Intellectual & Developmental Disabilities

Dear RCPA members,

Here is a link to a survey we are conducting to assess the impact of COVID-19 on CPS providers. This information will allow us to advocate for your financial needs in the most effective manner. As you are aware, the retainer payments for providers who operate in counties designated as “green” in PA, will receive a retainer payment of 25% beginning in July, and at this time it is anticipated that the retainers will only continue through September.

 

In order to prepare you for the survey, the questions are included here so that when you open the link, you will have the information you need to complete the survey. We appreciate your participation and realize that this could take some time for you to complete. As a result, we have included a few detailed questions at the end that are optional. If you are able to provide that information, we would be grateful. If you are not able to complete the last section, submitting answers for the other questions will still be very helpful to us in our advocacy efforts.

Thank you and if you have any questions, please feel free to contact Carol Ferenz.

PLEASE COMPLETE THE SURVEY BY COB JULY 13, 2020
ONE SURVEY PER AGENCY, PLEASE

ACL From Our Partners
Webinar 7/23: Sick and Tired of Being Sick and Tired: People of Color, Disabilities, and Mental Health

Register for the webinar on Thursday, July 23, at 2:00 PM ET.

The Mental Health and Developmental Disabilities National Training Center (MHDD-NTC) presents a webinar exploring the unique intersection of disability, mental health, and people of color. People of color experience higher rates of disability and mental health conditions, but often face decreased access to care and have other co-occurring health disparities. This presentation will highlight these inequities and discuss how we can work towards eliminating these disparities and becoming stronger allies for people of color.

Presenter:

Morénike Giwa Onaiwu is an educator, writer, public speaker, parent, and global advocate. A proactive, resourceful professional and disabled woman of color in a multicultural, neurodiverse, serodifferent family, Morénike, who is American-born to immigrant parents, possesses undergraduate and graduate degrees in International Relations and Education. She has been the recipient of numerous awards, including the “Advocating for Another: Health Activist of the Year” 2014 WEGO Health Award and the “Service to the Self-Advocacy Movement” 2015 Autistic Self Advocacy Network Award.

Register for the webinar.

ACL funds the Mental Health and Developmental Disabilities National Training Center (MHDD-NTC). Learn more at mhddcenter.org.

ODP has issued an updated Announcement 20-066 to provide guidance on establishing visitation policies in residential settings when a county transitions to the Green Phase of Governor Wolf’s Process to Reopen Pennsylvania. Residential settings include licensed and unlicensed community homes (55 Pa. Code Chapter 6400) and licensed and unlicensed family living homes (55 Pa. Code Chapter 6500).

The updated information addresses how to handle when individuals may wish to participate in a home visit with their family. Providers should establish a written policy for visits to a family home. This policy should include at a minimum:

  • Prior to the individual leaving the residence, the provider will conduct a screening of those people with whom the individual will have contact during the home visit. The policy should indicate the COVID-19 screening questions that will be asked. Providers should update the screening questions as necessary to reflect best practice for screening questions for COVID-19.
  • The provider will ensure that the individual and family are aware of Governor Wolf’s Green Phase social restrictions and encourage the individual and family to comply with them.
  • Prior to the individual’s return to the residential setting, the provider will complete a COVID-19 screening for the individual, remotely, within 24 hours of the planned return.
  • Upon the individual’s return to the residence, the provider will complete a COVID-19 screening.
  • If the individual is symptomatic or has had a known exposure to COVID-19 during the family visit, the provider will immediately quarantine the individual until such time as a negative COVID-19 test result is received from a test given to the individual after their return to the residential setting; or the individual remains without symptoms and meets the PAHAN 504–UPD criteria to be released from quarantine.
  • If the individual is symptomatic, the provider will test the individual for COVID-19 as soon as possible.

Providers should discourage home visits to counties that are not in the Green Phase.

FOR IMMEDIATE RELEASE
July 8, 2020  

Harrisburg, PA – The Department of Human Services today announced applicants selected through a Request for Applications (RFA) for Pennsylvania’s HealthChoices program, the Medicaid physical health managed care program that provides healthcare coverage to more than 2.6 million people.  DHS is unable to move forward with the selections, however, due to the pendency of protests.

