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Physical Disabilities & Aging

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The Medicare Payment Advisory Commission (MedPAC) has released its June 2017 Report to Congress: Medicare and the Health Care Delivery System. This report includes, among other topics, a chapter focusing on implementing a unified payment system for post-acute care. Specifics in this chapter includes implementing a post-acute care prospective payment system (PAC PPS) beginning in 2021 with a three-year transition, lower aggregate payments by five percent, absent prior reductions to the levels of payments, start to align setting-specific regulatory requirements, and periodically revise and rebase payments to keep payments aligned with the cost of care.

Some of the topics included in the other chapters include Medicare Part B drug payment policy issues; redesigning the merit-based incentive payment system (MIPS) and strengthening advanced alternative payment models, etc. MedPAC also released a fact sheet on the report.

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RCPA is partnering with PA Health & Wellness to provide a free webinar on contracting overview and training. We are preparing to ensure continued access of care for participants of the Community HealthChoices program. This webinar will review the PA Health & Wellness contract and the process to become a partner in their network.

This free webinar will be held on Tuesday, June 27, 1:00 pm – 2:00 pm EDT. Please register here. Please download the orientation file.

If you have any questions, please call Melissa J. Siwiec from PA Health & Wellness at 717-551-8020.

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Thu, Jul 20, 2017 11:00 am – 12:00 pm EDT

A PA ABLE Savings Program account gives individuals with qualified disabilities (Eligible Individuals), and their families and friends, a tax-free way to save for a wide range of disability-related expenses, while maintaining government benefits. The state and federal tax-free investment options are offered to encourage Eligible Individuals and  their families to save private funds to support health, independence, and quality of life. Some of the topics that we will discuss include: eligibility requirements for opening a PA ABLE account, the federal and state tax benefits of PA ABLE, and how PA ABLE account interacts with current benefits. Register here for this free webinar.

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Yesterday, the AARP Public Policy Institute released a document, Picking Up the Pace of Change, supported by the AARP Foundation, The Commonwealth Fund, and The Scan Foundation. The report, the third in a series, can be accessed online.

According to authors Susan Reinhard, Jean Accius, Ari Houser, Kathleen Ujvari, Julia Alexis, and Wendy Fox-Grage, the Long-Term Services and Supports (LTSS) State Scorecard aims to pick up the pace of improving LTSS by providing comparable state data to benchmark performance, measure progress, identify areas for improvement, and improve lives.

The goal is for the Scorecard to stimulate a dialogue among key stakeholders, encouraging them to collaborate on strategies for improving their state’s LTSS system. The LTSS State Scorecard — a compilation of state data and analysis — finds that progress toward better support for our rapidly increasing populations that are aging and living with disabilities is slow and uneven, with great variation among states. Still, states made significant improvements in a number of areas.

The two areas with the most significant declines are employment for working-age people with disabilities (21 states) and long-stay nursing home residents moving back to the community (21 states). The Scorecard shows the best, worst, and median scores on 25 indicators and can be compared across states. Pennsylvania’s Scorecard shows performance improvement in eight indicators and one performance decline since the 2014 report. Of the 50 states and the District of Columbia, Pennsylvania is ranked 36 overall and as follows in the five domains:

  • Affordability & Access                   37
  • Choice of Setting & Provider         23
  • Quality of Life & Quality of Care   25
  • Support for Family Caregivers       43
  • Effective Transitions                      28

According to the report, this progress is not enough, even though states are inching toward spending a greater proportion of Medicaid and state LTSS funding on home- and community-based services — a positive trend because it both enables greater independence and is cost-effective. The authors urge accelerated activity so that all states reach much higher benchmarks by 2026; the year when baby boomers begin to turn 80 and begin to experience a greater need for LTSS.

State and federal officials, providers, advocates, and other stakeholders can use the data analytics in this Scorecard to see how their state compares with others and to assess both their successes and areas in need of reform in order to improve support for older people, adults with physical disabilities, and their family caregivers.

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The Pennsylvania Departments of Aging and Human Services recently announced an agreement with Aging Well (a subsidiary of the Pennsylvania Association of Area Agencies on Aging or P4A that represents all Area Agencies on Aging) to partner on the implementation of Community HealthChoices (CHC).

Under this new agreement, Aging Well will have the following responsibilities:

