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Physical Disabilities & Aging

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The PROMISe Eligibility Verification System (EVS) enables providers to determine a participant’s Medical Assistance eligibility and scope of coverage. It is vital for providers to check EVS to verify a participant’s eligibility each time services are provided because a participant’s eligibility is subject to change. EVS methods, inquiries, and response formats will not change with the implementation of Community HealthChoices (CHC).

The attached fact sheet illustrates EVS return codes for participants enrolled in each of the CHC-MCOs and provides examples of the CHC-MCO participant identification cards. If you have any questions, please visit www.HealthChoices.pa.gov or email [email protected].

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To:  Service Coordinators (SC) who serve participants in the Southeast Region
Subject:  SC Training Materials:  Community HealthChoices (CHC) Implementation for Participant-Directed Services

Below are materials from the August 21, 2018 SC training, CHC Implementation and Participant-Directed Services. The purpose of this presentation was to provide information and process updates to SCs on the implementation of CHC for participants who utilize participant-directed services in the Southeast Region, including Bucks, Chester, Delaware, Montgomery, and Philadelphia counties.

Public Partnerships LLC (PPL) will also complete the following items to assist SCs:

  • Update the PPL Service Coordination Entity (SCE) Training Manual, post it to the PPL website and send it out via the PPL Enrollment Managers.
  • Re-record the training (to eliminate the end-of-presentation Q&A issues) and post it to the PPL website. PPL will notify SCEs that the training is posted to the website when PPL sends out the SCE Training Manual.
  • If PPL receives input from SCEs via the Enrollment Managers, PPL will review comments with the Office of Long-Term Living and CHC Managed Care Organizations to determine a follow-up format for an FAQ document, as applicable. If PPL does create an FAQ, PPL will similarly distribute through the Enrollment Managers and post to the PPL website.

If you have any questions, please contact your PPL Regional Enrollment Manager.

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The Office of Long-Term Living (OLTL) released the Service Coordinator (SC) training materials from the Community HealthChoices (CHC) Implementation for Participant-Directed Services training that was held on August 21, 2018. The presentation and training was to provide information and process updates to SCs on the implementation of CHC for participants who utilize participant-directed services in the Southeast Region, including Bucks, Chester, Delaware, Montgomery, and Philadelphia counties.

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

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(From OLTL)

TO: Office of Long-Term Living (OLTL) Cognitive Rehabilitation Therapy Providers
RE: Procedure Code for Cognitive Rehabilitation Therapy Services – Processing Issue

This notice is to advise Cognitive Rehabilitation Therapy Providers that after removing service procedure 97532 SE and replacing it with the new procedure code 97127 for Cognitive Rehabilitation, a processing issue occurred causing many claims to deny.

OLTL is aware of this issue and is working on a system fix.  OLTL will send a follow up communication in the very near future advising providers of the fix and when it is appropriate to rebill.  In the meantime, OLTL asks that providers refrain from billing for Cognitive Rehabilitation in the Independence and OBRA waivers.

If you have any questions regarding the procedure code change, please contact the OLTL Provider Inquiry Unit at [email protected] or 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.

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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.

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(From OLTL)

EVV Implementation Update

The 21st Century Cures Act requires implementation of electronic visit verification (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

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

Providers who do not have their own EVV will be able to utilize the Department’s system for compliance.

For Office of Long-Term Living waivers, including Agency and Participant-Directed Services, PCS includes:

  • Personal Assistance Services
  • Respite (unlicensed settings only)

Additional information will be shared when it becomes available.  You may also look for information on our website at http://dhs.pa.gov/provider/billinginformation/electronicvisitverification/index.htm.  For further questions regarding EVV, please 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.

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.

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The Office of Developmental Programs (ODP) has issued a Health Alert in order to make all providers, staff, and other caregivers aware of the serious issue of choking. All should become familiar with resources to aid in the identification of individuals at risk for choking, the training of staff, and the appropriate documentation of special dietary needs and choking precautions. Swift action is essential to prevent Irreversible harm or death!

There are two key issues to promote safety for individuals:

  1. The information contained in the participants’ care plans, including medical evaluations/recommendations, assessments, Individual Support Plans (ISPs), and any treatment plans used by the agency (hereafter “care plans”) must be accurate, consistent, and followed precisely for feeding plans, supervision of the individual while eating to maintain safety, proper positioning, and the use of specialized equipment.
  2. All staff providing service to an individual must be trained on the individual’s dietary needs, including awareness of proper foods and food textures, supervision needs during meals, proper positioning during a meal, and the use of specialized equipment related to the risk of aspiration and choking.

Action to Take for an Individual Choking:

  • Call 911 immediately! Seconds matter. Do not delay by seeking supervisory approval prior to calling 911.
  • Initiate First Aid with abdominal thrusts.
  • If the individual becomes unresponsive, move him/her to the floor and begin CPR.
  • Contact the health care practitioner after any episode of choking.

A single choking event may be a warning sign for future choking events. This warning sign needs to be taken seriously and follow-up with the health care practitioner can avoid tragic consequences.

Contact RCPA IDD Division Director Carol Ferenz with any questions.

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July 26 marked the 28th Anniversary of the Americans with Disabilities Act (ADA), signed into law in 1990 by President George Bush. The White House released the following proclamation:

THE WHITE HOUSE
Office of the Press Secretary
FOR IMMEDIATE RELEASE

July 25, 2018

Anniversary of the Americans with Disabilities Act, 2018
By the President of the United States of America
A Proclamation

On the 28th anniversary of the Americans with Disabilities Act (ADA), we celebrate this historic legislation, which echoed our Nation’s founding promise to recognize and secure the equal rights of all men and women. Today, we reaffirm our commitment to cultivate further opportunities for all Americans to live full and independent lives, and recognize the many contributions enabled by expanded participation of Americans with disabilities in our society.

President George H.W. Bush signed the ADA into law on July 26, 1990. It has transformed the lives of millions of Americans living with disabilities by promoting their equal access to employment, government services, public accommodations, commercial facilities, and public transportation. Today, people of all ages with disabilities are better able to thrive in the community, pursue careers, contribute to our economy, and fully participate in American society.

Our Nation must continue to build upon this foundation and continue to further the participation of the more than 56 million Americans living with disabilities. My Administration continues to encourage research that will lead to advancements in technology, medicine, and other fields and better enable independent living. We are also expanding and promoting equal education and employment opportunities for Americans with disabilities to live and work. In this regard, in June of last year, I signed an Executive Order to develop more apprenticeship programs for all people, including those with disabilities. Additional training will encourage better involvement from businesses and allow people with disabilities to contribute meaningfully to a wide variety of industries.

As we commemorate the anniversary of the ADA, we recommit ourselves to fostering an environment in which all Americans have the opportunity to pursue the American Dream.

NOW, THEREFORE, I, DONALD J. TRUMP, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim July 26, 2018, as a day in celebration of the 28th Anniversary of the Americans with Disabilities Act. I call upon all Americans to observe this day with appropriate ceremonies and activities that celebrate the contributions of Americans with disabilities and to renew our commitment to achieving the promise of our freedom for all Americans.

IN WITNESS WHEREOF, I have hereunto set my hand this twenty-fifth day of July, in the year of our Lord two thousand eighteen, and of the Independence of the United States of America the two hundred and forty-third.

DONALD J. TRUMP

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