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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.

The Office of Long-Term Living (OLTL) has announced that the Centers for Medicare and Medicaid Services (CMS) has approved the renewal of the OBRA Waiver for 2021. The waiver had no substantive changes and will become effective on July 1, 2021. The OBRA renewal will be posted to the OBRA web page by July 1, 2021. Questions about this renewal should be directed to the OLTL Bureau of Policy Development and Communications Management at (717) 857-3280.

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The Centers for Medicare and Medicaid Services (CMS) released their quarterly question and answer (Q&A) document on completing the inpatient rehabilitation facility patient assessment instrument (IRF-PAI). This document includes all prior Q&A documents as well as new clarification and guidance. CMS developed the guidance based on questions that have been received through the Quality Reporting Program (QRP) Help Desk.

The next Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting will be held on Wednesday, July 7, 2021, as a webinar with remote streaming from 10:00 am–1:00 pm.

To register for this webinar, please visit the webinar registration link. The dial-in number is: (914) 614-3221; Access Code: 716-025-613. After registering, you will receive a confirmation email containing information about joining the webinar. Remote captioning and streaming services will be provided. If you require these services, please visit this remote captioning and streaming services link.

A Financial Management Services (FMS) Stakeholder meeting has been scheduled for Monday, June 28, 2021, from 11:00 am – 12:30 pm. This purpose of this public meeting is to discuss the upcoming changes for the administration of FMS under the Community HealthChoices (CHC), OBRA Waiver, and Act 150 programs. There will be representatives from OLTL and the CHC Managed Care Organizations (MCOs) in attendance to discuss the upcoming changes.

To participate, please select one of the following options:

Join from the meeting link
https://pa-hhs.webex.com/pa-hhs/j.php?MTID=m15e2e495a802f00df6fa38c9e645237d

Join by meeting number
Meeting number (access code): 132 280 2499
Meeting password: Stakeholder

Tap to join from a mobile device (attendees only)
+1-408-418-9388,,1322802499## United States Toll
+1-202-860-2110,,1322802499## United States Toll (Washington D.C.)

Join by phone
+1-408-418-9388 United States Toll
+1-202-860-2110 United States Toll (Washington D.C.)
Global call-in numbers

Join from a video system or application
Dial 1322802499@pa-hhs.webex.com
You can also dial 173.243.2.68 and enter your meeting number.

Questions about the meeting should be directed to this email.

The Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting was held on Wednesday, June 2, 2021. The primary agenda topics at the meeting included a summary of the follow-up from the COVID-19 listening session feedback, which was presented by Deputy Secretary of the Office of Long-Term Living (OLTL) Jamie Buchenauer, and the 2020 Home and Community-Based Services (HCBS) Consumer Assessment of Healthcare Providers and Systems (CAHPS) Areas for Improvement Plans from the three Community HealthChoices (CHC) Managed Care Organizations (MCOs). The following handouts were shared during the meeting:

The next MLTSS Subcommittee meeting is scheduled for Wednesday, July 7, 2021.

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The PA BI Coalition has organized a 30 minute educational webinar for the entire State House and Senate with the help of the PA BI Caucus in Harrisburg. PLEASE take 5 minutes to call your legislator today and tell them to attend! Here are the high points they should expect:

  • Who is the Coalition and Caucus
  • Past accomplishments by these two groups
  • What is a brain injury
  • Unique crisis of brain injury and opioids & COVID
  • PA programs serving people with ABI (TBI, stroke, tumor)
  • Resources for your constituents

On May 29, 2020, Governor Wolf signed Act 24 of 2020, which allocated funding from the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act to assist providers with COVID-19-related costs that were incurred between March 1, 2020 and November 30, 2020.  Providers that accepted Act 24 funding agreed to provide documentation to the Department of Human Services (DHS) and were required to submit an Act 24 cost report through a web-based portal between December 9, 2020 and April 30, 2021.

The Office of Long-Term Living (OLTL) is urging providers to take the following actions:

  • Review the List of Providers — OLTL has compiled a list of providers that received Act 24 funding but for whom there is no record of submission of a cost report or the return of funds. If your organization is on this list, OLTL is encouraging you to complete an Act 24 cost report and submit it to OLTL no later than Friday, June 11, 2021. There are a number of RCPA members on this list. The applicable cost reports can be accessed here. If you believe that your organization submitted an Act 24 cost report, forward a screenshot of your submission to OLTL.
  • Return Unused Funding — Providers that prefer not to complete and submit a cost report can return their Act 24 funding to OLTL by sending a check with a cover letter to OLTL indicating the check is for the return of CARES Act 24 funding they did not utilize. Checks should be made payable to the Pennsylvania Department of Human Services and sent to the Office of Long-Term Living, P.O Box 8025, Harrisburg, PA 17105-8025, Attn: Daniel Sharar.  Providers should include their EIN on the memo line of the check to ensure refunds are traceable to the correct provider.

