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Authors Posts by Melissa Dehoff

Melissa Dehoff

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Melissa Dehoff is responsible for all medical rehabilitation and brain injury service issues. Ms. Dehoff attends multiple state-level meetings to advocate on behalf of members on brain injury and rehabilitation issues and is a member of the Department of Health Traumatic Brain Injury Advisory Board.

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The Administration for Community Living (ACL) has announced a virtual traumatic brain injury (TBI) stakeholder day planned for March 8, 2022, from 12:00 pm–4:30 pm. This free event will be held via webinar, and attendees will spend the afternoon talking about important issues around TBI services, supports, and systems.

Attendees will hear from brain injury survivors, family members, support networks, and state and federal representatives. This year’s sessions include Survivor Engagement Strategies, Domestic Violence and the Effect on Children, Effective Partnerships with Behavioral Health with a Focus on Suicide, and Effective Strategies for Using and Leveraging Data.

Individuals interested in participating should register here.

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The Medicare Payment Advisory Committee (MedPAC) voted last week and unanimously recommended a five percent payment reduction for inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), and home health agencies (HHAs). There was no additional feedback provided with this recommendation; however, additional information should be provided in their upcoming March 2022 report to Congress.

Also worth noting was that MedPAC discussed its mandated report related to designing a value incentive program (VIP) for post-acute care (PAC). This report is required under the Consolidated Appropriations Act of 2021, and this was the commission’s second session dedicated to development of the PAC VIP. The report is due to Congress by March 15, 2022. Due to the limited time to develop the report, MedPAC asserted it would not be making a formal recommendation in the March Report to Congress. Also during this session, MedPAC shared its plan to submit its separate report on a unified post-acute care payment prototype to Congress in 2023.

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The next Managed Long-Term Services and Supports Subcommittee (MLTSS) meeting is scheduled for February 2, 2022, from 10:00 am–1:00 pm.

To participate in the meeting via webinar, please register by visiting here. The Office of Long-Term Living (OLTL) encourages those participating by webinar to register early. Registrants will then receive a confirmation email containing information about joining the meeting.

Dial-In Number:
1 (914) 614-3221
Access Code: 300-175-489

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A national stakeholder call with the Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and her leadership team has been scheduled for January 18, 2022, from 1:00 pm–1:45 pm. Agenda topics include:

  • The legacy of Dr. Martin Luther King;
  • CMS strategic vision and key 2021 accomplishments; and
  • 2022 goals.

To participate in the call, please register here.

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Image by Dirk Wouters from Pixabay

In today’s Federal Register, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule that included updates to the Medicare Advantage program. Contained within this proposed rule is a Request for Information (RFI): Prior Authorization for Hospital Transfers to Post-Acute Care (PAC) Settings During a Public Health Emergency (PHE). The RFI highlights several concerns, including the fact that providers often wait up to three days for authorization determinations, and that a high rate of MA requests are initially denied, all of which hinder the ability of hospitals to maximize capacity during a public health emergency (PHE). The RFI requests several areas for feedback, including the overall impact of prior authorization on hospitals and patient care, the denial rates and associated burden on providers, and the consequences of delayed patient transfers.

Members are encouraged to share any direct examples of these prior authorization issues with Melissa Dehoff, Director, Rehabilitation Services Division. In addition, this issue will be discussed during the upcoming Outpatient Rehabilitation Committee and Medical Rehabilitation Committee meetings.

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The Department of Human Services (DHS) has issued updated guidance on COVID-19 for Personal Care Homes (PCHs) and Assisted Living Residences (ALRs). As the Commonwealth, along with the nation, has obtained additional data and expanded their knowledge and understanding of COVID-19, guidance continues to evolve and change. The revisions to the guidance are identified in red text.

Questions on these revisions should be sent electronically or to the regional office.

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The Pennsylvania Department of Health (DOH) has announced a new initiative to assist long-term care facilities (which includes skilled nursing facilities, personal care homes, assisted living residences, etc.) respond to COVID-19, recover, and improve resiliency.

This new initiative, the Long-Term Care Resiliency, Infrastructure Supports, and Empowerment (LTC RISE) is funded by a federal grant provided by the U.S. Centers for Disease Control and Prevention (CDC), which began on January 1, 2022, replacing the Regional Congregate Care Assistance Teams (RCATs), whose contract expired December 1, 2021.

With LTC RISE, these long-term care facilities may take advantage of improvement project opportunities in the following areas:

  • Implementing infection prevention and control and emergency preparedness best practices to enhance delivery of resident-centered care;
  • Building a sustainable outbreak response operation construct that meets the facility’s needs; and
  • Promoting professional development and a resilient long-term care facility workforce.

