The 2023 Pennsylvania Government Relations Power 100: RCPA Members UPMC and Woods Services Listed
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TBI Advisory Board Meeting Planned for February 3, 2023
The Traumatic Brain Injury (TBI) Advisory Board, established under section 1252 of the Federal Traumatic Brain Injury Act of 1996 (42 U.S.C. § 300d-52), will hold a public meeting on February 3, 2023, from 10:00 am – 3:00 pm. The meeting will be held at the Pennsylvania Training and Technical Assistance Network, 6340 Flank Drive, Harrisburg, PA 17112, in the Cambria Conference Room.
Meeting materials will be sent out before the meeting and will also be available on the TBI Board’s website and at the meeting location. Questions regarding the meeting should be directed to Nicole Johnson.
The Department of Health’s (DOH) Head Injury Program (HIP) strives to ensure that eligible individuals who have a TBI receive high quality rehabilitative services aimed at reducing functional limitations and improving quality of life. The TBI Board assists DOH in understanding and meeting the needs of persons living with TBI and their families. This quarterly meeting provides updates on a variety of topics, including the number of people served by HIP. In addition, meeting participants will discuss budgetary and programmatic issues, community programs relating to traumatic brain injury, and available advocacy opportunities.
For additional information or for persons with a disability who wish to attend the meeting and require an auxiliary aid, service, or other accommodation to do so, contact Nicole Johnson, Division of Community Systems Development and Outreach, (717) 772-2763. For speech and/or hearing-impaired persons, contact V/TT (717) 783-6514 or the Pennsylvania Hamilton Relay Service at (800) 654-5984.
RCPA IDD Committee Meeting Materials
Guidance Issued for Lifting of Regulatory Suspensions for PCH & ALRs
The Bureau of Human Services Licensing (BHSL) within the Office of Long-Term Living (OLTL) has issued the following guidance on the lifting of regulatory suspensions for Personal Care Homes (PCHs) and Assisted Living Residences (ALRs):
On July 1, 2022, the suspension of various regulatory provisions under the state disaster emergency declaration was extended to October 31, 2022. On November 1, 2022, the remaining regulatory suspensions expired, and the full regulatory requirements of 55. PA Code Chapter 2600 (Personal Care Homes) and 55. PA Code Chapter 2800 (Assisted Living Residences) were reinstated.
While most of these regulatory requirements required compliance beginning immediately on November 1, 2022, certain regulatory suspensions included 90-day grace periods designed to allow facilities to fully comply with the regulations. That 90-day period will come to an end on January 30, 2023. Facilities are expected to be able to demonstrate compliance with these regulations beginning January 31, 2023.
A guidance document for Personal Care Homes and Assisted Living Residences includes a list of all applicable regulations that were suspended under the emergency declaration, the dates and details of the suspensions, and clarification on what providers can expect when compliance is being measured in their facilities.
Please note that compliance with annual training requirements is dependent on the 12-month training year for Direct Care Staff and Administrators, as determined by the licensed entity. Training requirements for training years that ended between January 1, 2022, and December 31, 2022, are required to be in compliance by January 31, 2023. If a training year began in 2022 but does not end until 2023, that training year is incomplete and compliance cannot be measured until after the conclusion of the training year.
Please also note that for administrator training years ending in 2023, all 24 hours of administrator training may be completed online, provided that at least 12 of those hours are formatted as a live training (e.g., Zoom, Teams, etc.). A maximum of 12 hours of online asynchronous or pre-recorded trainings are permitted.
Questions about this announcement and the guidance document can be directed via email.
CMS Releases Third Edition of IRF QRP COVID-19 Public Reporting Tip Sheet
The Centers for Medicare and Medicaid Services (CMS) recently released the third edition of the COVID-19 public reporting tip sheets to learn about reporting during the public health emergency (PHE). One of the tip sheets released is specific to inpatient rehabilitation facilities quality reporting program (IRF QRP).
Workers Who Serve People With Disabilities Must Earn More: Letter to the Editor by RCPA President/CEO Richard Edley
Workers Who Serve People With Disabilities Must Earn More
By Richard Edley, RCPA President/CEO
Read the print version in the Harrisburg Patriot-News, January 19, 2023
Providers who care for individuals with intellectual disabilities and autism (ID/A) are being pummeled by a workforce shortage driven by low wages and high vacancy and turnover rates.
RCPA partnered with The Arc of Pennsylvania and The Provider Alliance to have the Center for Healthcare Solutions examine the state’s ID/A workforce. The survey evaluated critical data on pay practices, hourly wages, scheduled positions, filled positions and separations for more than 9,000 employees representing 40 positions in 52 organizations.
The findings are stark.
Wages for direct support professionals who help ID/A children and adults with their basic daily living needs average $16.61 per hour, less than some fast-food restaurants. The turnover rate for DSPs is 38%, with providers reporting a vacancy rate of 28%. The numbers are similar for other residential and program supervisors.
The study also found that 14% of all DSP hours are paid at an overtime rate, and 41% of providers are now engaged in a more costly practice of contracting for staffing services to manage the workforce shortage.
Because human services like ID/A are funded primarily by Medicaid, providers cannot raise prices like private businesses to pay higher wages. So chronic underfunding by the state only
exacerbates these operational challenges.
ID/A providers simply do not have the staff they need to serve the thousands of Pennsylvanians receiving or waiting for critical services.
This is a system that is strained past its breaking point, and it needs our support now.
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CMS Announces Increase in Accountable Care Initiatives for 2023
The Centers for Medicare and Medicaid Services (CMS) issued a press release announcing an increase in three accountable care initiatives that will grow and provide higher quality care to more than 13.1 million people with Medicare in 2023. The initiatives include:
- Medicare Shared Savings Program (Shared Savings Program)
- Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model
- Kidney Care Choices (KCC) Model
The Shared Savings Program is the largest accountable care initiative in the country and is a permanent program in Medicare that was established by the Affordable Care Act (ACA). The Shared Savings Program has 456 ACOs and 10.9 million assigned beneficiaries in 2023. While the Shared Savings Program experienced a decrease in the number of ACOs and assigned beneficiaries for 2023, the policies finalized in the calendar year (CY) 2023 Medicare Physician Fee Schedule final rule are expected to grow participation in the program for 2024 and beyond, when many of the new policies are set to go into effect. These policies are expected to drive growth in participation, particularly in rural and underserved areas, promote equity, and advance alignment across the accountable care initiatives, and increase the number of beneficiaries assigned to ACOs participating in the program by up to four million over the next several years.
The ACO REACH Model aims to improve the quality of care for people with Traditional Medicare through better care coordination and by increasing access to accountable care in underserved communities. Innovative features the Model will test include benchmark adjustments to shift payments to better support care for the underserved and enhanced Medicare benefits, including care in the home. In 2023, ACO REACH will increase access to accountable care in underserved populations. The ACO REACH Model will have 824 Federally Qualified Health Centers, Rural Health Centers, and Critical Access Hospitals participating in 2023 — more than twice the number in 2022. Increasing the number and reach of ACOs in underserved communities will help close racial and ethnic disparities that have been identified among people with Traditional Medicare in accountable care relationships.
The KCC Model focuses on coordinating care for Medicare beneficiaries with chronic kidney disease stages 4 and 5 and end-stage renal disease (ESRD). In addition to care coordination, the KCC Model focuses on key areas of concern for this population, including delaying the onset of dialysis and increasing access to kidney transplantation so more patients can live fuller and longer lives.
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