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chc

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The Wolf Administration is committed to serving more people in the community while giving them the opportunity to work, spend more time with their families, and experience an overall better quality of life. Community HealthChoices (CHC) is a new initiative that will increase opportunities for older Pennsylvanians and individuals with physical disabilities to remain in their homes. CHC rolled out in the Southwest region on January 1, 2018.

CHC was developed to: (1) enhance access to and improve coordination of medical care and; (2) create a person-driven, long-term support system in which people have choice, control, and access to a full array of quality services that provide independence, health, and quality of life. Long-term services and supports help eligible individuals to perform daily activities in their homes such as bathing, dressing, preparing meals, and administering medications.

Please see this online document that describes how CHC works in coordination with Medicare.

The document is available in alternate format upon request by contacting the Office of Long-Term Living, Bureau of Policy and Regulatory Management, at 717-857-3280. If you have any questions, please visit the HealthChoices web page or submit comments via email.

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The Office of Long-Term Living (OLTL) has released two documents for direct service providers that serve COMMCARE Waiver participants. The documents outline the activities that will occur in the coming months as the COMMCARE Waiver participants transition to either the Community HealthChoices (CHC) program or the Independence Waiver. These documents include a detailed overview and timeline of the transition and a fact sheet about CHC. The COMMCARE Waiver will end statewide on December 31, 2017.

OLTL Service Coordination Entities (SCEs) and participants will be notified of these changes in a separate communication in mid-July.

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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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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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Late on Friday, October 28, the Office of Long-Term Living (OLTL) released a draft Request for Proposal (RFP) for an Independent Enrollment Broker (IEB) to manage the enrollment processes for all OLTL programs. The RFP includes enrollments for Community Health Choices when implemented, Home and Community-based Services Waivers, the Act 150 program, and the LIFE program. Comments are due no later than 5:00 pm on Monday, November 21, 2016, and should be submitted via email by using the drop down menus within the comment template.

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The Departments of Human Services (DHS) and Aging just announced their selection of three managed care organizations (MCOs) for Community HealthChoices (CHC). CHC will coordinate physical health and long-term services and supports (LTSS) to individuals who are dually eligible for Medicare and Medicaid, older Pennsylvanians, and individuals with disabilities.

Through a review of a request for proposals, the following MCOs have been selected to proceed with negotiations to deliver services statewide in Pennsylvania beginning in 2017:

  • AmeriHealth Caritas
  • Pennsylvania Health and Wellness (Centene)
  • UPMC for You

CHC will roll out in three phases. Persons eligible for CHC are individuals aged 21 or older who have both Medicare and Medicaid, or who receive long-term services and supports through Medicaid because they need help with everyday activities of daily living.

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Today, the Departments of Human Services and Aging announced the release of the draft of the request for proposal (RFP) to procure Community HealthChoices (CHC) and the program requirements that will be part of the agreement with the managed care organizations (MCOs).

The draft RFP, program requirements, and a summary document are available on the CHC website. Comments on the draft RFP should be sent via email (with “Community HealthChoices” in the subject line) by Friday, December 11, 2015.

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