Physical Disabilities & Aging

On February 8, the Department of Human Services (DHS) Secretary Ted Dallas announced the availability of onboarding grant funds to help connect hospitals and ambulatory practices to the Authority’s Pennsylvania Patient & Provider Network, or P3N.

The P3N enables electronic health information exchange (eHIE) across the state through the connection of health care providers to health information organizations (HIO), and the participation of the HIOs in the P3N.

“These grants will assist providers in the efficient delivery of quality services to the individuals we serve across the commonwealth,” said DHS Secretary Ted Dallas. “As more providers participate, individuals will experience better coordination of care and a better quality of health care.”

The grant program, available to Pennsylvania HIOs to enable the connection of inpatient hospital/facilities and outpatient practice or other outpatient provider organizations participating in the Medicaid Electronic Health Records (EHR) Incentive Program, includes:

  • Up to $75,000 to connect each eligible inpatient hospital or other inpatient facility to an HIO;
  • Up to $35,000 to connect each eligible outpatient practice or other outpatient provider organization to an HIO; and
  • Up to $5,000 to enable other eligible providers that do not fit into the two categories above, but want to enable HIE participation and connect to an HIO via a portal.

Each eligible provider will connect via an HIO to the P3N.

Only a single award is permitted to any one hospital/facility or outpatient practice. The anticipated performance period for this grant runs through September 30, 2017.

The grant will:

  • Help providers deliver higher quality and more efficient care, particularly through better care coordination for patients covered by Medicaid;
  • Support provider participation in private-sector HIOs by offsetting connection costs;
  • Incentivize HIOs to join the P3N, a precondition for receiving funding;
  • Support rapid movement toward the participation in eHIE, and support various care reform efforts currently underway across the Commonwealth; and
  • Defray up-front costs for individual providers to join an HIO, thus helping to achieve meaningful use and satisfy obligations under the Medicaid EHR Incentive Program.

This program will be made possible through an $8.125 million grant from the federal Centers of Medicare & Medicaid Services (CMS). Under the terms of the federal grant, CMS will provide 90 percent of the onboarding grant, with the remaining 10 percent funded by the Commonwealth. The grant applications and supporting materials are available online here.

(Information courtesy of DHS)

The Department of Human Services (DHS) has announced the recent changes to the OBRA Waiver that have been approved by the Centers for Medicare and Medicaid Services (CMS). Some of the waiver amendments include:

  • Adds five new employment-related service definitions that are replacing two existing employment service definitions. Five employment services have been added (benefits counseling, career assessment, employment skills development, job coaching, and job finding) (C-1/C-3).
  • Corrects the regulatory citation for an Outpatient or Community-Based Rehabilitation Agency provider type in the Occupational Therapy (OT), Physical Therapy (PT), Speech and Language Therapy (SLP) service definitions (C-1/C-3).
  • Clarifies that Personal Assistance Services (PAS) are only available to individuals in the waiver 21 years of age and over. All medically necessary Personal Assistance Services for children under age 21 are covered in the state plan pursuant to the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit (C-1/C-3).

The complete service definitions and requirements are now included in an updated OBRA Waiver document. The effective date of these changes is February 1, 2017.

The OBRA Waiver PROPOSED rates for the new Employment Services have also been released. Questions regarding these rates should be directed to (717) 783-8412.

