium. This program affords caregivers the opportunity to connect with peers and professionals while enhancing their caregiving skills. Attend to learn practical tips as well as how to connect to vital community-based resources.

Featured Topics:

  • PERSPECTIVES ON CAREGIVING PANEL highlighting practical strategies and tools from varying outlooks. Moderated by Amy Goyer, AARP’s national family and caregiving expert.
  • RESOURCES IN MY COMMUNITY PANEL DISCUSSION with experts from the PA Caregiver Support Program and Pennsylvania Link to Aging and Disability Resources. Moderated by Matt Trott, Division Manager for the Greater Erie Community Action Committee.

PLUS… Learn about a new state law that helps expand benefits for Pennsylvania’s unpaid caregivers, and gain strategies for managing dementia-related symptoms and behaviors.

Mark your calendar, register to join, and invite others!
To learn more, call the 24/7 Alzheimer’s Association Helpline: 800-272-3900.

In partnership with:
AARP PA
P4A
PA Department of Aging

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The Centers for Medicare and Medicaid Services (CMS) released an MLN Matters publication reiterating how beginning January 1, 2022, payments will be reduced for physical therapy and occupational therapy services when they are provided in whole or in part by a physical therapy assistant (PTA) or an occupational therapy assistant (OTA). Members are encouraged to review the article to learn more, including information on the changes to payments due to the Bipartisan Budget Act (BBA) of 2018. The article also provides additional information on the payment reduction and the modifiers that will be required on the claims.

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