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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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On an annual basis, the Bureau of Human Services Licensing (BHSL) provides approximately 500 hours of training for Personal Care Home (PCH) and Assisted Living Residence (ALR) administrators and staff. In order to help maximize the impact of BHSL’s training programs, members are requested to complete a ten question survey. Survey results will be kept anonymous and will be used to shape their training programs in 2023 and beyond.

This survey is intended only for administrators and staff of a licensed PCH/ALR. The survey is optional; however, your participation is strongly encouraged. The survey will be available until February 28, 2023.

Questions should be directed via email.

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The Office of Long-Term Living (OLTL) issued information and clarification on the recent increase to the Personal Care Home (PCH) Supplement for PCH residents currently receiving Supplemental Security Income (SSI) or currently meeting SSI disability and income criteria while applying for SSI.

In August of 2022, the Pennsylvania legislature approved an increase to the PCH Supplement, retroactive to July 1, 2022. The supplement was increased from $439.30 to $639.30 for individuals and from $957.40 to $1357.40 for married couples. The Social Security Administration (SSA) administers both the federal SSI benefit and the PCH supplement. In January 2023, SSA applied the increase and began issuing retroactive payments in lump sums.

As indicated in the Personal Care Home regulations, 55. PA Code Chapter 2600, “If a home agrees to admit a resident eligible for SSI benefits, the home’s charge for actual rent and other services may not exceed the SSI resident’s actual current monthly income reduced by the current personal needs allowance.”

For the purpose of applying the regulations to the PCH Supplement increase, a resident’s actual monthly income should be calculated by including the increased PCH supplement beginning July 1, 2022, and applied as follows:

  • Residents and/or Representative Payees are expected to provide these retroactive payments to the PCH.
  • If a resident was admitted to a PCH between July 1, 2022, and the issuance of the retroactive benefit, the PCH is only entitled to the monthly increase for the months that the resident resided in the PCH.
  • If the resident lived in another PCH prior to admission to their current PCH, the resident and/or representative payee should ensure that the appropriate monthly portions of the retroactive benefit are paid to both the discharging and admitting facilities.
  • Resident-Home Contracts are not required to be updated for the retroactive benefit; however, contracts are required to reflect the actual charges for room, board, and services no later than March 31, 2023.

Questions about the status of individual retroactive and/or monthly SSI and PCH Supplement payments can be addressed by calling SSA at 800-772-1216. Additional questions about the application of the retroactive PCH Supplement increase can be directed via email. For information about applying for SSI and or the PCH Supplement, please contact your local agency.

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The Traumatic Brain Injury (TBI) Advisory Board, established under section 1252 of the Federal Traumatic Brain Injury Act of 1996 (42 U.S.C. § 300d-52), will hold a public meeting on February 3, 2023, from 10:00 am – 3:00 pm. The meeting will be held at the Pennsylvania Training and Technical Assistance Network, 6340 Flank Drive, Harrisburg, PA 17112, in the Cambria Conference Room.

Meeting materials will be sent out before the meeting and will also be available on the TBI Board’s website and at the meeting location. Questions regarding the meeting should be directed to Nicole Johnson.

The Department of Health’s (DOH) Head Injury Program (HIP) strives to ensure that eligible individuals who have a TBI receive high quality rehabilitative services aimed at reducing functional limitations and improving quality of life. The TBI Board assists DOH in understanding and meeting the needs of persons living with TBI and their families. This quarterly meeting provides updates on a variety of topics, including the number of people served by HIP. In addition, meeting participants will discuss budgetary and programmatic issues, community programs relating to traumatic brain injury, and available advocacy opportunities.

For additional information or for persons with a disability who wish to attend the meeting and require an auxiliary aid, service, or other accommodation to do so, contact Nicole Johnson, Division of Community Systems Development and Outreach, (717) 772-2763. For speech and/or hearing-impaired persons, contact V/TT (717) 783-6514 or the Pennsylvania Hamilton Relay Service at (800) 654-5984.