  • Complete the Functional Eligibility Determinations (FEDs) (via subcontracts with AAAs). Aging Well will conduct the FEDs for participants seeking eligibility for long-term services and supports. Aging Well will also perform the annual in-person re-determinations for people over the age of 60. While FEDs currently need to be completed for individuals applying for the Office of Long-Term Living (OLTL) waivers, ACT 150 program, Living Independence for the Elderly (LIFE), and nursing facility coverage, as the commonwealth begins its implementation of Community HealthChoices, Aging Well will continue to fulfill this role. In addition, as the commonwealth transitions from the existing assessment tool (the Level of Care Determination) to the FED, Aging Well will continue to actively support and facilitate this conversion.
  • Conduct Pennsylvania Preadmission Screening Resident Review Evaluation (PASRR-EV Level II Tool) (via subcontracts with AAAs). Aging Well will conduct the screening for individuals with a mental illness, intellectual disability or related condition, who are seeking admission to Medicaid certified nursing facilities regardless of payer source. These individuals must have the PASRR process completed prior to admission to the nursing facility.
  • Annual re-determinations (via subcontracts with AAAs). Prior to the implementation of CHC, Aging Well will conduct an annual in-person re-assessment within 10 business days of request by a service coordinating entity for all Aging Waiver participants. After the implementation of CHC, Aging Well will review FED assessment data collected by the managed care organizations for all CHC waiver participants in order to confirm annual redeterminations of level of care have been properly conducted. This will be completed as a desk review.
  • Conduct CHC outreach and education activities statewide (via partnerships with AAAs, nursing facilities, and community-based organizations). Aging Well will begin outreach and education activities in July 2017 for the rollout of Phase 1. These activities include 20 public information sessions and training of service coordinators and nursing facility staff.

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On Thursday, June 29, 2017, the Centers for Medicare and Medicaid Services (CMS) and the Office of Medicare Hearings and Appeals (OMHA) will host a call from 1:00 pm to 3:00 pm that will focus on the recent regulatory changes to the Medicare claims appeals process. There will also be discussion surrounding the Medicare Appeals Final Rule that was published in the January 17, 2017 Federal Register, as well as the changes that are intended to streamline the administrative appeals processes, reduce the backlog of pending appeals, and increase the consistency in decision making across appeal levels.

To participate in the call, registration is required by 12:00 pm on June 29, or until the event is full. Following the presentation, time will be allocated to a session for questions and answers.

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In this year of challenging state-level budget negotiations, RCPA is working with a coalition of community foundations, United Way organizations, Labor Unions, religious and advocacy groups, and other key stakeholders in the #FamilyFirstPA Coalition. The growing list of coalition members can be viewed on the #FamilyFirstPA#FamilyFirstPA website. The main goal of the #FamilyFirstPA Campaign is to ensure that there are no cuts to human services in upcoming 2017/2018 state budget. Cuts to human services not only cause irreparable damage to Pennsylvania families, but they also have adverse impacts on organizations that our families rely on. Sharing family stories via social media was the first phase of this campaign. Now, we need your support to push our efforts to the next level. As a coalition partner, RCPA is encouraging our members to amplify the work of the coalition by making use of the social media resources created by this initiative for the coalition. Engage with #FamilyFirstPA on social media; “Like” us on Facebook and “follow us” on Twitter. The initiative is now sharing family stories from across Pennsylvania and engaging legislators through our posts and tweets. Encourage your staff, families, other organizations, county and state level stakeholders, to like and follow the campaign as well.

Any questions about the work of the #FamilyFirstPA Coalition can be directed to Connell O’Brien, who is serving as liaison between RCPA and the #FamilyFirstPA initiative.

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The Office of Long-Term Living (OLTL) recently announced an upcoming stakeholder meeting regarding the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Home and Community-based Services (HCBS) survey. This meeting, scheduled for Wednesday, June 7, 2017, at 1:30 pm, will include representatives from the State of Connecticut (CT) who will share their experiences during the testing of the tool. Members are invited to participate in person (Honor’s Suite 333 Market Street Tower, Harrisburg, PA) or via webinar by registering prior to the meeting. After registering, you will receive a confirmation email containing information about the webinar. Members are encouraged to submit any questions for the representatives from CT in advance of the call to Melissa Dehoff by 12:00 pm on Tuesday, June 6.

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Webinar and FAQ Available on Home and Community-Based Settings (HCBS) Requirements

On March 7, 2017 and March 9, 2017, the Office of Long Term Living (OLTL) held webinar presentations on the Home and Community-Based Settings (HCBS) Requirements as described in OLTL Bulletin 59-16-14. This training was to provide guidance on the HCBS Final Rule and provide steps providers of waiver services must take in order to comply with the rule. A recording of this training, the powerpoint presentation, and an FAQ from these training sessions are now available on the DHS website.

Questions on the HCBS Final Rule should be sent via email.  For questions, call 717-783-8412.

A listserv has been established for ongoing updates on the CHC program. It is titled OLTL-COMMUNITY-HEALTHCHOICES, please visit the ListServ Archives page 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 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 to update or register your email address.

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Join MITC and RCPA on Thursday, June 1, 2017, 10:30 am–12:00 pm, at Penn Grant Centre (RCPA) for a special presentation on Workforce Management Priorities for Physical Disabilities and Aging (PD&A) Division members. This registration was previously an in-person meeting, but is now also available by webcast. We look forward to your participation. Register now to join in on this educational and networking event.

Following this presentation, the Physical Disabilities & Aging Division will meet at 1:00 pm. Deputy Secretary Jen Burnett and other Office of Long-Term Living (OLTL) representatives will be in attendance to discuss Community HealthChoices (CHC) and provide other OLTL updates. Also attending will be Josh Sloop, President, Government Programs, PA Health and Wellness, presenting on rebalancing strategies and the importance to CHC success. Register here for the PD&A Division meeting.

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