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Date: November 16, 2022
Time: 1:30 pm – 3:00 pm EST

The Medicaid Home and Community-Based Services (HCBS) Settings Final Rule was made effective on March 17, 2014. The settings rule set specific requirements for settings presumed to have institutional characteristics, including settings in institutions, settings on the grounds of or adjacent to a public institution, and settings that have qualities that isolate Medicaid beneficiaries. Referred to as “presumptively institutional settings,” states are required to assess these settings and, where the state has determined that the setting overcomes the institutional presumption and the setting complies or will comply with the settings rule by March 17, 2023, submit to CMS documentation that demonstrates the setting’s compliance. CMS has launched a series of heightened scrutiny site visits to presumptively institutional settings in states. This training will cover:

  • An overview of CMS’ heightened scrutiny site visit process;
  • Overarching themes identified during CMS’ heightened scrutiny site visits; and
  • Considerations for states moving forward.

Following the presentation, webinar participants will have the opportunity to share any questions, comments, experiences, or suggestions with CMS and the presenter.

Please register for this webinar here.
Conference Line: 844-875-7777; Access Code: 715810#

Please note that closed captioning will be provided.

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The Department of Human Services (DHS) published a notice in the Pennsylvania Bulletin for November 12, 2022, that announces revisions to the Medical Assistance (MA) fee schedule for the OBRA Waiver and the Act 150 Program: Personal Assistance Services (PAS) (Agency with Choice) and Respite (Agency with Choice).

DHS proposes the following substantive and technical changes to the OBRA Waiver:

  • Add Agency with Choice as a Financial Management Services model for the participant-directed services of PAS and Respite;
  • Revise the Benefits Counseling service definition;
  • Amend the responsibilities of the Fiscal/Employer Agent;
  • Update the Quality Improvement Strategy to the current process;
  • Add a new performance measure for Agency with Choice; and
  • Remove a performance measure that is duplicative.

The proposed OBRA Waiver amendment and a summary of all revisions are available for review on the OLTL Waiver Amendments, Renewals, and Accompanying HCBS Transition Plans web page under Additional Resources.

The following table provides the procedure code and rates for PAS (Agency with Choice):

Region OBRA Waiver
and Act 150		 Procedure Code Modifier Rate Unit
1 X W0164 N/A $4.02 15 minutes
2 X W0164 N/A $3.89 15 minutes
3 X W0164 N/A $4.12 15 minutes
4 X W0164 N/A $4.58 15 minutes

The following table provides the procedure code and rates for Respite (Agency with Choice):

Region OBRA Waiver
and Act 150		 Procedure Code Modifier Rate Unit
1 X W0165 N/A $4 15 minutes
2 X W0165 N/A $3.90 15 minutes
3 X W0165 N/A $4.12 15 minutes
4 X W0165 N/A $4.59 15 minutes

Interested persons are invited to submit written comments regarding these fee schedule rates and the proposed amendment to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: Robyn Kokus, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments can also be sent via email. Use ”OBRA 2023” as the subject line. Comments received within 30 days will be considered in subsequent revisions to the fee schedule or for revisions to the proposed amendment.

The revisions to the fee schedule and the amendment are proposed to take effect April 1, 2023.

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Image by Werner Moser from Pixabay

The Department of Human Services’ (DHS) Office of Long-Term Living (OLTL) published the proposed amendment to the Community HealthChoices (CHC) Waiver in the Pennsylvania Bulletin for November 12, 2022.

DHS and OLTL are proposing to amend the CHC Waiver by adding Agency with Choice as a Financial Management Services (FMS) model for the participant-directed services of Personal Assistance Services (PAS) and Respite. This would modify Service Coordinator and Service Coordinator Supervisor qualifications to align with the CHC Agreement and to amend the service definitions for the following CHC waiver services:

  • Benefits Counseling;
  • Nursing Services;
  • Physical Therapy Services;
  • Occupational Therapy Services; and
  • Speech and Language Therapy Services.

Also proposed is a technical change to the waiver by revising performance measures.

