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Intellectual & Developmental Disabilities

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As we reported in Monday’s Budget Overview Alert, the PA General Assembly and the Governor came to an agreement to repeal the Governor’s PA Overtime Rule. As you may recall, RCPA was part of a wide-ranging coalition headed up by the PA Chamber of Commerce and Industry. The Coalition sought to halt the enactment of this onerous rule. The PA Overtime Rule became effective on January 1, 2021, and implementation would have begun in October.

Prior to its repeal, health and human service providers for the past six-months and during the height of the COVID-19 pandemic had to plan to comply with both the Federal and PA Overtime Rules. Under the PA Overtime Rule, RCPA members had to plan for:

  • Raising their employee’s salary threshold on October 3, 2021. In October 2021, salaried workers earning $40,560/yr, or about $780/week, would have needed to receive a salary increase to at least this amount or be classified as non-exempt;
  • There would have been another increase on October 3, 2022. In October 2022, the employee salary threshold would have been raised to $45,500/yr, or about $875/week;
  • Plan for another automatic increase in October 2023 and every three years thereafter (i.e. after 2023, the next increase will occur in 2026); and
  • The employer would still have to show the employee still met both the salary test and the duties test to qualify as exempt.

If you recall, the Federal Department of Labor published its final rule on Friday, September 27, 2019. The Federal rule:

  • Raised the salary threshold from the current $23,660 ($455/week) to $35,568 ($684/week);
  • Became effective 1-1-2020;
  • Did not automatically update or change the duties test; and
  • Allowed nondiscretionary bonuses, incentive payments, and commissions to satisfy up to 10 percent of the salary requirement.

RCPA applauds the General Assembly and the Governor for repealing this duplicative and unnecessary rule.

If you have any questions, please contact Jack Phillips, Director of Government Affairs.

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Today, we received the below email from the Health Resources & Services Administration (HRSA) concerning the Provider Relief Fund.

Dear Stakeholder,

The Provider Relief Fund (PRF) Reporting Portal is now open for providers who need to report on the use of funds in Reporting Period 1. HRSA is committed to supporting the providers who have received PRF payments in completing their reporting requirements successfully. We communicated with providers this morning and we want to share that message with you.

To aid stakeholders as they support their networks, we have created two resources that contain easy-to-share information like a general email, newsletter, and social media content:

In addition, there are resources specifically for providers:

Provider Support Line at (866) 569-3522 for TTY dial 711. Hours of operation are 8:00 am to 10:00 pm CT, Monday–Friday.

HRSA will host a recorded webcast on July 8, 2021 at 3:00 pm ET to provide technical assistance on reporting requirements for PRF recipients and interested stakeholders. Interested parties can register to attend here. We hope you can join us and help spread the word.

We will be in touch as additional resources are developed in the future. Thank you for all you are doing to help your communities throughout this COVID-19 pandemic.

Thank you,

The Office of Provider Support

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Message from the Office of Developmental Programs:

Dear Community Participation Service (CPS) Providers:

As vaccination rates have climbed and transmission rates have declined, individuals and families are requesting supports and services return to pre-pandemic levels. CPS programs are a major support, and individuals are anxious to return to their programs, see their friends, and have an active lifestyle once again.

To assess current and future CPS service availability, the Office of Developmental Programs (ODP) is collecting information from providers in order to support individuals and families as we move forward. We request that providers complete the survey for each enrolled service location. This survey is to collect data on in-person services only, not remote services.

To access the survey, please visit here. ODP is requesting that all providers complete by Friday, July 9, 2021. This information is critical for planning purposes, and ODP appreciates provider participation in the survey. Please direct all questions here.

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Photo by Alena Shekhovtcova from Pexels

Beginning on July 1, 2021:

  • Anyone wanting to be vaccinated can find a vaccine provider at Vaccines.gov.
  • If you need assistance finding a vaccine provider, you can call 1-800-232-0233. You will need to schedule an appointment to be vaccinated with the selected provider. If you have questions about the vaccination process, call the Pennsylvania Department of Health hotline at 1-877-724-3258.
  • If you are unable to leave your home and wish to be vaccinated, please contact your HealthChoices Managed Care Organization (MCO) or local Area Agency on Aging (AAA) to coordinate your access to the vaccine.
  • Individuals may also contact the ODP Customer Service Line, Monday–Friday from 8:30 am–4:00 pm, at 1-888-565-9435 (TTY number: 1-866-388-1114) if they are unable to secure a vaccination through these other means.

As a reminder, Support Coordinators (SC) should continue to support individuals with ensuring vaccine access and scheduling vaccination appointments. As such, SCs should be aware of vaccine and vaccination process information.

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ODP Announcement 21-051 serves as a reminder to all stakeholders that on July 1, 2021, the IM Bulletin 00-21-02 (which was issued March 1, 2021) will be effective. Changes to the Enterprise Incident Management (EIM) system that align with the new bulletin will go live July 1, 2021. In addition, this communication is intended to draw attention to existing communications, available trainings, and resources, as well as other necessary activities, in order to ensure successful implementation.

