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Department of Human Services

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Harrisburg, PA – The Pennsylvania Department of Human Services (DHS) today released the latest issue of the Positive Approaches Journal, which aims to provide the most recent research and resources for people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities to live an everyday life. This edition focuses on sexuality and connectedness.

“Part of DHS’ mission is to ensure that people, regardless of disability, have the resources and information they need to live an everyday life. But too often, people with intellectual and developmental disabilities do not receive the support or education they need to be safe and healthy while exploring and experiencing social connections and sexuality,” said Acting DHS Secretary Meg Snead. “We hope that this edition of the Positive Approaches Journal will provide some of those resources and will chip away at myths and misconceptions about socialization and sexuality within the disability community.”

This edition features research and articles on the following:

  • Embracing Inclusion: Prioritizing LGBTQIA+ Inclusion for People with Intellectual and Developmental Disabilities: This article outlines the barriers and lack of supports that LGBTQIA+ people with disabilities face and emphasizes the importance of recognizing the needs of people who live at the intersection of these two identities.
  • Responding to the Victimization of Individuals with Intellectual Disabilities and Autism: This article details how sexual education and resources for people with disabilities can improve relationships and reduce the risk of victimization.
  • Detangling Sexuality Information: Misinformation, Confusion or Hope: This article outlines the importance of comprehensive sexual education, as lack of such education can create a dangerous lack of understanding of consequences and a misinterpretation of sexual nuances.
  • Approaching Sexuality in Service Spaces: An Invitation to Deeper Inquiry: This article explores ways both behavioral health providers and clients can express vulnerability in discussing sexuality and the sensitivities that surround it.
  • Building a Socially Fulfilling Life with a Mental Health Diagnosis: A Firsthand Perspective: A Certified Peer Specialist’s personal story of how helping others in managing their mental health was a crucial part of understanding social needs and their own recovery.
  • Social Skills for the “Real World”: Lessons Learned from the Autism Services, Education, Resources and Training (ASERT) Social Skills Groups: This article highlights research on effective social skills intervention methods to help caretakers address identified challenges for those with Autism Spectrum Disorder.

The journal is a collaboration of DHS’ Office of Developmental Programs and Office of Mental Health and Substance Abuse Services and collects resources, observations, and advancements in mental and behavioral health in order to better serve people with dual diagnoses in their communities.

Read this edition of the Positive Approaches Journal.

For more information visit DHS’ website.

MEDIA CONTACT: Erin James

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The Department of Human Services today announced that its Adult Community Autism Program (ACAP), a program that promotes integrated and meaningful employment for adults with autism, has been recognized by the Vienna, Austria-based Zero Project as a model deserving international attention and replication. ACAP was one of three American programs of 443 nominations from around the world to be honored by the Zero Project.

“DHS is committed to making a future that truly includes individuals with autism as fully integrated members of our communities. We work every day to ensure that all Pennsylvanians have what they need so they can live everyday lives, and I’m thankful to the Zero Project for recognizing DHS’ work,” said Acting DHS Secretary Meg Snead. “As the world recovers from the COVID-19 pandemic, it is absolutely critical that people with autism have the opportunities they deserve in order take part in that recovery. I hope that with this recognition, other states and countries will look to Pennsylvania as a world leader in supporting people on the autism spectrum.”

ACAP is a comprehensive system of care for adults with autism that provides services and supports to help them participate in their communities in the way that they choose. It is a managed care program that includes access to physical and behavioral health professionals, transportation services, education, in-home and independent living supports, and more, all with the goal of fostering independence and increasing a person’s quality of life.

The program also connects participants with support coordinators in order to develop job skills and create tailored employment plans while offering job coaching and guidance and support to companies and employers. ACAP has an employment rate 2-3 times higher than other programs supporting adults with autism – more than 50% of participants were employed in 2020, with an average job retention rate of 4.25 years.

ACAP was created in 2010 and is funded and administered by DHS’ Office of Developmental Programs’ Bureau of Supports for Autism and Special Populations, in partnership with Keystone Human Services, a managed care organization and a provider of services. ACAP is currently only available in Chester, Cumberland, Dauphin, and Lancaster counties. 

The Zero Project’s mission supports the implementation of the Convention on the Rights of Persons with Disabilities of the United Nations by sharing programs and models that improve the daily lives and legal rights of all people with disabilities. More information on the Zero Project can be found here.

