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Policy Areas

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On September 10, 2015, the Medicare Payment Advisory Commission (MedPAC) conducted a public meeting to discuss Medicare issues and policy questions and approve reports and recommendations to the Congress. Included in the agenda was a session that focused on MedPAC’s task of developing a prototype prospective payment system (PPS) that spans across the post-acute care (PAC) settings, as mandated by the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. The IMPACT Act requires MedPAC to submit a report to Congress regarding this by Thursday, June 30, 2016. Included in the meeting was their presentation Mandated Report: Developing a Unified Payment System for Post-Acute Care. It is expected that MedPAC will conduct multiple public meetings in the months ahead regarding the development of PAC PPS before presenting their draft recommendations.

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Today, the Departments of Human Services (DHS) and Aging (PDA) released their Managed Long-Term Services and Supports (MLTSS) concept paper. This concept paper, which was developed based on public input, describes the plan’s features and includes the following highlights:

  • Coordinates physical health and LTSS through Community HealthChoices managed care organizations (CHC-MCO).
  • Provides participants with a choice of two to five CHC-MCOs in each region.
  • Includes value-based incentives to increase the use of home and community-based services and meet other program goals.
  • Creates a system that allows Pennsylvanians to receive services in the community, preserves consumer choice, and lets consumers have an active voice in the services they receive.
  • Standardizes measures of both program and participant-level outcomes to assess overall program performance and improve CHC over time.
  • CHC-MCOs will be accountable for most Medicaid-covered services, including preventive services, primary and acute care, LTSS (home and community-based services and nursing facilities), prescription drugs, and dental services.
  • Participants who have Medicaid and Medicare coverage (dual eligible participants) will have the option to have their Medicaid and Medicare services coordinated by the same MCO.
  • Behavioral health services continue to be provided through the behavioral health managed care organizations (BH-MCOs), but CHC-MCOs and BH-MCOs will be required to coordinate services for individuals who participate in both programs.

The MLTSS plan, recently re-named Community HealthChoices, is an integrated system of physical health and LTSS which focuses on improving health outcomes and allowing individuals to live safe and healthy lives with as much independence as possible. CHC supports individuals dually eligible for Medicare and Medicaid, older adults, and adults with physical disabilities, in the most integrated settings possible.

Feedback on the concept paper may be submitted through Friday, October 16, 2015. The concept paper feedback will shape the November 2015 request for proposals (RFP) for CHC-MCOs. The RFP will be tentatively awarded in March 2016, contingent upon successful readiness reviews and negotiations. CHC will go live in the Southwest region in January 2017, the Southeast region in January 2018, and the Northwest, Lehigh-Capital, and Northeast regions in January 2019.

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SCO Option
The Office of Developmental Programs (ODP) is offering webcast trainings for supports coordinators regarding the HCSIS Improvements. The first training is offered on Thursday, September 17, 2015 at 1:00 pm. This is at the same time as RCPA’s IDD Committee meeting and our discussion with ODP Deputy Secretary Nancy Thaler.

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On September 15, 2015, an Info was issued regarding a webinar the Office of Long-Term Living (OLTL) will be holding on provider credentialing for Community HealthChoices. The registration link for this webinar sent by OLTL was incorrect. Please use the corrected link below to register for the webinar.

The Office of Long-Term Living (OLTL) will be holding a webinar on Wednesday, September 30, 2015, from 8:30 – 10:00 am for Home and Community Based Services providers and Service Coordination Entities interested in participating in Pennsylvania’s planned Managed Long Term Services and Supports (MLTSS) program, now known as Community HealthChoices. The purpose of the webinar is to provide a high level overview of OLTL’s current provider credentialing process, to obtain input on credentialing MLTSS providers, and to discuss how the provider credentialing process may look for Community HealthChoices. Information on how to access the webinar can be found below.

  1. Please join my Webinar.
    https://global.gotowebinar.com/register/152791275
  2. You will be connected to audio using your computer’s microphone and speakers (VoIP).  A headset is recommended. Or, you may select “Use Telephone” after joining the webinar.

Dial +1 (631) 992-3221
Access Code: 787-398-715
Audio PIN: Shown after joining the webinar
Webinar ID: 103-329-483

For questions regarding this email, please contact the OLTL Provider Inquiry Line at (800) 932-0939.

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Act 153 of 2014 requires the Department of Human Services, in conjunction with the Department of Education and the Pennsylvania Commission on Crime and Delinquency, to conduct a study which includes the analysis and development of recommendations on employment bans for those having contact with children. The study must include recommendations on changes in permanent and temporary employment bans to align and make uniform the provisions under the Child Protective Services Law and the Public School Code. A report of the study’s findings and recommendations must be submitted to the certain committees of the General Assembly by Thursday, December 31, 2015.

In order to complete this work, staff from the Department of Human Services have been conducting research specific to the employment bans within other states as they relate to child care service and school employees along with foster and adoptive parents. RCPA, along with other child serving and child advocacy organizations, has been invited to participate in a process to relate the recommendations to the General Assembly. This group will be meeting under the leadership of the Deputy Secretary for the Office of Children, Youth and Families over the next several months.

RCPA will be requesting that our members who provide services in the areas of child behavioral health, child welfare, pediatric rehabilitation, education, and juvenile justice, provide information regarding current employment bans on program operations, and service capacity and delivery in the communities served by members. Information requested can be sent to Connell O’Brien.

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

  • Announcement #074-15: CMS Final Rule for HCBS Waivers: An Overview Now Professional Developmental Course; webcast now available for all audiences which can include one credit hour for supports coordinators.
  • Pennsylvania’s Lifesharing Coalition is presenting its 2015 Lifesharing Conference on Monday-Tuesday, October 19-20, 2015, at the Ramada Hotel, State College. Keynote speakers will be
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School Based Services Work Group
Tuesday, September 29, 2015
2:00 – 3:30 pm (in person and via webcast)
PaTTAN Pittsburgh: 3190 William Pitt Way, Pittsburgh 

RCPA members providing school based behavioral health and rehabilitation services are encouraged to register and participate in this meeting along with their school partners in the community.

  • Welcome and Introductions
  • Open Forum: Challenges and Potential Solutions in School Based Behavioral Health
    • Family Engagement
    • Challenges for APS and Alt Ed Services
    • Implementing and Sustaining Collaborative SBBH Services
    • Funding, Grants, Contracts, Partner Agreements
    • Certification and Background Checks
  • Open Forum: Challenges and Potential Solutions in Pediatric Rehabilitation Health Care
    • Contracts, Partner Agreements for OT, PT, S&LT
    • Coordination of Autism/Neurobehavioral Services
    • Certification and Background Checks
  • Professional Staff Recruitment and Retention Challenges
    • Licensed Clinical and Rehab Staff
  • Report from the State SBBH Community of Practice

See full agenda here

RCPA thanks the leadership and staff of PaTTAN Pittsburgh for their hospitality.

Meeting will be available via webcast; webcast instructions sent 24-48 hours prior to meeting

Next meeting: January, 2016, date and location to be determined

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The location for the ODP meeting with SCOs on Wednesday, September 16, 2015, from 10:00 am – 4:00 pm, is the Hilton Harrisburg, 1 North Second Street, Harrisburg, PA, 717-233-6000. Coffee and tea will be available in the morning. However, lunch will be on our own.

The invitation is open to SCO directors and two additional key staff from your organization. Pre-registration

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