All Office of Developmental Programs (ODP) stakeholders who are responsible for incident management activities are now responsible to adhere to and implement all policies and procedures that are outlined in the IM Bulletin 00-21-021 beginning July 1, 2021.

As outlined in the live EIM training session, the following three EIM reporting and functionality activities will be effective July 1, 2021:

  1. The reporting of COVID-19 positive cases will be captured under the primary category of Illness and a secondary category of COVID. This replaces the use of the reporting categories of Emergency Room Visit — Illness New previously communicated in ODP Announcement 20-037.
  2. An incident that requires investigation by a Department-certified investigator will contain two new documents as part of the workflow:
    • The existing Provider Investigation document has been replaced with the Provider Certified Investigator Report (CIR).
    • The Provider Administrative Review document is a new document and will require completion before an incident may be submitted for review and closure.
  3. A new Incident Administrative Reviewer user access role (PW-EIM-IncidentAdmRev) has been created in EIM. Providers will ensure that this role is added through Identity Manager by the agency’s BP-Admin in order for a user to initiate, data enter, and submit the Provider Administrative Review document.

Reminder: Please continue to visit MyODP and HCSIS, as new trainings and resources will to be posted and updated.

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Information from ANCOR and Invite to an ANCOR Member Only Meeting Friday, July 2

Just the Highlights

  • The Better Care Better Jobs Act seeks to translate President Biden’s proposal for $400 billion in HCBS funding into actionable legislation.
  • The proposal offers many positive provisions, some of which have the potential to transform the Medicaid HCBS program, as well as a couple that may potentially raise implementation challenges.
  • Join us this Friday at 11 am EDT to learn more during a members-only briefing that will include remarks from Michael Gamel-McCormick, Disability Policy Director for the U.S. Senate Special Committee on Aging.

Dear ANCOR members,

I write to share exciting news about a bill ANCOR is supporting that was introduced in Congress late last week. The Better Care Better Jobs Act, or “Better Care” (S. 2210 / H.R. 4131), is being led in the Senate by Senators Bob Casey (D-PA), Ron Wyden (D-OR), Chuck Schumer (D-NY), Patty Murray (D-WA), Tammy Duckworth (D-IL), Sherrod Brown (D-OH) and Maggie Hassan (D-NH), and in the House by Representatives Debbie Dingell (D-MI), Frank Pallone (D-NJ), Jan Schakowsky (D-IL) and Doris Matsui (D-CA). The bill has already garnered support from more than 40 co-sponsors in the Senate.

Better Care seeks to translate President Biden’s proposal for $400 billion in HCBS funding into actionable legislation. Although the bill includes a few challenging provisions, on the whole, Better Care is nothing short of transformative, and ANCOR supports it for the investments it would make in the Medicaid Home and Community Based Services (HCBS) program, including both significantly expanded funding and structural transformations to strengthen the program. If passed, Better Care would allocate as much as $50 billion per year for the next 10 years in new HCBS spending, making it the single largest investment in the 50-year history of HCBS.

The proposed legislation includes a wide array of provisions, which you can learn more about by reading the full text of the legislation or the accompanying summary. However, there are several key highlights ANCOR is particularly excited about, some of which were included in the proposal expressly because of our advocacy. Among other provisions, Better Care would:

  • Increase the Federal Medical Assistance Percentage (FMAP) by 10 percent for the next 10 years. This FMAP enhancement would be in addition to the current 10-percent increase that went into effect for one year starting on April 1.
  • Allocate $100 billion for states at the onset of the funding increase described above to initiate an implementation planning process that includes stakeholder engagement.
  • Safeguard the delivery of services to current HCBS beneficiaries without jeopardizing the ability of potential beneficiaries to receive services by making new federal funding contingent on agreement by states not to (1) cut existing services or (2) make eligibility standards more stringent.
  • Require that states pay sufficient reimbursement rates to providers and mandate that reimbursement rates be reviewed at least once every two years. The biennial review process would mandate stakeholder engagement, to include providers, people with disabilities and their family members, direct support professionals and others.
  • Establish in statute “direct support professional” as a professional classification (i.e., distinct from personal care attendants, home health aides, etc.) and direct the U.S. Department of Labor to work with the Centers for Medicare and Medicaid Services to establish a Standard Occupational Classification for DSPs.
  • Offer, for the first time, FMAP funding to U.S. territories such as Puerto Rico and American Samoa, to supplement the territories’ existing Medicaid block grant funding.
  • Commit to the establishment of a set of standardized quality measures within two years of the bill’s passage.

Individually, these seven provisions have the potential to be gamechangers. Together, their potential is nothing short of transformative.

And—as with all legislation—Better Care is not perfect. Included are two particular provisions that have the potential to raise implementation challenges or be problematic: (1) a requirement that providers pass through a minimum proportional percentage of their increased reimbursement revenue to DSPs, and (2) an additional 2% FMAP incentive if states establish, either directly or through contracting with one or more nonprofit entities, a registry to connect people seeking services with qualified direct care workers. I flag both of these challenges for you not to suggest that ANCOR will or will not ultimately support these provisions, but rather to underscore that the extent to which we support these provisions will ultimately depend on how the details surrounding their implementation are codified into law.

