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A Question and Response Addendum has been added to the PA e-Marketplace website, for the request for proposals (RFP) for managed care organizations that will be submitting their proposals and responses for the Community HealthChoices program. The addendum is located under “Flyers/Addendums” on the web page. The 81-page addendum includes the RFP section, questions, and answers to each question posed.

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The Department of Human Services (DHS) Office of Long-Term Living (OLTL) will be submitting amendments to the Aging, Attendant Care, and Independence waivers. The public notice announcing the amendments will appear in the April 2, 2016 Pennsylvania Bulletin.

To view a side-by-side comparison of the current and revised language, and to access the amendments in their entirety (including specific HCBS Allowable Settings Transition Plans and the Community HealthChoices Transition Plans for each waiver, contained in the Main Module), visit the OLTL Waiver Amendment, Renewals, and Accompanying HCBS Transition Plans website and select the individual waiver amendment you would like to review under “Related Topics.”

OLTL is seeking public comment on the Aging, Attendant Care, and Independence waiver amendments. Those interested are invited to submit written comments to the Department of Human Services, Office of Long-Term Living, Bureau of Policy and Regulatory Management, Attention: Aging Waiver, Independence Waiver, or Attendant Care Waiver, PO Box 8025, Harrisburg, PA 17105-8025. Comments can also be sent via email, using the comment form link. On this site, select the individual waiver amendment you would like to view under “Related Topics” and the comment form will be listed in the documents.

The public comment period ends on Monday, May 2, 2016. Comments received within the 30-day comment period will be reviewed and considered for revisions to the amendments.

OLTL will offer two webinars in April for public input and discussion:

Aging, Attendant Care, and Independence Waiver Changes Webinar
Wednesday, April 13, 2:00 – 3:00 pm

Aging, Attendant Care, and Independence Waiver Changes Webinar
Tuesday, April 19, 10:00 – 11:00 am

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The Department of Human Services (DHS) Medical Assistance Online Provider Enrollment Application information is now electronic, online, and available to provider organizations. The improvements and modernization of the PROMISe system have been strongly encouraged by RCPA and a significant goal of DHS. Some of the benefits of online enrollment application submissions are:

  • Allowing documents that previously had to be mailed or faxed to be uploaded directly to the portal;
  • Permitting providers see the status of their submissions; and
  • Decreasing wait time to review applications.

The information you will need to submit an application for enrollment:

  • Access the online enrollment application
  • Review the training guide
  • Review the frequently asked questions document for important clarifications
  • A “Help” feature is available at any time during the completion of an application
  • Supplemental Services require the Behavioral Health Managed Care Organization to attest that a provider is credentialed

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On March 14, 2016, the House Energy and Commerce Oversight and Investigations Subcommittee convened a forum on the state of the knowledge relating to the causes, effects, and treatments of concussions. The forum featured input from experts representing the medical, military, athletic, and research communities with a goal of building a collaborative body of knowledge to help improve the diagnosis and treatment of concussions. Included in the opening statement by Honorable Tim Murphy, Chairman of the Subcommittee: “Today, we begin a new chapter in the national dialogue on concussions. We are not here to re-litigate past actions, point fingers or cast blame. We are here to take a step back, to gain some perspective and to begin a conversation focused on solutions, not on problems.” And most importantly, “We are also here today to make one thing clear – this is not just a sports issue or a military issue. This is a public health issue…That is why we are here today – to ensure we are on the path, though it may be long, to providing the public the answers they deserve.”

The list of participants and webcast of the forum are available on the Energy and Commerce Committee’s website.

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The next Community HealthChoices (CHC) Third Thursday webinar is coming up on Thursday, March 17, 2016 at 1:30 pm. Office of Long-Term Living’s (OLTL) Deputy Secretary Jennifer Burnett will offer an update on CHC, followed by information about the Commonwealth’s waiver documents. In addition, Virginia Brown will discuss the waiver authority Pennsylvania is pursuing to implement CHC. To participate in the webinar, please register online.

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The Department of Human Services (DHS) has released the long-awaited Request for Proposals (RFP) for Community HealthChoices (CHC). CHC is a new initiative that will provide managed long-term services and supports (MLTSS) to older individuals, persons with physical disabilities, and physical health coverage to those who are dually eligible for Medicare and Medicaid.

The goals of CHC are to:

  • Enhance opportunities for community-based services;
  • Strengthen health care and LTSS delivery systems;
  • Allow for new innovations;
  • Promote the health, safety, and well-being of enrolled participants; and
  • Ensure transparency, accountability, effectiveness, and efficiency of the program.

The official release of the RFP is the first step in the procurement process for the selection of managed care organizations (MCOs). The Commonwealth plans to coordinate health and LTSS through MCOs. Participants will have a choice of two to five MCOs in each region. Responses to the RFP by the managed care organizations are due on Monday, May 2, 2016.

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The Department of Human Services Office of Long-Term Living (OLTL) announced they will be submitting a renewal of the OBRA waiver, which expires on June 30, 2016. This announcement/public notice will be published in the February 27 Pennsylvania Bulletin, which seeks public comments.

