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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 Department of Human Services (DHS) published a notice in the Pennsylvania Bulletin for November 12, 2022, that announces revisions to the Medical Assistance (MA) fee schedule for the OBRA Waiver and the Act 150 Program: Personal Assistance Services (PAS) (Agency with Choice) and Respite (Agency with Choice).

DHS proposes the following substantive and technical changes to the OBRA Waiver:

  • Add Agency with Choice as a Financial Management Services model for the participant-directed services of PAS and Respite;
  • Revise the Benefits Counseling service definition;
  • Amend the responsibilities of the Fiscal/Employer Agent;
  • Update the Quality Improvement Strategy to the current process;
  • Add a new performance measure for Agency with Choice; and
  • Remove a performance measure that is duplicative.

The proposed OBRA Waiver amendment and a summary of all revisions are available for review on the OLTL Waiver Amendments, Renewals, and Accompanying HCBS Transition Plans web page under Additional Resources.

The following table provides the procedure code and rates for PAS (Agency with Choice):

Region OBRA Waiver
and Act 150		 Procedure Code Modifier Rate Unit
1 X W0164 N/A $4.02 15 minutes
2 X W0164 N/A $3.89 15 minutes
3 X W0164 N/A $4.12 15 minutes
4 X W0164 N/A $4.58 15 minutes

The following table provides the procedure code and rates for Respite (Agency with Choice):

Region OBRA Waiver
and Act 150		 Procedure Code Modifier Rate Unit
1 X W0165 N/A $4 15 minutes
2 X W0165 N/A $3.90 15 minutes
3 X W0165 N/A $4.12 15 minutes
4 X W0165 N/A $4.59 15 minutes

Interested persons are invited to submit written comments regarding these fee schedule rates and the proposed amendment to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: Robyn Kokus, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments can also be sent via email. Use ”OBRA 2023” as the subject line. Comments received within 30 days will be considered in subsequent revisions to the fee schedule or for revisions to the proposed amendment.

The revisions to the fee schedule and the amendment are proposed to take effect April 1, 2023.

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Image by Werner Moser from Pixabay

The Department of Human Services’ (DHS) Office of Long-Term Living (OLTL) published the proposed amendment to the Community HealthChoices (CHC) Waiver in the Pennsylvania Bulletin for November 12, 2022.

DHS and OLTL are proposing to amend the CHC Waiver by adding Agency with Choice as a Financial Management Services (FMS) model for the participant-directed services of Personal Assistance Services (PAS) and Respite. This would modify Service Coordinator and Service Coordinator Supervisor qualifications to align with the CHC Agreement and to amend the service definitions for the following CHC waiver services:

  • Benefits Counseling;
  • Nursing Services;
  • Physical Therapy Services;
  • Occupational Therapy Services; and
  • Speech and Language Therapy Services.

Also proposed is a technical change to the waiver by revising performance measures.

The proposed CHC waiver amendment and summary of all revisions are available for review on the OLTL Waiver Amendments, Renewals, and Accompanying HCBS Transition Plans web page under Additional Resources.

Interested persons are invited to submit written comments regarding the proposed waiver amendment to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: CHC 2023 Waiver Amendment, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments may also be submitted to the Department via email. Use ”CHC 2023 Waiver Amendment” as the subject line. Comments received within 30 days of publication of this notice will be reviewed and considered for revisions to the proposed waiver amendment.

The proposed amendment will be effective April 1, 2023.

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The Pennsylvania Department of Health (DOH) has released a Request for Applications (RFA) for the Long-Term Care Quality Investment Pilot, which will distribute approximately $11.7 million in federal funds to long-term care facilities, including skilled nursing facilities (SNFs), personal care homes (PCHs), assisted living facilities (ALFs), and intermediate care facilities (ICFs) for the purpose of building resilience. These funds are designed to be invested in key areas such as workforce development and retention, infection prevention control, emergency preparedness, and improvements to facility infrastructure.

Please note the following:

  • Facilities must be enrolled in the LTC RISE program’s quality improvement projects in order to be considered eligible for funding.
  • Facilities in Philadelphia are not eligible for this funding.

DOH encourages facilities to apply for this opportunity. The application deadline is 1:30 pm on December 31, 2022. Additional details and information can be found by here.

Questions about this funding opportunity should be addressed by submitting questions through the formal procurement process, which is detailed in the RFA.

