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Policy Areas

Due to the recent release of the final version of the proposed Chapter 6100 regulations, we are changing the format of our upcoming IDD and SCO Committee meetings. We will still meet on Thursday, September 13, 2018; however, the full IDD Committee will now be meeting at 9:00 am.

Acting Deputy Secretary Kristin Ahrens will attend along with Karen Kroh and Julie Mochon from 9:00 am till 11:00 am. Karen Kroh (Regulatory Consultant) will review the comments that RCPA submitted December 16, 2016 and will report on the department’s response to each comment. We will also review the whole package of the new Chapter 6100, and updates to Chapters 6400, 6500, 2380, 2390, and 6200.

This is a great opportunity for our members to speak to ODP representatives about the proposed changes and how they will affect the services you provide. These proposed changes represent over three years’ worth of work on creating updated regulations that strengthen community services and supports to promote person-centered approaches, community integration, personal choice, quality in service delivery, health and safety protections, competitive integrated employment, accountability in the utilization of resources, and innovation in service design.

As a result of this change, you will need to register (or re-register) for the meeting since the times have changed, and there is now an option to order a lunch, even if you have already registered for the meeting. We apologize for any confusion, but believe it was important for members to have this opportunity. Register here to participate.

The schedule for the day will now include a break at 11:00 am. You can order a lunch through the catering service, you can bring your own, or go to a nearby restaurant and return for the remainder of the meeting.

After the short lunch break, we will begin again with the full IDD Committee meeting — guests include Kelly Arnold, ODP Employment Lead, Julie Mochon to discuss the Technical Guidance for Claim and Service Documentation, and Rick Smith to discuss recent audit findings from the QA&I Year Two.

The SCO Subcommittee will meet after the IDD Committee and will conclude the day by 3:30 pm. Contact Carol Ferenz, IDD Division Director, with any questions.

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The Centers for Medicare and Medicaid Services (CMS) has released the updated Inpatient Rehabilitation Facility Quality Reporting Program (IRF QRP) Measure Calculations and Reporting User’s Manual (Version 3.0). This version of the manual is effective on October 1, 2018. The manual provides detailed information for IRF Patient Assessment Instrument (PAI) based quality measures, including inclusion and exclusion criteria, quality measure definitions, and measure calculation specifications. All of the materials are available on the Downloads section located at the bottom of the IRF Quality Reporting Measures Information web page.

Contact Melissa Dehoff, RCPA Director of Rehabilitation Services, with any questions.

The Office of Long-Term Living (OLTL) is pleased to announce that Public Partnerships, LLC, has been selected as the new statewide Vendor Fiscal/Employer Agent (VF/EA) for Financial Management Services (FMS) for OLTL-administered programs. The VF/EA performs fiscal-related functions for the successful operation of participant direction for multiple home and community-based waivers managed by OLTL. FMS reduce the employer-related burden for participants while making sure Medicaid and Commonwealth funds used to pay for services and supports are managed and disbursed appropriately as authorized. The new contract will begin on October 1, 2018.

If you have any questions regarding this email, please contact the OLTL provider helpline at 1-800-932-0939.

A listserv has been established for ongoing updates on the CHC program. It is titled OLTL-COMMUNITY-HEALTHCHOICES, please visit the ListServ Archives page at http://listserv.dpw.state.pa.us to update or register your email address.

Please share this email with other members of your organization as appropriate. Also, it is imperative that you notify the Office of Long-Term Living for changes that would affect your provider file, such as addresses and telephone numbers. Mail to/pay to addresses, email addresses, and phone numbers may be updated electronically through ePEAP, which can be accessed through the PROMISe™ provider portal. For any other provider file changes please notify the Bureau of Quality and Provider Management Enrollment and Certification Section at 1-800-932-0939 Option #1.

To ensure you receive email communications distributed from the Office of Long-Term Living, please visit the ListServ Archives page at http://listserv.dpw.state.pa.us to update or register your email address.

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

Today the long awaited Chapter 6100 regulation package has been sent in final form to the Independent Regulatory Review Commission (IRRC). It is anticipated that an IRRC public meeting for the regulation package will be held on October 18, 2018. Everyone that commented is receiving a copy either via email or hard copy; also the whole regulatory package can be accessed here. This should also be posted on the IRRC website sometime next week.

Here are some tips for reading the regulations:

Chapter 6100 — underlines are the additions from the proposed rulemaking; [brackets] are the deletions from the proposed rulemaking.

Chapters 2380, 2390, 6400, 6500 — (four codes appear) underlines are the proposed additions from the current regulation; [brackets] are the proposed deletions from the current regulation; UPPERCASES are the final additions from the proposed rulemaking; strikethroughs are the final deletions from the proposed rulemaking.

We plan to have an opportunity to review the regulation package with ODP representatives at our upcoming IDD Division meeting on September 13.
Contact Carol Ferenz, RCPA IDD Division Director, with any questions.

Due to the joint efforts of the Office of Developmental Programs (ODP), and Office of Vocational Rehabilitation (OVR), the College of Employment Supports (CES) Association of Community Rehabilitation Educators (ACRE) Basic Employment Certification Course became available to providers of employment and prevocational services in April of 2018. This course consists of two parts, 11 self-directed online modules and a CES ACRE Supplement. The supplement portion of the curriculum consists of 4 instructor-led webinars, case studies, and field assignments that are reviewed and approved by an instructor from the Institute for Community Inclusion (ICI).

In order to obtain the complete ACRE Basic Certificate of Achievement, participants must complete both Part 1 and Part 2 of the CES Certified Training.

