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Medical Rehab

Pursuant to Executive Order 1996-1, the State Board of Physical Therapy (PT) has requested member comments and suggestions on two draft rulemakings.

The first draft rulemaking, 16A-6518-Foreign Trained Evaluation, would amend the board’s regulations so that a foreign-trained applicant would be required to submit an evaluation showing that the applicant’s training was equivalent to what is required in a program accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE) — the accrediting body for United States programs — rather than program contents specified in the regulations.

The second draft rulemaking, 16A-6519-Student in Master’s Program Statement of Policy, is for a statement of policy that would make clear that, for purposes of the exception to the licensure requirement for physical therapy students, the term “Board-approved School” includes all physical therapy programs at a school that has a program accredited by CAPTE, as CAPTE accredits only pre-licensure programs.

The State Board of PT welcomes comments on these draft rulemakings. Comments are due by Friday, January 15, 2016, and should be submitted via email. Please specify rulemaking 16A-6518 (foreign-trained applicant evaluation) or 16A-6519 (student in master’s program) as appropriate on your comments.

On December 10, 2015, the Legislative Budget and Finance Committee (LB&FC) released and presented their report, Implementation of the PA Safety in Youth Sports Act, pursuant to HR 2014-1064. This bill called on the House of Representatives to direct the LB&FC to assess compliance with the Safety in Youth Sports Act, determine the best practices for managing concussions and traumatic brain injuries, and make recommendations on provisions of the act that should be strengthened to be more effective.

While changes were not recommended to the current act, there was concern expressed that concussions are still not taken as seriously as they should be. As a result, it was recommended that the Pennsylvania Department of Education (PDE) develop additional guidelines and recommended practices for schools to follow with regard to identifying, assessing, and managing student athletes suspected of having sustained a concussion. The recommendation was made to PDE to consider the guidelines developed by the New York Department of Education (Guidelines for Concussion Management in the School Setting) as a possible model. The report was accepted and approved to be released.

This article from Capitolwire is a good and extensive overview of what is going on with the budget here in Harrisburg. Health and Human service budget line items are still fluid until the House and Senate negotiate a final budget deal. RCPA will provide updates on any budget deal, and RCPA encourages members to continue to contact the governor and state legislators to inform them why it’s necessary for them to pass a state budget sooner rather than later. Questions, contact Jack Phillips.

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On Thursday, December 10, 2015, from 12:30–1:30 pm, the Centers for Medicare and Medicaid Services (CMS) will conduct a special open door forum to provide a summary of the dry run for inpatient rehabilitation facilities (IRFs) on all-cause unplanned readmissions for 30-day post discharge from IRFs. To participate in the call, dial: 800-837-1935; conference ID: 93892614. Prior to the call, the presentation slides will be posted to the IRF Quality Reporting Spotlight & Announcements page on the CMS website.

On November 23, the leadership of the Office of Mental Health and Substance Abuse Services (OMHSAS), including Deputy Secretary Dennis Marion and Medical Director Dr. Dale Adair, provided a webcast presentation on the development of Applied Behavior Analysis (ABA) services for children with an Autism Spectrum Disorder (ASD). The webcast to more than 130 RCPA members reviewed the current concepts and recommendations developed by a clinical work group, assisting OMHSAS in the development of ABA medical necessity guidelines, clarifying the authorization pathway for Behavioral Health Rehabilitation Services for children and adolescents diagnosed with Autism Spectrum Disorder.

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The Centers for Medicare and Medicaid Services released a Request for Information (RFI) in the November 20, 2015 Federal Register. The RFI is geared to Inpatient Rehabilitation Facilities (IRFs) and will assist in the design and development of a survey regarding patient and family member experiences with the care received in the IRF. Comments will be received until 5:00 pm on Tuesday, January 19, 2016.

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As a reminder to members, inpatient rehabilitation facility (IRF) quality reporting program (QRP) data collected between April 1, 2015 and June 30, 2015 must be submitted by Sunday, November 15, 2015. Additional information, including a list of the quality measure data that is due, is available on the IRF Quality Reporting Spotlight and Announcements web page.

Home Care Rule
Linda Drummond, RCPA director, Intellectual and Developmental Disabilities Division, is working with the PA State Independent Living Council and Temple’s Institute on Disabilities, to determine the impact of the new US Department of Labor’s Home Care Rule on providers. Please share any questions, issues, or recommendations regarding this rule with Linda Drummond, for inclusion with the document being developed for the Department of Human Services, on areas of concern impacting service providers on implementation of this rule. This may be impacting LifeSharing/Shared Living, Participant Directed, and Companionship services.

Today, the Centers for Medicare and Medicaid Services (CMS) released the proposed rule, Revisions to Requirements for Discharge Planning for Hospitals, Critical Access Hospitals, and Home Health Agencies. This revises the discharge planning requirements for hospitals (including inpatient rehabilitation facilities and long term care hospitals), critical access hospitals, and home health agencies; these requirements must be met in order to participate in the Medicare and Medicaid programs. The proposed rule also implements the discharge planning requirements of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, which strives to improve consumer transparency and beneficiary experience during the discharge planning process, by developing a discharge plan based on the goals, preferences, and needs of each patient.

 

Under the proposed rule, hospitals would be required to develop a discharge plan within 24 hours of admission or registration and complete a discharge plan before the patient is discharged home or transferred to another facility. These requirements will apply to all inpatients, and certain types of outpatients, including patients receiving observation services, patients undergoing surgery (or other same-day procedures where anesthesia or moderate sedation is used), and emergency department patients who have been identified as needing a discharge plan. In addition, hospitals will be required to:

  • Provide discharge instructions to patients who are discharged home;
  • Have a medication reconciliation process with the goal of improving patient safety by enhancing medication management;
  • For patients who are transferred to another facility, send specific medical information to the receiving facility; and
  • Establish a post-discharge follow-up process.

The proposed rule is scheduled to be published in the November 3, 2015 Federal Register with a 60-day comment period.