Intellectual & Developmental Disabilities

The RCPA Board of Directors recently approved full membership for the association with the American Network of Community Options and Resources (ANCOR), which in turn will benefit all members of RCPA. ANCOR represents over 1,400 service providers and 52 state provider organizations who support more than one million Americans with intellectual and developmental disabilities through the Medicaid Program. ANCOR provides advocacy on a federal level and represents the workforce of community providers across the country who empower people with developmental disabilities including Down Syndrome, cerebral palsy, and autism, to live and work with dignity in their own communities.

Effective in January 2019, all RCPA members will be considered members of ANCOR, and will enjoy the benefits of their membership. There is no additional charge to our members for this; you will receive a welcome email and may choose to opt out or sign up for pertinent email lists.

ANCOR membership offers a multitude of benefits, including:

  • Up to date information regarding federal policy;
  • Opportunities to be involved in shaping public policy;
  • Access to the ANCOR Amplifier – an interactive website that enables members to easily and efficiently communicate with elected officials on important issues;
  • Collaboration with other providers through the use of a private, professional networking community, sharing information and advice with peers across the country;
  • National Advocacy Campaign working to advance the professionalism, recognition of, and improved wages for Direct Support Professionals;
  • Educational offerings including webinars;
  • Technical assistance including guidance on HIPAA, Wage and Hour, and other regulations, including (limited) free access to legal consultation with Gilliland, Maguire & Harper, PC;
  • Shared Resource Purchasing Network that also offers some benefits to employees of organizations; and
  • Publications including weekly updates, Capitol Correspondence, and bi-monthly newsletters.

For a full description of benefits now available to you as members:

RCPA will notify members once this agreement is in full effect. Please contact Carol Ferenz, RCPA IDD Division Director, with questions.

The Office of Developmental Programs issued ODP Communication Number 102-18 announcing delays in two areas that were scheduled to go into effect for ODP Waiver programs. Amendments to the Consolidated, P/FDS, and Community Living Waivers were recently approved by the Centers for Medicare and Medicaid Services (CMS) effective November 1, 2018. This communication is regarding the following two changes in the amendments that were scheduled to take effect on January 1, 2019:

  1. Transportation Trip was to transition from a cost-based rate to a fee schedule rate

Implementation of the changes to Transportation Trip will be delayed until July 1, 2019. This delay includes all of the following changes associated with transitioning Transportation Trip from a cost-based service to a fee schedule service:

  • Changes to the number of miles covered in each zone designation;
  • Expanding the service to be provided by relatives, legal guardians, and Organized Health Care Delivery Systems; and
  • Expanding the service to be self-directed through the Agency With Choice or Vendor  Fiscal/Employer Agent participant-directed services models.

These changes are not to be included in a person’s Individual Support Plan effective January 1, 2019. ODP has submitted an amendment to CMS to maintain the Transportation Trip service definition and cost-based rate methodology in its current approved state with no changes effective January 1, 2019.

  1. As part of qualification requirements, staff were to complete the Certified Employment Support Professional (CESP) credential, Basic Employment Services Certificate of Achievement or a Professional Certificate of Achievement in Employment Services certification for certain employment services and components of Community Participation Support.

ODP has received feedback that providers are struggling to have all required staff complete the Basic Employment Services Certificate of Achievement or Professional Certificate of Achievement in Employment Services prior to the pending January 1, 2019 deadline. As a result, the requirement for staff to have one of those qualifications will be delayed until July 1, 2019.

It is imperative that all impacted providers and common law employers that have staff who are required to have one of these employment credentials or certificates start the process now if they have not already done so. There will be no further delays granted in implementation of this qualification criteria.

ODP is drafting another set of amendments to the Consolidated, P/FDS, and Community Living Waivers that will be effective July 1, 2019. Both the changes to transition Transportation Trip to a fee schedule rate and the delay of the qualification criteria regarding employment credentials and certificates discussed in this communication will be included in those amendments with other proposed changes. ODP anticipates that the proposed amendments will be released for public comment in February or March of 2019.

All other changes contained in the waiver amendments effective November 1, 2018 remain effective and must be followed. The current approved waivers can be accessed here.