LTC RISE will continue to offer the following RCAT prevention and response support to LTC RISE-eligible facilities:

  • A dedicated phone line with 24/7 access, including designated office hours for inquiries, consultations, and follow-up calls from long-term care facilities; and
  • Consultation and technical assistance, assessment and feedback, training, and incident management coaching.

The LTC RISE program is a partnership among DOH, Department of Human Services (DHS), Pennsylvania Emergency Management Association (PEMA), and the following healthcare organizations that have established partnerships covering six regions across Pennsylvania to support preventive and emergent assistance for LTCFs:

  • Penn Medicine, in partnership with Temple Health;
  • The Pennsylvania State University;
  • LECOM Health; and
  • AMI Expeditionary Healthcare.

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Folders with the label Applications and Grants

The Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control’s (NCIPC) Division of Injury Prevention recently announced a new notice of funding opportunities, which include:

RFA-CE-22-006 Research Grants to Evaluate the Effectiveness of Physical Therapy-Based Exercises and Movements Used to Reduce Older Adults Falls

NCIPC intends support up to two (2) recipients for 3 years at up to $350,000 per award per year.

Application Due Date: March 1, 2022

NCIPC is soliciting investigator-initiated research proposals to support both a process evaluation and an outcome evaluation of the effectiveness of strategies commonly used to improve community-dwelling older adults’ balance, strength, and mobility and subsequently reduce their risk of future falls and fall injuries. These strategies may include different types of physical therapy-based exercises and movements such as heel-to-toe walk, sit-to-stand exercise, calf raises, and side leg raises. Of particular interest is research that focuses on populations experiencing high rates of older adult falls and fall injuries, and could include populations disadvantaged by reduced economic stability or limited educational attainment.

Questions should be sent to NCIPC_ERPO (CDC).

RFA-CE-22-007 Reduce Health Disparities and Improve Traumatic Brain Injury (TBI) Related Outcomes Through the Implementation of CDC’s Pediatric Mild TBI Guideline

NCIPC intends support up to one (1) recipient for 4 years at up to $550,000 per year.

Application Due Date: February 22, 2022

NCIPC is soliciting investigator-initiated research proposals for an implementation study to promote the adoption and integration of the “Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children” in a large health care system to: a) improve mild traumatic brain injury (mTBI) outcomes in children and adolescents, and b) reduce disparities in TBI-related care and outcomes.

Applicants are expected to focus on the following research questions:

What type of disparities in mTBI-related processes and outcomes currently exist at baseline in a healthcare system(s) prior to initiation of an intervention to systematically implement CDC’s Pediatric mTBI Guideline?

Does an intervention aimed at systematically implementing CDC’s Pediatric mTBI Guideline in a healthcare system(s) result in a reduction of health disparities, relative to baseline, vis a vis improved process and health outcomes?

Applicants are encouraged to supplement the mTBI Guideline implementation with added outreach efforts to children experiencing disadvantage, and implementation strategies that address TBI-related care and health disparities identified within the health system.

For the purposes of this NOFO, mTBI-related processes and outcomes include those related to the identification and treatment of an mTBI such as discharge instructions, counseling regarding return to school and return to play, communication with the school about symptoms, recovery, accommodations, as well as health outcomes. An indicator of care might be length of time between injury and diagnosis and treatment of an mTBI or the recovery trajectory of an mTBI. Disparities (health outcomes seen to a greater or lesser extent between populations) may be related to various factors of the injured child or adolescent, their family or neighborhood, or community, such as race, gender, sexual identity, disability, socioeconomic conditions, or geographic location.

Questions should be sent to NCIPC_ERPO (CDC).

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All divisions within the Department of Human Services (DHS) recently shared a video message from Acting Secretary of DHS Meg Snead to thank providers for all you do for the communities you serve. Members are encouraged to watch and share it with staff.

As DHS plans for 2022, they would like to continue to recognize our county partners and providers — the dedicated professionals who spend their lives caring for others — and all others who make this work possible.

DHS is collecting stories from providers and caring professionals about why their work is essential and why they chose their careers. Their goal is to highlight the stories of our human services system and how those who make this work possible make an impact in all parts of our communities. If you or your colleagues are interested and willing, please share your story. DHS is looking for:

  • Why you chose a career in behavioral health or substance use disorder services;
  • How your career lets you help others;
  • A story about when you felt like you’ve made an impact;
  • A time you’ve felt proud in your work helping others; and/or
  • Any other story you’re willing to share.

Stories can be emailed to the DHS Press Office. Please include names, county/place of residence, and a picture if you’re willing to share. DHS may use these stories on social media, the DHS blog, or the central human services job recruitment page. The DHS Press Office team will be in touch to obtain consent to use these stories.

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The Managed Long-Term Services and Supports (MLTSS) Subcommittee held their first meeting of 2022 on January 5. The handouts referenced and shared during this monthly meeting are provided below:

The next MLTSS Subcommittee meeting is scheduled for Wednesday, February 2, 2022.

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