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Physical Disabilities & Aging

Young caregiver helping older lady to stand up

The Office of Mental Health and Substance Abuse Services (OMHSAS) is pleased to announce the issuance of Bulletin OMHSAS-22-06 titled “Revised Bulletin for Services to Older Adults.”

In 2019, Pennsylvania ranked 7th in the United States for the largest number of adults 65 and older. In the U.S., between 2020 and 2030, the number of older adults is projected to increase by almost 18 million, a 39% increase. The fastest growing segment of the population during the next two decades is expected to be in the age 85 and older group. Social isolation and limited access to supports negatively impact the well-being of older adults.

Depression, anxiety, addiction, and other mental illnesses are not a normal part of aging and should not be considered as such. As individuals age, the support networks utilized to help manage symptoms of a mental illness may change, resulting in individuals seeking services for the first time in their lives.

The development of depressive disorders occurs frequently in older adults, making it critical that comprehensive mental health evaluations are conducted based on presenting symptoms regardless of age. It is important for providers to evaluate for suicidality given that older adult males have the highest suicide completion rate of any age group.

Older persons diagnosed with a neurocognitive disorder, including dementia, who are experiencing symptoms of a mental illness, including depression, anxiety, substance use disorder, post-traumatic stress syndromes, and behavioral agitation, are guaranteed access to mental health services under laws and regulations of the Commonwealth.

If you have questions or concerns related to this bulletin, please email OMHSAS or contact your RCPA Policy Director.

Northampton Community College is offering free online training programs in the fall 2022 for personal care homes (PCHs) and Assisted Living Residences (ALRs). There are a variety of training topics being offered, including Verbal De-escalation Redirection Techniques, Dementia Care in PCH, and Safe Medication Practices.

In the announcement, you can select the linked course titles to register. You may also visit the College’s website. If you have any questions about registering, please contact Northampton Community College via email or at (610) 332-6585.

Participation is limited for each course. If you register and later discover you are unavailable to participate, please cancel your registration to allow other individuals the opportunity to register.

If you need information about additional available training for administrators, please contact the Operator Support Hotline at (866) 503-3926 or electronically.

Registration for the RCPA Conference 2022 Together! is now open! Together! will be held October 11 – 14, 2022, at the Hershey Lodge in person this year. Be sure to register, as the early bird rate is available now until September 9, 2022.

We are excited for the lineup of speakers who will be presenting at this year’s conference, as there will be pertinent information available and discussed for all service areas. Workshop sessions include:

  • Connecting Pieces for Success: Utilizing a Two-Generational Approach and Collaborative Multi-Organizational Work Model to Affect Lasting Change
    • Presented by Sara Newman of Project-Mosaic, Inc.
  • Having Difficult Conversations With Employees
    • Presented by John Amato of Familylinks
  • Specialized Telehealth for Individuals With IDD
    • Presented by Maulik Trivedi of StationMD
  • Improve Clinical Outcomes and Enter Into Value-Based Contracts Using Clinical Data
    • Presented by Dominick DiSalvo of KidsPeace
  • Returning Citizens Housing Smart Model
    • Presented by Claire Ryder and Curtis Gillard of Resources for Human Development, as well as Clayton Moser and Taeesha Smith of PMHCC
  • CMS Home and Community-Based Services Quality Measures Set
    • Presented by Juliet Marsala of Health Management Association

You also won’t want to miss our plenary speakers:

  • Chuck Ingoglia of National Council for Mental Wellbeing and Gabrielle Sedor of ANCOR will give us “Insights From Washington.”
  • Meg Snead of DHS and Jen Smith of DDAP will provide updates on how PA continues to be innovative in health care.

Be sure to check out the entire list of sessions in our brochure, and note that sessions will be recorded to allow participants access after the event.

In addition to an amazing roster of speakers, our 2022 Conference will have an exciting array of sponsors and exhibitors. We thank those who have committed to our conference thus far! If you are interested in sponsoring or exhibiting, visit here for more details.

Questions about the conference may be directed to Carol Ferenz or Sarah Eyster, Conference Coordinators.

The Department of Human Services (DHS) announced they will be accepting comments on Pennsylvania’s Final Statewide Transition Plan (STP) for Home and Community-Based Services (HCBS). This plan applies to Medicaid Waivers under the Office of Long-Term Living (OLTL), Office of Developmental Programs (ODP), and Office of Child Development & Early Learning (OCDEL). The notice is below and includes additional information about upcoming webinars.

HCBS Settings Rule – Background

CMS published the HCBS Rule, which amends the Medicaid regulations for HCBS waivers under section 1915(c) of the Social Security Act. The HCBS Rule supports enhanced quality of programs and services and adds protections for individuals receiving services. The HCBS Rule reflects CMS’ intent to ensure all individuals receiving services and supports through Medicaid waivers have full access to the benefits of community living, including receiving services in the most integrated setting. The HCBS Rule includes a provision requiring states to develop a transition plan to ensure that services will meet federal requirements by March 2023.

Statewide Transition Plan

The Department received initial approval of its STP on August 30, 2016, which can be accessed at the Department’s HCBS Stakeholder Waiver and Planning Team web page.

To receive final approval of Pennsylvania’s STP, the Department is required to complete the following remaining steps and submit an updated STP with this information included:

  • Complete a thorough, comprehensive site-specific assessment of all HCBS settings, implement necessary strategies for validating the assessment results, and include the outcomes of this assessment within the STP;
  • Draft remediation strategies and a corresponding timeline that will resolve issues that the site-specific settings assessment process and subsequent validation strategies uncovered by the end of the HCBS rule transition period (March 17, 2023);
  • Outline a detailed plan for identifying settings that are presumed to have institutional characteristics, including qualities that isolate HCBS beneficiaries, as well as the proposed process for evaluating these settings and preparing for submission to CMS for review under heightened scrutiny;
  • Develop a process for communicating with beneficiaries that are currently receiving services in settings that the state has determined cannot or will not come into compliance with the HCBS settings rule by March 17, 2023; and
  • Establish ongoing monitoring and quality assurance processes that will ensure all settings providing HCBS continue to remain fully compliant with the rule in the future.

This information is included in Pennsylvania’s Final STP for public comment. A presentation providing a general overview of the HCBS Rule and Pennsylvania’s Final STP will be recorded by the Department and posted by the end of August to prepare stakeholders for public comment. Information about where to access the presentation will be published when it is available.

As outlined in the public comment section below, the Office of Child Development and Early Learning (OCDEL), Office of Developmental Programs (ODP), and Office of Long-Term Living (OLTL) will each hold webinars to go over information in Pennsylvania’s STP that is specific to their waivers and programs. Public comment will be accepted during each of these webinars.

Public Comment

Pennsylvania’s Final STP is available for a 30-day public comment period at the Department’s HCBS STP web page. Comments will be accepted no later than 11:59 pm on September 22, 2022. Stakeholders may provide public comment through one of the following methods:

  1. Electronic comments submitted via email
    1. Stakeholders are asked to use the subject header “PA Final STP” and submit comments to this mailbox.
  2. Written comments submitted via mail
    1. Mailing address: Department of Human Services, Office of the Secretary, P. O. Box 2675, Harrisburg, PA 17105-2675.
  3. Verbal and written comments during public comment webinars
    1. The following dates and times below are for stakeholders to participate in the public comment webinars:
      1. Webinar Specific to STP Information for OCDEL
        September 12, 2022
        9:00 am – 10:00 am
        Please register for the webinar via email.
      2. Webinars Specific to STP Information for ODP
        September 8, 2022
        10:00 am – 12:00 pm
        Please register for the webinar.
        September 12, 2022
        1:00 pm – 3:00 pm
        Please register for the webinar.
      3. Webinar Specific to STP Information for OLTL
        September 15, 2022
        2:00 pm – 3:00 pm
        Please register for the webinar.

When submitting electronic or written comments, it is recommended that you include the following information:

  • The page number or Appendix where the information you are commenting on is located; and
  • Which office (OCDEL, ODP, or OLTL) the comment applies to, if applicable.

