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Authors Posts by Carol Ferenz

Carol Ferenz

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0 2465

In preparation for the launch of Community HealthChoices (CHC) in the Southeast region, this CHC Fact Sheet explains the delivery of service coordination through the program. Under CHC, service coordination is a function of the managed care organizations (MCOs). A service coordinator is the MCO’s designated, accountable point-of-contact for each participant receiving long-term care services, their person-centered service plan, and service coordination. Therefore, the Office of Long-Term Living (OLTL) sees the service coordinators as part of the MCO under CHC.

In addition to the fact sheets, there are now short, easily digestible overview trainings on CHC that can be found here in order to increase stakeholder knowledge in anticipation of the Southeast rollout of the program.

To assist stakeholders in finding answers to questions more quickly, all FAQs have been consolidated into a single CHC Questions and Answers Document. The new document is in searchable PDF format and contains a table of contents that allows the user to easily move to different sections within the document.

The CHC Questions and Answers Document can be found on both the Participant and Provider sections of the CHC website by clicking on “View CHC Publications” or by following this link.

CONTACT: If you have any questions, please visit the CHC website or submit comments via email.

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The Office of Developmental Programs (ODP) has announced upcoming course offerings for both the Initial Certified Investigator and the Certified Investigator (CI) Peer Review Courses. Registration is open on myODP.org. The courses posted cover July 2018 to December 2018.

The Initial Certification Couse is a four-day, face-to-face course that was created to ensure all incidents that require an investigation receive a systematic investigation that meets established standards. In order to perform investigations, the investigator must successfully complete all requirements under the ODP CI Training.

The Initial Certification Course consists of three parts:

  1. a) Three online prerequisite modules
  2. b) Four days of face-to-face training
  3. c) Online exam

Once all activities are completed within the current standards, the participant will be certified for three years.

The Peer Review Course was created to support the Peer Review Process. The Peer Review Process is an ongoing evaluation process that is designed to provide information about the overall quality of incident investigations to an organization. The primary objective of the Peer Review Process is to ensure a continued quality improvement of investigatory practices. To support ODP stakeholders in the implementation of the Peer Review practices, ODP, along with Temple University, has created a Peer Review Course. The course is a 3½ hour, face-to-face training.

To register for the Certified Investigator Peer Review course, users can:

  1. a) Navigate to myODP.org
  2. b) Use the following path: Training > Certified Investigator Program > Peer Review Training and Resources > Register for a scheduled Summer/Fall 2018 CI Peer Review training session

OR

  1. c) Click on the Certified Investigator Peer Review Course Information page link

To register for the Certified Investigator Initial Course:

  1. a) Navigate to myODP.org
  2. b) Use the following path: Training > Certified Investigator Program> Initial Certification Instructions > Register for a scheduled CI training Session

OR

  1. c) Click on the Certified Investigator Initial Certification Course Information page link

For assistance with registration, contact the myODP website Helpdesk by clicking on Website Technical Support.

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The Office of Developmental Programs (ODP) distributed Communication 056-18  to instruct AEs, SCOs, and Providers to review and submit updates to their primary and secondary contact information for the Quality Assessment and Improvement (QA&I) Process.

The ODP QA&I Process is designed to conduct a comprehensive quality management review of county programs, AEs, SCOs, and providers delivering services and supports to individuals with intellectual disabilities and autism spectrum disorders. This QA&I Process is one of the tools that ODP uses to evaluate our current system and identify ways to improve services for all individuals.

The identified contact person(s) is the individual(s) whom the entity has designated to receive specific information related to the QA&I Process. Information shall include any unique electronic links, access to QA&I process specific information, ongoing direction and communication from ODP or the AE regarding the QA&I Process, etc. Please note that the primary identified contacts will be the individual persons receiving the electronic link for completion of the self-assessments. For the AEs conducting provider QA&I onsite reviews, the primary contact will receive the unique links necessary to access the tool for completion of onsite review activities.

Please review the document posted on MyODP and submit any changes by using this link.

ODP QA&I Contact Information Form Changes can be submitted throughout the QA&I year. ODP will post an updated version of the QA&I Contact List spreadsheet at least every 2 weeks.

As a reminder, it is the responsibility of the entity to ensure that this information remains up to date.

INQUIRIES: Please direct any questions, issues, or concerns regarding this communication to your QA&I Regional Coordinator and CC the QA&I Process mailbox.

QA&I Regional Coordinators:      
Central Region Northeast Region Southeast Region Western Region
Robyn Seville Rachel Toman Roger Crisanty Renee Bruno

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The Home and Community-Based Services (HCBS) Settings Provider Self-Assessment period closed June 12, 2018. As of close of business on that date, ODP received more than 6,150 Residential Self-Assessments (Residential Habilitation, Life Sharing and Family Living) and over 550 Non-Residential Self-Assessments (Community Participation Supports and Day Habilitation).