The proposed CHC waiver amendment and summary of all revisions are available for review on the OLTL Waiver Amendments, Renewals, and Accompanying HCBS Transition Plans web page under Additional Resources.

Interested persons are invited to submit written comments regarding the proposed waiver amendment to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: CHC 2023 Waiver Amendment, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments may also be submitted to the Department via email. Use ”CHC 2023 Waiver Amendment” as the subject line. Comments received within 30 days of publication of this notice will be reviewed and considered for revisions to the proposed waiver amendment.

The proposed amendment will be effective April 1, 2023.

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Image by Wokandapix from Pixabay

Each year between November 13–19, people and organizations around the country participate in Transgender Awareness Week to help raise the visibility about transgender people and address issues members of the community face.

The week before Transgender Day of Remembrance on November 20, people and organizations around the country participate in Transgender Awareness Week to help raise the visibility of transgender people and address issues members of the community face.

Learn More:

GLAAD — Transgender Awareness Week

AAP Journal Article — Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents

NICHQ Blog — Exploring a Nonbinary Approach to Health

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Photo by Markus Winkler from Pexels

Recognizing the continued movement toward integration of mental health (MH) and substance use disorder (SUD) treatment, and the opportunity to better support and serve its MH and SUD provider members, RCPA has created a Behavioral Health Division.

RCPA’s MH and SUD policy focus will now operate under the BH Division umbrella, where shared MH and SUD interests and initiatives (e.g., workforce, value-based purchasing, telehealth, criminal justice, ICWCs/CCBHCs) will now be managed and supported across the disciplines — while still maintaining existing MH- and SUD-specific committees, subcommittees, and work groups where those interests are specific to one of the two policy areas.

Jim Sharp and Jason Snyder will direct the new BH Division.

  • As Director of Mental Health Services, BH Division, Sharp, whose work to date has focused largely on children’s MH, will maintain his MH policy focus, including continuing to lead separate Children’s Mental Health and Adult Mental Health Committees, along with the other MH-specific committees and work groups already in place.
  • As Director of Substance Use Disorder Treatment Services, BH Division, Snyder will maintain his policy focus on SUD and the existing SUD-specific committees and work groups.
  • In addition, RCPA will no longer use the Drug and Alcohol title (or D&A acronym), replacing it with SUD.
  • Both directors will also collaborate in areas of shared interest, including legislative, regulatory, and policy initiatives as appropriate.

RCPA will be hiring a BH policy analyst to support the new division.

“The new BH Division has the opportunity to capitalize on synergies where they exist while still maintaining discipline-specific focus on MH and SUD,” said RCPA President/CEO Richard Edley. “Rather than taking anything away from our mental health and substance use disorder members, we are really enhancing their membership.

“As we look at where the behavioral health field continues to move, integration of mental health and substance use disorder is a hallmark of the advancing field. RCPA will better position itself to support its provider members’ needs by structuring a BH Division that recognizes this evolution.”

Contact Division Directors Jim Sharp or Jason Snyder with questions.

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Webinar
Sponsored by Streamline Healthcare Solutions, featuring Microsoft

Why EHR Infrastructure Matters: Streamline and Microsoft Discuss How Different Hosting & Deployment Options Impact Performance, Security, and Cost

Behavioral Health and Human Services organizations have a choice of hosting and deployment options when selecting an Electronic Health Record (EHR) system, and which option they choose has a significant impact on performance, security, and cost. Join executives from Streamline Healthcare Solutions and Microsoft as they discuss the most common hosting and deployment options, including the SaaS model, single-tenant vs multi-tenant architecture, and cloud hosting.

Speakers:
Andy Pitman U.S. Director, Health and Human Services, Microsoft
Matt Chamberlain EVP of Sales and Marketing, Streamline Healthcare Solutions
Javed Husain, Co-Founder & CEO, Streamline Healthcare Solutions
Solome Tibebu, Founder & CEO, Going Digital: Behavioral Health Tech

Webinar Date: Wednesday, November 30, 2022
Time: 12:00 pm – 1:00 pm CT
REGISTER HERE

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