More information on DHS’ resources for people with disabilities seeking employment can be found here. More information on Keystone Human Services can be found here.

For additional info, please contact Carol Ferenz, RCPA Director of Intellectual and Developmental Disabilities.

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FOR IMMEDIATE RELEASE
January 28, 2021 

Harrisburg, PA – Today Department of Human Services (DHS) Secretary Teresa Miller outlined recent changes to the Employment, Advancement, and Retention Network (EARN) and Work Ready programs – two comprehensive employment and training programs that provide support for people who receive Temporary Assistance for Needy Families (TANF) benefits in order to obtain employment skills, prepare for work, and sustain good jobs.

The previous iteration of DHS’s largest employment and training programs prioritized a work-first job placement in any job, regardless of job quality and participant readiness. An analysis of these programs found that, for people who left TANF for employment, about 50 percent returned to TANF within a year.

“Our goal at DHS is to help families reach long-term economic sustainability. We want to be advocates and partners for the people we serve and use TANF both to meet essential needs and empower people to take a step forward for themselves and their family. To accomplish this, we recognized that we need to shift how we serve this population. One immediate way to do so was in the way we operate our employment and training programs,” said DHS Secretary Teresa Miller. “Last year, we launched a redesign of these programs to make sure we were meeting the needs of the people we serve. It is our hope that this redesign will put the people we serve on the path to economic stability and independence.”

Rather than prioritizing a job regardless of job quality and participant readiness, the redesign includes a more thorough assessment that addresses clients holistically to support financial independence. DHS worked with all 22 local workforce development boards and multiple community action agencies and used direct feedback from participants, caseworkers, and providers to shape the new design, which officially launched on July 1, 2020.

Under the redesigned programs, each person will work with a caseworker to identify strengths and barriers in reaching career goals and will receive the support they need to meet those goals. The redesign introduces a focus on education and training activities that will help participants get the skills and certifications they need in the workforce, including GED diplomas or job credentials. Participants will also have access to case managers, individualized coaching, and mental health counseling services. These supports will be available for one year following sustainable employment, meaning that participants will have continued support if issues arise within the first year of employment to help them problem solve and establish stability and independence during this time.

The redesign also supports participants by addressing barriers to employment so that employment can not only be achieved but also maintained. In many instances, participants may be eligible for financial support for materials, supplies, child care, transportation costs, and more in order to successfully participate in employment.

Funding for the redesign comes from an increase in the amount of federal TANF block grant funding allocated to the employment and training programs to support these expanded services. DHS also adjusted the programs’ funding structure to allow providers more flexibility to implement these services and modified incentives for vendors to help get people into job training programs.

DHS will work closely with program providers throughout the year to deliver these new services and to evaluate how these changes impact participants. They will also be monitoring if providers achieve established performance outcomes such as whether a client has achieved long-term employment. 

Current participation in the employment and training programs has been shifted to remote services due to COVID-19. In the months since the redesign’s launch, more than 300 people have interacted with a licensed counselor via ongoing counseling, more than 100 participants have been engaged in remediating their barriers to employment, and 112 individuals have met at least one of their personal goals in their individualized employment plan. DHS is continuing to support families by providing skills trainings and mental health service referrals, continuing job-related work activities and services, and implementing options to ensure that participants have adequate devices where possible.

“We want to create programs that give people the space they need to envision a better future for themselves and their families and then provide them with the tools they need to actualize those dreams. This is our opportunity to really try to help change circumstances for parents and families living in incredibly difficult circumstances. No one should have to go at this alone, and we must take a community-wide approach to help people know that they will be supported throughout their journey. We hope that this employment and training redesign will help our clients achieve just that,” said Secretary Miller.

Only families with children are eligible for TANF. Job loss, domestic violence, child care availability, and the need for education are just some of the reasons that someone may need the support of the TANF program. Statistics show that in Pennsylvania, black individuals and families are disproportionately impacted by poverty. This disproportionality is also reflected in the demographics of our public assistance program enrollment – 53 percent of TANF beneficiaries are black. Discussions about TANF must acknowledge the ways that racial inequities and systemic racism impact the populations DHS serves, and we must work to actively dispel the myth that poverty and enrollment in public assistance programs are tied to some kind of moral or personal failure.

