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Yesterday, after Governor Wolf delivered his 2019/20 budget address to the General Assembly, the Department of Health (DOH) and the Department of Human Services (DHS) held a budget briefing updating stakeholders on the status of 2018/19 initiatives and rolling out the Governor’s 2019/20 DOH/DHS budget initiatives. The Governor’s main initiatives for DOH and DHS for the upcoming fiscal year are as follows:

  • Increase the minimum wage;
  • Help low-income working parents support their families;
  • Strengthen high quality care for infants and toddlers;
  • Expand evidence-based home visiting;
  • Expand services for individuals with intellectual disabilities and autism on the waiting list;
  • Protect individuals in personal care homes and residential and day-treatment programs;
  • Support Pennsylvanians with disabilities;
  • Invest in mental health services; and
  • Combat the opioid epidemic.

For further information on the above initiatives, please see the DOH and DHS PowerPoint presentations. Questions, contact RCPA Director of Government Affairs Jack Phillips.

The Department of Human Services (DHS) has announced that effective July 1, 2018, the cost of child abuse clearances will increase from $8 to $13. Child abuse clearance fees for volunteers will continue to be waived one time within a five-year period.

The legislative passage of Act 40 of 2017 included the increase to assist in covering actual costs for processing child abuse clearances, after the previously amended Child Protective Services Law (CPSL) expanded who is required to receive clearances, and instituted a five-year renewal cycle. Beginning in December 2014, individuals who required clearances expanded to include: volunteers, youth camp employees, coaches, youth mentors, Boy Scout and Girl Scout leaders, work study programs, internships, family-living home employees, and community-home employees for individuals with disabilities.

In 2014 and 2015, legislation was passed amending the CPSL. These amendments expanded clearance and background check requirements for individuals working or volunteering with children. In 2016, DHS received 951,414 child abuse clearance applications and identified 2,272 substantiated or alleged perpetrators of child abuse.

For more information on clearance and background check requirements as required by the CPSL, please visit this website.

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Governor Wolf announced that he has selected Teresa Miller, current Commissioner for the Pennsylvania Insurance Department, to lead the Department of Human Services, effective Monday, August 21. Commissioner Miller’s leadership, advocacy, and dedication to the people of the Commonwealth have been evident during her tenure at Insurance, and the Governor’s Office is confident that she will lead DHS with those same characteristics and commitment. As Commissioner Miller joins DHS, Jessica Altman will begin serving at the helm of the Pennsylvania Insurance Department.

The Pennsylvania Departments of Aging and Human Services recently announced an agreement with Aging Well (a subsidiary of the Pennsylvania Association of Area Agencies on Aging or P4A that represents all Area Agencies on Aging) to partner on the implementation of Community HealthChoices (CHC).

Under this new agreement, Aging Well will have the following responsibilities:

  • Complete the Functional Eligibility Determinations (FEDs) (via subcontracts with AAAs). Aging Well will conduct the FEDs for participants seeking eligibility for long-term services and supports. Aging Well will also perform the annual in-person re-determinations for people over the age of 60. While FEDs currently need to be completed for individuals applying for the Office of Long-Term Living (OLTL) waivers, ACT 150 program, Living Independence for the Elderly (LIFE), and nursing facility coverage, as the commonwealth begins its implementation of Community HealthChoices, Aging Well will continue to fulfill this role. In addition, as the commonwealth transitions from the existing assessment tool (the Level of Care Determination) to the FED, Aging Well will continue to actively support and facilitate this conversion.
  • Conduct Pennsylvania Preadmission Screening Resident Review Evaluation (PASRR-EV Level II Tool) (via subcontracts with AAAs). Aging Well will conduct the screening for individuals with a mental illness, intellectual disability or related condition, who are seeking admission to Medicaid certified nursing facilities regardless of payer source. These individuals must have the PASRR process completed prior to admission to the nursing facility.
  • Annual re-determinations (via subcontracts with AAAs). Prior to the implementation of CHC, Aging Well will conduct an annual in-person re-assessment within 10 business days of request by a service coordinating entity for all Aging Waiver participants. After the implementation of CHC, Aging Well will review FED assessment data collected by the managed care organizations for all CHC waiver participants in order to confirm annual redeterminations of level of care have been properly conducted. This will be completed as a desk review.
  • Conduct CHC outreach and education activities statewide (via partnerships with AAAs, nursing facilities, and community-based organizations). Aging Well will begin outreach and education activities in July 2017 for the rollout of Phase 1. These activities include 20 public information sessions and training of service coordinators and nursing facility staff.

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The Secretaries of the Departments of Human Services, Aging, Health, and Drug and Alcohol Programs sent a letter to the Senate and House Appropriations Committee Chairs and copied other committee chairs, expressing grave concerns about proposed funding cuts to human services programs in House budget bill HB 218.

RCPA strongly supports the Secretaries’ position. RCPA believes that these funding cuts will hurt our providers and those they serve; therefore, RCPA asks members to contact your state senator and representative and ask them to fully fund the line items that have been targeted for cuts. Questions, contact Jack Phillips, RCPA Director, Government Affairs.

This week the Pennsylvania Department of Human Services (DHS) announced several new initiatives to reduce the use of psychotropic medication among our state’s most vulnerable children. Speaking at The Children’s Hospital of Philadelphia, DHS Secretary Ted Dallas reported on the partnership of DHS with the Pennsylvania Chapter of the American Academy of Pediatrics and the Pennsylvania Psychiatric Society. A state-commissioned PolicyLab study that found that in 2012 in Pennsylvania, the use of psychotropic medications was nearly three times higher among 6-18 year olds in foster care than among youth in Medicaid overall. Based on this study and the collaborative effort mentioned above, Pennsylvania has initiated the following:

  • Best practice guidelines are being developed for clinicians regarding comprehensive assessments of behavior and treatment interventions;
  • Managed care organizations will be required to give prior authorization for antipsychotic medications for children;
  • A new electronic dashboard will make it easier for DHS to monitor what medications children are taking and improve care coordination;
  • In April, DHS will open a telephonic child psychiatric consultative service to help prescribing physicians, physician assistants, and nurse practitioners appropriately prescribe psychotropic medication for children; and
  • In July, the department will begin training child welfare caseworkers and caregivers on the appropriate use of psychotropic medication.

“The inappropriate use of these powerful medications for children in the foster care system compounds the trauma experienced by children who have been the victim of abuse and neglect and is simply unacceptable,” Dallas said, “The recommendations and analysis from PolicyLab provide Pennsylvania with an invaluable roadmap to improve the safety and quality of life for foster children served by the Medicaid system.”