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pa department of human services

The Office of Inspector General (OIG) has released their report after conducting a review of ODP’s Incident Management for individuals served in waiver programs. The report, entitled Pennsylvania Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities, outlines findings from the review as well as PA Department of Human Services’ response to the report.

The data that was reviewed is from 2015–2016. Since that time, DHS has made many advances in incident management oversight. These improvements include the development and implementation of a more sophisticated IM system, implementation of mortality reviews for all participant deaths, clarification of the types of incidents to be reported, strengthened collaboration with law enforcement, and strengthened protocols for referrals to law enforcement.

The following are excerpts from the report:

What OIG Found
Pennsylvania did not fully comply with Federal Medicaid waiver and State requirements for reporting and monitoring 24-hour reportable incidents involving Medicaid beneficiaries with developmental disabilities who resided in community-based settings. Specifically, Pennsylvania did not (1) ensure that community-based providers reported thousands of 24-hour reportable incidents within required timeframes, (2) ensure that community-based providers and county and regional investigators analyzed and investigated all beneficiary deaths, and (3) ensure that community-based providers referred all suspicious deaths to law enforcement. Pennsylvania did not have adequate controls to detect unreported 24-hour reportable incidents and did not have controls in place to ensure that all beneficiary deaths were investigated and that all suspicious deaths were referred to law enforcement. Therefore, Pennsylvania did not fulfill participant safeguard assurances it gave to CMS to ensure the health, welfare, and safety of the 18,770 Medicaid beneficiaries with developmental disabilities covered by the Medicaid waiver in their audit.

What OIG Recommends and Pennsylvania Comments
OIG recommends that Pennsylvania improve its controls regarding the reporting and monitoring of 24-hour reportable incidents involving Medicaid beneficiaries with developmental disabilities residing in community-based settings. Specific recommendations were made for these controls. Pennsylvania concurred with six of the seven recommendations and described corrective actions that it plans to take or has already taken, but it did not concur with the recommendation that it record the 24-hour reportable incidents noted in the report. Instead, Pennsylvania stated that it plans to focus on recording unreported emergency room visits and hospital stays that contain diagnoses indicative of high risk for suspected abuse or neglect and take remedial action as appropriate. OIG agrees that Pennsylvania should prioritize recording unreported incidents that contain diagnoses indicative of high risk for suspected abuse or neglect but maintains that all unreported 24-hour reportable incidents must be reported.

The full report can be found here, including the response from DHS.

The Pennsylvania Department of Human Services and Department of Education recently conducted a webinar on PA’s Parent Pathways Initiative. Please see this link for the recording of the webinar. The slide presentations and other information are also available below:

Visit the Parent Pathways Padlet site for more information.

If you have additional questions, please contact RCPA Children’s Division Director Jim Sharp or DHS Special Advisor Caitlin Palmer.

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The Department of Human Services (DHS) has announced rate increases for Personal Assistance Services (PAS) in the OBRA Waiver and Act 150 program. There will also be a rate increase for Residential Habilitation in the OBRA Waiver. These rate increases become effective on January 1, 2020. The new rates for the OBRA Waiver were published in the August 24, 2019 edition of the Pennsylvania Bulletin. The new rates for the Act 150 Program were published in the November 30, 2019 edition of the Pennsylvania Bulletin. These new rates are based on a participant’s county of residence.

In addition, Home and Community Services Information System (HCSIS) service plans were updated on November 30, 2019. Service Coordinators (SCs) do not need to make any service plan updates for this rate change, as a HCSIS system-wide update is being initiated to make the necessary service data updates onto the impacted service plans.

Questions about these updates should be directed to the Office of Long-Term Living (OLTL) Provider Inquiry Line at 800-932-0939, Option 2, Monday–Friday from 9:00 am – 12:00 pm and 1:00 pm – 4:00 pm.

The Department of Human Services (DHS), Office of Long-Term Living (OLTL) will conduct the next Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting on Tuesday, December 3, 2019, in the Honor’s Suite at 333 Market Street Tower in Harrisburg from 10:00 am – 1:00 pm. Those who cannot attend in person may participate by dialing: 213-929-4212; Access Code: 524-290-985, or by webinar. If you plan to participate via webinar, registration is required.