Contact RCPA IDD Division Director Carol Ferenz with questions.

In June of this year, the Office of Developmental Programs (ODP) established a new Special Populations Unit within the Bureau of Autism Services. This unit oversees the management of the Harry M. Settlement and supports efforts to build system-wide capacity to support individuals with communication challenges. A focus of the work will align with the Everyday Lives recommendation that emphasizes the need to build communication supports for the individuals assisted by ODP programs.

ODP has announced a kickoff series of training webinars presented by the Special Populations Unit in the month of December. These trainings will focus on specific topics related to communication. ODP Communication Number 101-18 includes a listing of the training topics, dates and times, and intended audience; this is the reissue of 101-18 which has the correct dates. To register, click on the linked title of each training you plan to attend. Once you pre-register, you will receive an email with instructions to participate, including a new link to join the meeting.

Questions about this ODP Communication should be directed to the ODP Deaf Services Mailbox.

November 15 is Pressure Injury Prevention Day. ODP Medical Director Dr. Gregory Cherpes, MD released a Health Alert with important information for those who provide care to individuals at risk of developing pressure injuries.

The skin is the largest organ of the body. Skin protects the body by creating a barrier to the environment, regulates the body’s temperature, supports peripheral circulation, and helps maintain fluid balance. Skin also is a reservoir for the formation of Vitamin D. The nerves in the skin provide sensations that detect changes in the environment such as heat, cold, touch, and pain. The skin is made of two layers, the epidermis and dermis, which cover the underlying tissues, muscles, and bones. “Skin integrity” refers to the intact, unbroken nature of healthy skin. Open wounds to the skin, such as those that occur with pressure injuries, make an individual more vulnerable to infection, sickness, and death.

This document provides information defining pressure injuries, why prevention is important, who is at risk of developing pressure injuries, signs and stages, treatment, and prevention of these injuries.

Due to the serious nature of pressure injuries, the pain associated with these injuries, and the additional conditions that may result from pressure injuries, prevention and immediate action at the first sign of pressure injuries are of utmost importance. In addition to skin, muscle, and bone loss, bacteria entering the sore can cause infection. In some cases, infection in the tissue can lead to bone infection, also called osteomyelitis. Infections can worsen and result in sepsis (when infection enters the blood), which can lead to shock and even death.

IMPORTANT: Notify the health care practitioner (HCP) if there are concerns for a pressure wound. Because pressure injuries can have many different appearances, the HCP should be alerted to any skin changes that are noted, particularly in areas at risk for pressure injury. Notify the HCP at the first sign of redness that does not resolve within 15 minutes after relieving the pressure.

IDA Coalition Logos - updated

Members of the ID/A coalition have joined together to advocate for funding in the Governor’s budget for fiscal year 19/20. Attached is a joint petition supported by RCPA, The Arc of PA, UCP of Central PA, and PAR.

Please sign and share widely to increase our efforts to call attention to the Direct Support Professional (DSP) crisis and other budget priorities. Please contact Carol Ferenz, RCPA IDD Division Director, with questions.

ODP Announcement Number 100-18 provides an update regarding feedback to providers after the completion of self-assessments this summer. Due to the amount of analysis needed and the quantity of self-assessments received, ODP began to email providers this week. The email contains a report for each self-assessment completed per service location along with guidance on how to correct areas on the self-assessment that could potentially be non-compliant according to Centers for Medicare and Medicaid Services (CMS) HCBS Final Rule.

ODP began emailing residential providers who completed a self-assessment starting Monday, November 5, 2018. It will take at least two weeks for ODP to email all residential providers. Non-residential providers will begin to receive emails starting Monday, November 19, 2018. If a provider does not receive a report for all of their service locations for which they completed a self-assessment by November 30, 2018, please contact ODP via email.

Please note that if a new service location has opened since June 12, 2018 (the date the HCBS Provider Settings Self-Assessment process officially closed), a self-assessment is not required to be completed for that service location. The only exception is for new Life Sharing homes that will provide services to individuals in the Community Living Waiver, for which a self-assessment must be completed. ODP will assess compliance with the CMS HCBS Final Rule for all other new service locations through multiple processes such as licensing, Quality Assessment and Improvement (QA&I), and approved program capacity and noncontiguous clearance.

