Brain Injury

The Administration for Community Living (ACL) recently posted a number of grant opportunities associated with traumatic brain injuries (TBI).

On February 7, 2018, College and Career Success for Students with Serious Mental Illness or Traumatic Brain Injury was posted. The purpose of this grant opportunity is to generate new knowledge about the effectiveness of interventions to improve college education and employment outcomes of people with serious mental illness or traumatic brain injury. The funding for this grant is $475,000 and the closing date for applications is April 9, 2018.

On February 14, 2018, two additional grant opportunities were posted:

Traumatic Brain Injury State Partnership Program Partner State Funding Opportunity, whose purpose is to create and strengthen a system of services and supports that maximizes the independence, well-being, and health of persons with TBI across the lifespan, their families, and their caregivers. Through the TBI State Partnership Program, the goal is two-fold:

  1. To allow states to strengthen and grow their capacity to support and maintain a system of services and supports that will help maximize the independence, well-being, and health of persons with TBI; and
  2. To learn from and call upon the expertise of states that have built and maintained a strong and sophisticated state TBI infrastructure. This grant opportunity has an award ceiling of $150,000.

The Traumatic Brain Injury State Partnership Program Mentor State Funding Opportunity has a purpose to create and strengthen a system of services and supports that maximizes the independence, well-being, and health of persons with TBI across the lifespan, their families, and their caregivers. Through the TBI State Partnership Program, the goal is two-fold:

  1. To help states strengthen and grow their capacity to support and maintain a system of services and supports that will help maximize the independence, well-being, and health of persons with TBI; and
  2. To learn from and call upon the expertise of states that have built and maintained a strong and sophisticated state TBI infrastructure. For the 2018 funding cycle, ACL is funding two tiers of grantees that will work together to maximize the program’s impact nationally.

Partner State Grants will provide funding to states for building and enhancing basic infrastructure, while Mentor State Grants will provide funding to more established states to maintain and expand their infrastructure and also to mentor Partner States and work together with other Mentor States and ACL to improve the national impact of the TBI program. Applicants must agree to provide the required 2:1 state match, support a state TBI advisory board, provide at least one full-time dedicated staff person, create an annual TBI state plan, create and/or expand their state TBI registry, work with one or more Partner States to increase their capacity to provide access to comprehensive and coordinated services for individuals with TBI and their families, and work with other Mentor States and ACL to improve national coordination and collaboration around TBI services and supports.

ACL encourages organizations that are interested and qualify to apply for both funding opportunity announcements; however, ACL will not make more than one award to a single applicant. Applicants that score in the fundable range on both reviews may choose which award they wish to receive. Applicants that are only interested in receiving a Partner State Grant do not need to apply for this opportunity. This grant opportunity has an estimated award ceiling of $300,000. The closing date for both of these grant opportunities is April 16, 2018.

RCPA will be working with the Pennsylvania Department of Health (DOH) to review the grant applications and discuss next steps surrounding these opportunities.

The Office of Long-Term Living (OLTL) will conduct the next Community HealthChoices (CHC) Third Thursday webinar on Thursday, February 15, 2018, 1:30 pm – 3:00 pm. Providing updates during the webinar will be OLTL’s Acting Deputy Secretary, Kevin Hancock, and representatives from the three managed care organizations (MCOs): Pennsylvania Health and Wellness, AmeriHealth Caritas, and UPMC For You. Tentative agenda topics include CHC updates and launch indicators and transportation.

To register for the webinar, please use this link. After registering, you will receive a confirmation email containing information about joining the webinar. If you require captioning services, please use this link and use the login information: Username: OLL / Password: OLL.

All CHC related information can be found online here. Comments can be submitted electronically via email. If you have any questions, please contact the OLTL Bureau of Policy and Regulatory Management at 717-857-3280.

Senior Woman Being Served Meal By Carer

The Office of Long-Term Living (OLTL) implemented Community HealthChoices (CHC) effective January 1, 2018, in the counties identified as the CHC Southwest Region. With the roll-out of CHC, the process for referring individuals for nursing home transition (NHT) has changed for anyone who is enrolled in CHC.

For CHC participants in the following counties, referrals for NHT must be made to the participant’s Managed Care Organization (MCO).  For the purposes of making referrals according to MDS Section Q guidelines, the MCO is to be considered the local contact agency for individuals who are enrolled in CHC. The counties affected as of January 1 are:

  • Allegheny
  • Armstrong
  • Beaver
  • Bedford
  • Blair
  • Butler
  • Cambria
  • Fayette
  • Greene
  • Indiana
  • Lawrence
  • Somerset
  • Washington
  • Westmoreland

Please see contact information for the CHC MCOs below:

For all other questions regarding this notification, please contact the OLTL NHT staff at:

  • Rachel Sink 717-783-7378
  • Brandy Staub 717-783-7219
  • Janel Maple 717-857-3149
  • Mariah Henry 717-772-2542
  • or via email

The Wolf Administration is committed to serving more people in the community while giving them the opportunity to work, spend more time with their families, and experience an overall better quality of life. Community HealthChoices (CHC) is a new initiative that will increase opportunities for older Pennsylvanians and individuals with physical disabilities to remain in their homes. CHC rolled out in the Southwest region on January 1, 2018.

