Physical Disabilities & Aging

Medical assistance and cardiology concept: red heart, case with first aid kit and stethoscope isolated on white background

The Office of Developmental Programs (ODP) has issued a Health Alert in order to make all providers, staff, and other caregivers aware of the serious issue of choking. All should become familiar with resources to aid in the identification of individuals at risk for choking, the training of staff, and the appropriate documentation of special dietary needs and choking precautions. Swift action is essential to prevent Irreversible harm or death!

There are two key issues to promote safety for individuals:

  1. The information contained in the participants’ care plans, including medical evaluations/recommendations, assessments, Individual Support Plans (ISPs), and any treatment plans used by the agency (hereafter “care plans”) must be accurate, consistent, and followed precisely for feeding plans, supervision of the individual while eating to maintain safety, proper positioning, and the use of specialized equipment.
  2. All staff providing service to an individual must be trained on the individual’s dietary needs, including awareness of proper foods and food textures, supervision needs during meals, proper positioning during a meal, and the use of specialized equipment related to the risk of aspiration and choking.

Action to Take for an Individual Choking:

  • Call 911 immediately! Seconds matter. Do not delay by seeking supervisory approval prior to calling 911.
  • Initiate First Aid with abdominal thrusts.
  • If the individual becomes unresponsive, move him/her to the floor and begin CPR.
  • Contact the health care practitioner after any episode of choking.

A single choking event may be a warning sign for future choking events. This warning sign needs to be taken seriously and follow-up with the health care practitioner can avoid tragic consequences.

Contact RCPA IDD Division Director Carol Ferenz with any questions.

July 26 marked the 28th Anniversary of the Americans with Disabilities Act (ADA), signed into law in 1990 by President George Bush. The White House released the following proclamation:

THE WHITE HOUSE
Office of the Press Secretary
FOR IMMEDIATE RELEASE

July 25, 2018

Anniversary of the Americans with Disabilities Act, 2018
By the President of the United States of America
A Proclamation

On the 28th anniversary of the Americans with Disabilities Act (ADA), we celebrate this historic legislation, which echoed our Nation’s founding promise to recognize and secure the equal rights of all men and women. Today, we reaffirm our commitment to cultivate further opportunities for all Americans to live full and independent lives, and recognize the many contributions enabled by expanded participation of Americans with disabilities in our society.

President George H.W. Bush signed the ADA into law on July 26, 1990. It has transformed the lives of millions of Americans living with disabilities by promoting their equal access to employment, government services, public accommodations, commercial facilities, and public transportation. Today, people of all ages with disabilities are better able to thrive in the community, pursue careers, contribute to our economy, and fully participate in American society.

Our Nation must continue to build upon this foundation and continue to further the participation of the more than 56 million Americans living with disabilities. My Administration continues to encourage research that will lead to advancements in technology, medicine, and other fields and better enable independent living. We are also expanding and promoting equal education and employment opportunities for Americans with disabilities to live and work. In this regard, in June of last year, I signed an Executive Order to develop more apprenticeship programs for all people, including those with disabilities. Additional training will encourage better involvement from businesses and allow people with disabilities to contribute meaningfully to a wide variety of industries.

As we commemorate the anniversary of the ADA, we recommit ourselves to fostering an environment in which all Americans have the opportunity to pursue the American Dream.

NOW, THEREFORE, I, DONALD J. TRUMP, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim July 26, 2018, as a day in celebration of the 28th Anniversary of the Americans with Disabilities Act. I call upon all Americans to observe this day with appropriate ceremonies and activities that celebrate the contributions of Americans with disabilities and to renew our commitment to achieving the promise of our freedom for all Americans.

IN WITNESS WHEREOF, I have hereunto set my hand this twenty-fifth day of July, in the year of our Lord two thousand eighteen, and of the Independence of the United States of America the two hundred and forty-third.

DONALD J. TRUMP

The Office of Long-Term Living (OLTL), on behalf of The Self-Determination Housing Project of Pennsylvania, Inc. (SDHP)Regional Housing Legal Services (RHLS), and the Housing Alliance of Pennsylvania (nonprofit organizations focused on affordable housing issues), has agreed to distribute the following survey to those who work on addressing housing barriers and locating housing services.

