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Authors Posts by Richard Edley

Richard Edley

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Dr. Richard Edley is the lead executive for RCPA and is responsible for all aspects of operations and direction for the association. His professional career began in 1988 and most recently he was president and CEO of PerformCare/Community Behavioral HealthCare Network of Pennsylvania, Inc., a national, full-service, behavioral health managed care organization.

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To:  Service Coordinators (SC) who serve participants in the Southeast Region
Subject:  SC Training Materials:  Community HealthChoices (CHC) Implementation for Participant-Directed Services

Below are materials from the August 21, 2018 SC training, CHC Implementation and Participant-Directed Services. The purpose of this presentation was to provide information and process updates to SCs on the implementation of CHC for participants who utilize participant-directed services in the Southeast Region, including Bucks, Chester, Delaware, Montgomery, and Philadelphia counties.

Public Partnerships LLC (PPL) will also complete the following items to assist SCs:

  • Update the PPL Service Coordination Entity (SCE) Training Manual, post it to the PPL website and send it out via the PPL Enrollment Managers.
  • Re-record the training (to eliminate the end-of-presentation Q&A issues) and post it to the PPL website. PPL will notify SCEs that the training is posted to the website when PPL sends out the SCE Training Manual.
  • If PPL receives input from SCEs via the Enrollment Managers, PPL will review comments with the Office of Long-Term Living and CHC Managed Care Organizations to determine a follow-up format for an FAQ document, as applicable. If PPL does create an FAQ, PPL will similarly distribute through the Enrollment Managers and post to the PPL website.

If you have any questions, please contact your PPL Regional Enrollment Manager.

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The Office of Long-Term Living (OLTL) is pleased to announce that Public Partnerships, LLC, has been selected as the new statewide Vendor Fiscal/Employer Agent (VF/EA) for Financial Management Services (FMS) for OLTL-administered programs. The VF/EA performs fiscal-related functions for the successful operation of participant direction for multiple home and community-based waivers managed by OLTL. FMS reduce the employer-related burden for participants while making sure Medicaid and Commonwealth funds used to pay for services and supports are managed and disbursed appropriately as authorized. The new contract will begin on October 1, 2018.

If you have any questions regarding this email, please contact the OLTL provider helpline at 1-800-932-0939.

A listserv has been established for ongoing updates on the CHC program. It is titled OLTL-COMMUNITY-HEALTHCHOICES, please visit the ListServ Archives page at http://listserv.dpw.state.pa.us to update or register your email address.

Please share this email with other members of your organization as appropriate. Also, it is imperative that you notify the Office of Long-Term Living for changes that would affect your provider file, such as addresses and telephone numbers. Mail to/pay to addresses, email addresses, and phone numbers may be updated electronically through ePEAP, which can be accessed through the PROMISe™ provider portal. For any other provider file changes please notify the Bureau of Quality and Provider Management Enrollment and Certification Section at 1-800-932-0939 Option #1.

To ensure you receive email communications distributed from the Office of Long-Term Living, please visit the ListServ Archives page at http://listserv.dpw.state.pa.us to update or register your email address.

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

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(From OLTL)

EVV Implementation Update

The 21st Century Cures Act requires implementation of electronic visit verification (EVV) by January 1, 2019 for personal care services (PCS).  On July 30, 2018, the President signed a law delaying penalties for implementation to January 1, 2020 for PCS.  The requirement for implementation of EVV for home health services by January 1, 2023 has not changed.

This delay will allow Pennsylvania an opportunity to extend implementation activities and training, to make sure that providers are fully ready for the implementation of EVV.  The tentative plan for Pennsylvania’s implementation of EVV is:

  • January 2019 – PA guidance will be distributed
  • Spring 2019 – provider training will be offered with phased-in system use
  • Summer 2019 – full implementation of system

As shared previously, we will utilize an open system for EVV.  This means that providers who already have an EVV system will be able to submit information to the state’s EVV vendor.  The Department of Human Services is using the existing PROMISe™ fiscal agent contract with DXC for EVV.

Providers who do not have their own EVV will be able to utilize the Department’s system for compliance.

For Office of Long-Term Living waivers, including Agency and Participant-Directed Services, PCS includes:

  • Personal Assistance Services
  • Respite (unlicensed settings only)

Additional information will be shared when it becomes available.  You may also look for information on our website at http://dhs.pa.gov/provider/billinginformation/electronicvisitverification/index.htm.  For further questions regarding EVV, please email RA-PWEVVNotice@pa.gov.

A listserv has been established for ongoing updates on the CHC program. It is titled OLTL-COMMUNITY-HEALTHCHOICES, please visit the ListServ Archives page at http://listserv.dpw.state.pa.us to update or register your email address.