CHC was developed to: (1) enhance access to and improve coordination of medical care and; (2) create a person-driven, long-term support system in which people have choice, control, and access to a full array of quality services that provide independence, health, and quality of life. Long-term services and supports help eligible individuals to perform daily activities in their homes such as bathing, dressing, preparing meals, and administering medications.

Please see this online document that describes how CHC works in coordination with Medicare.

The document is available in alternate format upon request by contacting the Office of Long-Term Living, Bureau of Policy and Regulatory Management, at 717-857-3280. If you have any questions, please visit the HealthChoices web page or submit comments via email.

The 2018 RCPA conference will take place October 2–4 (please note new dates) at the Hershey Lodge. A premier statewide event, the Conference Committee is seeking workshop proposals for possible inclusion. This event offers diverse educational opportunities and submissions are needed in every area; a complete listing of focus tracks is available on the online proposal form. Presentations are encouraged that assist providers to develop and maintain quality, stable, and effective treatments, services, and agencies in an industry where change is constant. The committee looks for presentations which:

  • Highlight new policy, research, and treatment initiatives such as the CCBHC model and Centers of Excellence, to name a few;
  • Provide specific skills and information related to individual and organizational leadership development and enhancement;
  • Address system changes that affect business practices such as Community HealthChoices and integrated and co-located care; and
  • Offer concrete skills and tools to operate more efficient and effective agencies, allowing organizations to strive, survive, and thrive.

Workshop ideas beginning to percolate for 2018 include pharmacogenomics; technology as a human resource option; executive leadership; integrated care strategies for implementation and reimbursement; XYZ rate setting; social capital; ethics; sexuality and sexual abuse issues in the intellectual and developmental disabilities (IDD) service area; trauma informed care across service types; emergency planning for community violence; acquisitions/mergers and consolidations; value-based purchasing; abuse and protection in the aging population; emerging leaders. The committee welcomes any proposal that addresses these and other topics essential to the rehabilitation, brain injury, mental health, addiction, aging, children’s, and developmental disability communities. Members are encouraged to consider submitting proposals and to forward this opportunity to those who are exceptionally good speakers and have state-of-the-art information to share.

The Call for Proposals and accompanying guidelines outline requirements for submissions. The deadline for submissions is Friday, March 16 at 5:00 pm. Confirmation of receipt will be sent. Proposals submitted after the deadline will not be considered.

Proposals selected stand out by inclusion of solid learning objectives, information that a participant can use to enhance professional skills or methods, and being geared to a diverse and advanced audience. If the proposal is accepted, individuals must be prepared to present on any day of the conference. Workshops are 90 or 180 minutes in length. At the time of acceptance, presenters will be required to confirm the ability to submit workshop handouts electronically four weeks prior to the conference. Anyone unable to meet this expectation should not submit proposals for consideration.

Individuals are welcome to submit multiple proposals. Notification of inclusion will be made by May 15. Questions may be directed to Sarah Eyster, Conference Coordinator.

The Office of Long-Term Living issued guidance to Service Coordinators and Direct Service Providers  regarding the reporting of critical incidents for the Southwest Pennsylvania Counties. Please note the two texts below.

FOR SERVICE COORDINATION ENTITIES
This communication is to service coordinators of Office of Long-Term Living (OLTL) participants in the 14 Southwest Community HealthChoices (CHC) counties. Service coordinators are required to submit critical incidents according to OLTL’s critical incident management bulletin; however, OLTL is making a time-limited change in the incident submission process in order to ensure all service coordinators in these 14 Southwest CHC counties receive necessary Enterprise Incident Management (EIM) user IDs for each CHC-MCO.

Do not submit incidents for CHC-MCO participants using your fee-for-service user IDs in EIM. Instead, please work with the CHC-MCOs and submit incidents to them directly until you receive your user IDs that will allow you to submit an incident in EIM which will be directed to the relevant CHC-MCO.

If you have not already received a user ID from UPMC or PA Health and Wellness, please contact them directly to receive more information on how they want you to submit incidents to them in this interim period.

At this time, AmeriHealth Caritas will be utilizing this RA email box for service coordinator submission of critical incidents. If you have questions about this information, please contact OLTL at 717-787-8091.

FOR ALL DIRECT SERVICE PROVIDERS
This communication is to Direct Service Providers of Office of Long-Term Living (OLTL) participants in the 14 Southwest Community HealthChoices (CHC) counties. Direct Service Providers are required to submit critical incidents according to OLTL’s critical incident management bulletin. Currently, providers serving participants in the ‘under-60’ waivers submit incidents into the EIM System, and Aging Waiver Direct Service Providers submit critical incidents into an RA-incident email box.

With the implementation of CHC on January 1, 2018, in 14 Southwest counties, all OLTL Direct Service Providers will now submit critical incidents into EIM for participants enrolled in CHC. Aging Waiver providers will no longer submit critical incidents to an RA email box if the participant is enrolled in CHC.

