Policy Areas

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On November 13, 2017, the Centers for Medicare and Medicaid Services (CMS) began to post a list of potential audits for Recovery Audit Contractors (RACs) to review. The topics will be listed, on a monthly basis, on the Provider Resources page of the CMS website. The topics currently proposed include: review of pre-admission screening, post-admission examination, and other requirements for inpatient rehabilitation facility (IRF) stays. The review type is identified as a “complex review.” Comments or questions should be submitted via email.

The National Council Conference will be held Mon–Wed, April 23–25, 2018, at the Gaylord National Resort & Convention Center, Washington, DC. This event is the health care industry’s foremost behavioral health conference. Each year, more than 5,000 leaders like you explore health care’s greatest innovations in practice improvement, financing, integrated health care, technology, policy and advocacy, and professional development at the National Council Conference. Pennsylvania is consistently among the most well represented groups from around the country.

Please register before Friday, December 1, 2017, to take advantage of a special preview rate. RCPA members are offered a more deeply discounted registration; please use the coupon code 18memberPA for an additional $225 in savings. Contact Richard Edley with any additional questions.

(From OMHSAS)

The Department of Human Services is making available for public review and comment the proposed Federal Section 1115 Demonstration waiver application for substance use disorder (SUD) services.

The purpose of this Demonstration is to afford continued access to high quality, medically necessary treatment for opioid use disorder (OUD) and other substance use disorders (SUDs). Pennsylvania recognizes the importance of a full continuum of treatment services, including residential services that are provided in a cost-effective manner and for a length of stay that is governed by appropriate clinical guidelines.  This Demonstration is critical to provide the necessary funding to support the continuation of medically necessary services.

The goals of this Demonstration are to:

  1. Improve the overall population health outcomes for Medicaid beneficiaries diagnosed with a substance use disorder by:
    1. Reducing overdose deaths
    2. Increasing the number of Medicaid beneficiaries who access substance use treatment
    3. Increasing the rate of retention in treatment across all levels of care
  2. Decrease utilization of high-cost emergency department and hospital services by:
    1. Decreasing the number of emergency department visits and inpatient admissions
    2. Decreasing the number of readmissions to the same level of care or higher levels of care for a primary SUD diagnosis
  3. Improve care transition across the continuum of substance use services by:
    1. Enhancing coordination of care with other behavioral and physical health services
    2. Enhancing the process for transitions between levels of care

The 1115 Demonstration waiver application is available here. In addition, copies of the application are available upon written request to the Director, Bureau of Policy, Planning, and Program Development, Office of Mental Health and Substance Abuse Services, 11th Floor Commonwealth Tower, 303 Walnut Street, Harrisburg, PA 17101.

The Department will hold four public hearings throughout the Commonwealth to accept testimony on the proposed 1115 Demonstration waiver application.  The Department will also present updates and solicit comment on the waiver application at the Medical Assistance Advisory Committee meeting on December 14, 2017.

The schedule of dates, times and locations for the public hearings is listed below:

Public Hearing Schedule

December 4, 2017, 10:00 a.m. to 12 noon
OMHSAS NE Field Office Conference Room
100 Lackawanna Avenue
Scranton, PA

December 5, 2017, 10:00 a.m. to 12 noon
Norristown State Hospital Auditorium
1001 Sterigere Street
Norristown, PA

December 8, 2017, 8:00 a.m. to 10:00 am
Child Welfare Resource Center
403 East Winding Hill Road
Mechanicsburg, PA

December 11, 2017 from 1:00 p.m. to 3:00 pm
Shenango Crossing
2520 New Butler Road
New Castle, PA 16101

Public Comment

The Department seeks public input on the proposed 1115 Demonstration waiver application for SUD services.  The 30-day public comment period began on November 18, 2017 and ends on December 18, 2017.  Persons who wish to testify on the proposed 1115 Demonstration waiver application at one of the public hearings should schedule a time by telephoning (717) 772-7900.  Persons from outside the Harrisburg area may send a written request, including telephone number, to Satoko Hariyama, Bureau of Policy, Planning, and Program Development, Office of Mental Health and Substance Abuse Services, 11th Floor, Commonwealth Tower, 303 Walnut Street, Harrisburg, PA 17101.

Individuals also may submit written comments at any of the public hearings or by email or by mail to the address of the contact person identified above.  The Department will consider all comments received by December 18, 2017 in developing the final waiver application.

Persons with a disability who require auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

The Wolf Administration has launched the Pennsylvania Link to Community Care website, which connects older Pennsylvanians and individuals with a disability or behavioral health need to services and supports available in their community.

