Physical Disabilities & Aging

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.

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.

The PROMISe Eligibility Verification System (EVS) enables providers to determine a participant’s Medical Assistance eligibility and scope of coverage. It is vital for providers to check EVS to verify a participant’s eligibility each time services are provided because a participant’s eligibility is subject to change. EVS methods, inquiries, and response formats will not change with the implementation of Community HealthChoices (CHC).

The attached fact sheet illustrates EVS return codes for participants enrolled in each of the CHC-MCOs and provides examples of the CHC-MCO participant identification cards. If you have any questions, please visit www.HealthChoices.pa.gov or email RA-PWCHC@pa.gov.

To:  Service Coordinators (SC) who serve participants in the Southeast Region
Subject:  SC Training Materials:  Community HealthChoices (CHC) Implementation for Participant-Directed Services

Below are materials from the August 21, 2018 SC training, CHC Implementation and Participant-Directed Services. The purpose of this presentation was to provide information and process updates to SCs on the implementation of CHC for participants who utilize participant-directed services in the Southeast Region, including Bucks, Chester, Delaware, Montgomery, and Philadelphia counties.

Public Partnerships LLC (PPL) will also complete the following items to assist SCs:

  • Update the PPL Service Coordination Entity (SCE) Training Manual, post it to the PPL website and send it out via the PPL Enrollment Managers.
  • Re-record the training (to eliminate the end-of-presentation Q&A issues) and post it to the PPL website. PPL will notify SCEs that the training is posted to the website when PPL sends out the SCE Training Manual.
  • If PPL receives input from SCEs via the Enrollment Managers, PPL will review comments with the Office of Long-Term Living and CHC Managed Care Organizations to determine a follow-up format for an FAQ document, as applicable. If PPL does create an FAQ, PPL will similarly distribute through the Enrollment Managers and post to the PPL website.

If you have any questions, please contact your PPL Regional Enrollment Manager.

The Office of Long-Term Living (OLTL) released the Service Coordinator (SC) training materials from the Community HealthChoices (CHC) Implementation for Participant-Directed Services training that was held on August 21, 2018. The presentation and training was to provide information and process updates to SCs on the implementation of CHC for participants who utilize participant-directed services in the Southeast Region, including Bucks, Chester, Delaware, Montgomery, and Philadelphia counties.

Contact Melissa Dehoff, RCPA Director of Rehabilitation Services, with any questions.

(From OLTL)

TO: Office of Long-Term Living (OLTL) Cognitive Rehabilitation Therapy Providers
RE: Procedure Code for Cognitive Rehabilitation Therapy Services – Processing Issue

This notice is to advise Cognitive Rehabilitation Therapy Providers that after removing service procedure 97532 SE and replacing it with the new procedure code 97127 for Cognitive Rehabilitation, a processing issue occurred causing many claims to deny.

OLTL is aware of this issue and is working on a system fix.  OLTL will send a follow up communication in the very near future advising providers of the fix and when it is appropriate to rebill.  In the meantime, OLTL asks that providers refrain from billing for Cognitive Rehabilitation in the Independence and OBRA waivers.

If you have any questions regarding the procedure code change, please contact the OLTL Provider Inquiry Unit at RA-ProviderOperation@pa.gov or 1-800-932-0939.

A listserv has been established for ongoing updates on the CHC program. It is titled OLTL-COMMUNITY-HEALTHCHOICES, please visit the ListServ Archives page at http://listserv.dpw.state.pa.us to update or register your email address.

Please share this email with other members of your organization as appropriate. Also, it is imperative that you notify the Office of Long-Term Living for changes that would affect your provider file, such as addresses and telephone numbers. Mail to/pay to addresses, email addresses, and phone numbers may be updated electronically through ePEAP, which can be accessed through the PROMISe™ provider portal. For any other provider file changes please notify the Bureau of Quality and Provider Management Enrollment and Certification Section at 1-800-932-0939 Option #1.

To ensure you receive email communications distributed from the Office of Long-Term Living, please visit the ListServ Archives page at http://listserv.dpw.state.pa.us to update or register your email address.

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