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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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Department of Human Services (DHS) Secretary Ted Dallas spoke at the RCPA Board of Directors meeting on February 22 regarding Governor Wolf’s proposal to consolidate four state health and human service agencies. If approved by the legislature, the plan would be launched on July 1, 2017.

Although the Secretary referenced approximately $90 million in savings from this process, he also affirmed that this “cannot be just about saving money.” Dallas remarked that time spent dealing with the bureaucracies as currently constructed takes time away from providing services, and so the goal is to eliminate redundancies.

RCPA members brought up key topics such as population health, licensing, and services for persons with co-existing conditions. When asked how this consolidation will affect addressing the opioid crisis, Secretary Dallas responded that the focus would be shifted to treating the whole person, rather than each individual condition.

The meeting concluded with the Secretary requesting ideas for continued efficiencies and how to ultimately better serve members. On the day of the Governor’s announcement, RCPA issued a statement expressing support for the proposal and committing to working with the administration to implement the plan in a smart and cost-effective manner.

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On February 8, the Department of Human Services (DHS) Secretary Ted Dallas announced the availability of onboarding grant funds to help connect hospitals and ambulatory practices to the Authority’s Pennsylvania Patient & Provider Network, or P3N.

The P3N enables electronic health information exchange (eHIE) across the state through the connection of health care providers to health information organizations (HIO), and the participation of the HIOs in the P3N.

“These grants will assist providers in the efficient delivery of quality services to the individuals we serve across the commonwealth,” said DHS Secretary Ted Dallas. “As more providers participate, individuals will experience better coordination of care and a better quality of health care.”

The grant program, available to Pennsylvania HIOs to enable the connection of inpatient hospital/facilities and outpatient practice or other outpatient provider organizations participating in the Medicaid Electronic Health Records (EHR) Incentive Program, includes:

  • Up to $75,000 to connect each eligible inpatient hospital or other inpatient facility to an HIO;
  • Up to $35,000 to connect each eligible outpatient practice or other outpatient provider organization to an HIO; and
  • Up to $5,000 to enable other eligible providers that do not fit into the two categories above, but want to enable HIE participation and connect to an HIO via a portal.

Each eligible provider will connect via an HIO to the P3N.

Only a single award is permitted to any one hospital/facility or outpatient practice. The anticipated performance period for this grant runs through September 30, 2017.

The grant will:

  • Help providers deliver higher quality and more efficient care, particularly through better care coordination for patients covered by Medicaid;
  • Support provider participation in private-sector HIOs by offsetting connection costs;
  • Incentivize HIOs to join the P3N, a precondition for receiving funding;
  • Support rapid movement toward the participation in eHIE, and support various care reform efforts currently underway across the Commonwealth; and
  • Defray up-front costs for individual providers to join an HIO, thus helping to achieve meaningful use and satisfy obligations under the Medicaid EHR Incentive Program.

This program will be made possible through an $8.125 million grant from the federal Centers of Medicare & Medicaid Services (CMS). Under the terms of the federal grant, CMS will provide 90 percent of the onboarding grant, with the remaining 10 percent funded by the Commonwealth. The grant applications and supporting materials are available online here.

(Information courtesy of DHS)

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This just in from the governor’s office:

FOR IMMEDIATE RELEASE
January 30, 2017
View Online 

Governor Wolf Announces Plan to Create Department of Health and Human Services

Seeks to Improve Services and Benefits for Seniors, People with Intellectual and Physical Disabilities, and Those Suffering From Substance Use Disorder

Harrisburg, PA – Today, Governor Wolf announced his plan to create a Department of Health and Human Services (HHS) in his 2017-2018 budget in order to promote more effective collaboration and service delivery, enhance program effectiveness, and eliminate duplicative processes.

“This new department will streamline government and allow the commonwealth to deliver more effective services to seniors, individuals with intellectual and physical disabilities, and those suffering from a substance use disorder as well as promote the health and well-being of all Pennsylvanians,” said Governor Tom Wolf. “Over the past several months, I have worked closely with these four departments to break down silos and reimagine how we deliver critical services that will provide treatment to those suffering from substance use disorder, ensure children are receiving high quality services, and expand community-based opportunities for seniors. The creation of a new, unified Department of Health and Human Services will not result in any program cuts for Pennsylvanians, but will dramatically improve our ability to deliver services that will improve lives. “

The Departments of Aging (PDA), Drug and Alcohol Programs (DDAP), Health (DOH), and Human Services (DHS) have the same core mission: to improve public health and quality of life for all residents of the commonwealth. These four separate state agencies currently serve similar, and sometimes overlapping, populations.