“Pennsylvania’s HealthChoices program is a lifeline for more than 2.6 million Pennsylvanians covered under the Medical Assistance program. This program not only helps with essential health services like doctors’ visits, routine and preventive care, and access to prescriptions necessary to live a healthy life – it also is an opportunity to greatly impact participants’ social and economic trajectory,” said Human Services Secretary Teresa Miller. “As one of our farthest-reaching and highest-cost programs, we are committed to constant quality improvement that focuses on participants’ health and well-being, and innovative, outcomes-driven efficiencies.”

Applicants were selected through a competitive procurement that evaluated applicants’ soundness of approach, personnel qualifications and staffing and prior experience and performance. More information about evaluation criteria can be found in the RFA. Applicants selected were the top scoring applicants for their zone. Selected applicants for each service zone are as follows:

  • Southeast: Geisinger Health Plan, Health Partners Plans, UnitedHealthCare, UPMC for You, and Vista Health Plan (Keystone First);
  • Lehigh/Capital: Gateway Health, Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas);
  • Northeast: Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas);
  • Northwest: Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas); and,
  • Southwest: Gateway Health, Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas).

At the time of this release, two non-selected applicants filed protests of their non-selection.  Due to the filing of these protests, DHS may not take any further action on the procurement until the protests are resolved.

For more information on the HealthChoices procurement and requirements of the RFA, view the RFA here.

MEDIA CONTACT: Erin James, ra-pwdhspressoffice@pa.gov

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FOR IMMEDIATE RELEASE
July 8, 2020

Harrisburg, PA – Department of Human Services (DHS) Secretary Teresa Miller today announced a Request for Expressions of Interest (RFEI) for the commonwealth to establish a resource and referral tool. The tool will serve as a care coordination system for providers such as health care and social services organizations and will include a closed-loop referral system that will report on the outcomes of the referrals. It will also serve as an access point to search and obtain meaningful information to help Pennsylvanians find and access the services they need to achieve overall well-being and improve health outcomes.

“No one person or provider can help a person fully address all of these goals on their own, and that is okay. We want to make sure that we are focused on how to promote a more holistic approach to health and well-being and that we are ensuring that individuals’ and families’ needs are met through the delivery of the right service at the right time,” said Sec. Miller. “With this resource and referral tool, we hope to establish a system where we can break down walls in the health care and social service system and improve health outcomes and quality of life for Pennsylvanians.”

The purpose of the RFEI is to determine what experienced firms are available to assist DHS and the commonwealth in executing the development and implementation of a statewide resource and referral tool within an aggressive timeframe. Interested parties should have relevant experience and proven success implementing projects of similar scope and working with a wide range of sectors including healthcare organizations, community-based organizations, and state and local government agencies.

The resource and referral tool, when implemented, will allow providers to assess an individual during a physician’s office or emergency department visit, or when receiving case management services, among others. The tool will also gather data that can help the Commonwealth and its partners better understand the needs of vulnerable Pennsylvanians and identify service gaps across the state. By looking at critical social determinants of health, including employment, childcare, transportation, food security, access to health care, and housing stability, the Commonwealth and all network organizations can help individuals achieve better long-term health outcomes and maximize the impact of health care dollars.

The COVID-19 pandemic has emphasized the urgent need for a customer-friendly system to assist the public in locating resources and to efficiently and effectively connect individuals with critical services such as food, housing, transportation and childcare, as well as many other needed critical services. This tool can provide an alternative to in-person interactions between social services organizations and clients in order to facilitate social distancing.

Individuals, service providers, government agencies, caregivers, educational institutions, faith-based groups, and advocates will be able to use this tool to help navigate the system of resources, and work together to reduce duplication of services as well as the time it takes for individuals to receive much-needed services. The tool will allow service providers to bridge the gaps that make service continuity and follow-up on referrals difficult.

“We all can help Pennsylvanians on a path to achieve better long-term health outcomes, meet their social determinant of health needs, and empower them towards economic self-sufficiency, and our hope is this tool will be a platform to make this possible,” said Sec. Miller. “Governor Wolf and this Administration is working to make sure individuals and families, particularly our most vulnerable, have a strong relationship with a person who can help them navigate across systems and organizations so they know that they are not alone on their path to a better life.”

