Intellectual & Developmental Disabilities

Last Friday, at the state’s Act 62 External Work Group meeting, the Office of Mental Health and Substance Abuse Services (OMHSAS) released and reviewed the data collected by HealthChoices contractors during the April 2015 survey of autism spectrum disorder (ASD) service capacity. This point-in-time survey reflects what was at that time the level of ASD service capacity for the delivery of behavior specialist consultant and applied behavior analysis services.

Among the highlights in this data are service access trends as of April 2015, showing:

  • A 19% level of service access delays of more than 31 days, with delays ranging by managed care organizations from 14% to 30% for children that had been accepted, evaluated, and authorized for services.
  • The level and reasons given for staff recruitment challenges, showing a significant level of hiring challenges among providers, with the predominant reasons being the licensure requirements of
    • At least one year of experience involving functional behavior assessments of individuals under 21 years of age; and
    • At least 1,000 hours of in-person clinical experience with individuals with behavioral challenges or experience in a related field with individuals with an ASD.

During review and discussion of the data, OMHSAS Deputy Secretary Marion indicated that OMHSAS will begin to meet with the managed care organizations, to more closely analyze the data, and discuss approaches and solutions to the service access and professional labor pool challenges in provider networks.

OVR Policies Revisions
The Office of Vocational Rehabilitation is updating its policies and procedures regarding “College and post-Secondary Training” and “Comprehensive Transition Programs.” Comments are due by Monday, February 22, via either email or mail to Pamela Brauchli, OVR, 1521 N Sixth Street, Harrisburg, PA 17102.

HCBS Waiver Methodologies
The US Office of Disability Employment Policy (ODEP) has released a review of the reimbursement rates and methodologies used by each state, for their home and community based services (HCBS) waiver, for supported employment and integrated day services. This report covers each service the state provides under the HCBS waiver, states’ limits on what is covered by each waiver’s services, number of users for each service, and the average cost per unit. Topics include customized employment, self-employment, resource leveraging, and waiver services.

HCBS Settings Toolkit
The Home and Community Based Services (HCBS) Advocacy Coalition has developed a new toolkit with detailed information regarding the new HCBS settings rules. The toolkit contains three documents:

1) The Medicaid HCBS Settings Rules: What You should Know;
2) HCBS Regulations Q&A: Settings Presumed to be Institutional & the Heightened Scrutiny Process; and
3) HCBS Setting Rules: How to Advocate for Truly Integrated Community Settings.

ODP Updates
The Office of Developmental Programs has released the following information:

  • Announcement #009-16: Supporting Families Community of Practice Framework for System Change Series Webinar; scheduled for January 28, 2016 at 2:00 pm.
  • Communication #010-16: Biennial Provider Qualifications; due by March 31, 2016.
  • Announcement #011-16: Independent Monitoring for Quality 2016 Manual Update Issued

This training session is designed to educate new providers wishing to enroll, and existing enrolled providers wishing to revalidate, in the PA Medical Assistance program on the electronic provider application system. The electronic provider enrollment user interface will allow providers to complete their PA Medical Assistance enrollment application online, effective January 29, 2016.

Please join any of the following sessions:

  • Monday, January 25 – 9:00 to 11:00 am
  • Monday, January 25 – 1:00 to 3:00 pm
  • Tuesday, January 26 – 9:00 to 11:00 am
  • Tuesday, January 26 – 1:00 to 3:00 pm
  • Wednesday, January 27 – 9:00 to 11:00 am
  • Wednesday, January 27 – 1:00 to 3:00 pm

Providers can register here. DHS encourages providers who need to revalidate by March 24, 2016, to submit revalidation applications as soon as possible. Please do not wait for the electronic provider enrollment application to submit your revalidation application.