Please share this email with other members of your organization as appropriate. Also, it is imperative that you notify the Office of Long-Term Living for changes that would affect your provider file, such as addresses and telephone numbers. Mail to/pay to addresses, email addresses, and phone numbers may be updated electronically through ePEAP, which can be accessed through the PROMISe™ provider portal. For any other provider file changes please notify the Bureau of Quality and Provider Management Enrollment and Certification Section at 1-800-932-0939 Option #1.

To ensure you receive email communications distributed from the Office of Long-Term Living, please visit the ListServ Archives page at http://listserv.dpw.state.pa.us to update or register your email address.

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

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Nancy Thaler, Deputy Secretary of the Office of Developmental Programs (ODP), has announced her retirement effective August 31, 2018. Secretary Thaler has served as the Deputy Secretary since June 2015. Previously, Thaler was Executive Director of the National Association of State Directors of Developmental Disabilities Services. She also previously served as the Director of Quality Improvement for the Center for Medicare and Medicaid Services (CMS). Deputy Thaler served the Commonwealth in the Department of Public Welfare (now DHS) from 1986 to 2003, first as Director of the Bureau of Community Programs, then as Deputy Secretary for the Office of Developmental Programs. During her tenure as Deputy Secretary, she advanced the philosophy of “Everyday Lives,” confirming the right of people with disabilities to live an everyday life; a life that is no different from that of all other citizens. Secretary Thaler has always demonstrated the utmost respect for people with disabilities, promoted full inclusion in the community, and has been referred to as a “champion for individuals with disabilities in Pennsylvania.”

Kristin Ahrens, Director, Bureau of Policy and Quality Management will serve in the role of Acting Deputy Secretary upon Secretary Thaler’s retirement. Ahrens has served in her current position since July of 2016. She has been instrumental in developing the ODP waivers and has been responsible for policy development, training, quality, and communications for the past two years. Prior to her appointment at ODP she served as the Policy Director at Temple University, where she was responsible for directing all policy-related activities for the institute, including policy analysis; training and technical assistance to staff, community groups, and policymakers; and creating and/or disseminating briefs on local, state, and federal policy issues that affect people with disabilities and families. Ahrens also provided consultation to ODP on fiscal policy and the HCBS settings rule, served on the Adult Protective Services Coalition, Disability Budget Coalition, DHS Regulatory Revision Work Group, and Association for University Centers Legislative Affairs Committee. She also has experience in Person-Driven Services, including her work at Self Determination Resources (SDRI) for six years, where she was instrumental in the growth of SDRI from a pilot project to a fully operational model brokerage which was replicated statewide. In addition, Ms. Ahrens served as a consultant on the Substance Abuse and Mental Health Services Administration (SAMHSA) Transformation Transfer Initiative for building sustainable self-directed services in PA’s mental health system.

We wish Deputy Secretary Thaler well in her retirement and look forward to continuing collaborative work with Kristin Ahrens in her new role at the Office of Developmental Programs.

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Announcement: Vice President of Ambulatory and Community Behavioral Health Services

RCPA congratulates Noreen Fredrick, DNP, RN, on her new position as Vice President of Ambulatory and Community Behavioral Health Services for the Western Psychiatric Institute & Clinic (WPIC) of UPMC. Ms. Fredrick is currently serving as Secretary for the RCPA Board of Directors. We wish her much success in her new role at UPMC. Below is a letter from the president of WPIC:

Dear Colleagues,

It is my pleasure to announce that effective July 1, 2018 Noreen Fredrick, DNP, RN has taken on a broader leadership role as the Vice President of Ambulatory and Community Behavioral Health Services. In this capacity, Noreen will oversee the operations and financial performance of all WPIC’s outpatient programs, our expanding  community based behavioral health network and physician services within UPP’s Department of Psychiatry and UPMC Behavioral Health Care. In this capacity she will report to me and Dr. Ken Nash, the Chief of Clinical Services and Vice Chair of the Department of Psychiatry.

Noreen began her career in behavioral health as a staff nurse at WPIC and worked at the bedside for 6 years before her accepting her first leadership position as an assistant nursing clinical manager.  Over a period of 13 years, she was promoted into various inpatient nursing leadership positions in such areas as Adult/Geriatrics and Schizophrenia before becoming the Program Administrator of WPIC’s Comprehensive Care Services. In July 2001, Noreen transitioned to Mon Yough Community Services and accepted a position as the Director of Clinical Services and eventually served as the Executive Director of Mon Yough for 11 years before becoming the Senior Executive Director for WPIC’s Community  Behavioral Health Network in May 2015.

Noreen will be charged with regionalizing outpatient behavioral care in Western PA and creating synergistic partnerships between our programs and other community based services. Her initial areas of focus include: 1) completing the conversion to EPIC and EPICARE; 2) improving access to and growing our ambulatory services throughout the region; and 3) reducing unnecessary variation across our ambulatory programs in order to: increase efficiency; improve patient and consumer experience; improve productivity and elevate the quality of care we provide.

