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Physical Disabilities & Aging

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Please take two minutes today to ask your US Senators to complete the work begun by the House and vote to renew Money Follows the Person (MFP) program before this session ends!

On Tuesday, the US House of Representatives passed a bill to renew the MFP program for three months. The Senate is NOW considering whether to pass it and send it to the President for his signature. Time is of the essence because Congress is slated to go on recess for the holidays in less than two weeks.

THE ASK: Email your Senators to ask them to vote YES on the IMPROVE Act (HR 7217) through an expedited process known as “the hotline.” Our email tool will allow you to send an email directly to their health staff in Washington, DC, who advise them on their decision-making.

THE DETAILS: Money Follows the Person is an important program that has helped over 85,000 people with disabilities and chronic conditions voluntarily move from state-run institutions into the community. It expired in 2016, and with state programs now running out of funds this is already having consequences for people with disabilities. In its annual survey of state Medicaid directors, the Kaiser Family Foundation found that half planned to discontinue program services or administrative activities if Congress did not renew the MFP program’s funding.

By renewing MFP for three months, the IMPROVE Act gives the program a needed bridge into the new Congress in 2019, where we can advocate for a longer renewal. Read ANCOR’s letter of support for the program here, and learn more about the expedited “hotline” voting process here (page 3, “The Operation of Unanimous Consent” section).

Speak up today so that people with I/DD who want to live in the community can live with their family, friends, and peers – just like everyone else!

Contact Jack Phillips, RCPA Director of Government Affairs, with questions.

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In June of this year, the Office of Developmental Programs (ODP) established a new Special Populations Unit within the Bureau of Autism Services. This unit oversees the management of the Harry M. Settlement and supports efforts to build system-wide capacity to support individuals with communication challenges. A focus of the work will align with the Everyday Lives recommendation that emphasizes the need to build communication supports for the individuals assisted by ODP programs.

ODP has announced a kickoff series of training webinars presented by the Special Populations Unit in the month of December. These trainings will focus on specific topics related to communication. ODP Communication Number 101-18 includes a listing of the training topics, dates and times, and intended audience; this is the reissue of 101-18 which has the correct dates. To register, click on the linked title of each training you plan to attend. Once you pre-register, you will receive an email with instructions to participate, including a new link to join the meeting.

Questions about this ODP Communication should be directed to the ODP Deaf Services Mailbox.

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All Community HealthChoices (CHC) participants have access to emergency and non-emergency medical transportation.  Emergency medical transportation is provided by an ambulance in the event of a medical emergency. Non-emergency medical transportation can help participants travel to and from a medical facility, doctor’s office, hospital, clinic, pharmacy, or medical equipment vendors.

The attached fact sheet outlines transportation options and how transportation is billed and coordinated for CHC participants based on where the participant resides and the type of transportation needed.

CHC goes live January 1, 2019 in the Southeast. To learn more about CHC, take the 30 minute online training. If you have any questions, please visit www.HealthChoices.pa.gov or email [email protected].

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.

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In order to promote improved coordination between Medicare and Medicaid as the rollout of Community HealthChoices (CHC) in the Southeast portion of the state gets closer, the Office of Long-Term Living (OLTL) released a CHC Medicaid/Medicare billing fact sheet. The fact sheet includes information and answers to frequently asked questions (FAQs) regarding coverage and how billing works under CHC.

Contact Melissa Dehoff with questions.

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OLTL outlines the requirements for Electronic Visit Verification (EVV) roll out and the services impacted by it. EVV is required by Managed Care Organizations (MCOs) in the Community HealthChoices SW and SE roll out zones, effective January 1, 2019.

Electronic Visit Verification (EVV) Implementation Update:

The 21st Century Cures Act requires implementation of EVV for personal care services (PCS) and home health services.  For Office of Long-Term Living (OLTL) waivers, including agency and participant-directed services, PCS includes:

  • Personal Assistance Services
  • Respite (unlicensed settings only)

As shared previously, the Department of Human Services (Department) will utilize an open system for EVV.  This means that providers who already have an EVV system will be able to use their existing systems to submit information to the Department’s EVV vendor.  The Department is using the existing PROMISe™ fiscal agent contract with DXC for EVV.

Providers who do not have their own EVV system will be able to utilize the Department’s system for compliance. Providers participating in Community HealthChoices (CHC) can also reach out to the CHC-MCOs they are contracted with to discuss potential opportunities to meet compliance requirements with the CHC-MCO- contracted EVV system, HHAeXchange.

For participant-directed programs in the OLTL waivers, the vendor fiscal agent, Public Partnerships, LLC (PPL), will be utilizing their EVV system, Time4Care, to satisfy EVV requirements.

EVV Implementation Timeline Reminder:

The 21st Century Cures Act requires implementation of EVV by January 1, 2019 for personal care services (PCS).  On July 30, 2018, the President signed a law delaying penalties for implementation to January 1, 2020 for PCS.  The requirement for implementation of EVV for home health services by January 1, 2023 has not changed.