DHS knows how important this funding has been to providers to cover COVID-19-related costs such as labor, Personal Protective Equipment (PPE), and testing supply costs and is encouraging providers to submit their cost reports by the June 11, 2021 deadline. DHS is obligated to report how these funds were used to the Pennsylvania legislature and return all unused funds to the U.S. Department of the Treasury. Providers that fail to submit a cost report or return their funding by the established deadline will be deemed by DHS to have no COVID-related expenses; DHS will proceed to recoup the Act 24 funding that was distributed to these providers. Questions and concerns can be directed to OLTL.

On May 19, 2021, the Senate Finance Committee conducted a hearing, “COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned,” that focused on how the flexibilities granted during the pandemic have been beneficial to patients and assisted providers in responding to the public health emergency (PHE). The hearing also discussed the potential for permanent policy changes after the pandemic and focused heavily on the support of telehealth.

Photo by Markus Winkler on Unsplash

The Department of Human Services (DHS) issued an update regarding the implementation of an Enterprise Case Management (ECM) system to support the administration and management of various DHS-supervised programs.

A primary goal of ECM is to provide a complete picture of the DHS services provided to participants and families through multiple DHS program offices, regardless of the human services program or county providing the service. ECM will be implemented on a common technology platform that will be configured for various case management system needs across DHS programs. ECM will provide DHS staff and business partners with the tools needed to effectively serve participants by eliminating redundancies, lessening administrative burden, and streamlining core processes. ECM will mostly affect the Offices of Administration (OA), Children, Youth and Families (OCYF), Child Development and Early Learning (OCDEL), Mental Health and Substance Abuse Services (OMHSAS), Long-Term Living (OLTL), and Developmental Programs (ODP). When implemented, ECM will support a statewide child welfare case management system; enrollment and case management for Home and Community-Based Services (HCBS); intake and management for hearings and appeals; and application, enrollment, and support services for programs administered by OLTL. ECM will replace several legacy systems across program offices through the implementation of one common solution, composed of the following four major subsystems:

  • Home and Community-Based Services Subsystem (HCBSS): The HCBSS will replace what is currently known as the Home & Community Services Information System (HCSIS). It will serve as the enrollment and case management system for the DHS program offices, counties, and providers supporting the HCBS programs, including Medicaid waivers.
  • Hearings and Appeals: The Hearings & Appeals subsystem will replace the collection of legacy systems DHS uses to manage appeals under the jurisdiction of the Bureau of Hearings and Appeals (BHA).
  • Office of Long-Term Living Enrollment Services: The OLTL Enrollment Services subsystem will be used by an Enrollment Services Entity and DHS to manage the process to assist individuals/participants in exploring and applying for Long-Term Services and Supports (LTSS).
  • Child Welfare Case Management (CW CM): The CW CM subsystem will create a single, statewide Child Welfare Case Management System for all Pennsylvania Counties.

The ECM At a Glance document contains a high-level overview of DHS’ ECM initiative, positive impacts to participants, goals and objectives, scope and interfaces, and the anticipated timelines for subsystem implementations.

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The rate of emergency departments (ED) visits for bicycle-related traumatic brain injuries (TBI) and concussions decreased by almost half (49%) among children, but only by 6% among adults between 2009 and 2018 according to a new report in CDC’s Morbidity and Mortality Weekly Report.

Key findings from the report, “Emergency Department Visits Due to Bicycle-Related Traumatic Brain Injuries Among Children and Adults — United States, 2009-2018,” also show that:

  • There were more than half a million estimated ED visits for bicycle-related TBI in the U.S. during the study period.
  • The rate of ED visits for bicycle-related TBI decreased by almost half (49%) among children age 17 and under, and by only 6% among adults during the study period.
  • Among all age groups examined, ED visits for bicycle-related TBIs were highest for children ages 10-14 years.
  • The rate of bicycle-related TBI ED visits among males of all ages was three times greater than among females.

Bicycling is a great physical activity and is growing in popularity among Americans. Findings in this report highlight the need to expand effective bicycle safety interventions such as improving compliance to traffic laws, helmet use and bicycling infrastructure. These can help children and adults enjoy the benefits of bicycling and stay safe from injury, including TBIs.

Additional Information: