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On September 10, 2015, the Medicare Payment Advisory Commission (MedPAC) conducted a public meeting to discuss Medicare issues and policy questions and approve reports and recommendations to the Congress. Included in the agenda was a session that focused on MedPAC’s task of developing a prototype prospective payment system (PPS) that spans across the post-acute care (PAC) settings, as mandated by the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. The IMPACT Act requires MedPAC to submit a report to Congress regarding this by Thursday, June 30, 2016. Included in the meeting was their presentation Mandated Report: Developing a Unified Payment System for Post-Acute Care. It is expected that MedPAC will conduct multiple public meetings in the months ahead regarding the development of PAC PPS before presenting their draft recommendations.

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Today, the Departments of Human Services (DHS) and Aging (PDA) released their Managed Long-Term Services and Supports (MLTSS) concept paper. This concept paper, which was developed based on public input, describes the plan’s features and includes the following highlights:

  • Coordinates physical health and LTSS through Community HealthChoices managed care organizations (CHC-MCO).
  • Provides participants with a choice of two to five CHC-MCOs in each region.
  • Includes value-based incentives to increase the use of home and community-based services and meet other program goals.
  • Creates a system that allows Pennsylvanians to receive services in the community, preserves consumer choice, and lets consumers have an active voice in the services they receive.
  • Standardizes measures of both program and participant-level outcomes to assess overall program performance and improve CHC over time.
  • CHC-MCOs will be accountable for most Medicaid-covered services, including preventive services, primary and acute care, LTSS (home and community-based services and nursing facilities), prescription drugs, and dental services.
  • Participants who have Medicaid and Medicare coverage (dual eligible participants) will have the option to have their Medicaid and Medicare services coordinated by the same MCO.
  • Behavioral health services continue to be provided through the behavioral health managed care organizations (BH-MCOs), but CHC-MCOs and BH-MCOs will be required to coordinate services for individuals who participate in both programs.

The MLTSS plan, recently re-named Community HealthChoices, is an integrated system of physical health and LTSS which focuses on improving health outcomes and allowing individuals to live safe and healthy lives with as much independence as possible. CHC supports individuals dually eligible for Medicare and Medicaid, older adults, and adults with physical disabilities, in the most integrated settings possible.

Feedback on the concept paper may be submitted through Friday, October 16, 2015. The concept paper feedback will shape the November 2015 request for proposals (RFP) for CHC-MCOs. The RFP will be tentatively awarded in March 2016, contingent upon successful readiness reviews and negotiations. CHC will go live in the Southwest region in January 2017, the Southeast region in January 2018, and the Northwest, Lehigh-Capital, and Northeast regions in January 2019.

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On September 15, 2015, an Info was issued regarding a webinar the Office of Long-Term Living (OLTL) will be holding on provider credentialing for Community HealthChoices. The registration link for this webinar sent by OLTL was incorrect. Please use the corrected link below to register for the webinar.

The Office of Long-Term Living (OLTL) will be holding a webinar on Wednesday, September 30, 2015, from 8:30 – 10:00 am for Home and Community Based Services providers and Service Coordination Entities interested in participating in Pennsylvania’s planned Managed Long Term Services and Supports (MLTSS) program, now known as Community HealthChoices. The purpose of the webinar is to provide a high level overview of OLTL’s current provider credentialing process, to obtain input on credentialing MLTSS providers, and to discuss how the provider credentialing process may look for Community HealthChoices. Information on how to access the webinar can be found below.

  1. Please join my Webinar.
    https://global.gotowebinar.com/register/152791275
  2. You will be connected to audio using your computer’s microphone and speakers (VoIP).  A headset is recommended. Or, you may select “Use Telephone” after joining the webinar.

Dial +1 (631) 992-3221
Access Code: 787-398-715
Audio PIN: Shown after joining the webinar
Webinar ID: 103-329-483

For questions regarding this email, please contact the OLTL Provider Inquiry Line at (800) 932-0939.

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The Department of Human Services Office of Long-Term Living (OLTL) is establishing a Managed Long-Term Services and Supports (MLTSS) Subcommittee of the Medical Assistance Advisory Committee (MAAC). The kickoff meeting is scheduled for Tuesday, September 1, from 10:00 am to 1:00 pm at Temple University in Strawberry Square, Harrisburg, PA.

The second meeting of the MLTSS Subcommittee will be held on Monday, September 14, from 10:00 am to 1:00 pm in the PA Department of Education Honors Suite, 333 Market Street, 1st floor, Harrisburg, PA. Future meetings will be posted on the OLTL website as dates are confirmed.

The membership of the subcommittee will be announced in the coming weeks. A majority of subcommittee members will be users of long-term living services and supports, and family caregivers. The subcommittee will advise the department on the design and implementation of MLTSS in Pennsylvania. A number of RCPA members submitted nominations to be considered for the subcommittee.

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The Departments of Human Services (DHS) and Aging have announced they will present their next third Thursday webinar associated with Managed Long-Term Services and Supports. The next webinar, Managed Care 101, is scheduled for Thursday, August 20, at 1:30 pm.

Included will be details on Medicare and Medicaid coordination, role of the MIPPA agreements, provider and service coordination, participant impacts, and other state’s experiences. During the webinar, participants will have the opportunity to submit questions using the chat feature provided.

To participate:

  1. Please join my Webinar.
    https://global.gotowebinar.com/register/155011011
  2. You will be connected to audio using your computer’s microphone and speakers (VoIP).  A headset is recommended.

Or, you may select “Use Telephone” after joining the Webinar.

