Richard Edley
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.
Nursing Home Transition Process Change for CHC Counties Only
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:
- AmeriHealth Caritas – Provider: 1-800-521-6007
- PA Health & Wellness (PHW) – Provider: 1-844-626-6813
- UPMC – Provider: 1-844-860-9303
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
Community HealthChoices Coordination of Services with Medicare
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.
OLTL Issues Guidance About Critical Incident Reporting in CHC Counties
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.
Physical Disabilities and Aging Division First Anniversary & Feb Meeting
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.
CESP Exam Preparation Webinar Available
Community HealthChoices Guidance on Service Plans and Service Authorizations
Today the Office of Long-Term Living (OLTL) issued guidance to service coordinators providing services to waiver participants residing in the Community HealthChoices (CHC) Southwest Zone (Zone 1) in their caseloads. The information was copied to providers of waiver services in Zone 1 as well.
The frequently asked questions includes the following statement: The current Service Authorization Form (SAF) that is in place remains effective through the continuity of care period.
OLTL has made available SCE update and resource documents regarding continuity of care, and HCSIS and SAMS service plan updates, for waiver participants in the Southwest Zone who are transitioning to CHC on January 1, 2018.
The following information is available:
- Letters describing actions that SCs can take to address service plan changes in HCSIS and SAMS.
- Flow-charts that illustrate the HCSIS or SAMS service plan changes.
- An EVS resource
OLTL notes that participants residing in Zones 2 through 5 enrolled in any other waiver (Attendant Care, Independence, or OBRA) will not have enrollments, services, or plans automatically end-dated at this time.
If you have any questions, or to request the attachments in alternate format, please call the OLTL Participant Helpline at 800-757-5042 or send an email.
RCPA Welcomes Carol Ferenz as New IDD Division Director
It is our great pleasure to announce that Carol Ferenz has accepted the position of Director of the Intellectual and Developmental Disabilities (IDD) Division of RCPA. Carol comes to RCPA with 36 years of experience providing services and supports to individuals with special needs and their families. This came through several positions at The ARC of Cumberland/Perry Counties (CPARC), where she served as the Director of Residential Services since 1986. Carol oversaw a great expansion of services in this area and has a solid understanding of the system and regulations.
Most recently, Carol served as one of the RCPA provider representatives on the Office of Developmental Programs (ODP) work group to revise the Chapter 51 regs and create the newly proposed 6100 regs. She has also served on the RCPA Annual Conference Committee since 2015.
Carol is a committed and dedicated individual and has done a great deal of volunteer work in her community. We look forward to her work and leadership at RCPA and within the IDD Division. She will begin on January 02, 2018. Please join us in welcoming her!
Pennsylvania Link to Community Care
The Wolf Administration has launched the Pennsylvania Link to Community Care website, which connects older Pennsylvanians and individuals with a disability or behavioral health need to services and supports available in their community.
The website provides users with a wide variety of resources, including a home care directory and an information referral tool. It is a collaboration of the departments of Aging (PDA) and Human Services (DHS), and is an extension of PDA’s Aging and Disability Resource call center. By providing assistance online, the initiative further enhances the Commonwealth’s efforts to help Pennsylvanians locate and best utilize services at the local level.
The site features 12 service and support categories: Advocacy, Behavioral Health, Employment, Finance, Health Care, Housing, In-Home Services, Legal, Meals, Protection from Abuse, Support Groups, and Transportation.
Users can find information about organizations, services, and programs within these categories. A major component to the site is the home care directory, which connects individuals to in-home services available in their counties. In-home service providers appearing on the searchable directory may offer personal care, assistance with activities of daily living, companionship services, respite care, and/or habilitation services.
If you are an in-home service provider licensed by the Pennsylvania Department of Health, and would like to appear on the home care directory, you may submit your information by navigating to the footer of the site and selecting “Apply.”
In addition to the home care directory, another major feature of the website is the information referral tool. This tool guides users through a series of questions and then provides a list of resources based on their specific needs.
Moving forward, the departments of Aging and Human Services will continue to enhance the website using data and feedback from users, and expand the resources and information provided through the site. This includes working with your organization and other stakeholders to increase the number of options appearing within each category. Read the press release here.
RCPA’s Melissa Dehoff Elected TBI Advisory Board Chair
Congratulations to RCPA Director of Rehabilitation Services, Melissa Dehoff, for being elected Chair of the TBI Advisory Board! Also, RCPA congratulates member Bridget Lowery, of Main Line Rehabilitation Associates, for being chosen as Vice Chair of the advisory board!
Prev