';
Intellectual & Developmental Disabilities

On February 8, the Department of Human Services (DHS) Secretary Ted Dallas announced the availability of onboarding grant funds to help connect hospitals and ambulatory practices to the Authority’s Pennsylvania Patient & Provider Network, or P3N.

The P3N enables electronic health information exchange (eHIE) across the state through the connection of health care providers to health information organizations (HIO), and the participation of the HIOs in the P3N.

“These grants will assist providers in the efficient delivery of quality services to the individuals we serve across the commonwealth,” said DHS Secretary Ted Dallas. “As more providers participate, individuals will experience better coordination of care and a better quality of health care.”

The grant program, available to Pennsylvania HIOs to enable the connection of inpatient hospital/facilities and outpatient practice or other outpatient provider organizations participating in the Medicaid Electronic Health Records (EHR) Incentive Program, includes:

  • Up to $75,000 to connect each eligible inpatient hospital or other inpatient facility to an HIO;
  • Up to $35,000 to connect each eligible outpatient practice or other outpatient provider organization to an HIO; and
  • Up to $5,000 to enable other eligible providers that do not fit into the two categories above, but want to enable HIE participation and connect to an HIO via a portal.

Each eligible provider will connect via an HIO to the P3N.

Only a single award is permitted to any one hospital/facility or outpatient practice. The anticipated performance period for this grant runs through September 30, 2017.

The grant will:

  • Help providers deliver higher quality and more efficient care, particularly through better care coordination for patients covered by Medicaid;
  • Support provider participation in private-sector HIOs by offsetting connection costs;
  • Incentivize HIOs to join the P3N, a precondition for receiving funding;
  • Support rapid movement toward the participation in eHIE, and support various care reform efforts currently underway across the Commonwealth; and
  • Defray up-front costs for individual providers to join an HIO, thus helping to achieve meaningful use and satisfy obligations under the Medicaid EHR Incentive Program.

This program will be made possible through an $8.125 million grant from the federal Centers of Medicare & Medicaid Services (CMS). Under the terms of the federal grant, CMS will provide 90 percent of the onboarding grant, with the remaining 10 percent funded by the Commonwealth. The grant applications and supporting materials are available online here.

(Information courtesy of DHS)

Northampton Community College is offering free statewide training for personal care home staff and administrators, as well as staff licensed agencies serving individuals with intellectual disabilities. The classes will be held in four regions throughout the state: Northeast, West, Southeast, and Central PA. The training is funded by the Department of Human Services (DHS) and each continuing education class is equal to three annual training hours.

The course descriptions and registration information is available on the Northampton Community College website. Registration is required for attendance and can be completed online or by calling 877-543-0998.

Message from Richard Edley, RCPA President & CEO:

On January 19, 2017, RCPA sent out an announcement urging individuals to contact the governor’s office regarding the concerns over the proposed ODP Medicaid waiver amendments, specifically related to Chapter 2390 licensed vocational facilities and Chapter 2380 licensed adult training facilities. I am pleased to say that this is NOT a necessary step at this time.

I have spoken directly with Nancy Thaler, Deputy Secretary of the Office of Developmental Programs (ODP), and she has notified me that ODP will hold a meeting of all day/vocational providers in early March to review questions, concerns, and the entire process. This is similar to the recent meeting ODP had with all residential providers.

This is in addition to the upcoming three day (01/31 – 02/02) work group of stakeholders being held by ODP to review the proposed regulations and the comments received. I will be representing RCPA and we will have several provider and other member representatives also in attendance.

In light of these meetings and the proposed process, it would be more appropriate to enter in that discussion and suspend direct calls to the governor’s office. While we have concerns, ODP has assured us that there will be a forum and mechanism to voice these concerns and to have a more constructive discussion.

If you have any questions, please contact me. RCPA will certainly provide an update after the conclusion of these meetings.

From: “HS, Secretary’s Office”
Date: January 5, 2017 at 1:01:56 PM EST
To: “DHS-STAKEHOLDERS@LISTSERV.DPW.STATE.PA.US”
Subject: [DHS-STAKEHOLDERS] DHS Awards Medicaid Agreements

Department of Human Services (DHS) Secretary Ted Dallas announced that DHS has agreed to move forward and negotiate agreements with six managed care organizations (MCOs) to deliver physical health services to Pennsylvanians through HealthChoices, Pennsylvania’s mandatory Medicaid managed care program since 1997.

“These agreements will be the most significant changes to Pennsylvania’s Medicaid program since we moved to managed care two decades ago,” said Dallas. “Over the next three years, MCOs will be investing billions of dollars in innovative approaches that reward high-quality care that improves patient health rather than just providing services for a fee.”

The $12 billion, three-year contracts include a 30 percent target for payments based on value received or outcomes, rather than on the quantity of services provided.

The MCOs were selected based on several criteria, including their current performance, the level of customer service delivered, member satisfaction, and their value-based performance plan. Performance criteria measured, among other things, management of chronic conditions such as high blood pressure, diabetes, and asthma; frequency of prenatal and post-partum care; and access to preventive services.