The 2017 RCPA conference, Connections, will be held October 10–13 at the Hershey Lodge. The Conference Committee is seeking workshop proposals for possible inclusion in this premier statewide event. The conference offers diverse educational opportunities and submissions are needed in every area. A complete listing of focus tracks is available on the 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;
  • provide specific skills and information related to individual and organizational leadership development and enhancement;
  • address system changes that affect business practices; 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 2017 include technology as a human resource option; executive leadership; integrated care strategies for implementation and reimbursement; managed care models for people with intellectual/developmental disabilities – other state experiences; ethics topics across the membership; emergency planning for community violence; acquisitions/mergers and consolidations; value-based purchasing – where is PA and other state experiences; and employing people with disabilities including the Centers for Medicare and Medicaid Services (CMS) and Rehabilitation Services Administration (RSA) rules impacting vocational facilities – what has or will be changing? The committee welcomes any proposal that addresses these and other topics essential to the rehabilitation, mental health, drug & alcohol, and intellectual/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 Workshop Proposal Form and accompanying Helpful Hints outline requirements for submissions. The deadline for submissions is Friday, March 24 at 5:00 pm. Proposals must be submitted electronically to Sarah Eyster. Confirmation of receipt will be sent. Proposals submitted after the deadline will not be considered.

Proposals selected will 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. Upon acceptance, presenters will be required to confirm the ability to submit workshop handouts electronically four weeks prior to the conference. Individuals 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.

RCPA is pleased to announce that it has recently formed a new division called the Physical Disabilities and Aging Division. This division has been created to support and provide information and networking opportunities to long-term services and support organizations including Personal Assistance Services Providers (PAS) and Service Coordination Entities (SCE) as well as other RCPA agencies/organizations providing services to these populations.

The first quarterly Physical Disabilities and Aging Division meeting will be held on Monday, February 27, 2017, at 10:00 am. This meeting will feature updates regarding Community HealthChoices (CHC) and representatives from all three selected managed care organizations (MCOs) will be in attendance: AmeriHealth Caritas, Pennsylvania Health and Wellness (Centene), and UPMC for You. The Office of Long Term Living (OLTL) has also been invited.

This is an exciting development for RCPA and its members and we look forward to seeing you. Register here for this meeting.

For hotel accommodations, contact the Best Western Premier, 800-780-7234 — be sure to mention RCPA to take advantage of our local negotiated rate at $102.95 plus taxes, including a $10 food voucher per room.

NATIONAL COUNCIL FOR BEHAVIORAL HEALTH CONFERENCE
PENNSYLVANIA RECEPTION
The National Council Conference is the nation’s premier annual specialty health care conference, attended by senior executives, board members, and staff from the nation’s community mental health, inpatient facility, and addiction treatment organizations. Each year, this can’t-miss event features presentations on the latest innovations, science and business, and clinical best practices. With more than 4,700 attendees and 200 workshops, there is something for everyone. Over 150 Pennsylvanians travel to this prestigious conference, and enjoy the evening social event to share their experiences and discuss new trends, along with other national invitees and National Council leadership.

The conference is at the Seattle, Washington conference center April 3–5, with the Pennsylvania reception being held Monday, April 3, from 5:30 pm – 7:00 pm. Sponsorships range from $3,000 – $15,000, determined by whether the organization is one of a group of sponsors or the sole sponsor.

RCPA ANNUAL MEETING
This annual event brings together the CEOs and primary agency contacts for board elections and a review of key RCPA issues and planning. The annual meeting is being held Friday, May 12, at the Hershey Lodge, Hershey, PA. This meeting is coupled with a program of speakers for a full day of events including a continental breakfast and luncheon. Sponsorship amounts range from $1,000 –$10,000.

This year, RCPA will also hold its annual PAC golf tournament on Thursday, May 11, the day before the annual meeting at the Hershey Country Club. Sponsorships and golf participants are being actively recruited. Sponsorship amounts range from $250 – $5,000. After the golf tournament there will be a reception for all the golfers, sponsors, and out of town participants coming in the evening before the annual meeting.

If interested in any of the above sponsorship opportunities, contact Tina Miletic.

RCPA ANNUAL CONFERENCE
A premier statewide event that brings together over 700 professionals who are interested in continuing their education, participating in formal and informal networking events, and cultivating new and longtime relationships. Conference attendees are CEOs, managers, and decision-makers, representing organizations providing mental health, drug and alcohol, intellectual and developmental disability, medical rehabilitation, brain injury, and children’s services. These organizations impact the lives of more than one million Pennsylvanians every year.