Please work with the CHC-MCOs to receive training to use the EIM system. Please note: Direct Service Providers will need to select the “search for CHC participants” checkbox when creating incidents in EIM for CHC participants.

Direct Service Providers serving participants that are NOT in the current 14 Southwest CHC counties (listed below), and NOT enrolled in CHC, must continue to submit critical incidents into EIM for the ‘under 60’ waivers, and Aging Waiver providers must continue to submit critical incidents to the RA incident email box until further notice.

CHC counties — Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Somerset, Washington, and Westmoreland. If you have questions about this information, please contact OLTL at 717-787-8091.

The Social Security Advisory Board (SSAB) has released a report this month outlining recommendations on how to strengthen the Representative Payee Program of the Social Security Administration (SSA). This report is the result of a two-year study of the current Representative Payee Program serving more than 8 million vulnerable beneficiaries/recipients, including children and adults.

The five section report includes short-term recommendations to SSA and Congress, and also advocates for the Office of Management and Budget to pursue long-term structural changes which will involve comprehensive government-wide coordination efforts and cross-agency reforms. More information, as well as a link to the full report, is available on the SSAB website.

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The Department of Human Services’ (DHS) Office of Long-Term Living (OLTL) has updated the list of Frequently Asked Questions (FAQ) related to Community HealthChoices (CHC). Many of the FAQs have been generated through their Third Thursday CHC webinars, as well as questions received at the Southwest Participant Education meetings. The FAQs are separated by Provider FAQs and Participant FAQs.

In February 2017, RCPA launched the Physical Disabilities and Aging Division to provide members with information, networking, and opportunities to access Pennsylvania Legislators and Administration. This division advocates for all HCBS services funded by the Office of Long-Term Living (OLTL) and Department of Aging, including service coordination, personal assistance, brain injury, community integration, and employment and vocational services to name a few. It has been a year of significant action and with your support, RCPA is now considered one of the leading associations in the services you provide. Here are some highlights of the past year and why you want to engage even more:

  • The Secretaries of the Department of Human Services and Department of Aging, as well as the Deputy Secretaries from the Office of Long-Term Living and Office of Medical Assistance Programs, presented at the RCPA Conference, providing members the opportunity to get to know the leadership at the state level and to network with them on a one-on-one basis.
  • Quarterly meetings have included leadership from the Community HealthChoices (CHC) Managed Care Organizations (MCOs), with two of them providing in-depth presentations on policies and rollout of this program.
  • RCPA has established monthly meetings with the leadership of OLTL, providing an opportunity to represent our members’ challenges and to advocate for regulatory changes.
  • RCPA facilitated and continues to provide access to trainings to meet the regulations for newly announced OLTL employment services.
  • A new track was added to the annual conference, offering members sessions addressing changes in regulations, nursing home transition, and value-based payments, with the opportunity to earn continuing education credits.
  • RCPA leadership participates in weekly calls with OLTL as CHC is being rolled out to bring forth key issues to be addressed by OLTL and the MCOs.

As we look forward to the year ahead, the need will continue to broaden the horizons of what we share. This begins with the meeting on February 22, 2018, when we will facilitate networking and a focus on aging during lunch. Teresa Osborne, Secretary of the Department of Aging and Rebecca May-Cole, Executive Director of the Association of Area Agencies on Aging (P4A), will present updates and their perspectives on the single largest group served in the Commonwealth. We will also discuss the leadership structure and future meetings of this division.

Your involvement and engagement is vital to meeting the needs you have in these services. We look forward to seeing you at the meeting on February 22. Please Register Here.

The Department of Defense (DoD) published the final rule, TRICARE; Reimbursement of Long Term Care Hospitals and Inpatient Rehabilitation Facilities, in the December 29, 2017 Federal Register. This final rule finalizes the changes in the inpatient rehabilitation facility (IRF) payments from the proposed rule that was published back in 2016 and establishes TRICARE inpatient care reimbursement methodologies and rates similar to Medicare. Currently, IRFs are exempted from the TRICARE diagnosis related group (DRG) based payment system and paid by TRICARE at the lower of a negotiated rate or billed charges.

 

To reduce the burden from sudden significant reductions on the IRFs, the final rule includes a gradual transition from TRICARE’s current policy of allowing 100 percent of allowable charges (either the billed charge or voluntary negotiated rate), by phasing-in the Medicare IRF prospective payment system (PPS) rates as follows:

  • Allowing 135 percent of Medicare IRF PPS amounts in the first 12-month period after implementation (estimated reduction of $24M);
  • 115 percent in the second 12-month period after implementation (an estimated reduction of $41M); and
  • 100 percent in the third 12-month period after implementation (an estimated $57M).

The DoD will apply the FY 2019 IRF PPS for purposes of the 12-month period beginning on October 1, 2018, and follow any changes adopted by the Medicare IRF PPS for subsequent years. The provisions in the final rule become effective on March 5, 2018.