Applications for TANF and other public assistance programs can be submitted here. Those who prefer to submit paper documentation can pick up an application at their local County Assistance Office (CAO), where social distancing protocols are in place, They can also print from the website or request an application by phone at 1-800-692-7462. They can then mail it to their local CAO or place it in a CAO’s secure drop box if available. You do not need to know your own eligibility in order to apply. While CAOs remain closed, work processing applications, determining eligibility, and issuing benefits continue. Clients should use COMPASS or the MyCOMPASS PA mobile app to submit necessary updates to their case files while CAOs are closed.

For more information on DHS’s employment and training programs, visit this webpage.

MEDIA CONTACT: Erin James

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The Department of Human Services (DHS) has announced the recent changes to the OBRA Waiver that have been approved by the Centers for Medicare and Medicaid Services (CMS). Some of the waiver amendments include:

  • Adds five new employment-related service definitions that are replacing two existing employment service definitions. Five employment services have been added (benefits counseling, career assessment, employment skills development, job coaching, and job finding) (C-1/C-3).
  • Corrects the regulatory citation for an Outpatient or Community-Based Rehabilitation Agency provider type in the Occupational Therapy (OT), Physical Therapy (PT), Speech and Language Therapy (SLP) service definitions (C-1/C-3).
  • Clarifies that Personal Assistance Services (PAS) are only available to individuals in the waiver 21 years of age and over. All medically necessary Personal Assistance Services for children under age 21 are covered in the state plan pursuant to the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit (C-1/C-3).

The complete service definitions and requirements are now included in an updated OBRA Waiver document. The effective date of these changes is February 1, 2017.

The OBRA Waiver PROPOSED rates for the new Employment Services have also been released. Questions regarding these rates should be directed to (717) 783-8412.

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From: “HS, Secretary’s Office”
Date: January 5, 2017 at 1:01:56 PM EST
To: “[email protected]”
Subject: [DHS-STAKEHOLDERS] DHS Awards Medicaid Agreements

Department of Human Services (DHS) Secretary Ted Dallas announced that DHS has agreed to move forward and negotiate agreements with six managed care organizations (MCOs) to deliver physical health services to Pennsylvanians through HealthChoices, Pennsylvania’s mandatory Medicaid managed care program since 1997.

“These agreements will be the most significant changes to Pennsylvania’s Medicaid program since we moved to managed care two decades ago,” said Dallas. “Over the next three years, MCOs will be investing billions of dollars in innovative approaches that reward high-quality care that improves patient health rather than just providing services for a fee.”

The $12 billion, three-year contracts include a 30 percent target for payments based on value received or outcomes, rather than on the quantity of services provided.

The MCOs were selected based on several criteria, including their current performance, the level of customer service delivered, member satisfaction, and their value-based performance plan. Performance criteria measured, among other things, management of chronic conditions such as high blood pressure, diabetes, and asthma; frequency of prenatal and post-partum care; and access to preventive services.

“The average performance ratings of the selected organizations are consistently higher than the current averages in every region. This transition will result in higher levels of quality care for the 2.2 million Pennsylvanians served by Medicaid,” said Dallas.

To drive Pennsylvania’s Medicaid system towards these better outcomes, the three-year agreements set gradual targets for all MCOs to increase the percentage of value-based or outcome-based provider contracts they have with hospitals, doctors, and other providers to 30 percent of the medical funds they receive from DHS. The result will be that billions in funds that would have otherwise been spent on traditional payment arrangements will instead be invested in outcome or value-based options such as:

  • Accountable care organizations (voluntary networks of hospitals, doctors, and other providers that work together to provide coordinated care to patients);
  • Bundled payments (increases value-based purchasing);
  • Patient-centered medical homes; and
  • Other performance-based payments.

“We’re going to reward folks for providing the right services, not just more services. You get what you pay for so we’re shifting the focus of Pennsylvania’s Medicaid system toward paying providers based on the quality, rather than the quantity of care they give patients,” said Dallas. “In addition, by focusing on improving the health of consumers, we will drive down the cost of care and ultimately save the taxpayer funds we spend on health care in Pennsylvania.”

HealthChoices delivers quality medical care and timely access to all appropriate services to 2.2 million children, individuals with disabilities, pregnant women, and low-income Pennsylvanians.

For more information, visit www.HealthChoicesPA.com or www.dhs.pa.gov.

