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Physical Disabilities & Aging

(From OMHSAS)

COMMUNITY HEALTHCHOICES (CHC) is a new initiative that will increase opportunities for older Pennsylvanians and individuals with physical disabilities to remain in their homes. CHC will use managed care organizations (MCOs) to coordinate physical health care and long-term services and supports (LTSS).

The Commonwealth of Pennsylvania is committed to improving service coordination and health outcomes for older residents and adults with disabilities. In order to meet this commitment,

Community HealthChoices (CHC) joins with Physical HealthChoices and Behavioral HealthChoices to ensure a complete system of coordinated managed care. Behavioral HealthChoices provides a range of mental health and substance use disorder treatment services.

What does CHC mean for Behavioral HealthChoices?
Behavioral health services will continue to be offered through the existing network of behavioral health managed care organizations (BH-MCOs). Behavioral health providers will not be required to contract with a CHC-MCO to provide behavioral health services. CHC-MCOs and BH-MCOs will work together to coordinate the services that each participant needs.

Will CHC increase behavioral health services recipients?
CHC will enable individuals previously excluded from the Behavioral HealthChoices program to be eligible for BH-MCO coverage. The majority of new enrollees will include individuals in the Aging Waiver and residents of nursing facilities. Behavioral health providers serving these individuals can ensure continuity of care by enrolling to provide services through Behavioral HealthChoices. Providers should continue to check the Eligibility Verification System (EVS) daily to confirm BH-MCO enrollment.

Who are the Community HealthChoices managed care organizations?
Through a request for proposals, the commonwealth has selected the following MCOs to proceed with negotiations to deliver services on a statewide basis:

  • AmeriHealth Caritas
    • Pennsylvania Health and Wellness (Centene)
    • UPMC for You

When does the CHC program begin?
Pennsylvania is undertaking a regionally based, three phase implementation of CHC, beginning with the Southwest region. Prior to the implementation of CHC in each region, DHS will hold an in-person regional event for providers, which will include a session addressing BH-MCOs and behavioral health providers. Southwest region providers will receive an event announcement soon.

Please visit the DHS website for detailed information on CHC including helpful FAQs. If you have any specific questions or comments about the CHC program, please email RA-PWCHC@pa.gov.

On March 17, 2017, The Office of Long-Term Living (OLTL) announced the availability of classroom trainings for staff of Service Coordination (SC) Entities.

As a prerequisite to these classroom trainings, participants must have completed the three OLTL online SC modules available online, which provide a strong foundation for the basics needed to fulfill service coordination requirements.

The one-day, instructor-led classroom sessions will allow participants to take what they learned from the online modules and apply it to situations found every day on the job. Attendance at these sessions will be limited to SCs (not supervisors or directors) and to two participants per agency. Preference will be given to new SCs hired in 2016 and 2017. Additional registrations will be considered on a first-come, first-served basis.

There will be three, one-day instructor-led sessions held this spring (there will be additional trainings in other parts of the state later this year) which will run from 8:00 am to 4:30 pm each day, as follows:

The first training will be held in Harrisburg on Wednesday, April 5, 2017, at the PaTTAN Building, which is located at 6340 Flank Drive, Harrisburg, PA 17112 (717-541-4960). Addresses for the other trainings will be provided when established, and will be held in the following locations:

  • Bethlehem – May 3, 2017 – Location TBD
  • State College – June 6, 2017 – Location TBD

You must register in order to attend one of these sessions and complete the registration form. If you have questions about the training, please contact OLTL’s Bureau of Participant Operations at 717-787-8091.

On March 17, the Pennsylvania Department of the Treasury announced that the official launch of its PA Achieving a Better Life Experience (ABLE) Savings Program will occur on Monday, April 3, 2017, at a media and legislative event in the Capitol Rotunda at 12:30 pm. On that date, the PA Treasury ABLE program officially begins accepting accounts for enrollment and opens the door on hope for individuals with disabilities and the families who care for those loved ones. Kathleen F. McGrath, Esq., PA Savings Programs Director, invites stakeholders to join Treasurer Joe Torsella, US Senator Robert Casey, and PA Senator Lisa Baker as ABLE officially opens for business.

Pennsylvanians with eligible disabilities are about to receive the tools they need to build a sound fiscal future. ABLE accounts mean a new, fresh perspective on what living as a financially empowered individual can mean. A PA ABLE account gives individuals with qualified disabilities (Eligible Individuals), and their families and friends, a tax-free way to save for disability-related expenses, while maintaining government benefits. Federal and state law authorized the creation of PA ABLE accounts; additional information is available online.

The Pennsylvania Department of the Treasury welcomes the attendance of all stakeholders. Attendees are asked to RSVP with your name and the number you are bringing with you by March 30, 2017. Additional details will be provided to you once you RSVP your attendance.

Stakeholders are invited to share this information with anyone who has a stake in the successful launch of this new product. While program material will be available at the launch event, PA ABLE asks that requests for bulk material and outreach or speaking opportunities are sent by email. The more people who know about this program and what it means to be ABLE to look to living a secured future, the better.

In addition, PA ABLE invites stakeholders to share stories of those who are going to benefit from the ABLE account by contacting them by March 24, 2017. Ms. McGrath also invites stakeholders to follow the Twitter handle @PATreasury for the latest updates, and help drive the conversation with the hashtag #PAABLE.

Please join the Office of Long-term Living (OLTL) and the Office of Mental Health and Substance Abuse Services (OMHSAS) for an informational webinar on Community HealthChoices (CHC) on Friday, March 31, 2017 at 1:00 pm. The webinar will feature a presentation from OLTL’s Chief of Staff, Kevin Hancock. Kevin will provide an update on CHC, describe progress to date, and discuss next steps. There will be an opportunity for questions and answers at the end of the presentation.

Background on CHC
The commonwealth is in the process of implementing CHC. CHC is a mandatory managed care program for eligible individuals, providing physical health services and long-term services and supports, such as attendant care services. CHC is being geographically phased in across the commonwealth beginning in January of 2018 in 14 counties in southwestern Pennsylvania, followed in July 2018 by five counties in the southeastern portion of the commonwealth. The CHC implementation will be completed in January 2019, when the remaining counties are implemented. The move to CHC will assist DHS in continuing to provide quality services.  CHC managed care organizations will be required to coordinate covered services, Medicare, and behavioral health services for enrolled participants.

To register for the webinar, please follow this link. Once you have registered, you will receive a confirmation email containing connection information. Please note, the connection information you receive will be unique to you and should not be shared with others.

Reminder: All CHC-related information can be found here. Comments can be submitted electronically. If you have any questions, please contact the Office of Long-Term Living Bureau of Policy and Regulatory Management at 717-783-8412.

A listserv has been established for ongoing updates on the CHC program, titled OLTL-COMMUNITY-HEALTHCHOICES. If you would like to update or register your email address, please follow this link.

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 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.