The details of the Better Care proposal—including its many positive provisions as well the few provisions that demand more detail—mean that you will be essential in its pathway toward becoming law. Like most legislation these days, we don’t anticipate the legislation will secure the 60 votes needed to break a filibuster in the Senate, meaning the surest route for this bill to become law is its inclusion in the budget reconciliation process this fall. If you want to lend your support, there are things you can do now, soon and later to increase its chances of passing:

  • Now: Register for a members-only briefing to learn more about the bill and its path to becoming law. The briefing will take place this Friday, July 2 at 11 am EDT, and will feature ANCOR’s government relations professionals, as well as Michael Gamel-McCormick, Disability Policy Director for the U.S. Senate Special Committee on Aging. Register for free today.
  • Soon: On Friday, we will be issuing an action alert to aggregate support for Better Care and urge members of Congress to sign on in support of the legislation. Be on the lookout for an email from us or visit the ANCOR Amplifier to take action starting Friday.
  • Later: Assuming the bill is destined for the reconciliation process, it will be essential that lawmakers on Capitol Hill hear from constituents like you to preserve its many positive provisions in the version that is ultimately voted on. Stay tuned for more as the events of the summer unfold.

We say it a lot, but the changes ANCOR is championing on your behalf in Washington simply would not be possible without your passion, support and commitment. Thank you for all you’re doing—now, soon and later—to help us ensure this significant federal legislation becomes the law of the land.

Sincerely,

Barbara Merrill

CEO, ANCOR

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Photo by Markus Winkler on Unsplash

Hi all,

1. OSHA has created a web page for materials to help with the OSHA Emergency Temporary Standard (which applies to the ICF-IID program) compliance. COVID-19 Healthcare ETS | Occupational Safety and Health Administration (osha.gov) I found the plan template to be especially helpful. Of note, most of the standards require compliance by July 6, 2021. For the training, physical barriers, and ventilation sections compliance is required by July 21, 2021.

2. On 6/21/21, CMS released a revised version of QSO-20-41-ALL Revised – Guidance related to Emergency Preparedness-Exercise Exemption based on A Facility’s Activation of their Emergency Plan (cms.gov) which states that if a facility is still operating under an activated emergency plan for COVID-19, it may be exempt from the 2021 full-scale exercise.

If the facility is still operating under its currently activated emergency plan, any currently-activated emergency plan will be recognized by surveyors as having met the full-scale exercise requirement for 2021 (even if it claimed the exemption for the 2020 full-scale exercise).

If the facility claimed the full-scale exercise exemption in 2020 based on its activated emergency plan and has since resumed normal operating status, the inpatient provider/supplier is expected to complete its required full-scale exercise in 2021, unless it has reactivated its emergency plan for an actual emergency during its 12-month cycle for 2021.

Reach out if you have questions.

——————————
Catherine Thibedeau
Orono, ME
(207) 866-3769 (103)
——————————

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From the Department of Human Services (DHS):

As you may know, on Monday, June 14, DHS submitted a preliminary spending plan to the Centers for Medicare & Medicaid Services (CMS) that serves as a foundation for Pennsylvania’s planning efforts by outlining our principles and overarching priorities for expanding and enhancing home and community-based services (HCBS). The preliminary plan encompasses many of the stakeholder recommendations that have been made to date. The overarching priorities include:

  1. Increasing access to Home and Community-Based Services (HCBS);
  2. Enhancing HCBS provider payment rates and benefits;
  3. Protecting the health and well-being of direct care workers and direct support professionals through the provision of supplies and equipment;
  4. Recruitment and retention efforts to support the workforce;
  5. Supporting caregivers;
  6. Assistive technology and other supports to improve functional capabilities of persons with disabilities;
  7. Supporting the transition of individuals to community-based living arrangements;
  8. Investing in activities to address Mental Health and Substance Use Disorder treatment and recovery needs of Medicaid beneficiaries; and
  9. Building HCBS capacity and rebalancing Long-term Services and Supports.

The Department of Human Services has already heard from many stakeholders about Pennsylvania’s plan to use the increased Federal Medicaid Assistance Percentages (FMAP) available under the American Rescue Plan, but for those who are unable to submit feedback via email, you are able to do so by participating in Wednesday’s virtual public comment session beginning at 10:00 am. To ensure all who register are able to speak, each individual will have 5 minutes to provide their feedback.

Click on this link to register for the session. You can click here to view Pennsylvania’s preliminary spending plan.

Thank you for your continued collaboration and for all you do to serve Pennsylvanians.

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Direct Support Professionals (DSPs) are one of the critical groups at the forefront of the fight against COVID-19. To show our appreciation, MITC is giving away $5,000 to 13 hardworking and dedicated DSPs who are nominated by someone from their agency.
– 1 prize of $1,000
– 2 prizes of $500
– 10 prizes of $300

MITC values the hard work put forth by DSPs every day and is hoping to show our appreciation through these prizes! The deadline to nominate a DSP is Saturday, July 31, 2021. MITC will share the awardees’ stories during DSP Recognition Week in September 2021.

Nominate Your DSP here.

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