The website provides users with a wide variety of resources, including a home care directory and an information referral tool. It is a collaboration of the departments of Aging (PDA) and Human Services (DHS), and is an extension of PDA’s Aging and Disability Resource call center. By providing assistance online, the initiative further enhances the Commonwealth’s efforts to help Pennsylvanians locate and best utilize services at the local level.

The site features 12 service and support categories: Advocacy, Behavioral Health, Employment, Finance, Health Care, Housing, In-Home Services, Legal, Meals, Protection from Abuse, Support Groups, and Transportation.

Users can find information about organizations, services, and programs within these categories. A major component to the site is the home care directory, which connects individuals to in-home services available in their counties. In-home service providers appearing on the searchable directory may offer personal care, assistance with activities of daily living, companionship services, respite care, and/or habilitation services.

If you are an in-home service provider licensed by the Pennsylvania Department of Health, and would like to appear on the home care directory, you may submit your information by navigating to the footer of the site and selecting “Apply.”

In addition to the home care directory, another major feature of the website is the information referral tool. This tool guides users through a series of questions and then provides a list of resources based on their specific needs.

Moving forward, the departments of Aging and Human Services will continue to enhance the website using data and feedback from users, and expand the resources and information provided through the site. This includes working with your organization and other stakeholders to increase the number of options appearing within each category. Read the press release here.

The Pennsylvania Office of Vocational Rehabilitation (OVR) has announced that individuals who are interested in OVR services can complete a pre-application online through JobGateway. This is considered to be a streamlined approach that should expedite the process of connecting with OVR services. To request services, a person can simply complete and submit the online pre-application using these instructions. Anyone having difficulty completing their pre-application can contact their closest OVR district office for assistance.

It is important to note that completing a pre-application online is not required; rather, it is being made available to streamline the process.

Anyone can refer themselves or someone else to OVR. If not using the online process, then simply call OVR’s toll free number (1-800-442-6351 voice/1-866-830-7327 TTY) or a district office. OVR exists to assist people with disabilities in securing or maintaining employment and independence. Generally, people are eligible for OVR services if they have a “physical or mental impairment that results in a significant impediment to employment.” Additional information about OVR, who can be served, and the services available through OVR can be found here.

The ABFT training originally scheduled for November 15, December 5, and December 6 has been rescheduled.

THE NEW DATES ARE:

We want to thank the providers who expressed an interest. Registration fees will be refunded unless you specify otherwise. For instance, if you wish to retain your registration status and keep your spot reserved, to determine if the newly scheduled dates work for you and/or your clinical staff, we could place the registration fees “ON HOLD” for you.

We have been consulting with the model developers at Drexel University and our partners at OMHSAS Children’s Bureau to update the plan for making this a successful training. We have negotiated reduced fees for the total training package in hopes of attracting more trainees.

The clinical strategies of ABFT can be utilized in various child serving programs to include schools, outpatient clinics, and residential treatment programs. It is designed to treat depression and prevent suicide among adolescents and young adults, ages 14–24.

Download the updated registration brochure here. If you have any questions or concerns, please contact Robena Spangler.

Executive Order to Review State Licensure Board Requirements & Processes

In the November 11, 2017 Pennsylvania Bulletin, Governor Wolf issued an Executive Order (No. 2017-03) that directs the Commissioner of Professional and Occupational Affairs within the Department of State to conduct a review of the State Professional and Occupational Licensure board requirements and processes. This includes a comprehensive review of the processes, fees, training, and continuing education requirements and prepared report for each type of professional and occupational license. The report is to include: training requirements; licensing, registration, and renewal fees; continuing education requirements; and any other requirements described within the executive order. The report is to also include information regarding the number of other states which require a license for each professional or occupational license, the national and regional averages for training requirements, fees, and continuing education requirements.

The Commissioner has been given the authority to establish an advisory group to assist with the research, data collection, and formatting of the reports, and any other function the Commissioner deems necessary. The advisory group shall be composed of members chosen by the Commissioner from the professional Boards and Commissions, Bureau of Professional and Occupational Affairs (BPOA) staff, and any other persons the Commissioner deems necessary. The advisory group must be established within 30 days from the effective date of this executive order. Additional details regarding the report are provided in the bulletin.

The report is due to the Governor, the Secretary of Policy and Planning, and the Secretary of the Commonwealth no later than 180 days from the establishment of the advisory group or 210 days from the effective date of this executive order, whichever is sooner.

Some of the boards impacted by this executive order include: State Board of Physical Therapy, State Board of Speech–Language Pathology and Audiology, the State Board of Medicine, the State Board of Nursing, the State Board of Occupational Therapy, etc.

The executive order is effective immediately.