The Office of Long-Term Living (OLTL) issued the following notice regarding the American Rescue Plan Act (ARPA) one-time payments for personal care homes (PCH) and Assisted Living Residences (ALR):

Background Info:

Governor Wolf signed Act 54 of 2022, which allocates $26.767 million of federal funding from the American Rescue Plan Act (ARPA) for payments to nursing facilities (NF), personal care homes (PCH), and assisted living residences (ALR). To qualify for the one-time payment, a facility must be in operation as of July 1, 2022.

These one-time ARPA funds must be used for COVID-19 related costs not otherwise reimbursed by federal, state, or other sources of funding. OLTL will send a letter with details about the payments, including information about the approved use of and reporting on these funds. An Act 54 Facility Acceptance Form must be completed by September 2, 2022.

Additional information on Act 54, payment amounts and approved use of this funding will be available at the DHS Long-Term Care Providers page.

PCH/ALR Payments:

  • ARPA PCH/ALR Payment #1 — Licensed Occupancy
    • The total funds available for a one-time ARPA payment to PCHs and ALRs pursuant to Act 54 (ARPA PCH/ALR Payment #1) is $24,090,000. Each PCH/ALR Payment #1 is calculated by the dividing the census of the PCH or ALR, as determined by the most recent DHS inspection on or before July 1, 2022, by the total census of all PCHs and ALRs, including those with a special care designation, as determined by the most recent DHS inspection on or before July 1, 2022, to obtain a facility-specific quotient for each PCH and ALR. Each facility’s quotient is multiplied by $24,090,000 to determine its payment amount.
  • ARPA PCH/ALR Payment #2 — Supplemental Security Income (SSI) Residents Served
    • The total funds available for a one-time ARPA payment to PCHs and ALRs pursuant to Act 54 (ARPA PCH/ALR Payment #2) is $2,677,000. Each ARPA PCH/ALR Payment #2 is calculated by dividing the number of individuals for whom the PCH/ALR received a state SSI payment as in March 2022, divided by the total of all PCH’s/ALR’s individuals for whom a state SSI payment was made in March 2022, to obtain a facility-specific quotient. Each PCH’s/ALR’s quotient is multiplied by $2,677,000 to determine its payment amount.

PCHs and ALRs must complete the Facility Acceptance Form by August 26, 2022. Checks will be issued and mailed in the order in which DHS receives the Facility Acceptance Forms.

Act 54 of 2022 requires the ARPA funding to be obligated by December 31, 2024, and spent by December 31, 2026, or returned to the commonwealth. Additionally, these funds must be used for COVID-19 related expenses. Providers must keep documentation to prove that these funds were used for their response to the COVID-19 pandemic in case of an audit. Any person or entity accepting an ARPA payment agrees to provide documentation to DHS, upon request, for purposes of determining compliance with Act 24 requirements. Instructions on expenditure reporting will be provided at a later date.

The Department of Human Services (DHS) recommends that providers consult their accountants or attorneys for further clarification on acceptable uses of ARPA funding. DHS encourages providers to review guidance for eligible expenditures on the U.S. Department of the Treasury website in their Compliance and Reporting Guidance.

Any questions about this information or the Facility Acceptance Form should be sent to PW, OLTL COVID Payments.

Advancing Health Equity: Leading Care, Payment, and Systems Transformation (AHE), a national program of the Robert Wood Johnson Foundation, is seeking applicants for the next cohort of the learning collaborative, which will include five teams comprised of Medicaid agencies, managed care organizations, and health care provider organizations or systems. The learning collaborative will help teams develop shared equity priorities, uncover the drivers of disparities in their member populations, and create payment models to support equity-focused care transformation.

There is growing consensus among health care policy experts that aligning payment and quality improvement activities offers critical opportunities to improve health equity. AHE recently released a Call for Applications to help multi-sector state teams advance their collective health equity goals. The initiative, led by the University of Chicago in partnership with the Center for Health Care Strategies (CHCS) and the Institute for Medicaid Innovation, helps multi-organizational teams reduce and eliminate disparities in health and health care through a variety of approaches, including innovative Medicaid payment and contracting models.

Applications are due September 23, 2022.

Learn More and Apply

Informational Webinar