This event is being held October 10–13 at the Hershey Lodge, Hershey, PA. Sponsorships range from $500 – $30,000, dependent upon the specific event sponsored (e.g., meals, receptions, mobile application, and exciting new options for 2017). There is also the opportunity to exhibit as a vendor. If you are interested in a conference sponsorship, contact Sarah Eyster.

CESP Exam Logo

Earn the Designation of Certified Employment Support Professionals (CESP™)
by Passing the National CESP™ Examination

Hawley, PA Exam (information/registration links)
Wednesday, February 15, 2017

Wyomissing, PA Exam (information/registration links)
Wednesday, April 19, 2017

WHO SHOULD TAKE THE CESP™ EXAM?

Job Coaches • Job Developers • Transition Employment Specialists • Job Placement Specialists • Employment Specialists/Consultants • Employment Managers and/or Directors

What is CESP™ Certification?

  • CESP™ certification is a national credential for Employment Support Professionals who assist people with disabilities in finding and maintaining regular, community-based employment.
  • The CESP™ credential is earned by passing a comprehensive examination based onnational standardized competencies.
  • CESP™ certification is a complement to program certification and licensing, demonstrating a level of professionalism has been achieved.
  • The CESP™ certification is a national, portable, individual credential that remains valid for three years.

What are the Benefits of EARNING THE CESP™ Credential?

  • CESP™ certification opens the door to: improved professional advancement & job opportunities, increased income opportunities, and enhanced credibility with employers
  • Become a member of a rapidly growing, elite group of professionals:

• Reduced APSE membership fee
• National networking opportunities
• Exclusive access to CESP ™ publications & webinars
• A professional credential — not just a certificate of completion
• CESP™ Meet-ups
• CESP™ LinkedIn Group
• Your name listed on the APSE website
• Recognized as a leader in your field

The decision for Pennsylvania to postpone the implementation of Community HealthChoices (CHC) was announced today. This decision was made as a result of the delays associated with the resolution of several bid protests.

Following the announcement of the selection of the managed care organizations (MCOs) that would deliver health care coverage in Community HealthChoices, several protests were filed. As a result, the progress of major components of CHC implementation was delayed, resulting in the Department of Human Services (DHS) feeling uncertain with moving forward with their established start dates. Some of the impacted activities associated with this decision include:

  • Developing an adequate network: DHS has not been able to engage with the selected offerors. The agreement and rate negotiations and finalization typically take six weeks, and the agreements need to be finalized before the MCOs are able to engage in network development activities. The current delays mean the MCOs will not have enough time to meet the network adequacy requirements by July 1, 2017.
  • Completing a readiness review: Readiness review is a requirement for the MCOs before they are certified to be able to go live and provide services. Protests prohibit MCO engagement for readiness review and the window to complete the certification continuously shrinks. New programs require a minimum of six months to complete a readiness review.
  • Communicating: Communication about selected MCOs and their available networks is a critical component to CHC education and outreach. Individuals who will be enrolling in CHC need to have complete information about the MCO provider network in order to be able to make an informed provider choice. That communication will not be able to take place until the agreements are largely finalized and the MCOs are in a position to provide network information.

Important dates to note include:

  • Phase 1 will now begin in January 2018 in the Southwest region of the state.
  • Phase 2 will now begin in July 2018 in the Southeast region of the state.
  • The January 2019 start date for the rest of the state remains unchanged.

From the Department of Human Services:

The Wolf Administration is committed to serving more people in the community whenever possible, and we believe that the work performed by direct care workers (DCWs), including personal attendants and other household aides, enables individuals with disabilities to live a more independent life. We have heard from many people asking for a policy clarification on the types of non-skilled, home care services and activities that DCWs can perform in home- and community-based settings.

Last week, the Wolf Administration issued a policy clarification surrounding the role of DCWs.