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Due to a scheduling conflict with the Office of Long-Term Living (OLTL) participating in RCPA’s Brain Injury Committee meeting on October 26, 2022, OLTL has agreed to provide their update via a separate webcast. The update/webcast has been scheduled for November 16, 2022, at 11:00 am and will be led by Randy Nolen. The topics of discussion include:

  • Clarification of the role of the Service Coordinators and the process providers should use for reporting inaccuracies, etc. Providers are experiencing an increase of SCs telling families and providers that job functions are not their job, including not assisting participants, families/support persons, and providers with issues such as the participant needing a higher or lower level of care.
  • Updates on the next RFP for the CHC-MCOs.
  • Consideration of a bed hold provision and how this could help ease some financial strain for the BI providers. Is this something that can be included in the next RFP for the CHC-MCOs?
  • Possibility and consideration of having a BI Specialist within OLTL and the CHC-MCOs.
  • With only 25% of ARPA funds spent, is there a possibility of applying for more?
  • Status/update on the checklist that was shared in April 2022.
  • Updates on next steps from OLTL regarding CMS’ HCBS quality measure set.

Register to participate in this discussion here. If you have any questions, please contact Melissa Dehoff.

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The Administration for Community Living (ACL) has awarded a five-year grant totaling over $6 million to establish a national center to expand and strengthen the direct care workforce across the country. This initiative will provide technical assistance to states and service providers and facilitate collaboration with stakeholders to improve recruitment, retention, training, and professional development of the direct care workers who provide the critical services that enable people with disabilities and older adults to live in their own homes and communities.

Long-standing workforce shortages have reached crisis levels during the COVID-19 pandemic; today, more than three-quarters of service providers are not accepting new clients and more than half have cut services as a result of the direct care workforce shortage. The high turnover of staff has also meant that individuals who are able to receive services often experience service disruptions and receive inconsistent care. As a result, increasing numbers of people are left with no option but to move to nursing homes and other institutions, people who want to leave these facilities cannot, and the health and safety of those who live in the community are at risk.

The national Direct Care Workforce Capacity Building Center will serve as a hub, providing tools, resources, and training to assist state systems and service providers and to support the development and coordination of policies and programs that contribute to a stable, robust direct care workforce. The center’s website will share resources from the federal government, highlight state and local model policies and best practices that can be replicated or adapted, and share training and technical assistance materials. In addition, the center will facilitate peer-to-peer sharing of lessons learned and promising practices through learning collaboratives and support collaboration between state systems, including Medicaid, aging, disability, and workforce agencies; service providers; and aging, disability, and labor stakeholders. Additional information is available on the ACL website.

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The agenda for the November 2, 2022, Managed Long-Term Services and Supports (MLTSS) Subcommittee has been released. Included on the bottom of the agenda is a link to register to participate in the meeting, as well as a link to connect to the livestream of the meeting. The meeting is scheduled for 10:00 am – 1:00 pm and will be conducted in person (PA Department of Education Honors Suite, 1st floor, at 333 Market St. in Harrisburg). Participants can also join via webinar.

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Photo by Christina @ wocintechchat.com on Unsplash

The Traumatic Brain Injury (TBI) Advisory Board, established under section 1252 of the Federal Traumatic Brain Injury Act of 1996 (42 U.S.C.A. § 300d-52), will hold a public meeting on November 4, 2022, from 10:00 am to 3:30 pm. The meeting will be held at the Giant Food Store, 3301 Trindle Road, Camp Hill, PA 17011, in the large conference room of the community center, located on the 2nd floor.

Meeting materials will be sent out before the meeting, and the agenda will also be available on the 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 Advisory Board assists DOH in understanding and meeting the needs of persons living with TBI and their families. This quarterly meeting will provide 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 new HEADS UP to Sports Officials: Online Concussion Training was developed through a partnership between the Centers for Disease Control and Prevention (CDC) and the National Association of Sports Officials (NASO) to share the latest guidance on concussion safety and prevention. The training provides essential information to help sports officials spot possible concussion signs and symptoms that can help keep athletes safe.

Sports officials will learn how to:

  • Recognize the signs and symptoms of concussion;
  • Determine when athletes should be removed from play due to signs and symptoms of concussion; and
  • Promote a culture of concussion safety.

Illustrated case studies in the training help guide sports officials through practical scenarios they can use in their on-field activities.

Additionally, there are other CDC HEADS UP resources for concussion safety:

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