“The average performance ratings of the selected organizations are consistently higher than the current averages in every region. This transition will result in higher levels of quality care for the 2.2 million Pennsylvanians served by Medicaid,” said Dallas.

To drive Pennsylvania’s Medicaid system towards these better outcomes, the three-year agreements set gradual targets for all MCOs to increase the percentage of value-based or outcome-based provider contracts they have with hospitals, doctors, and other providers to 30 percent of the medical funds they receive from DHS. The result will be that billions in funds that would have otherwise been spent on traditional payment arrangements will instead be invested in outcome or value-based options such as:

  • Accountable care organizations (voluntary networks of hospitals, doctors, and other providers that work together to provide coordinated care to patients);
  • Bundled payments (increases value-based purchasing);
  • Patient-centered medical homes; and
  • Other performance-based payments.

“We’re going to reward folks for providing the right services, not just more services. You get what you pay for so we’re shifting the focus of Pennsylvania’s Medicaid system toward paying providers based on the quality, rather than the quantity of care they give patients,” said Dallas. “In addition, by focusing on improving the health of consumers, we will drive down the cost of care and ultimately save the taxpayer funds we spend on health care in Pennsylvania.”

HealthChoices delivers quality medical care and timely access to all appropriate services to 2.2 million children, individuals with disabilities, pregnant women, and low-income Pennsylvanians.

For more information, visit www.HealthChoicesPA.com or www.dhs.pa.gov.

DHS has selected the following MCOs to proceed with negotiations to deliver services in Pennsylvania beginning in June 2017. The agreements are awarded in five geographic regions:

Southeast Region Gateway Health
Health Partners Plans
PA Health and Wellness
UPMC for You
Vista–Keystone First Health Plan
Southwest Region Gateway Health
PA Health and Wellness
UPMC for You
Vista—AmeriHealth Caritas Health Plan
Lehigh/Capital Region Gateway Health
Geisinger Health Plan
Health Partners Plans
PA Health and Wellness
Northeast Region Gateway Health
Geisinger Health Plan
UPMC for You
Northwest Region Gateway Health
UPMC for You
Vista—AmeriHealth Caritas Health Plan

###

CESP Exam Logo

Earn the Designation of Certified Employment Support Professionals (CESP™)
by Passing the National CESP™ Examination

Hawley, PA Exam (information/registration links)
Wednesday, February 15, 2017

Wyomissing, PA Exam (information/registration links)
Wednesday, April 19, 2017

WHO SHOULD TAKE THE CESP™ EXAM?

Job Coaches • Job Developers • Transition Employment Specialists • Job Placement Specialists • Employment Specialists/Consultants • Employment Managers and/or Directors

What is CESP™ Certification?

  • CESP™ certification is a national credential for Employment Support Professionals who assist people with disabilities in finding and maintaining regular, community-based employment.
  • The CESP™ credential is earned by passing a comprehensive examination based onnational standardized competencies.
  • CESP™ certification is a complement to program certification and licensing, demonstrating a level of professionalism has been achieved.
  • The CESP™ certification is a national, portable, individual credential that remains valid for three years.

What are the Benefits of EARNING THE CESP™ Credential?

  • CESP™ certification opens the door to: improved professional advancement & job opportunities, increased income opportunities, and enhanced credibility with employers
  • Become a member of a rapidly growing, elite group of professionals:

• Reduced APSE membership fee
• National networking opportunities
• Exclusive access to CESP ™ publications & webinars
• A professional credential — not just a certificate of completion
• CESP™ Meet-ups
• CESP™ LinkedIn Group
• Your name listed on the APSE website
• Recognized as a leader in your field

The decision for Pennsylvania to postpone the implementation of Community HealthChoices (CHC) was announced today. This decision was made as a result of the delays associated with the resolution of several bid protests.

Following the announcement of the selection of the managed care organizations (MCOs) that would deliver health care coverage in Community HealthChoices, several protests were filed. As a result, the progress of major components of CHC implementation was delayed, resulting in the Department of Human Services (DHS) feeling uncertain with moving forward with their established start dates. Some of the impacted activities associated with this decision include:

  • Developing an adequate network: DHS has not been able to engage with the selected offerors. The agreement and rate negotiations and finalization typically take six weeks, and the agreements need to be finalized before the MCOs are able to engage in network development activities. The current delays mean the MCOs will not have enough time to meet the network adequacy requirements by July 1, 2017.
  • Completing a readiness review: Readiness review is a requirement for the MCOs before they are certified to be able to go live and provide services. Protests prohibit MCO engagement for readiness review and the window to complete the certification continuously shrinks. New programs require a minimum of six months to complete a readiness review.
  • Communicating: Communication about selected MCOs and their available networks is a critical component to CHC education and outreach. Individuals who will be enrolling in CHC need to have complete information about the MCO provider network in order to be able to make an informed provider choice. That communication will not be able to take place until the agreements are largely finalized and the MCOs are in a position to provide network information.

Important dates to note include:

  • Phase 1 will now begin in January 2018 in the Southwest region of the state.
  • Phase 2 will now begin in July 2018 in the Southeast region of the state.
  • The January 2019 start date for the rest of the state remains unchanged.