The non-skilled activities provided in the consumer’s place of residence or other independent living environment are specialized care, a type of home care service unique to the consumer’s care needs that are exempt from the licensure requirements under the Professional Nursing Law and Practical Nurse Law.

DCWs may perform these non-skilled services/activities, with evidence of competency or training, provided they do not represent or hold themselves out as being licensed nurses, licensed registered nurses, or registered nurses; or use in connection with their names, any designation tending to imply they are licensed to practice nursing.

Individuals with disabilities will have a greater chance of remaining in their homes and community when they are able to receive assistance with long-term supports and services from DCWs. These non-skilled, routine activities/services include:

  • assistance with bowel and bladder routines;
  • assistance with medication;
  • ostomy care;
  • clean intermittent catheterization;
  • assistance with skin care; and
  • wound care.

DHS appreciates the partnership with the departments of Health and State and the collaboration with ADAPT and Disability Rights Pennsylvania in issuing this important policy clarification. Further guidance will be issued as appropriate to ensure successful implementation.

Today, the Office of Long-Term Living (OLTL) issued communication on changes to four OLTL home and community-based services waivers that were recently approved by the Centers for Medicare and Medicaid Services (CMS).

The changes include:

Aging Waiver amendments (effective 10/1/16)

  • Introduces the department’s intent to transition individuals from the Aging waiver into a managed care delivery system;
  • Revises language to reflect the current practice under the new child abuse clearance laws;
  • Breaks out the home health and therapeutic and counseling service definition into five discreet service definitions; and
  • Adds a new entity to perform waiver enrollments.

Attendant Care Waiver amendments (effective 10/1/16)

  • Introduces the department’s intent to transition individuals from the Attendant Care waiver into a managed care delivery system; and
  • Revises language to reflect the current practice under the new child abuse clearance laws.

Independence Waiver amendments (effective 10/1/16)

  • Adds five new employment-related service definitions* which are replacing one existing employment service definition;
  • Breaks out the Home Health and Therapeutic and Counseling service definition into eight discreet service definitions;
  • Introduces the Department’s intent to transition individuals from the Independence waiver into a managed care delivery system; and
  • Revises language to reflect the current practice under the new child abuse clearance laws.

CommCare Waiver amendments (effective 10/1/16)

  • Adds five new employment-related service definitions* which are replacing two existing employment service definitions;
  • Breaks out the home health and therapeutic and counseling service definition into eight discreet service definitions;
  • Introduces the department’s intent to transition of individuals from the Independence waiver into a managed care delivery system; and
  • Revises language to reflect the current practice under the new child abuse clearance laws.

OBRA Waiver renewal (effective 7/1/16)

  • Renewal of the waiver for an additional five years;
  • Introduces the department’s intent to transition individuals from the OBRA waiver into a managed care delivery system;
  • Breaks out the home health and therapeutic and counseling service definition into eight discreet service definitions; and
  • Revises language to reflect the current practice under the new child abuse clearance laws.

*New employment-related services are benefits counseling, career assessment, employment skills development (replaces prevocational services), job coaching (replaces supported employment), and job finding. For complete service definitions, provider qualifications, and requirements of each waiver, please refer to the approved waiver documents.

Providers of these new services will be paid at the proposed rates. Information on implementation of the new employment services, including transition from current employment services and billing procedures, is forthcoming.

In addition to the above changes, CMS has required OLTL to add limitations to any waiver services that are state plan services and are available to individuals under the age of 21. These services include: assistive technology, counseling, nursing services, nutritional consultation services, occupational therapy, personal assistance services, physical therapy, specialized medical equipment and supplies, and speech and language therapy. These services are only to be provided to individuals aged 21 and over. All medically necessary services for children under age 21 are to be covered in the state plan pursuant to the EPSDT benefit.

Questions on this information may be referred to either OLTL’s Bureau of Quality and Provider Management at 800-932-0939 or Bureau of Policy and Regulatory Management at 717-783-8412.