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Brain Injury

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Message from Gibbel Kraybill & Hess LLP:

On Friday evening, the Sixth Circuit lifted the stay on OSHA’s Emergency Temporary Standard (ETS). The ETS states that any employer with more than 100 employees must require its employees to either show proof of a COVID vaccination or submit to weekly testing and mask at all times when indoors. In the absence of a Supreme Court ruling to the contrary, the ETS will go into effect, and employers will be required to adhere to its standards. Read the article here.

GKH attorneys are closely monitoring the COVID-19 crisis and will continue to post updates and resources for individuals and businesses.

View Resources Here

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Message from the Department of Human Services (DHS):

FOR IMMEDIATE RELEASE
December 20, 2021 

Department of Human Services Discusses Spending Plan for Home and Community-Based Services Enhanced Federal Funding to Support Mental Health Services, Children 

Harrisburg, PA — Pennsylvania Department of Human Services (DHS) today highlighted Pennsylvania’s spending plan for approximately $1.2 billion in enhanced federal Medicaid funding made available to states through the American Rescue Plan Act (ARPA). This funding will support Medicaid’s home and community-based services (HCBS) system throughout the commonwealth, which helps seniors, people with disabilities, children with complex medical needs, and many other groups safely live in their community among their family and peers. This funding will strengthen Pennsylvania’s home and community-based services system by allowing more Pennsylvanians access to critical services in their communities and supporting service providers that perform this work every day.

“We owe a huge debt of gratitude to the professionals who care for our most vulnerable, including children, seniors, people with disabilities, and those needing mental health services,” said Acting Secretary Meg Snead. “This enhanced funding through the American Rescue Plan Act will allow employers to recruit and retain skilled workers and allows them to plan for the future to provide training, certification, technology access, and much more.”

DHS received conditional approval of its spending plan on December 1 from the Centers for Medicare & Medicaid Services. On today’s call, DHS outlined how funding will be used through the Office of Mental Health and Substance Abuse Services (OMHSAS), the Office of Child Development and Early Learning (OCDEL), and the Office of Medical Assistance Programs (OMAP).

  • OMHSAS will prioritize funding for workforce recruitment and retention to qualifying providers, specifically mobile crisis mental health services, intensive behavioral health services (IBHS), psychiatric rehabilitation, and family-based mental health services. While many mental health services are not considered HCBS under ARPA, within the parameters of this funding opportunity, OMHSAS also will invest in training clinicians in trauma-informed treatment modalities, technology and training for telehealth, and updating the state hospital system’s technology infrastructure and providing staff training for use of electronic health records to facilitate more efficient transitions to community-based placements and services.
  • OCDEL supported a 3 percent rate increase for Infant/Toddler Early Intervention services, which allows all providers of Early Intervention services, including Service Coordination, to receive a 3 percent rate increase for services. This rate increase went into effect on July 1, 2021.
  • OMAP will use the recommendations of its pediatric shift care nursing work group to inform ARPA spending with a focus on achieving the following goals: improve care and service coordination for children with complex medical needs; support training of private duty nurses; leverage health information technology to allow for the sharing of clinical information; use a value-based payment structure for managed care organizations to improve outcomes of children receiving pediatric shift care nursing services; and facilitate co-training opportunities for both shift nurses and families to help improve coordination, continuity, and support among caregivers.

“When we invest in the caring workforce, Pennsylvania benefits both socially and economically,” said Acting Secretary Snead. “Having care provided in your own home or within your community allows family caregivers to be part of the workforce themselves and it allows those needing home and community-based services to stay safe, healthy, and to thrive.”

More information about Pennsylvania’s home and community-based services spending plan is available on DHS’s website.

RCPA continues to meet with DHS advocating for members on the spending plan and distribution strategies to ensure the workforce issues are front and center of the plan. If you have any questions, please contact your RCPA Policy Director.

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The Centers for Medicare & Medicaid Services (CMS) has approved the Office of Long-Term Living’s (OLTL) Community HealthChoices (CHC) Waiver amendment. The amendment is effective January 1, 2022.