To answer questions from learners and provide clearer information about this useful resource for employment, a webinar titled ACRE Basic Employment Certification Course Certification Overview is being conducted on Tuesday, August 28, 2018 from 9:00 am – 10:00 am.

To register, please visit the College of Employment Services Registration web page.
Event number: 742 900 315

If you have additional questions about CES or the webinar, please contact PACES.

See ODP Communication Number 079-18 for further information about this announcement. Or submit any questions via email.

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The Office of Long-Term Living (OLTL) recently issued a notice to share that Community HealthChoices (CHC) pre-transition notices were being sent this week to individuals eligible for CHC in Bucks, Chester, Delaware, Montgomery, and Philadelphia counties. If members receive questions from eligible enrollees, they should encourage them to visit the HealthChoices website for more details or to enroll in information sessions. Please note that information sessions are intended for potential enrollees, and providers may attend only if they are not taking a spot from a potential enrollee. A copy of the notices and all CHC participant communications are available online.

OLTL also issued a CHC Complaints and Grievances Fact Sheet. CHC offers protections for participants who disagree with a CHC managed care organization (CHC-MCO) decision to deny or decrease a service or approve a service or item that differs from what was requested. Participants also have protections if they are dissatisfied with their CHC-MCO.

Contact Melissa Dehoff, RCPA Director of Rehabilitation Services, with questions.

The Office of Developmental Programs (ODP) will be performing an automated data fix to adjust service segments (i.e. split service authorizations) on all applicable FY 2018/19 plans to account for the new VF/EA FMS organization, Palco, Inc. After the data fix and once notified that the participant has transitioned to Palco, Inc., AEs and SCOs should review each impacted ISP to determine if the data fix adjusted the plan appropriately to meet the needs of the individual. SCs/SCOs should collaborate with AEs to confirm if any additional ISP changes are required and perform critical revisions as needed.

The anticipated Data Fix Implementation Date is Thursday August 30, 2018. Please refer to ODP Communication Number 078-18 for instructions to handle this transition process.  For further information and questions regarding this process, contact your ODP PDS Regional Lead.

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Recently, the Centers for Medicare and Medicaid Services (CMS) posted to the Proposed Recovery Audit Contractor (RAC) Topics web page a proposed complex nationwide review/audit of inpatient rehabilitation facility (IRF) stays, to determine if they met the requirements to be considered reasonable and necessary.

As part of its updated process for initiating RAC audits, CMS now posts proposed topics on its website for public comment for 30 days. Providers can respond to CMS regarding this proposed audit by sending an email.

This year’s Suicide Prevention Conference is on Wednesday, September 12, 8:00 am – 4:30 pm at the Ambassador Hotel and Conference Center in Erie, PA.

The conference theme is First Responders. The keynote speaker, Govan Martin III, retired as a 29-year veteran of the Pennsylvania State Police (PSP) in 2012. In his tenure with the PSP, Govan worked in patrol, crime, and the highlight of his career was becoming Manager of the Member Assistance Program (an internal Peer Support/Employee Assistance Program for the Pennsylvania State Police) in 2000. In 2010, Govan helped create legislation for Confidentiality for Law Enforcement Peer Support and Critical Incidents. Along with the FBI, he started the Annual Law Enforcement Employee Assistance/Peer Support Program Conference from 2006 through 2012 for State Police agencies across the country. He has been a keynote speaker for Suicide Prevention, Employee Assistance/Peer Support Programs, and CISM conferences across the country (e.g., American Association of Suicidology, International Employee Assistance Program Association, the International Critical Incident Stress Foundation, etc.).

Currently, Govan is the Chair of the Board of Directors for Prevent Suicide PA and serves on the First Responder Committee for the American Association of Suicidology.

Govan lost his brother, Michael, in 1980.

Other speakers include:

  1. Mandy Fauble, PhD, LCSW Safe Harbor Behavioral Health of UPMC Hamot
  2. Patty Puline, BS, EdSafeKids Erie/LECOM Health
  3. Dan Eaton, MSN, RNPenn State Behrend College of Nursing
  4. Greg Purchase, LCSW and Bill Hollenbeck, MACity of Erie Fire Department
  5. Ron Bryant, Deputy Warden, Mike Holman, Deputy Warden, and Stacey Petruso Erie County Prison
  6. Chief KellyCranberry Township EMS
  7. Kurt HinkleRetired Firefighter/Paramedic City of Phoenix Fire Department

For more information, please contact Nicole Moore or register at EventBrite.

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Webinar: Value-Based Payment and Contracting Approaches for Caries Management: Implications for State Medicaid Programs

CMS’ Medicaid Innovation Accelerator Program (IAP) Children’s Oral Health Initiative (OHI) Value-Based Payment (VBP) team is hosting a national webinar on Wednesday, August 22, 2018 from 1:00 pm – 2:00 pm ET on monitoring and implementing VBPs, as well as contracting approaches that aim to improve caries management (i.e., assessing and treating the disease process that causes tooth decay).

Despite increases in dental service utilization among children with public insurance, opportunities to better align payment approaches with the quality of care provided remain. Children’s oral experts and representatives from a state participating in a related IAP technical support opportunity will share their insights on efforts to develop and implement a VBP approach to improve pediatric oral health care. Panelists will also discuss considerations and challenges in ensuring financial sustainability for new care delivery models. To register for this webinar, please visit this link.

Contact Robena Spangler, RCPA Children’s Division Director, with any questions.