Fighting Opioid Epidemic to Remain a Top Priority for New Integrated Agency
Governor Wolf has led the battle against the opioid and heroin epidemic and each of these agencies has been critical to this effort. Among many other initiatives, DOH launched a prescription drug monitoring program and has been raising awareness of the naloxone standing order, DDAP has led the effort to increase the availability of naloxone and drug take back boxes, DHS has created 45 centers of excellence to coordinate treatment for those suffering from substance use disorders, and PDA has led prescription drug take back efforts among the senior population encouraging proper use, storage, and disposal of unused prescription medications.

By creating an organization that is structurally better able to support and coordinate these efforts, individuals in desperate need of substance use disorder treatment will be able to access services through one agency with an integrated data and delivery system. The new HHS will serve as the single state authority for Medicaid, substance use, and mental health purposes enabling the commonwealth to maximize available federal dollars and offset state costs for staff and services. There will continue to be a cabinet-level position in Governor Wolf’s administration that will be dedicated to battling the opioid and heroin epidemic.

Delivering better services to those suffering from substance use disorder is just one example of the benefits realized through the creation of a new, unified department.

Senior Benefits and Programs Will Be Bolstered By Ease, Focus of Single Agency
Seniors will also have a single agency as their point of contact within state government to receive health and human services. Instead of receiving prescription assistance from PACE through PDA, applying for an aging waiver through DHS while seeking home and community-based services from PDA, finding where to dispose of unwanted or expired prescription drugs through DDAP, or searching for information on the quality of nursing homes through DOH, seniors would find the services they need through the Department of Health and Human Services. Furthermore, the creation of this department will have no impact on how lottery fund monies are used to support senior programs.

Reducing Complexity and Confusion for Seniors and Individuals with Disabilities
Currently, at least 21 separate services across the departments provide care for seniors and individuals with physical disabilities. The creation of the Department of Health and Human Services will eliminate the unnecessary duplication of effort and confusion among consumers and their families. The Wolf Administration is dedicated to continuing to provide the same quality services for seniors and individuals with disabilities and will dramatically improve the delivery of services like health screenings, programs to allow individuals to remain in their homes and communities, adult protective services, and home health care and housing supports, though the creation of this new department.

Reducing Red-Tape for Providers and Non-Profits Subject to Regulation
Currently, providers ranging from hospitals and child care centers to substance use treatment facilities and nursing homes are licensed by multiple agencies, many times for the provision of the exact same services. Requiring these businesses to subject themselves to multiple, duplicative inspections and audits costs them money. By centralizing facility licensure in one agency we will improve coordination, increase transparency, and promote uniformity for the health and human services field. The state and providers will be able to better focus our resources on our mission to improve the health and quality of life for citizens rather than back office functions.

In 2015, the administration transferred the Children’s Health Insurance Program (CHIP) from the Department of Insurance to DHS. Through this consolidation, the administration has increased the number of kids covered by 10 percent, shortened the average processing time for applications from 40 days to only one day, and saved taxpayers $8 million annually. Additionally, this consolidation resulted in an improved customer experience as many families move between the two programs on a regular basis due to income guidelines. In the same way, combining the Supplemental Nutrition Assistance Program (SNAP) and Women, Infants and Children (WIC) program will result in improved outcomes, shortened application timelines and cost savings to taxpayers.

“Responding to the diverse and sometimes complex needs of older Pennsylvanians often requires interaction with multiple state agencies which can be confusing and incredibly frustrating,” said PDA Secretary Osborne. “The opportunity to create a single, unified, Department of Health and Human Services will reduce fragmentation, eliminate silos, promote accountability, and create a culture of shared responsibility that puts Pennsylvanians first.”

“By working together under Governor Wolf’s leadership, this administration has saved lives by expanding access to naloxone, combatted the stigma of the disease of addiction, and has raised awareness of the severity of this crisis. However, our work is not done,” said Department of Drug and Alcohol Acting Secretary Jennifer Smith. “The creation of the Department of Health and Human Services will help us continue this fight in a collaborative, coordinated manner.”