The changes in the approved amendment include:

  • Revised service definitions, service limitations, and/or provider qualifications for the following CHC waiver services:
    • Adult Daily Living;
    • Home Adaptations;
    • Participant-Directed Community Supports;
    • Personal Assistance Services;
    • Personal Emergency Response System (PERS);
    • Specialized Medical Equipment and Supplies; and
    • Vehicle Modifications.
  • Revised waiver performance measures.
  • Revised number of unduplicated recipients for Waiver Years 3–5 and revised corresponding cost neutrality estimates.
  • Revised Service Coordinator selection or assignment time frame from 14 days to 7 days to be consistent with the CHC Agreement.

Questions about the 2022 CHC amendment can be submitted electronically.

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The Office of Long-Term Living (OLTL) has updated the Home and Community-Based Services (HCBS) Medical Assistance (MA) Fee Schedule. The updates reflect the fee schedule rates for Personal Assistance Services (PAS) procedure codes W1793, W1793 TT, W1792, and W1792 TU in the referenced Pennsylvania Bulletin below.

The updated OLTL HCBS MA Fee Schedule (effective January 1, 2022) may be found here. The new rates for the OBRA Waiver and Act 150 Program were announced in the Pennsylvania Bulletin on November 6, 2021, in the Volume 51, Number 45 issue and can be found here.

Questions related to this update should be directed to the OLTL Provider Inquiry Line at 800-932-0939, option 2, Monday–Friday between 9:00 am–12:00 pm and 1:00 pm–4:00 pm.

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The Office of Long-Term Living (OLTL) has issued additional guidance on the Enterprise Incident Management (EIM) Enhancements.

As stated in the communication sent on December 10, 2021, Critical Incident Report Extensions changes were implemented in the EIM system on December 11, 2021. With these changes, once the maximum number of allowed extensions is reached, providers and service coordinators (SC) will need to contact OLTL if additional extensions are needed.

The December 10, 2021, communication indicated that OLTL had drafted a form to use in the near future, and once approved, you would be notified. The OLTL EIM Critical Incident Report Extension Request form has been approved and is here for your use.

When requesting incident report extensions, please follow these instructions:

  • Request forms must be submitted to OLTL at least 5 business days prior to incident report due date, via email.
  • Reasons for prior extensions must be clearly documented in the incident report.
  • The reason for an extension request must be detailed, valid, and clearly documented in the incident report as well as in the Home and Community Services Information System (HCSIS) notes.
  • Incident report extensions will be approved for 30 days from previous report due date.

OLTL staff will respond to extension requests within 3 business days by replying to the requestor to let them know if the request was approved or rejected. If rejected, the reason for the rejection will be included in the response. If approved, OLTL staff will enter the extension in EIM.

Any questions regarding the information in this email should be directed here.

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Project Goal: To improve service delivery and processes for DHS’ clients, DHS staff, and business partners

The Pennsylvania Department of Human Services (PA DHS) is launching a website to share information about the ECM system up to and beyond implementation. The website is intended to communicate key information of the services provided to participants and families through multiple DHS program offices, regardless of the human services program or county providing the service.

The ECM website can be accessed here.

ECM will replace several legacy systems across program offices through the implementation of one common solution. By means of this website, users can get acclimated with all ECM subsystems and their functions. The primary pages and a brief synopsis are as follows:

  • About ECM: An overview of ECM, its timelines, goals and objectives, benefits, scope, and project governance structure.
  • Stakeholder: An overview of the participants who benefit from ECM. This will include links to the subpages for the different stakeholder groups, including the Program Areas, County Organizations, Hearings and Appeals, Providers, Service/Support Coordinators, Administrative Entities and Those we Serve.
  • Development: Description of the scope of the project, the technology used, methods used to implement and operate the future ECM, and the phases of the project. The development and maintenance of the ECM system will follow a hybrid-agile system methodology which will be described in more detail within this area of the website. System development involves the process of producing and sustaining an information technology system. It covers technology, people, and processes.
  • Change and Training: Information about the system including training materials, user guides, and schedules. It is key that the stakeholders and those we serve are supported throughout the entire project process.
  • News: Communications such as press releases, news coverage, and announcements.
  • ECM FAQs: Frequently Asked Questions that cover various topics like general information, the timeline for the project, implementation process, and trainings.

We hope that you will refer to the website often as more information is posted while PA DHS and its partners prepare for the initial launch.

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