The purpose of the survey is to gather information from people who provide housing-related services about the types of housing issues they are seeing, where connections between fields are needed, and what additional information/education could be helpful.

Use this link to take the survey. It should take approximately ten minutes to complete. The survey will remain open until August 10, 2018. If you have any questions, please contact Rachel Sink at 717-783-7378.

On June 19, 2018, Governor Tom Wolf signed House Bill 1641, codifying the Employment First Policy that the governor established by executive order in March 2016 to increase competitive employment opportunities for people with disabilities.

“My executive order two years ago focused Pennsylvania on being a model state that is hospitable to workers with disabilities and I’m proud to sign this bill adding the weight of law,” said Governor Wolf. “This is a win-win for Pennsylvania. Our employers need smart and skilled workers and increasing employment opportunities ensures people with disabilities can achieve greater independence and inclusion in our communities.”

House Bill 1641, sponsored by Rep. Bryan Cutler, creates the Employment First Act requiring state, county, and other entities receiving public funding to first consider competitive integrated employment as the preferred outcome of publicly funded education, training, employment, and related services, and long-term services and support for individuals with a disability who are eligible to work under state law.

The statute also creates the Governor’s Cabinet for People with Disabilities and the Employment First Oversight Commission. The Governor’s Cabinet for People with Disabilities will review existing regulations and policies to recommend changes to laws, regulations, policies, and procedures that ensure implementation of Employment First. The Employment First Oversight Commission will establish measurable goals and objectives to guide agencies and report annual progress.

Following the governor’s Executive Order 2016-03, entitled Establishing ‘Employment First’ Policy and Increasing Competitive-Integrated Employment for Pennsylvanians with a Disability, the Departments of Labor and Industry, Human Services, and Education have been working to obtain stakeholder and business input to meet the administration’s goals. The agencies, which helped to develop HB 1641, released recommendations in September 2016.

The recommendations include:

  • Review, identify, and change policy to align with Executive Order 2016-03.
  • Raise the expectations of employment goals for children with a disability at an early age. Work with parents and publicly funded programs to shift expectations towards this goal.
  • Prepare young people with a disability to become working adults with a disability.
  • Transition students from secondary education to adult life. Assist adults with a disability in getting and keeping a job.
  • Improve access to reliable transportation to get to and from work, on time, every time.
  • Lead by example – improve state contracts and reduce barriers to commonwealth employment.
  • Expand private-public partnerships.
  • Increase public awareness.
  • Collect and coordinate data.
  • Implement, monitor, and provide accountability.

In support of the Employment First initiative, 20 Pennsylvania college students with disabilities are participating in a 12-week paid internship with the Wolf Administration this summer. The interns are working in positions at state agencies related to their academic backgrounds and gaining experience in their field of study and building connections with potential employers.

The Office of Long-Term Living (OLTL) released the following notice to Service Coordination Entities (SCEs) regarding a procedure code change for Cognitive Rehabilitation Therapy (CRT) Services.

This notice is to advise all SCEs that due to 2018 Healthcare Common Procedure Coding System (HCPCS) updates, the procedure code for Cognitive Rehabilitation in the Independence and OBRA Waivers will change effective 7/1/18. The service procedure code 97532 SE will be end-dated as of 6/30/2018. The new service procedure code for Cognitive Rehabilitation is 97127 and will be effective 7/1/18. The service definition and units of service remain the same. OLTL requires the attention and assistance of SCEs in order to update the service procedure code for HCSIS Fiscal Year (FY) 2018-2019 service plans.

OLTL is systemically removing the service procedure code of 97532 SE from any impacted HCSIS FY 2018-2019 service plans in order to end-date service contracts and offerings as of 6/30/18 for providers enrolled to render the service. A system update must be completed prior to making the new service procedure code of 97127 available for selection onto service plans.  A data fix is scheduled to occur in HCSIS on 6/21/18 to remove the remaining impacted 97532 SE service lines from FY 2018-2019 service plans. Please do not add the service 97532 SE to any additional FY 2018-2019 service plans as this will impact the success of the data fix. The new service procedure code of 97127 will be added to HCSIS and available for selection onto service plans as of 6/25/18. Service Coordinators (SCs) will be required to add the new service code for impacted FY 2018-2019 service plans.

