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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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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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The Office of Long-Term Living (OLTL) implemented Community HealthChoices (CHC) effective January 1, 2018, in the counties identified as the CHC Southwest Region. With the roll-out of CHC, the process for referring individuals for nursing home transition (NHT) has changed for anyone who is enrolled in CHC.

For CHC participants in the following counties, referrals for NHT must be made to the participant’s Managed Care Organization (MCO).  For the purposes of making referrals according to MDS Section Q guidelines, the MCO is to be considered the local contact agency for individuals who are enrolled in CHC. The counties affected as of January 1 are:

  • Allegheny
  • Armstrong
  • Beaver
  • Bedford
  • Blair
  • Butler
  • Cambria
  • Fayette
  • Greene
  • Indiana
  • Lawrence
  • Somerset
  • Washington
  • Westmoreland

Please see contact information for the CHC MCOs below:

For all other questions regarding this notification, please contact the OLTL NHT staff at:

  • Rachel Sink 717-783-7378
  • Brandy Staub 717-783-7219
  • Janel Maple 717-857-3149
  • Mariah Henry 717-772-2542
  • or via email

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The Wolf Administration is committed to serving more people in the community while giving them the opportunity to work, spend more time with their families, and experience an overall better quality of life. Community HealthChoices (CHC) is a new initiative that will increase opportunities for older Pennsylvanians and individuals with physical disabilities to remain in their homes. CHC rolled out in the Southwest region on January 1, 2018.

CHC was developed to: (1) enhance access to and improve coordination of medical care and; (2) create a person-driven, long-term support system in which people have choice, control, and access to a full array of quality services that provide independence, health, and quality of life. Long-term services and supports help eligible individuals to perform daily activities in their homes such as bathing, dressing, preparing meals, and administering medications.

Please see this online document that describes how CHC works in coordination with Medicare.

The document is available in alternate format upon request by contacting the Office of Long-Term Living, Bureau of Policy and Regulatory Management, at 717-857-3280. If you have any questions, please visit the HealthChoices web page or submit comments via email.

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The Office of Long-Term Living issued guidance to Service Coordinators and Direct Service Providers  regarding the reporting of critical incidents for the Southwest Pennsylvania Counties. Please note the two texts below.

FOR SERVICE COORDINATION ENTITIES
This communication is to service coordinators of Office of Long-Term Living (OLTL) participants in the 14 Southwest Community HealthChoices (CHC) counties. Service coordinators are required to submit critical incidents according to OLTL’s critical incident management bulletin; however, OLTL is making a time-limited change in the incident submission process in order to ensure all service coordinators in these 14 Southwest CHC counties receive necessary Enterprise Incident Management (EIM) user IDs for each CHC-MCO.

Do not submit incidents for CHC-MCO participants using your fee-for-service user IDs in EIM. Instead, please work with the CHC-MCOs and submit incidents to them directly until you receive your user IDs that will allow you to submit an incident in EIM which will be directed to the relevant CHC-MCO.

If you have not already received a user ID from UPMC or PA Health and Wellness, please contact them directly to receive more information on how they want you to submit incidents to them in this interim period.

At this time, AmeriHealth Caritas will be utilizing this RA email box for service coordinator submission of critical incidents. If you have questions about this information, please contact OLTL at 717-787-8091.

FOR ALL DIRECT SERVICE PROVIDERS
This communication is to Direct Service Providers of Office of Long-Term Living (OLTL) participants in the 14 Southwest Community HealthChoices (CHC) counties. Direct Service Providers are required to submit critical incidents according to OLTL’s critical incident management bulletin. Currently, providers serving participants in the ‘under-60’ waivers submit incidents into the EIM System, and Aging Waiver Direct Service Providers submit critical incidents into an RA-incident email box.

With the implementation of CHC on January 1, 2018, in 14 Southwest counties, all OLTL Direct Service Providers will now submit critical incidents into EIM for participants enrolled in CHC. Aging Waiver providers will no longer submit critical incidents to an RA email box if the participant is enrolled in CHC.

Please work with the CHC-MCOs to receive training to use the EIM system. Please note: Direct Service Providers will need to select the “search for CHC participants” checkbox when creating incidents in EIM for CHC participants.

Direct Service Providers serving participants that are NOT in the current 14 Southwest CHC counties (listed below), and NOT enrolled in CHC, must continue to submit critical incidents into EIM for the ‘under 60’ waivers, and Aging Waiver providers must continue to submit critical incidents to the RA incident email box until further notice.

CHC counties — Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Somerset, Washington, and Westmoreland. If you have questions about this information, please contact OLTL at 717-787-8091.

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In February 2017, RCPA launched the Physical Disabilities and Aging Division to provide members with information, networking, and opportunities to access Pennsylvania Legislators and Administration. This division advocates for all HCBS services funded by the Office of Long-Term Living (OLTL) and Department of Aging, including service coordination, personal assistance, brain injury, community integration, and employment and vocational services to name a few. It has been a year of significant action and with your support, RCPA is now considered one of the leading associations in the services you provide. Here are some highlights of the past year and why you want to engage even more:

  • The Secretaries of the Department of Human Services and Department of Aging, as well as the Deputy Secretaries from the Office of Long-Term Living and Office of Medical Assistance Programs, presented at the RCPA Conference, providing members the opportunity to get to know the leadership at the state level and to network with them on a one-on-one basis.
  • Quarterly meetings have included leadership from the Community HealthChoices (CHC) Managed Care Organizations (MCOs), with two of them providing in-depth presentations on policies and rollout of this program.
  • RCPA has established monthly meetings with the leadership of OLTL, providing an opportunity to represent our members’ challenges and to advocate for regulatory changes.
  • RCPA facilitated and continues to provide access to trainings to meet the regulations for newly announced OLTL employment services.
  • A new track was added to the annual conference, offering members sessions addressing changes in regulations, nursing home transition, and value-based payments, with the opportunity to earn continuing education credits.
  • RCPA leadership participates in weekly calls with OLTL as CHC is being rolled out to bring forth key issues to be addressed by OLTL and the MCOs.

As we look forward to the year ahead, the need will continue to broaden the horizons of what we share. This begins with the meeting on February 22, 2018, when we will facilitate networking and a focus on aging during lunch. Teresa Osborne, Secretary of the Department of Aging and Rebecca May-Cole, Executive Director of the Association of Area Agencies on Aging (P4A), will present updates and their perspectives on the single largest group served in the Commonwealth. We will also discuss the leadership structure and future meetings of this division.

Your involvement and engagement is vital to meeting the needs you have in these services. We look forward to seeing you at the meeting on February 22. Please Register Here.

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