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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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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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Background
In administering the Office of Long-Term Living (OLTL) Home and Community-Based Services (HCBS) Waivers, OLTL requires service coordinators to monitor that waiver participants receive all HCBS services authorized in their service plans and to develop a backup plan in case a service could not be provided. If a provider is unable to provide an authorized service, the service coordinator must work with the participant to secure another provider to provide the service as specified in the participant’s backup plan. In addition, service coordinators and providers must report critical incidents, including any occurring as a result of the participant’s failure to receive services which placed the participant’s health or safety at risk, in accordance with OLTL’s Critical Incident Management Bulletin.

Policy
With the implementation of Community HealthChoices (CHC), OLTL is adopting a different reporting process for HCBS similar to the process currently implemented in the HealthChoices program. Since CHC-MCOs cover all authorized home health skilled care, home health aide, and personal assistance services, OLTL is expanding the current HealthChoices operations report to identify all missed services for participants who utilize these services.

Providers of CHC-covered home health skilled care, home health aide services, and personal assistance services must submit information on missed services to the CHC-MCOs. CHC-MCOs must submit a missed services operations report to OLTL on a monthly basis that includes detailed information on missed services, such as the date of the missed service, the reason for the missed service, and actions taken to address the missed service in both the short and long term.

In its CHC oversight role, OLTL will review these monthly reports along with complaint and grievance, CHC-MCO inquiry, and EIM data to monitor the health and welfare of CHC participants. Providers who do not submit the required information to the CHC-MCO may face corrective actions.

CHC-MCOs will notify their home health and home care network providers of their reporting requirements. Please direct any questions about these reporting requirements to the CHC-MCOs.

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Ted Dallas, most recently Special Advisor to Governor Wolf and former Secretary of the Department of Human Services (DHS), joined RCPA member NHS, a leading provider of community-based, nonprofit education and human services, as Chief Operating Officer (COO) on March 12.

“Having worked with former Secretary Dallas over the years, we are confident that he will make an outstanding addition to the NHS team,” said RCPA President and CEO Richard Edley. “RCPA wishes Ted much success in his new role and we look forward to working with him and NHS to continue improving services to those living with disabilities in the Commonwealth.”

See the NHS press release here.

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The Office of Long-Term Living (OLTL) is offering webinars on the Center for Assistive and Rehabilitation Technology (CART) Services, the Transitional Living Program, the Assistive Technology Lending Library, the Comprehensive Hiram G. Andrews Center (HGAC) and Commonwealth Technical Institute Training (CTI) Programs.

Please join staff from the HGAC and CTI, who will conduct these webinars.

OLTL Service Coordination Entities, Direct Service Providers and Community HealthChoices providers are strongly encouraged to participate in these webinars. OLTL participants can benefit from these programs.

The webinar on the CART, the Transitional Living Program, and the Assistive Technology Lending Library is scheduled as follows:
March 8, 2018, from 10:00 a.m. until 11:30 a.m.
Please register at:
https://attendee.gotowebinar.com/register/8473324076214041346

The webinar on the HGAC and CTI is scheduled as follows:
March 8, 2018, from 1:00 p.m. until 2:30 p.m.
Please register at:
https://attendee.gotowebinar.com/register/6257804847710581762

After registering, you will receive a confirmation email containing information about joining the webinars.

If you have questions regarding this email please contact Edward M. Butler, OLTL, and 717-214-3718 or edbutler@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.

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