DHS has selected the following MCOs to proceed with negotiations to deliver services in Pennsylvania beginning in June 2017. The agreements are awarded in five geographic regions:

Southeast Region Gateway Health
Health Partners Plans
PA Health and Wellness
UPMC for You
Vista–Keystone First Health Plan
Southwest Region Gateway Health
PA Health and Wellness
UPMC for You
Vista—AmeriHealth Caritas Health Plan
Lehigh/Capital Region Gateway Health
Geisinger Health Plan
Health Partners Plans
PA Health and Wellness
Northeast Region Gateway Health
Geisinger Health Plan
UPMC for You
Northwest Region Gateway Health
UPMC for You
Vista—AmeriHealth Caritas Health Plan

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From the Department of Human Services:

The Wolf Administration is committed to serving more people in the community whenever possible, and we believe that the work performed by direct care workers (DCWs), including personal attendants and other household aides, enables individuals with disabilities to live a more independent life. We have heard from many people asking for a policy clarification on the types of non-skilled, home care services and activities that DCWs can perform in home- and community-based settings.

Last week, the Wolf Administration issued a policy clarification surrounding the role of DCWs.

The non-skilled activities provided in the consumer’s place of residence or other independent living environment are specialized care, a type of home care service unique to the consumer’s care needs that are exempt from the licensure requirements under the Professional Nursing Law and Practical Nurse Law.

DCWs may perform these non-skilled services/activities, with evidence of competency or training, provided they do not represent or hold themselves out as being licensed nurses, licensed registered nurses, or registered nurses; or use in connection with their names, any designation tending to imply they are licensed to practice nursing.

Individuals with disabilities will have a greater chance of remaining in their homes and community when they are able to receive assistance with long-term supports and services from DCWs. These non-skilled, routine activities/services include:

  • assistance with bowel and bladder routines;
  • assistance with medication;
  • ostomy care;
  • clean intermittent catheterization;
  • assistance with skin care; and
  • wound care.

DHS appreciates the partnership with the departments of Health and State and the collaboration with ADAPT and Disability Rights Pennsylvania in issuing this important policy clarification. Further guidance will be issued as appropriate to ensure successful implementation.

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The Department of Human Services (DHS) has just issued a Medical Assistance (MA) Bulletin for providers relating to Act 62 titled, Payment of Claims for Services Provided to Children and Adolescents for the Diagnostic Assessment and Treatment of Autism Spectrum Disorder (ASD). The purpose of this bulletin is to remind providers enrolled in the MA Program, both fee-for-service (FFS) and HealthChoices, of the requirement to bill a child’s or adolescent’s private health insurance company before submitting a claim for the diagnostic assessment or treatment of ASD. It is also to inform providers of the diagnosis codes and procedure codes which will be included in the MA FFS cost avoidance process, effective Friday, September 30. HealthChoices managed care organizations will provide guidance and information to contracted practitioners and providers in the Medicaid managed care system with regard to implementation by September 30.

The DHS clinical staff has identified behavioral health, physical health, and rehabilitation procedure codes that reflect services for the diagnostic assessment and treatment of ASD covered under Act 62. The procedure codes that are on the MA Program fee schedule will be subject to the cost avoidance process for MA FFS claims beginning September 30.

Registration is open now for two webinar sessions on Thursday, August 25 that are being held by DHS in collaboration with RCPA:

  • Session 1, 12:00–1:00 pm: The target audience for this webinar session is BH-MCOs, counties, and county oversight organizations.
  • Session 2, 1:00–2:00 pm: The target audience for this webinar session is behavioral health and pediatric rehabilitation provider organizations.

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RCPA is collaborating with key state agencies to host a very important webinar on changes impacting providers of child and adolescent autism services as well as HealthChoices managed care organizations. Representatives from the Department of Human Services (DHS) will review Act 62 of 2008, billing guidance for providers, and the revised ICD-10 diagnostic codes and intervention procedure codes related to children and adolescents with autism spectrum disorders. These codes may apply to both commercial health plans and Medical Assistance plans. The webinar will also include updated information and guidance for families. Registration is now open for both sections of the webinar.

The webinar will be held in two sessions on Thursday, August 25, 2016:

  • Session 1, 12:00–1:00 pm: The target audience for this webinar session is BH-MCOs, counties, and county oversight organizations.
  • Session 2, 1:00–2:00 pm: The target audience for this webinar session is behavioral health and pediatric rehabilitation provider organizations.

All participants are welcome to sit in for either or both sessions. Both webinars will be recorded and made available on RCPA and state websites. The DHS Bulletin related to the changes in diagnostic and intervention procedure will be sent to members once it is issued.

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