In March 2018, ODP conducted a data extraction to track service locations for the HCBS Provider Self-Assessments. ODP received a significant number of Self-Assessments for service locations opened after ODP developed that list of service locations. During the Self-Assessment period, ODP also received a significant number of notices from providers that service locations were no longer active.

The next steps in the Self-Assessment process are:

  • Over the next two weeks, ODP will be reviewing all corrected service location data submitted by providers to validate active service locations for which no HCBS Provider Self-Assessment was completed.
  • No later than Saturday, June 30, 2018, ODP will communicate directly with providers regarding any active service location for which ODP does not have an HCBS Provider Self-Assessment on file. After ODP has completed this process, service locations for which ODP has not received a completed self-assessment will be deemed non-compliant and will have an on-site inspection scheduled.
  • ODP is reviewing and analyzing the submitted HCBS Provider Self-Assessments. By September 30, 2018, ODP will provide feedback to providers that identify any areas for any service locations that will require a transition plan. ODP will also notify appropriate Administrative Entities of these findings.

For questions related to this communication, please contact PAODPHCBS@pcgus.com or RA-odpcomment@pa.gov.

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ODP has announced the creation and posting of the Administrative Review Process Manual as a tool for Administrative Review Committees, upcoming Q&A sessions, and that a revised version of the Certified Investigation Report (CIR) is now available.

The purpose of the Administrative Review Committee is to ensure that the management of an organization “is responsible for validating the investigation, determining the final conclusions, outcomes, and recommendations for corrective action.” Therefore, all organizations that complete investigations (i.e. Providers, Supports Coordination Organizations [SCOs], etc.) under the ODP Certified Investigator Program, are responsible for having an Administrative Review Committee.

The Administrative Review Committee is an essential part of the final stage of the investigatory process (Stage 4 – Conclusion of the Investigation). Results of the Administrative Review Committee are documented in Section V of the Certified Investigator Report (CIR) titled Administrative Review, Findings, Recommendations, and Implementation.

The items listed below were created to support ODP entities in the completion of the Administrative Review Process.

Administrative Review Manual Revisions:
ODP has revised the Administrative Review Process manual to ensure Administrative Review Committees have clear and consistent direction regarding: who should be a part of the Administrative Review Committee, what functions should be completed by the committee, and where to find the information needed to complete the Administrative Review Form.

Specifically, organizations are responsible for developing and implementing sound, competent investigatory and incident management practices to assure compliance with standards set forth by ODP. The manual will address the following processes associated with investigations:

  1. Assessing the investigation prior to conclusion for errors in managing evidence;
  2. Evaluating the quality of the investigation for speed, objectivity, and thoroughness;
  3. Applying rules used to reconcile conflicting evidence to determine the preponderance of evidence in investigations;
  4. Understanding and applying the terms Confirmed, Inconclusive, and Not Confirmed when concluding a certified investigation;
  5. Determining the necessary corrective actions (preventative and additional) as a result of the conclusions drawn from the certified investigation; and
  6. Guidance for point persons about appropriate placement of information into the Enterprise Incident Management (EIM) system related to the investigation.*

The Admin Review Manual can be found on the MyODP.org website.

All ODP entities should replace older versions of the Administrative Review Manual with the new version. This will ensure that all entities are using consistent practices when completing the Administrative Review Process.

Administrative Review Q&A Sessions:
To provide guidance to ODP Stakeholders regarding completion of the Administrative Review process, and to answer questions that stakeholders may have regarding the new manual, ODP has partnered with Temple University to host Question and Answer (Q&A) Sessions. Attendees have the opportunity to submit questions before the session and also ask questions during the sessions. These Q&A sessions are now posted on MyODP.

Updates to the Certified Investigator Report:
As a result of the development of the Administrative Review Process Manual, there have been slight modifications made to the Certified Investigator Report (CIR) Section V. In Section V, Question #4 was modified, while Question #6b has been added. These changes were made to clarify what the Administrative Review Committee should look for while reviewing the Certified Investigators Report. All versions of the CIR have been changed (i.e. CIR in the Certified Investigator Manual, CIR posted on the myODP website, and the CIR sections reflected in the Administrative Review Manual). The new form can be found via this link.

Questions:
If you have any questions regarding the Administrative Review Process, Q&A sessions, or other information in this manual, please contact Sarah Naughton or Amy Hines.

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OPD Communication Number 052-18 announced that ODP will be initiating the approved FY 17/18 Needs Exception Allowance rates for the period from July 1, 2018 through June 30, 2019 and a provider/individual specific letter will not be issued. This is pertinent to residential providers with existing FY 17/18 Needs Exception Allowance rates, supports coordinators (SC), and administrative entity (AE) staff. It will not be necessary for providers to re-submit a request for the Needs Exception Allowance. Please direct all questions to the Rate Setting Mailbox.