Once the service is available for selection onto FY 2018-2019 service plans, SCs will then submit a Critical Revision to OLTL for review and approval for the addition of the new service procedure code 97127. OLTL’s Service Plan Review Team within the Bureau of Participant Operations will be communicating with SCEs that are directly impacted by this service procedure code change. A separate email communication will be sent to impacted SCEs to provide additional detail and guidance.

If you have any questions regarding the necessary service plan updates, please contact the Bureau of Participant Operations or Stacey Griffiths with the Bureau of Participant Operations at: 717-724-6547.

In preparation for the launch of Community HealthChoices (CHC) in the Southeast region, this CHC Fact Sheet explains the delivery of service coordination through the program. Under CHC, service coordination is a function of the managed care organizations (MCOs). A service coordinator is the MCO’s designated, accountable point-of-contact for each participant receiving long-term care services, their person-centered service plan, and service coordination. Therefore, the Office of Long-Term Living (OLTL) sees the service coordinators as part of the MCO under CHC.

In addition to the fact sheets, there are now short, easily digestible overview trainings on CHC that can be found here in order to increase stakeholder knowledge in anticipation of the Southeast rollout of the program.

To assist stakeholders in finding answers to questions more quickly, all FAQs have been consolidated into a single CHC Questions and Answers Document. The new document is in searchable PDF format and contains a table of contents that allows the user to easily move to different sections within the document.

The CHC Questions and Answers Document can be found on both the Participant and Provider sections of the CHC website by clicking on “View CHC Publications” or by following this link.

CONTACT: If you have any questions, please visit the CHC website or submit comments via email.

As a reminder, Providers of Home and Community-Based Services (HCBS) for Office of Developmental Programs (ODP) — to include providers of residential services, community participation support, and day habilitation services in the Adult Community Autism Program (ACAP) and Consolidated, Community Living, Person/Family-Directed Support and Adult Autism Waivers — must complete a Self-Assessment to determine compliance with the HCBS Settings Rule, published by the Centers for Medicare and Medicaid Services (CMS) in 2014.

HCBS Provider Self-Assessments must be completed online by 11:59 pm on Tuesday, June 12, 2018. Service locations for which ODP has not received a completed self-assessment will be deemed non-compliant.

These HCBS Provider Self-Assessments will assist in identifying potential areas of non-compliance and allow the provider to develop a corrective action plan outlining how they plan to achieve full compliance. While CMS has given states an extension to ensure all settings have achieved compliance with the rule by March of 2022, various requirements and effective dates have been built into ODP”s waivers and upcoming regulations which will impact the dates by which compliance must be achieved.

It is important to note that the intent of the self-assessment is not to close or terminate any home or community-based services but instead, to work with individuals, providers, and other stakeholders to transition these waiver services, to meet compliance with the HCBS Settings Rule and the vision of ensuring individuals are fully integrated into the community, afforded choice, and have their health and safety needs met.

See Communication #035-18 for all of the details.

This week, both the US Senate and US House introduced bipartisan legislation (HR 5912 in the House and S 2897 in the Senate) designed to delay implementation of the Electronic Visit Verification (EVV) provision of the 21st Century Cures Act and require public input from stakeholders. The bill was led by Senators Lisa Murkowski (R-AK) and Sherrod Brown (D-OH) and co-sponsored by a range of Democrats and Republicans in the Senate and House. The EVV delay bill gives states an additional year to implement EVV, having it take effect on January 1, 2020 instead of January 1, 2019.

In late 2016, Congress had ordered states to install EVV systems as a way of preventing fraud in Medicaid as part of the 21st Century Cures Act, but many challenges arose after the bill passed. This is partially due to CMS not releasing guidance on the EVV statute until May 2018, leaving states in the dark for a full 18 months following passage of the EVV law. Even despite CMS’ recent guidance, many concerns remain about which disability supports and services are required to comply with the rule. Additionally, because there has been little stakeholder input, questions abound about privacy, costs, and other aspects of compliance.

Please contact your legislators and ask them to support the EVV delay bill. The American Network of Community Options and Resources (ANCOR) has been instrumental in advocating for this legislation; RCPA is proud to be a member of ANCOR and appreciates their initiative on this issue.