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Children's Services

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The Department of Human Services (DHS) Secretary Ted Dallas announced several improvements to ChildLine, the department’s child abuse hotline, as well as to the child abuse history clearance process.

“Keeping children safe is a critical part of our mission at DHS and has been a priority of the Wolf Administration from day one,” said DHS Secretary Ted Dallas, “The improvements we are announcing today represent the highest performance levels since 24 new bills that amended the child protection law went into effect in January 2015.” The department experienced significant challenges in January 2015, when the changes went into effect, and by the Wolf Administration’s first day in office, DHS was inundated with calls and clearance applications that the department was not adequately staffed or funded to handle. From 2014 – 2015, the department experienced:

  • 14 percent increase in calls to ChildLine from 164,911 to 188,357;
  • 39 percent increase in reports of suspected child abuse; and
  • 162 percent increase in clearance requests from 587,545 to 1,536,921.

As a result of these increases, performance and ChildLine suffered in early 2015. Specifically:

  • Processing time for child abuse clearances averaged 26 days – well above the 14 days required by law;
  • 48 percent of clearances were processed on time; and
  • 43 percent of calls to ChildLine were abandoned or deflected.

DHS acted immediately to address these issues by adding staff and improving training. In addition, DHS has implemented technology changes that properly record all calls, regardless of the nature of the call, and make it easier for staff to receive and process calls. As a result, DHS data today reads much differently:

  • Clearances are processed on average in 1.6 days, well below the statutorily required 14 days;
  • 100 percent of clearances are processed on time; and
  • The abandoned or deflected rate is down to 2 percent.

“None of the improvements I am announcing today could have happened without the hard work of staff at DHS and, on behalf of the administration, I thank them for all their efforts,” said Dallas. DHS has also encouraged individuals to use its website to get more information on the changes to the law, mandated reporting information and training, and clearances. This has resulted in approximately 80 percent of clearance requests and 42 percent of child abuse referrals currently coming in electronically, reducing paperwork for staff and the public.

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Robena Web Edited

RCPA is pleased to announce the hiring of Robena Spangler as the new director for its Children’s Division. Robena has worked for NHS Human Services for many years in several key positions, including operations resource specialist, regional director – children’s services, director of out of home services and gender responsive services, and children and youth program specialist. In addition to her bachelor’s degree in sociology/human services, she holds an MS degree in leadership and professional advancement from Duquesne University.

Robena will begin in this position on September 26 – just in time for the RCPA Annual Conference. As many of you know, Connell O’Brien serves as the current children’s services director and will be retiring. Connell will remain with RCPA to assist in the transition and to continue with select initiatives. Please join us in welcoming Robena to RCPA!

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The RCPA Board of Directors is pleased to announce the appointment of Steven Alwine, CEO of HealthSouth Rehabilitation Hospital of York, as its newest member. Steve has worked at HealthSouth for almost 25 years. He was promoted in 2002 to chief financial officer at HealthSouth Nittany Valley and returned to York in 2011 as chief executive officer. He currently fills a vacancy for an unexpired term ending June 30, 2017, as an RCPA director-at-large.

In addition, the board also selected Charles Barber, CEO of Erie County Care Management, Inc., to complete the unexpired term ending June 30, 2017, as board treasurer. Charlie has already been serving on the RCPA Board of Directors, but was recently voted to fill the vacant officer position of treasurer.

Join us in congratulating these individuals in their appointments. For a complete listing of the RCPA board members, please visit our website.

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The Departments of Human Services (DHS) and Aging just announced their selection of three managed care organizations (MCOs) for Community HealthChoices (CHC). CHC will coordinate physical health and long-term services and supports (LTSS) to individuals who are dually eligible for Medicare and Medicaid, older Pennsylvanians, and individuals with disabilities.

Through a review of a request for proposals, the following MCOs have been selected to proceed with negotiations to deliver services statewide in Pennsylvania beginning in 2017:

  • AmeriHealth Caritas
  • Pennsylvania Health and Wellness (Centene)
  • UPMC for You

CHC will roll out in three phases. Persons eligible for CHC are individuals aged 21 or older who have both Medicare and Medicaid, or who receive long-term services and supports through Medicaid because they need help with everyday activities of daily living.

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On August 25, RCPA, in collaboration with key state agencies, hosted a webinar on changes impacting providers of child and adolescent autism services as well as HealthChoices managed care organizations. The webinar also reviewed the use of behavioral health, physical health, and rehabilitation procedure codes that reflect services for the diagnostic assessment and treatment of ASD covered under Act 62. The procedure codes that are on the MA Program fee schedule will be subject to the cost avoidance process for MA FFS claims beginning September 30.

The webinar also included a review of updated information and guidance for families that providers can duplicate and make available to families of children with an autism spectrum disorder. Visit the DHS Act 62 web page for resources to use when communicating with families, including:

  • Fact Sheet
  • Frequently Asked Questions
  • How to Appeal
  • Sample Appeal Letters
  • Act 62 Infographics

Representatives from the Department of Human Services (DHS) and the Insurance Department reviewed the recently issued Medical Assistance (MA) Bulletin for providers relating to Act 62 titled, Payment of Claims for Services Provided to Children and Adolescents for the Diagnostic Assessment and Treatment of Autism Spectrum Disorder (ASD). The purpose of this bulletin is to remind providers enrolled in the MA Program, both fee-for-service and HealthChoices, of the requirement to bill a child’s or adolescent’s private health insurance company before submitting a claim for the diagnostic assessment or treatment of ASD. New codes will be implemented by September 30. The recording of the webinar is available for review. The Power Point presentations for both the managed care and the service provider presentations are also now available.