“The health of all Pennsylvanians is first and foremost to the Wolf Administration,” said Secretary of Health Dr. Karen Murphy. “Consolidating state agencies into one new agency while improving services for Pennsylvanians is not only fiscally responsible, but will ensure that we can continue to meet their needs. The Department of Health team looks forward to working with our sister agencies on the consolidation plan to ensure that Pennsylvanians continue to receive needed services.”

“Consolidation puts the focus where it always should be — on the consumer,” said Secretary of Human Services Ted Dallas. “The Governor’s plan to create HHS will result in a more streamlined and cost-effective agency that delivers better services for Pennsylvania.”

The goal of the Department of Health and Human Services will be to deliver services that will improve the health and quality of life for all Pennsylvanians in an efficient, transparent, and uniform manner.

MEDIA CONTACT:    J.J. Abbott, 717.783.1116

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RCPA is pleased to announce that it has recently formed a new division called the Physical Disabilities and Aging Division. This division has been created to support and provide information and networking opportunities to long-term services and support organizations including Personal Assistance Services Providers (PAS) and Service Coordination Entities (SCE) as well as other RCPA agencies/organizations providing services to these populations.

The first quarterly Physical Disabilities and Aging Division meeting will be held on Monday, February 27, 2017, at 10:00 am. This meeting will feature updates regarding Community HealthChoices (CHC) and representatives from all three selected managed care organizations (MCOs) will be in attendance: AmeriHealth Caritas, Pennsylvania Health and Wellness (Centene), and UPMC for You. The Office of Long Term Living (OLTL) has also been invited.

This is an exciting development for RCPA and its members and we look forward to seeing you. Register here for this meeting.

For hotel accommodations, contact the Best Western Premier, 800-780-7234 — be sure to mention RCPA to take advantage of our local negotiated rate at $102.95 plus taxes, including a $10 food voucher per room.

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Governor Wolf announced Tuesday afternoon that Gary Tennis, Secretary of the Department of Drug and Alcohol Programs (DDAP), will no longer hold that position. The governor did not state a reason for Tennis’ departure; RCPA will report any further details as they become available. Deputy Secretary Jen Smith will serve as Acting Secretary. View the governor’s official press release here.

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From: “HS, Secretary’s Office”
Date: January 5, 2017 at 1:01:56 PM EST
To: “DHS-STAKEHOLDERS@LISTSERV.DPW.STATE.PA.US”
Subject: [DHS-STAKEHOLDERS] DHS Awards Medicaid Agreements

Department of Human Services (DHS) Secretary Ted Dallas announced that DHS has agreed to move forward and negotiate agreements with six managed care organizations (MCOs) to deliver physical health services to Pennsylvanians through HealthChoices, Pennsylvania’s mandatory Medicaid managed care program since 1997.

“These agreements will be the most significant changes to Pennsylvania’s Medicaid program since we moved to managed care two decades ago,” said Dallas. “Over the next three years, MCOs will be investing billions of dollars in innovative approaches that reward high-quality care that improves patient health rather than just providing services for a fee.”

The $12 billion, three-year contracts include a 30 percent target for payments based on value received or outcomes, rather than on the quantity of services provided.

The MCOs were selected based on several criteria, including their current performance, the level of customer service delivered, member satisfaction, and their value-based performance plan. Performance criteria measured, among other things, management of chronic conditions such as high blood pressure, diabetes, and asthma; frequency of prenatal and post-partum care; and access to preventive services.

“The average performance ratings of the selected organizations are consistently higher than the current averages in every region. This transition will result in higher levels of quality care for the 2.2 million Pennsylvanians served by Medicaid,” said Dallas.

To drive Pennsylvania’s Medicaid system towards these better outcomes, the three-year agreements set gradual targets for all MCOs to increase the percentage of value-based or outcome-based provider contracts they have with hospitals, doctors, and other providers to 30 percent of the medical funds they receive from DHS. The result will be that billions in funds that would have otherwise been spent on traditional payment arrangements will instead be invested in outcome or value-based options such as:

  • Accountable care organizations (voluntary networks of hospitals, doctors, and other providers that work together to provide coordinated care to patients);
  • Bundled payments (increases value-based purchasing);
  • Patient-centered medical homes; and
  • Other performance-based payments.

