Physical Disabilities & Aging

On February 23, 2017, the Pennsylvania Department of Health (DOH) released guidance to Home Care Agencies and Registries in follow-up to a policy clarification issued on November 23, 2016 regarding Direct Care Workers Non-Skilled Services in Home and Community-Based Services Settings.

The guidance includes a tool for organizations to use to comply with the Department of Health’s Home Care Agency and Registry regulations. The tool describes the consumer characteristics of individuals who can receive non-skilled activities/services, defined as Specialized Care. In addition, it describes the Home Care Agency/Registry responsibility for training and documentation of the direct care worker’s competency prior to delivering the Specialized Care. The guidance also establishes guidelines for the inclusion of Specialized Care into an individual’s care or service plan. RCPA’s policy statement in support of this clarification and guidance for expanded service options is available here.

Department of Human Services (DHS) Secretary Ted Dallas spoke at the RCPA Board of Directors meeting on February 22 regarding Governor Wolf’s proposal to consolidate four state health and human service agencies. If approved by the legislature, the plan would be launched on July 1, 2017.

Although the Secretary referenced approximately $90 million in savings from this process, he also affirmed that this “cannot be just about saving money.” Dallas remarked that time spent dealing with the bureaucracies as currently constructed takes time away from providing services, and so the goal is to eliminate redundancies.

RCPA members brought up key topics such as population health, licensing, and services for persons with co-existing conditions. When asked how this consolidation will affect addressing the opioid crisis, Secretary Dallas responded that the focus would be shifted to treating the whole person, rather than each individual condition.

The meeting concluded with the Secretary requesting ideas for continued efficiencies and how to ultimately better serve members. On the day of the Governor’s announcement, RCPA issued a statement expressing support for the proposal and committing to working with the administration to implement the plan in a smart and cost-effective manner.

The next OMHSAS Mental Health Planning Council (MHPC) is taking place on Thursday, March 2, 2017, from 10:00 am – 3:00 pm at the Child Welfare Resource Center (403 East Winding Hill Road, Mechanicsburg). The joint session will run from 10:00 am – 12:00 pm. The individual committees (Children’s, Adult, and Older Adult) will meet separately from 12:00 pm – 3:00 pm. A map and directions are available for your convenience.

The agenda and PowerPoint for the joint session are available as well, in addition to the agendas for the individual committee meetings, as well as the outcomes from the December 1, 2016 MHPC meetings, listed below:

Outcomes:

Agendas:

This meeting is open to the public. There is no need to RSVP; feel free to bring anyone you think would be interested in attending. Please contact Cristal Leeper with any questions.

On February 7, 2017, Governor Wolf unveiled his proposed state budget for Fiscal Year 2017/18. According to the Governor’s Budget-in-Brief, “the 2017/18 Budget proposes the consolidation of the Departments of Human Services (DHS), Health (DOH), Drug and Alcohol Programs (DDAP) and Aging (PDA) into a new, unified Department of Health and Human Services (DHHS) to encourage more effective collaboration and service delivery, enhance program effectiveness, reduce administrative costs, and eliminate duplicate positions.” For additional information about the proposed unified Department, see the HHS PowerPoint. RCPA has come out in support of this consolidation; see the public statement here.

On pages E23–24 through 26 of the Governor’s Executive Budget 2017/2018, the appropriations formerly in the Departments of Aging and DHS Office of Long-Term Living are described. None of these programs are slated for rate increases. In summary, the proposed program expansions are as follows:

Aging and Adult Community Living:

  • Overall General Fund growth for Aging and Adult Community Living lines is 8.64%
  • Reflects implementation of Community Health Choices (CHC) effective 1/1/2018 in the Southwest Region
  • The Long Term Care appropriation includes nursing facility, operational contracts, and CHC funding moved from affected OLTL waivers and related health care appropriations
  • HCBS (Aging waiver) appropriation includes $12.931 million to fund 1,428 additional participants
  • Long-Term Care Managed Care (LIFE program) appropriation includes $7.003 million to fund 600 additional participants and $7.119 million to expand to nine additional counties
  • Services to Persons with Disabilities (OBRA, CommCare, and Independence waivers) appropriation includes $21.182 million to fund 1,470 additional participants
  • Attendant Care (waiver and Act 150) appropriation includes $7.961 million to fund 840 additional participants
  • PENNCARE (senior services) appropriation includes $4.015 million to fund 420 additional participants

A full RCPA budget analysis for all health and human services is pending and will be distributed upon completion.

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.