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The Department of Human Services (DHS) has just issued a Medical Assistance (MA) Bulletin for providers relating to Act 62 titled, Payment of Claims for Services Provided to Children and Adolescents for the Diagnostic Assessment and Treatment of Autism Spectrum Disorder (ASD). The purpose of this bulletin is to remind providers enrolled in the MA Program, both fee-for-service (FFS) and HealthChoices, of the requirement to bill a child’s or adolescent’s private health insurance company before submitting a claim for the diagnostic assessment or treatment of ASD. It is also to inform providers of the diagnosis codes and procedure codes which will be included in the MA FFS cost avoidance process, effective Friday, September 30. HealthChoices managed care organizations will provide guidance and information to contracted practitioners and providers in the Medicaid managed care system with regard to implementation by September 30.

The DHS clinical staff has identified behavioral health, physical health, and rehabilitation procedure codes that reflect services for the diagnostic assessment and treatment of ASD covered under Act 62. The procedure codes that are on the MA Program fee schedule will be subject to the cost avoidance process for MA FFS claims beginning September 30.

Registration is open now for two webinar sessions on Thursday, August 25 that are being held by DHS in collaboration with RCPA:

  • Session 1, 12:00–1:00 pm: The target audience for this webinar session is BH-MCOs, counties, and county oversight organizations.
  • Session 2, 1:00–2:00 pm: The target audience for this webinar session is behavioral health and pediatric rehabilitation provider organizations.

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RCPA is encouraging leaders and training staff from residential treatment facilities (RTFs) to attend this important event and staff development opportunity on Tuesday, August 30, 10:00 am – 3:00 pm at the Child Welfare Resource Center, 403 Winding Hill Road, Mechanicsburg.

The day’s agenda will include a presentation on youth suicide prevention by Dr. Matt Wintersteen, covering such topics as risk assessment and safety planning. Following the networking lunch will be a presentation on an evidence-based screening tool and a review and discussion of enhancing family engagement and the attachment-based family therapy model. The day will also include an introduction to a specific suicide prevention and intervention approach and strategies for implementing a train-the-trainer resource for interested RTFs. Register here for this event.

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RCPA is collaborating with key state agencies to host a very important webinar on changes impacting providers of child and adolescent autism services as well as HealthChoices managed care organizations. Representatives from the Department of Human Services (DHS) will review Act 62 of 2008, billing guidance for providers, and the revised ICD-10 diagnostic codes and intervention procedure codes related to children and adolescents with autism spectrum disorders. These codes may apply to both commercial health plans and Medical Assistance plans. The webinar will also include updated information and guidance for families. Registration is now open for both sections of the webinar.

The webinar will be held in two sessions on Thursday, August 25, 2016:

  • Session 1, 12:00–1:00 pm: The target audience for this webinar session is BH-MCOs, counties, and county oversight organizations.
  • Session 2, 1:00–2:00 pm: The target audience for this webinar session is behavioral health and pediatric rehabilitation provider organizations.

All participants are welcome to sit in for either or both sessions. Both webinars will be recorded and made available on RCPA and state websites. The DHS Bulletin related to the changes in diagnostic and intervention procedure will be sent to members once it is issued.

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The Department of Human Services (DHS), in collaboration with the Insurance Department, will be implementing updated physical health and behavioral health autism spectrum disorder (ASD) related procedure and diagnosis codes as a key element of the state’s Medicaid (MA) cost avoidance initiative, effective September 30. These changes will reflect a more complete and updated array of ASD related procedure and diagnostic codes that will be recognized by commercial insurance plans as well as MA. The goal of these changes is to identify the service array that is covered by commercial health insurance plans, reduce the financial burden on the MA system, and to improve the uniformity of coding and billing for services. The September 30 implementation date will allow additional time for the state, in collaboration with RCPA, to provide outreach and training to providers of services for children with an ASD. As a member of the state’s Act 62 External Work Group, RCPA will be meeting with DHS to develop materials and plan for informational webinars to prepare providers for these changes. RCPA will provide information and updates as they become available.

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A recent news release from the American Psychiatric Association reports that diagnosis of autism spectrum disorder before the age of 4 means that a child is more likely to get effective, evidence-based treatment, such as behavioral therapy. When children are diagnosed after that threshold, they are less likely to receive such treatment, but they are more likely to be treated with medication, according to research published online in the August 1 release of Psychiatric Services in Advance. The strongest evidence for effective treatment for autism is for behavioral intervention therapy directed at core autism symptoms, such as social skills and inflexible behaviors. Early intensive treatments may have long-term benefits for children’s functioning. Other therapies, including complementary and alternative medicine and medication treatments for autism, are more controversial and are not as strongly supported by scientific studies. Psychiatric Services in Advance articles have been peer reviewed but have not yet appeared in the print journal. Publication ahead of print allows articles to become available in a rapid and timely manner.

The American Academy of Pediatrics recommends that all children be screened for autism at 18 months and again at 24 months. Current information suggests that only about half of primary care practitioners screen for autism. The average age at diagnosis in the United States is more than 4 years old.

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