“We’re going to reward folks for providing the right services, not just more services. You get what you pay for so we’re shifting the focus of Pennsylvania’s Medicaid system toward paying providers based on the quality, rather than the quantity of care they give patients,” said Dallas. “In addition, by focusing on improving the health of consumers, we will drive down the cost of care and ultimately save the taxpayer funds we spend on health care in Pennsylvania.”

HealthChoices delivers quality medical care and timely access to all appropriate services to 2.2 million children, individuals with disabilities, pregnant women, and low-income Pennsylvanians.

For more information, visit www.HealthChoicesPA.com or www.dhs.pa.gov.

DHS has selected the following MCOs to proceed with negotiations to deliver services in Pennsylvania beginning in June 2017. The agreements are awarded in five geographic regions:

Southeast Region Gateway Health
Health Partners Plans
PA Health and Wellness
UPMC for You
Vista–Keystone First Health Plan
Southwest Region Gateway Health
PA Health and Wellness
UPMC for You
Vista—AmeriHealth Caritas Health Plan
Lehigh/Capital Region Gateway Health
Geisinger Health Plan
Health Partners Plans
PA Health and Wellness
Northeast Region Gateway Health
Geisinger Health Plan
UPMC for You
Northwest Region Gateway Health
UPMC for You
Vista—AmeriHealth Caritas Health Plan

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CESP Exam Logo

Earn the Designation of Certified Employment Support Professionals (CESP™)
by Passing the National CESP™ Examination

Hawley, PA Exam (information/registration links)
Wednesday, February 15, 2017

Wyomissing, PA Exam (information/registration links)
Wednesday, April 19, 2017

WHO SHOULD TAKE THE CESP™ EXAM?

Job Coaches • Job Developers • Transition Employment Specialists • Job Placement Specialists • Employment Specialists/Consultants • Employment Managers and/or Directors

What is CESP™ Certification?

  • CESP™ certification is a national credential for Employment Support Professionals who assist people with disabilities in finding and maintaining regular, community-based employment.
  • The CESP™ credential is earned by passing a comprehensive examination based onnational standardized competencies.
  • CESP™ certification is a complement to program certification and licensing, demonstrating a level of professionalism has been achieved.
  • The CESP™ certification is a national, portable, individual credential that remains valid for three years.

What are the Benefits of EARNING THE CESP™ Credential?

  • CESP™ certification opens the door to: improved professional advancement & job opportunities, increased income opportunities, and enhanced credibility with employers
  • Become a member of a rapidly growing, elite group of professionals:

• Reduced APSE membership fee
• National networking opportunities
• Exclusive access to CESP ™ publications & webinars
• A professional credential — not just a certificate of completion
• CESP™ Meet-ups
• CESP™ LinkedIn Group
• Your name listed on the APSE website
• Recognized as a leader in your field

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From the Department of Human Services:

The Wolf Administration is committed to serving more people in the community whenever possible, and we believe that the work performed by direct care workers (DCWs), including personal attendants and other household aides, enables individuals with disabilities to live a more independent life. We have heard from many people asking for a policy clarification on the types of non-skilled, home care services and activities that DCWs can perform in home- and community-based settings.

Last week, the Wolf Administration issued a policy clarification surrounding the role of DCWs.

The non-skilled activities provided in the consumer’s place of residence or other independent living environment are specialized care, a type of home care service unique to the consumer’s care needs that are exempt from the licensure requirements under the Professional Nursing Law and Practical Nurse Law.

DCWs may perform these non-skilled services/activities, with evidence of competency or training, provided they do not represent or hold themselves out as being licensed nurses, licensed registered nurses, or registered nurses; or use in connection with their names, any designation tending to imply they are licensed to practice nursing.

Individuals with disabilities will have a greater chance of remaining in their homes and community when they are able to receive assistance with long-term supports and services from DCWs. These non-skilled, routine activities/services include:

  • assistance with bowel and bladder routines;
  • assistance with medication;
  • ostomy care;
  • clean intermittent catheterization;
  • assistance with skin care; and
  • wound care.

DHS appreciates the partnership with the departments of Health and State and the collaboration with ADAPT and Disability Rights Pennsylvania in issuing this important policy clarification. Further guidance will be issued as appropriate to ensure successful implementation.

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