Written comments regarding the OBRA Waiver renewal should be sent to the Department of Human Services, Office of Long-Term Living, Bureau of Policy and Regulatory Management, Attention: OBRA Renewal, PO Box 8025, Harrisburg, PA 17105-8025 or via email, using the comment forms that OLTL has provided. Please use OBRA Renewal as the subject line. The comment forms, as well as a side-by-side comparison of the current and revised language, and the renewal in its entirety (including the OBRA-specific HCBS Allowable Settings Transition Plan and the Community HealthChoices Transition Plan, which are contained in the main module), can be found on the “OLTL Waiver Amendment, Renewals and Accompanying HCBS Transition Plans” web page. The public comment period ends on Monday, March 28, 2016.

OLTL will offer two webinars for public input and discussion on March 9 and March 23, 2016. Please see the information below for further details on the scheduled webinars.

Title: OBRA Renewal
Date: Wednesday, March 9, 2016
Time: 1:00 – 2:00 pm
Join WebEx meeting
Meeting number:  644 892 538
Meeting password:  OBRA##1
Join by phone
1-877-668-4493 Call-in toll-free number (US/Canada)
1-650-479-3208 Call-in toll number (US/Canada)
Access code: 644 892 538
Toll-free calling restrictions

Title: OBRA Renewal
Date: Wednesday, March 23, 2016
Time: 10:00 – 11:00 am
Join WebEx meeting
Meeting number:  640 051 990
Meeting password:  OBRA##2
Join by phone
1-877-668-4493 Call-in toll-free number (US/Canada)
1-650-479-3208 Call-in toll number (US/Canada)
Access code: 640 051 990
Toll-free calling restrictions

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This week the Pennsylvania Department of Human Services (DHS) announced several new initiatives to reduce the use of psychotropic medication among our state’s most vulnerable children. Speaking at The Children’s Hospital of Philadelphia, DHS Secretary Ted Dallas reported on the partnership of DHS with the Pennsylvania Chapter of the American Academy of Pediatrics and the Pennsylvania Psychiatric Society. A state-commissioned PolicyLab study that found that in 2012 in Pennsylvania, the use of psychotropic medications was nearly three times higher among 6-18 year olds in foster care than among youth in Medicaid overall. Based on this study and the collaborative effort mentioned above, Pennsylvania has initiated the following:

  • Best practice guidelines are being developed for clinicians regarding comprehensive assessments of behavior and treatment interventions;
  • Managed care organizations will be required to give prior authorization for antipsychotic medications for children;
  • A new electronic dashboard will make it easier for DHS to monitor what medications children are taking and improve care coordination;
  • In April, DHS will open a telephonic child psychiatric consultative service to help prescribing physicians, physician assistants, and nurse practitioners appropriately prescribe psychotropic medication for children; and
  • In July, the department will begin training child welfare caseworkers and caregivers on the appropriate use of psychotropic medication.

“The inappropriate use of these powerful medications for children in the foster care system compounds the trauma experienced by children who have been the victim of abuse and neglect and is simply unacceptable,” Dallas said, “The recommendations and analysis from PolicyLab provide Pennsylvania with an invaluable roadmap to improve the safety and quality of life for foster children served by the Medicaid system.”

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The Office of Long-Term Living (OLTL) has announced changes that are being made to the enrollment process for Home and Community-based Services (HCBS), including the Aging Waiver, Attendance Care Waiver, CommCare Waiver, Independence Waiver, OBRA Waiver, and Act 150 Program. Effective Tuesday, March 1, 2016, OLTL will enter into a new contract with MAXIMUS, the PA Independent Enrollment Broker (IEB). According to OLTL, the adjustments being made and expectations regarding this new contract will streamline the enrollment process, as well as ensure consistency across all home and community-based programs, in anticipation of the roll-out of Community HealthChoices (CHC), a Managed Long-Term Services and Supports program for older Pennsylvanians and adults with physical disabilities. CHC will move the Commonwealth’s home and community-based waiver system from fee-for service to a capitated Medicaid managed long-term services and supports delivery system. The changes OLTL is making to the enrollment process support the Commonwealth’s efforts to ensure that the enrollment process is conflict free, strengthening necessary firewalls between enrollment in services and the provision of ongoing service coordination and other services.

Changes made to improve the IEB process:

  • The enrollment timeframe requirement has been reduced from 90 days to 60 days. This change is effective March 1, 2016.
  • The IEB will assume the Aging Waiver enrollment process effective April 1, 2016.
  • Enrollments that are already in process before April 1 will remain the responsibility of the Area Agency on Aging. Aging Waiver applications initiated prior to April 1 must be completed by the AAA prior to June 30. Applications still pending on June 30 will revert to Maximus for completion. OLTL will provide additional information on this process in an upcoming webinar.
  • These changes, which affect all OLTL Home- and Community-Based Programs – Aging, Attendant Care, CommCare, Independence, OBRA and the Act 150 program administered through the Office of Long-Term Living – will be completed by the PA Independent Enrollment Broker (IEB), Maximus.

The tasks completed by the IEB (Maximus) include the following:

  • Coordinate with the County Assistance Office to ensure timely completion of the PA 600L Medical Assistance Applications.
  • Coordinate with the Area Agency on Aging to ensure timely completion of the Clinical Eligibility Determination (formerly known as the Level of Care Determination). Complete in-home visit with applicant to gather information for enrollment.
  • Complete the Program Eligibility Determination.
  • Provide applicant with choice of Service Coordination provider.
  • Enroll applicant in waiver upon receipt of PA 162.
  • Transfer record and enrollment documentation to the selected Service Coordination agency.

If you have any questions, please contact Amy High, Office of Long-Term Living, Bureau of Participant Operations, at 717-787-8091.

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