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Dual Diagnosis Professional Conference – Behavioral Manifestations of Physical Pain and Illness

Through the Money Follows the Person Initiative, a free training will be offered on Thursday August 9, 2018, 10:00 am to 3:00 pm at the Child Welfare Resource Center, 403 E Winding Hill Rd, Mechanicsburg, PA 17055.

This facilitated panel session will address the many physical conditions, including pain, which may mimic mental health or behavioral difficulties. Emphasis includes the recognition and appropriate treatment of physical conditions behaviorally manifested prior to individual’s distress and inability to function. During the session, the presenters will help attendees to understand the behavioral

manifestation of physical illness causing distress and impairing function from a whole person perspective, as well as the behavioral manifestation of pain in verbal and non‐verbal individuals with an

intellectual disability and autism. The strategies shared will empower caregivers to advocate for individuals demonstrating behavioral manifestations of physical illness and pain through management tools.

This Dual Diagnosis training presents a collaborative initiative between the Northeastern PA Health Care Quality Unit, the Luzerne Wyoming Counties MHDS/Quality Council, and Geisinger Commonwealth School of Medicine students.

Moderator:
Dr. Sharon Falzone, Director, Advocacy Alliance, Northeastern PA Health Care Quality Unit (HCQU); Clinical Assistant Professor of Medicine, Department of Clinical Services, The Commonwealth Medical College

Panelists:

  • Gina Galli, Administrative Entity and Quality Management Lead, Luzerne‐Wyoming Counties Mental Health and Developmental Services
  • Theresa Schrig, Behavioral Health Coordinator, Northeastern PA Health Care Quality Unit

Registration Fee: There is no registration fee to participate in this event.
Register via this link.
Questions: Email Robin Levine

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The Office of Developmental Programs (ODP) had previously issued Announcement 017-18, indicating that pending approval by the Centers for Medicare and Medicaid Services (CMS), waiver Transportation (Trip) services would be paid on a fee schedule effective July 1, 2018. ODP does not anticipate receiving this approval by July 1, 2018. Therefore, ODP is requesting that providers who deliver discrete Transportation (Trip) services as Provider Type 26 to individuals enrolled in the Consolidated, Person/Family-Directed Support (P/FDS), or Community Living (CL) Waiver programs complete this cost report in order for ODP to develop rates based on the provider’s historical expense data.

If the provider does not complete the cost report by June 17, 2018, ODP will pay the Transportation (Trip) provider the Fiscal Year (FY) 2017/2018 assigned rates. The data in the approved cost reports will be used by ODP in the development of cost-based Transportation (Trip) rates during FY 2018/2019 until ODP receives approval from CMS for the Transportation (Trip) fee schedule.

Completed cost reports should be submitted via email by 11:59 pm on Sunday, June 17, 2018. The posted materials described above can be accessed via this link. Direct all questions to the Rate Setting Mailbox.

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The Office of Developmental Programs (ODP) has announced the availability of two training webinars in June. ODP staff will review changes in the Quality Assessment and Improvement (QA&I) tools and process and expectations for self-assessment, onsite and remediation activities for Cycle 1, Year 2 which begins July 1, 2018.

The webinars will be presented Thursday, June 14 & Thursday, June 21, 2018, 10:00 am – 11:30 am. Please only register for one as the same presentation will be offered on both days. Please register for the training webinar following this link.

INQUIRIES: Please direct any questions, issues or concerns to your QA&I Regional Coordinator and cc the QA&I Process mailbox.

QA&I Regional Coordinators:

Central Region Northeast Region Southeast Region Western Region
Robyn Seville

c-rseville@pa.gov

 Rachel Toman

c-rtoman@pa.gov

 Roger Crisanty

c-rcrisant@pa.gov

 Renee Bruno

c-clbruno@pa.gov

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Last week, Congressman Glenn Grothman (R-WI-06) questioned Secretary of Education Betsy DeVos regarding the Department’s response to Obama-era rules and guidance relating to Competitive Integrated Employment (CIE) during a hearing in the House Committee on Education and the Workforce. You can watch Rep. Grothman’s line of questioning here, and you can read the Congressman’s press release here.

Tell your Representative in Congress to cosponsor HR 5658, The Workplace Choice and Flexibility for Individuals with Disabilities Act. This bill will restore common sense to the definition of competitive integrated employment and provide increased employment opportunities for people with disabilities. People with disabilities across the country have been denied placements in high-paying jobs because of the regulations that implement the Workforce Innovation and Opportunity Act (WIOA). ACCSES supports expanding opportunities and keeping a full array of options available.

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