Public comments will be accepted during presentations instead of just being heard at the end of the meeting; however, there will be an additional 15-minute period at the end of the meeting for any additional public comments.

If you have any questions about registering for the webinar or require a toll-free number to dial in, please contact the Office of Long-Term Living.

The Department of Human Services, Bureau of Procurement and Contracts Management has released the Request for Application (RFA) for Managed Care Organizations to provide physical health services in the Commonwealth of Pennsylvania in the five HealthChoices zones. These zones include the Southeast, Southwest, Lehigh/Capital, Northeast, and Northwest.

The RFA can be found here. Appendix A of the agreement can be viewed here. Contact Sarah Eyster, RCPA Mental Health Division Director, with questions.

Senior woman with her caregiver at home

The Pennsylvania Department of Human Services (DHS) recently announced a fourteen-county expansion of the Living Independence For the Elderly (LIFE) program. LIFE is a long-term care program that assists seniors with living independently in their homes, while receiving services and supports that meet their health and personal needs. LIFE is one of the Commonwealth’s home and community-based services (HCBS) options that currently serves over 7,000 individuals.

The LIFE program was implemented initially in 1998, and is known in other states across the nation as the Program of All-Inclusive Care for the Elderly (PACE). In order to be eligible for the LIFE program, an individual must be 55 or older, meet the level of care for a skilled nursing facility or special rehabilitation facility, and be able to be safely served in the community.

Through this expansion, LIFE programs will be established in the following counties: Bradford, Cameron, Carbon, Centre, Clearfield, Elk, Fulton, Jefferson, Monroe, Potter, Sullivan, Susquehanna, Tioga, and Wayne. Contact Melissa Dehoff, RCPA Rehabilitation Services Director, with questions.

RCPA would like to congratulate Jonathan Rubin and Amy Grippi on their new positions with the Department of Human Services. We look forward to collaborating in the future, to continue improving the quality of life for our children across the Commonwealth.

(From DHS Secretary Teresa Miller)

DHS Staffing Update

I am excited to announce that Jonathan (Jon) Rubin will join the Department of Human Services as the Office of Children, Youth, and Families’ Deputy Secretary. Jon has led Bucks County’s Housing and Human Services division since 2014, overseeing the county’s child welfare agency, behavioral and developmental health programs, drug and alcohol services, mental health and developmental programs, housing services, and Area Agency on Aging.  As director, Jon has focused on creating a more integrated approach to Housing and Human Services’ work, encouraging two-generation, whole-family focuses and facilitating public-private partnerships and generative program development.

Jon started his career spending 15 years with the Bucks County Children & Youth Social Services agency, beginning as a social worker and eventually serving four years as a child protective services manager. He has also worked to strengthen the child welfare system on a state level, working at the Pennsylvania Child Welfare Resource Center, providing technical assistance and training to children and youth agencies around Pennsylvania, and later with Deloitte as a senior consultant and child welfare subject matter expert, helping implement the Child Welfare Information Solution project. Jon has also worked at the national level supporting child welfare systems across the country when he served as an Organizational Effectiveness Consultant for the American Public Human Services Association.

Jon will join DHS on November 4. At that point, Amy Grippi will transition into a new role, Child Services Executive Director, in the Secretary’s Office. This role will focus on synthesizing initiatives and priorities around child services and create a stronger bridge between OCYF and the Office of Child Development and Early Learning. Amy will be focused on strengthening services provided to children around Pennsylvania, including our work to implement the enterprise case management system and Family First, increasing the incorporation of predictive analytics and trend analyses through improved data collection, and other initiatives.

I think this new role will be an invaluable asset to help enhance and support the work done at DHS and at the county level, and I know Amy’s skills and experience will help us do more to support children and families around Pennsylvania.

I want to thank Amy for her tireless work and leadership as OCYF’s Acting Deputy Secretary over the last few months, and I am so excited to welcome Jon to the agency. I look forward to seeing the good work that DHS and OCYF will accomplish as we move forward.

Thank you,
Secretary Teresa Miller