For more information and to read the RFEI, visit eMarketplace.

MEDIA CONTACT: Erin James, ra-pwdhspressoffice@pa.gov

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FOR IMMEDIATE RELEASE
July 8, 2020

Harrisburg, PA – The Pennsylvania Department of Health today confirmed as of 12:00 a.m., July 8, that there are 849 additional positive cases of COVID-19, bringing the statewide total to 92,148. All 67 counties in Pennsylvania have cases of COVID-19.

The number of new cases in Allegheny County increased by 230 cases overnight. Philadelphia County increased by 90 cases overnight.

The number of tests administered since July 1 is 118,128 with 5,542 positive test results.

There are 6,812 total deaths attributed to COVID-19, an increase of 25 new deaths reported.

“As the entire state is now in the green phase, we must remain committed to protecting against COVID-19 by wearing a mask, practicing social distancing and avoiding large gatherings this holiday weekend,” Secretary of Health Dr. Rachel Levine said. “Pennsylvania has been a model for the country on how to reopen effectively using a careful, measured approach. However, the virus has not gone away and we are seeing cases rise, especially in Southwest Pennsylvania.”

Mask-wearing is required in all businesses and whenever leaving home. Consistent mask-wearing is critical to preventing the spread of COVID-19.

There are 635 patients who have a positive serology test and either COVID-19 symptoms or a high-risk exposure, which are considered probable cases and not confirmed cases. There are 774,378 patients who have tested negative to date. Of the patients who have tested positive to date the age breakdown is as follows:

  • Nearly 1% are ages 0-4;
  • 1% are ages 5-12;
  • Nearly 3% are ages 13-18;
  • Nearly 8% are ages 19-24;
  • 37% are ages 25-49;
  • Nearly 24% are ages 50-64; and
  • Nearly 27% are ages 65 or older.

Most of the patients hospitalized are ages 65 or older, and most of the deaths have occurred in patients 65 or older.

The department is seeing significant increases in the number of COVID-19 cases among younger age groups, particularly 19 to 24-year-olds. The following regions have seen significant increases among 19 to 24-year-olds in each month from April to July:

  • SW – Approximately 5 percent of cases in April to over 28 percent of cases so far in July;
  • SE – Nearly 5 percent of cases in April to over 16 percent of cases so far in July;
  • NE – Nearly 6 percent of cases in April to over 16 percent of cases so far in July;
  • NW – Nearly 7 percent of cases in April to over 13 percent of cases so far in July; and
  • SC – Approximately 7 percent of cases in April to nearly 13 percent of cases so far in July.

In nursing and personal care homes, there are 18,060 resident cases of COVID-19, and 3,380 cases among employees, for a total of 21,440 at 727 distinct facilities in 55 counties. Out of our total deaths, 4,663 have occurred in residents from nursing or personal care facilities. A county breakdown can be found here.

Approximately 6,903 of our total cases are in health care workers.

For the latest information for individuals, families, businesses and schools, visit “Responding to COVID-19” on pa.gov.

Currently, all 67 counties are in the green phase of reopening.

The Wolf Administration stresses the role Pennsylvanians play in helping to reduce the spread of COVID-19:

  • Wash your hands with soap and water for at least 20 seconds or use hand sanitizer if soap and water are not available.
  • Cover any coughs or sneezes with your elbow, not your hands.
  • Clean surfaces frequently.
  • Stay home to avoid spreading COVID-19, especially if you are unwell.
  • If you must go out, you are required to wear a mask when in a business or where it is difficult to maintain proper social distancing.

All Pennsylvania residents are encouraged to sign up for AlertPA, a text notification system for health, weather, and other important alerts like COVID-19 updates from commonwealth agencies.

MEDIA CONTACT:  April Hutcheson, 717-787-1783 or ra-dhpressoffice@pa.gov

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Note from RCPA President and CEO Richard S. Edley, PhD:

I would like to personally thank you for honoring me with your vote as a new board member for the National Council for Behavioral Health, representing Region 3. I look forward to providing leadership and strategic direction to the National Council and to be the voice for our community of members.