This delay will allow Pennsylvania an opportunity to extend implementation activities and training, to make sure that providers are fully ready for the implementation of EVV.  The tentative plan for Pennsylvania’s implementation of EVV is:

  • January 2019 – PA guidance will be distributed
  • Spring 2019 – provider training will be offered with phased-in system use
  • Summer 2019 – full implementation of system

Additional information will be shared when it becomes available.  You may also look for information on our website.

For further questions regarding EVV, please email [email protected].

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November 15 is Pressure Injury Prevention Day. ODP Medical Director Dr. Gregory Cherpes, MD released a Health Alert with important information for those who provide care to individuals at risk of developing pressure injuries.

The skin is the largest organ of the body. Skin protects the body by creating a barrier to the environment, regulates the body’s temperature, supports peripheral circulation, and helps maintain fluid balance. Skin also is a reservoir for the formation of Vitamin D. The nerves in the skin provide sensations that detect changes in the environment such as heat, cold, touch, and pain. The skin is made of two layers, the epidermis and dermis, which cover the underlying tissues, muscles, and bones. “Skin integrity” refers to the intact, unbroken nature of healthy skin. Open wounds to the skin, such as those that occur with pressure injuries, make an individual more vulnerable to infection, sickness, and death.

This document provides information defining pressure injuries, why prevention is important, who is at risk of developing pressure injuries, signs and stages, treatment, and prevention of these injuries.

Due to the serious nature of pressure injuries, the pain associated with these injuries, and the additional conditions that may result from pressure injuries, prevention and immediate action at the first sign of pressure injuries are of utmost importance. In addition to skin, muscle, and bone loss, bacteria entering the sore can cause infection. In some cases, infection in the tissue can lead to bone infection, also called osteomyelitis. Infections can worsen and result in sepsis (when infection enters the blood), which can lead to shock and even death.

IMPORTANT: Notify the health care practitioner (HCP) if there are concerns for a pressure wound. Because pressure injuries can have many different appearances, the HCP should be alerted to any skin changes that are noted, particularly in areas at risk for pressure injury. Notify the HCP at the first sign of redness that does not resolve within 15 minutes after relieving the pressure.

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ODP issued Communication Number 099-18: Requesting an Enhanced Communication Rate for Services for Individuals Who Use Sign Language. This communication provides a process for providers to request an enhanced communication rate for Consolidated, Person/Family-Directed Support (P/FDS), and Community Living Waiver services for individuals who use Sign Language to communicate. The Harry M settlement agreement was approved by a federal court judge on August 20, 2013 to ensure Pennsylvanians are provided with necessary communication assistance services based on their assessed needs. The enhanced communication rate is available for services for individuals who are enrolled in the Consolidated, P/FDS, and Community Living waiver from providers who have signing staff to serve individuals who use Sign Language to communicate.

An enhanced communication rate is available for the following services:

  • Companion Services
  • In-Home and Community Supports
  • Older Adult Daily Living Centers
  • Community Participant Support (CPS)
  • Small Group Employment
  • Benefits Counseling
  • Supported Employment to include: Career Assessment, Job Finding and Development, Job Coaching and Support
  • Advanced Supported Employment to include: Discovery Profile Outcome, Job Acquisition Outcome, Job Retention Outcome
  • Respite
  • Supports Broker Services
  • Housing Transition and Tenancy Sustaining
  • Residential Habilitation
  • Shift Nursing RN
  • Shift Nursing LPN
  • Behavioral Supports
  • Communication Specialist
  • Therapies to include: Physical, Occupational, Speech/Language, Orientation, Mobility, and Vision
  • Music Therapy
  • Art Therapy
  • Equine Assisted Therapy
  • Consultative Nutritional Services
  • Family Caregiver Support Counseling (with participant present)
  • Supplemental Habilitation
  • Supported Living
  • Life Sharing

Providers who wish to request an enhanced communication rate must complete the Enhanced Communication Rate Request Form and submit the completed form to: ODP’s Deaf Services Mailbox. The Enhanced Communication Rate Request Form can be accessed at MyODP.

The following documentation must be provided in addition to the form:

  • Certificates of completion for the Harry M web-based training
  • Quiz on Harry M training (sent to the provider once the request for the enhanced rate is made)
  • Video of signing skills (sent to the provider once the request for the enhanced rate is made)

Following receipt of a provider’s request, ODP will review the information submitted and determine whether the provider is eligible for the enhanced communication rate. The provider will be notified of ODP’s decision following the review. If additional information or discussion concerning the request is required, ODP will reach out to the contact persons identified on the Enhanced Communication Rate Request Form.

Questions about the contents of this communication may be directed to the ODP Deaf Services Mailbox. This communication obsoletes ODP Announcement 002-17, Requesting Enhanced Communication Residential Habilitation Rates for Harry M Class Members.

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