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The Bureau of Human Services Licensing (BHSL) within the Office of Long-Term Living (OLTL) has issued the following guidance on the lifting of regulatory suspensions for Personal Care Homes (PCHs) and Assisted Living Residences (ALRs):

On July 1, 2022, the suspension of various regulatory provisions under the state disaster emergency declaration was extended to October 31, 2022. On November 1, 2022, the remaining regulatory suspensions expired, and the full regulatory requirements of 55. PA Code Chapter 2600 (Personal Care Homes) and 55. PA Code Chapter 2800 (Assisted Living Residences) were reinstated.

While most of these regulatory requirements required compliance beginning immediately on November 1, 2022, certain regulatory suspensions included 90-day grace periods designed to allow facilities to fully comply with the regulations. That 90-day period will come to an end on January 30, 2023. Facilities are expected to be able to demonstrate compliance with these regulations beginning January 31, 2023.

A guidance document for Personal Care Homes and Assisted Living Residences includes a list of all applicable regulations that were suspended under the emergency declaration, the dates and details of the suspensions, and clarification on what providers can expect when compliance is being measured in their facilities.

Please note that compliance with annual training requirements is dependent on the 12-month training year for Direct Care Staff and Administrators, as determined by the licensed entity. Training requirements for training years that ended between January 1, 2022, and December 31, 2022, are required to be in compliance by January 31, 2023. If a training year began in 2022 but does not end until 2023, that training year is incomplete and compliance cannot be measured until after the conclusion of the training year.

Please also note that for administrator training years ending in 2023, all 24 hours of administrator training may be completed online, provided that at least 12 of those hours are formatted as a live training (e.g., Zoom, Teams, etc.). A maximum of 12 hours of online asynchronous or pre-recorded trainings are permitted.

Questions about this announcement and the guidance document can be directed via email.

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The Centers for Medicare and Medicaid Services (CMS) issued a press release announcing an increase in three accountable care initiatives that will grow and provide higher quality care to more than 13.1 million people with Medicare in 2023. The initiatives include:

The Shared Savings Program is the largest accountable care initiative in the country and is a permanent program in Medicare that was established by the Affordable Care Act (ACA). The Shared Savings Program has 456 ACOs and 10.9 million assigned beneficiaries in 2023. While the Shared Savings Program experienced a decrease in the number of ACOs and assigned beneficiaries for 2023, the policies finalized in the calendar year (CY) 2023 Medicare Physician Fee Schedule final rule are expected to grow participation in the program for 2024 and beyond, when many of the new policies are set to go into effect. These policies are expected to drive growth in participation, particularly in rural and underserved areas, promote equity, and advance alignment across the accountable care initiatives, and increase the number of beneficiaries assigned to ACOs participating in the program by up to four million over the next several years.

The ACO REACH Model aims to improve the quality of care for people with Traditional Medicare through better care coordination and by increasing access to accountable care in underserved communities. Innovative features the Model will test include benchmark adjustments to shift payments to better support care for the underserved and enhanced Medicare benefits, including care in the home. In 2023, ACO REACH will increase access to accountable care in underserved populations. The ACO REACH Model will have 824 Federally Qualified Health Centers, Rural Health Centers, and Critical Access Hospitals participating in 2023 — more than twice the number in 2022. Increasing the number and reach of ACOs in underserved communities will help close racial and ethnic disparities that have been identified among people with Traditional Medicare in accountable care relationships.

The KCC Model focuses on coordinating care for Medicare beneficiaries with chronic kidney disease stages 4 and 5 and end-stage renal disease (ESRD). In addition to care coordination, the KCC Model focuses on key areas of concern for this population, including delaying the onset of dialysis and increasing access to kidney transplantation so more patients can live fuller and longer lives.

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The Office of Management and Budget (OMB) has released the Unified Regulatory Agenda and Regulatory Plan, which outlines regulatory actions federal agencies are considering in the coming months. Regulations can be searched by specific agency, such as Department of Health and Human Services (HHS), which includes the Centers for Medicare and Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC), and the Substance Abuse and Mental Health Services Administration (SAMHSA).

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