For questions related to this communication, please contact ODP via email.

As we announced on Friday, September 28, RCPA has joined with six other Pennsylvania Associations that provide Intellectual Disability and Autism (ID/A) services to develop The 2018 Pennsylvania ID/A Services DSP & Frontline Supervisor Compensation Survey. Those associations include: MAX, PAR, RCPA, The Alliance CSP, The Arc of PA, TPA, and UCP of PA. The purpose of this study is to collect reliable and current information regarding compensation practices for Direct Support Professionals (DSPs) and Frontline Supervisors.

You can access the survey online here and a printable pdf copy here. Help strengthen our collective voice by filling out the survey. Although the requested deadline was October 31, 2018, we are extending the deadline for another week in order to obtain the greatest amount of participation.  If your organization has not yet completed the survey, please take the time to do so.

The principal investigator, Dr. Scott Spreat, will collect responses on the online survey platform SurveyMonkey®. There should be only ONE response per provider, even if you belong to more than one association. The survey should be completed by someone in the Human Resources area of your organization, getting assistance as needed from staff members.

If you have any survey-related questions, Dr. Spreat can be reached via email or 215-750-4015. For any other questions, please contact Carol Ferenz, RCPA IDD Division Director.

ODP issued Communication Number 099-18: Requesting an Enhanced Communication Rate for Services for Individuals Who Use Sign Language. This communication provides a process for providers to request an enhanced communication rate for Consolidated, Person/Family-Directed Support (P/FDS), and Community Living Waiver services for individuals who use Sign Language to communicate. The Harry M settlement agreement was approved by a federal court judge on August 20, 2013 to ensure Pennsylvanians are provided with necessary communication assistance services based on their assessed needs. The enhanced communication rate is available for services for individuals who are enrolled in the Consolidated, P/FDS, and Community Living waiver from providers who have signing staff to serve individuals who use Sign Language to communicate.

An enhanced communication rate is available for the following services:

  • Companion Services
  • In-Home and Community Supports
  • Older Adult Daily Living Centers
  • Community Participant Support (CPS)
  • Small Group Employment
  • Benefits Counseling
  • Supported Employment to include: Career Assessment, Job Finding and Development, Job Coaching and Support
  • Advanced Supported Employment to include: Discovery Profile Outcome, Job Acquisition Outcome, Job Retention Outcome
  • Respite
  • Supports Broker Services
  • Housing Transition and Tenancy Sustaining
  • Residential Habilitation
  • Shift Nursing RN
  • Shift Nursing LPN
  • Behavioral Supports
  • Communication Specialist
  • Therapies to include: Physical, Occupational, Speech/Language, Orientation, Mobility, and Vision
  • Music Therapy
  • Art Therapy
  • Equine Assisted Therapy
  • Consultative Nutritional Services
  • Family Caregiver Support Counseling (with participant present)
  • Supplemental Habilitation
  • Supported Living
  • Life Sharing

Providers who wish to request an enhanced communication rate must complete the Enhanced Communication Rate Request Form and submit the completed form to: ODP’s Deaf Services Mailbox. The Enhanced Communication Rate Request Form can be accessed at MyODP.

The following documentation must be provided in addition to the form:

  • Certificates of completion for the Harry M web-based training
  • Quiz on Harry M training (sent to the provider once the request for the enhanced rate is made)
  • Video of signing skills (sent to the provider once the request for the enhanced rate is made)

Following receipt of a provider’s request, ODP will review the information submitted and determine whether the provider is eligible for the enhanced communication rate. The provider will be notified of ODP’s decision following the review. If additional information or discussion concerning the request is required, ODP will reach out to the contact persons identified on the Enhanced Communication Rate Request Form.

Questions about the contents of this communication may be directed to the ODP Deaf Services Mailbox. This communication obsoletes ODP Announcement 002-17, Requesting Enhanced Communication Residential Habilitation Rates for Harry M Class Members.