Dial +1 (702) 489-0003
Access Code: 428-878-113
Audio PIN: Shown after joining the webinar

Webinar ID: 155-011-011

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The Centers for Disease Control and Prevention (CDC) has released a new report, Concussion at Play: Opportunities to Reshape the Culture Around Concussion. The report provides an overview of current research on concussion knowledge, awareness, attitudes, and behaviors among athletes, coaches, parents, health care providers, and school professionals.

This report also describes opportunities to help build a culture in sports where athletes take steps to lower their chances of getting a concussion, and recognize and report concussion symptoms. This involves moving beyond our general concussion knowledge and changing the way we talk about and respond to concussion. The goal is to empower athletes not to play with a concussion or hide their symptoms. The document builds from the work of the Institute of Medicine (IOM) report, Sports-Related Concussions in Youth: Improving the Science, Changing the Culture.

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On July 22, the Departments of Human Services and Aging announced the next steps in Governor Wolf’s plan to improve care coordination and move to Medicaid Managed Long-Term Services and Supports (MLTSS). These updates are a result of overwhelming response to the public comment period and stakeholder input.

Along with feedback on how MLTSS should be implemented in the Commonwealth, the departments heard feedback on changes that can be made today to improve the current system. They will take the following steps:

 

Doubling the number of staff who work on Nursing Home Transition (NHT)
PDA and DHS recognize that current processes to move individuals who are able to be better served in the community from institutional settings are lengthy and complicated. To address this, the departments will:

  • Increase the number of staff assigned to NHT from 5 to 10;
  • Identify and implement strategies intended to
    • improve the process
    • enhance program outcomes
    • advance the opportunities for individuals to either avoid premature placement and/or transition back into the community;
  • Evaluate and redesign the entire NHT process; and
  • Increase training for all current NHT staff and providers.

 

Creating an advisory committee with at least 50 percent representation by participants and caregivers and conducting monthly webinars
Throughout the MLTSS public input sessions, participants, advocates, and providers made it clear that more education, involvement, and communication are necessary as the Commonwealth moves to MLTSS. In order to accomplish this, the departments will:

  • Host monthly webinars on the third Thursday of every month.
  • Create an MLTSS Advisory Committee that will meet under the federally mandated purview of the Medical Assistance Advisory Committee (MAAC).
    • MLTSS program participants will comprise half of the membership, with the remaining half representing provider communities
    • Opportunities for participation via telephone for increased accessibility and convenience
    • This committee will meet bi-weekly
  • Encourage open communications; questions can be submitted via email.

 

Restructuring existing contracts to provide more choice for participants
Issue a procurement for a home modification quality improvement program in August 2015: In some cases, the transition from a nursing home to living in the community can be accomplished through a simple home modification such as the installation of a ramp for wheelchair access. The new procurement will streamline the current process to make this easier to complete these modifications, while at the same time ensuring that only high-quality contractors complete the work. The contracts will include two providers in each part of the state to provide choices in completing the work.

Issue a financial management services procurement in November 2015: There is currently one statewide vendor that acts on behalf of the consumer to make payroll, withhold and report taxes, and pay bills for individuals in home- and community-based waiver programs. Moving forward, multiple vendors will be awarded the contracts to ensure choice, and they will be required to maintain a regional presence throughout the state.

Award New Contracts for Independent Enrollment Broker (IEB) Services in November 2015: One of the most significant barriers to serving individuals in the community is the length of time it takes to enroll someone in home- and community-based services. The new contracts will be awarded in four regional lots and include new, strong performance standards, to ensure that the vendors are held accountable and participants are not stuck waiting for services.

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The Pennsylvania Athletic Trainers’ Society, through a grant from the Pennsylvania Department of Health, brings you “A Consumer’s Guide to the Management and Care of Concussion in Sport.” This program gives a detailed look at the importance of proper identification and treatment of sport concussion, and the role of the licensed athletic trainer as part of the health care team to manage these injuries appropriately. The Safety in Youth Sports Act directs schools and athletic programs to create a health care team, and a concussion policy action plan, to aid in the management of concussions. This program will air on the Pennsylvania Cable Network (PCN) during the “Sunday Fusion” programming on the following dates and times:

  • Sunday July 26, 3:30 pm
  • Sunday August 2, 2:30 pm
  • Sunday August 9, 5:30 pm
  • Sunday August 16, 2:30 pm
  • Sunday August 23, 4:00 pm

Beginning Monday, July 20 the program will be available on the PCN website.

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On July 14, Estelle Richman, former secretary of the Department of Human Services (DHS), will conduct a presentation; Person-Driven Services in Managed Care Long-Term Services and Supports (MLTSS), from 1:00 to 3:00 pm at Temple University, Ritter Annex Room 555, 1301 Cecil B. Moore Avenue, Philadelphia, PA 19122. Members can participate in person or online.

Topics will include:

  • Overview of DHS discussion document on managed care;
  • Overview of federal options for self-directed services and supports in managed care; and
  • Discussion of what stakeholders can do to ensure that good self-directed options are available in any managed care model that DHS administers.

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The Department of Human Services has announced the July training schedule and related information for the approved and required Medication Administration Training. Training will be available online and at various locations across the Commonwealth. Future classroom training sessions are being scheduled throughout the year; announcements will be released when finalized. Classroom training sites have limited capacity, and training candidates from agencies with no certified medication administration staff are required to complete the online course work before they are permitted to attend the classroom training.

Medication administration training is required for designated staff working in: adult training facilities, adult day services, personal care homes, assisted living residences, child residential and residential treatment and day treatment facilities, community homes for individuals with an intellectual disability, and intermediate care facilities. Questions about the information in the training document can be directed to (717) 221-1630 or email.

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