I would also like to thank Susan Blue, CEO of Community Services Group, for her nomination. Susan, as many of you know, is a current National Council and RCPA Board member and past Chair of both organizations. For more information on all new board members, view the National Council for Behavioral Health Announces New Board Members press release.

Thank you again for your support.

CMS has posted additional Medicaid & CHIP COVID-19 FAQs on June 30, 2020, designed to aid State Medicaid and CHIP agencies in their response to the pandemic. The FAQs address key questions on Home and Community-Based Services; the Money Follows the Person program; and Advance and Retainer Payments (for home and community-based services). Topics include:

  • Eligibility and Enrollment;
  • Notice and Fair Hearings;
  • Optional COVID-Testing Group FAQs;
  • Premiums and Cost Sharing;
  • Benefits;
  • Non-Emergency Medical Transportation (NEMT);
  • Information Technology; and
  • Financing

In the Financing Q&A section (beginning on page 23 of the document), there are several items that providers should pay close attention to.  On pages 24 and 25 the guidance regarding Retainer payments presents guiderails that states are expected to follow.  An excerpt is below:

States interested in utilizing retainer payments for multiple (up to three) episodes of up to 30 days per beneficiary will be expected to include or add the following guardrails in their Appendix K submissions:

 

  • Limit retainer payments to a reasonable amount and ensure their recoupment if other resources, once available, are used for the same purpose. In terms of setting a reasonable amount, a retainer payment cannot exceed the payment for the relevant service; the state may specify that a retainer payment will be made at a percentage of the current rate, or a state may specify retainer payments will not be made to a setting until attendance is below an identified percentage of the enrollment (e.g., 75 percent).
  • Collect an attestation from the provider acknowledging that retainer payments will be subject to recoupment if inappropriate billing or duplicate payments for services occurred (or in periods of disaster, duplicate uses of available funding streams), as identified in a state or federal audit or any other authorized third party review. Note that “duplicate uses of available funding streams” means using more than one funding stream for the same purpose.
  • Require an attestation from the provider that it will not lay off staff and will maintain wages at existing levels.
  • Require an attestation from the provider that they had not received funding from any other sources, including but not limited to unemployment benefits and Small Business Administration loans, that would exceed their revenue for the last full quarter prior to the PHE (public health emergency), or that the retainer payments at the level provided by the state would not result in their revenue exceeding that of the quarter prior to the PHE.
  1. If a provider had not already received revenues in excess of the pre-PHE level but receipt of the retainer payment in addition to those prior sources of funding results in the provider exceeding the pre-PHE level, any retainer payment amounts in excess would be recouped.
  2. If a provider had already received revenues in excess of the pre-PHE level, retainer payments are not available.

CMS also clarifies that consecutive days are those days that are eligible for billing. As typical day habilitation services are rendered Monday through Friday, 30 consecutive billing days would encompass a 6-week period of time.

These newly released FAQs have also been integrated into the previously released COVID-19 FAQ document, available online.

From ANCOR:
Late last week, Politico Pro published and HHS later confirmed that providers who were left out of the latest Medicaid tranche from the provider relief fund will be getting another chance. While no official timeline has been finalized, Hill staff confirm that HHS is close to announcing more specifics.

The HHS spokesperson said any provider that missed the deadline will be able to apply. They will be eligible to receive 2 percent of their revenue from seeing patients. More guidance will be forthcoming, the spokesperson said.

See the Politico Pro article for more on what we know at this time.

Senator Casey will be hosting a virtual Disability Employment Summit on Friday, July 24, 2020. The summit is scheduled from 10:30 am to 11:45 am. We will examine the impact of the novel coronavirus (COVID-19) health crisis on disability employment, as well as discuss strategies to improve the disability employment rate and ensure people with disabilities are able to return to work. An agenda and registration information will be sent closer to July 24.

Senator Casey hopes that you mark the date on your calendar! If you have any questions, please reach out to Josh Dubensky or Josh Kramer.