Her rich history and understanding of Western Psych and its academic excellence; in-depth clinical  knowledge of behavioral health; and years of experience of managing people and running a complicated community based organization have positioned Noreen to hit the ground running and add tremendous value in this new, critically important role. Please join me and Dr. Nash in congratulating Noreen on her new position.

Christopher A. Gessner
President
Children’s Hospital of Pittsburgh of UPMC
Western Psychiatric Institute & Clinic of UPMC
4401 Penn Avenue
Pittsburgh, PA 15224

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Community HealthChoices (CHC) is coming in January 2019 to Bucks, Chester, Delaware, Montgomery, and Philadelphia counties.

Here is what you need to know:

  • Find CHC information online for providers or participants. The website will be updated as events are scheduled, so check back often.
  • Click here to take our online trainings and read CHC fact sheets.
  • Contact a CHC managed care organization (CHC-MCO) to become part of their provider network:
    • Keystone First Community HealthChoices
      Phone: 1-800-521-6007 // Email
    • Pennsylvania Health & Wellness
      Phone: 1-844-626-6813 // Email
    • UPMC Community HealthChoices
      Phone: 1-844-860-9303 // Email
  • Sign up and encourage your peers to subscribe to CHC emails here. By signing up, you will receive regular communications regarding CHC distributed from the Office of Long-Term Living.

Here’s a schedule of what’s coming up:

Late Spring/Early Summer 2018

Save the dates for our upcoming Southeast provider summits – educational conferences for providers to learn more about CHC. More information regarding time and location coming soon!

  • Philadelphia: June 4–8
  • Chester County: June 18
  • Delaware County: June 19
  • Montgomery County: June 20
  • Bucks County: June 21

Summer 2018

An introductory flyer will be sent to participants identified within the CHC population.

Fall 2018

  • Notices and enrollment packets will be mailed to participants.
  • Information on the LIFE Program will be sent to potentially eligible participants.
  • Informational sessions will be held for participants to learn about CHC and how to select a CHC-MCO.
  • For a full look at the CHC implementation timeline, use this link.
  • To learn the differences between CHC vs HealthChoices, use this link.

If you have any questions, please contact the Office of Long-Term Living’s provider line at 1-800-932-0939 or visit the HealthChoices website.

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Licensing, Certification, and Incident Management Conducted by the Departments of Human Services, Health, Drug and Alcohol Programs, and Aging

The Departments of Human Services, Health, Drug and Alcohol Programs, and Aging regulate a variety of health and human services providers in order to protect the health and safety of Pennsylvanians. Among the regulatory activities, they license or certify providers and conduct incident management, as required by state and federal law. The departments are currently reexamining processes to identify opportunities for coordinating efforts in order to streamline the licensing, certification, and incident management process and increase efficiencies for providers and the commonwealth, while maintaining and enhancing the quality of licensing and certification activities of the providers they regulate. As part of this process, they are seeking input from stakeholders of the Departments of Human Services, Health, Drug and Alcohol Programs, and/or Aging on the following questions. These questions are focused on providers, but feedback is welcome from advocates and other stakeholders. Please send responses via email by Monday, April 30, 2018.

  1. Which of the following commonwealth agencies do you interact with for licensing and certification: the Departments of Human Services, Health, Drug and Alcohol Programs, and/or Aging? Please identify the specific license or certificate types you have.
  2. Which of the following commonwealth agencies do you interact with when you must report an incident that took place at your facility/agency: the Departments of Human Services, Health, Drug and Alcohol Programs, and/or Aging? This could include incidents required to be reported per licensing regulations, or home and community based (waiver) programs.
  3. What works well in interacting with multiple commonwealth agencies on licensing, certification, and incident management activities?
  4. What challenges do you experience in interacting with multiple commonwealth agencies on licensing, certification, and incident management activities? If possible, please identify whether the challenges are caused by statutory or regulatory requirements, policy or operational guidance, or agency processes or technology.
  5. What opportunities do you see for the commonwealth to streamline your experience interacting with multiple commonwealth agencies on licensing, certification, and incident management activities?

This is a major opportunity that can’t be missed. The work being done by the departments is what RCPA and its members have been advocating for over many years. We currently have an administration willing and able to make significant changes. Members are asked to provide as much detail as possible in your responses.

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On January 24, the Office of Long-Term Living (OLTL) sent an email to Community HealthChoices (CHC) providers stating “All OLTL Direct Service Providers will now submit critical incidents into EIM for participants enrolled in CHC.” Pennsylvania Health and Wellness is offering two webinars on March 28 to train providers on using the system.

The webinar will cover:

  • Critical Incident Reporting Requirements
  • Definition of Critical Incidents
  • How to obtain access to EIM
  • EIM System Training

10:00 am – 11:30 am session – Click here to register
1:00 pm – 2:30 pm session – Click here to register

If an agency has previously attended this training provided by UPMC or AmeriHealth Caritas, it is not necessary to attend this session.

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