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Policy Areas

Provider Transformation Series
ANCOR and the US Office of Disability Employment Policy are offering a technical assistance series, Virtual Provider Transformation Technical Assistance. This is a six-month program that will feature webinars every three weeks from December 2015 through March 2016. Webinar topics to assist agencies transitioning to community integrated employment services include: Leadership, Strategic Planning, Operations Focus, Workforce Focus, Customer Focus, and Measuring Results. Registration deadline is Monday, November 30, 2015.

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.

RCPA Input Session for Medical Necessity Guidelines for BHRS including Applied Behavioral Analysis

In August 2015, OMHSAS convened a small, time-limited clinical work group to assist in the development of new Medical Necessity Guidelines (MNG) for children and adolescents with ASD. The guidelines are specific to Applied Behavioral Analysis within the home and community based services level of care. The work group is seeking stakeholder feedback on preliminary MNG content prior to issuing recommendations to OMHSAS.

OMHSAS will present an update with Dennis Marion via webcast on Monday, November 23, 2015 from 9:30 – 10:30 am. OMHSAS Deputy Secretary Marion will provide RCPA members with updates from OMHSAS;

L&I State Plan
RCPA has been asked by the executive director of the Senate Labor & Industry (L&I) Committee to provide recommendations related to workforce development for the state’s Department of L&I Unified State Plan, required by the federal Workforce Innovation and Opportunities Act. Please share your suggestions with Linda Drummond by Sunday, November 22.

ODP Updates
The Office of Developmental Programs has released the following information:

Based on the federal Workforce Innovation and Opportunity Act enacted in 2014, the state’s Office of Vocational Rehabilitation (OVR) is required to write its own stand-alone annual state plan, “Vocational Rehabilitation Services Portion of the Combined State Plan.” This is a four-year workforce development strategy. The combined state plan will be available for public comment in January of 2016.

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Today, the Departments of Human Services and Aging announced the release of the draft of the request for proposal (RFP) to procure Community HealthChoices (CHC) and the program requirements that will be part of the agreement with the managed care organizations (MCOs).

The draft RFP, program requirements, and a summary document are available on the CHC website. Comments on the draft RFP should be sent via email (with “Community HealthChoices” in the subject line) by Friday, December 11, 2015.

SCO Committee Clarification
The December 10, 2015, 9:00-11:00 am SCO Committee meeting is for RCPA’s Supports Coordination Organizations that are ODP funded. It is not for Service Coordination under the OLTL waivers.

Benjamin Lawsuit
A class action lawsuit filed against the state in 2009, Benjamin v. Department of Public Welfare, with a settlement agreement finalized in 2014, focuses on transitioning 80 individuals from state centers to the community by June 30, 2015. Since these transfers were not accomplished, an independent reviewer has been retained by the settlement parties to address the reasons and seek recommendations.

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According to sources, it appears the caucuses have a framework in place for the 2015/16 state budget. The proposed plan would spend an additional $350 million for basic education, an additional $50 million for special education, and a 5 percent increase in funding for higher education.

In the potential budget deal, there will be additional property tax relief. Terms were still being negotiated on how the additional education funding will be distributed. Additionally, officials are trying to impose caps on how much school districts can raise property taxes in the future.

The potential budget deal would include:

  • An increase in state spending up to $30.7 billion; that would be a 6 percent increase from last year’s approved budget.
  • $500 million in slot-machine gambling revenue that is currently passed along to homeowners as school property tax cuts. That money would be diverted into a restricted account to pay for public school employee pension obligations.
  • The loss of the slot-machine money for school property tax cuts would be replaced by about $2 billion expected from a state sales tax increase to 7.25 percent, up from the current 6 percent. The rate would rise to 8.25 percent in Allegheny County, where it is currently 7 percent, and to 9.25 percent in Philadelphia, where it is currently 8 percent.

The proposed budget would not include a new tax on Marcellus Shale; however, a cigarette tax and a tax on banks were still being discussed as potential revenue enhancements. Currently, there has been no specific mention of dollar amounts for health and human services, or providers being reimbursed by the Commonwealth for interest payments being made on loans that providers took out to continue health and human services.

Despite a possible agreement, legislators are still cautious about any last minute hiccups that might derail a potential budget deal. The budget deal could blow up if the governor and legislators cannot come to terms on how new money for schools and property tax cuts would be distributed to each district, and how to further limit the ability of school boards to raise taxes as part of the package of new money.

Some of the other budget highlights include:

  • On pensions, the traditional pension benefit would survive, but newly hired public school and state government employees would get a diminished traditional pension benefit, plus a new, 401(k) style plan with a 2 percent contribution. According to estimates, this plan would save the state $12.5 billion in the coming decades.
  • Changes to the state-controlled wine and liquor system were still under discussion, although the sides have agreed to make it part of an overall budget deal.

RCPA will provide updates on any budget deal, and 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. Contact Jack Phillips with any questions.

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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.