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This just in from the governor’s office:

FOR IMMEDIATE RELEASE
January 30, 2017
View Online 

Governor Wolf Announces Plan to Create Department of Health and Human Services

Seeks to Improve Services and Benefits for Seniors, People with Intellectual and Physical Disabilities, and Those Suffering From Substance Use Disorder

Harrisburg, PA – Today, Governor Wolf announced his plan to create a Department of Health and Human Services (HHS) in his 2017-2018 budget in order to promote more effective collaboration and service delivery, enhance program effectiveness, and eliminate duplicative processes.

“This new department will streamline government and allow the commonwealth to deliver more effective services to seniors, individuals with intellectual and physical disabilities, and those suffering from a substance use disorder as well as promote the health and well-being of all Pennsylvanians,” said Governor Tom Wolf. “Over the past several months, I have worked closely with these four departments to break down silos and reimagine how we deliver critical services that will provide treatment to those suffering from substance use disorder, ensure children are receiving high quality services, and expand community-based opportunities for seniors. The creation of a new, unified Department of Health and Human Services will not result in any program cuts for Pennsylvanians, but will dramatically improve our ability to deliver services that will improve lives. “

The Departments of Aging (PDA), Drug and Alcohol Programs (DDAP), Health (DOH), and Human Services (DHS) have the same core mission: to improve public health and quality of life for all residents of the commonwealth. These four separate state agencies currently serve similar, and sometimes overlapping, populations.

Fighting Opioid Epidemic to Remain a Top Priority for New Integrated Agency
Governor Wolf has led the battle against the opioid and heroin epidemic and each of these agencies has been critical to this effort. Among many other initiatives, DOH launched a prescription drug monitoring program and has been raising awareness of the naloxone standing order, DDAP has led the effort to increase the availability of naloxone and drug take back boxes, DHS has created 45 centers of excellence to coordinate treatment for those suffering from substance use disorders, and PDA has led prescription drug take back efforts among the senior population encouraging proper use, storage, and disposal of unused prescription medications.

By creating an organization that is structurally better able to support and coordinate these efforts, individuals in desperate need of substance use disorder treatment will be able to access services through one agency with an integrated data and delivery system. The new HHS will serve as the single state authority for Medicaid, substance use, and mental health purposes enabling the commonwealth to maximize available federal dollars and offset state costs for staff and services. There will continue to be a cabinet-level position in Governor Wolf’s administration that will be dedicated to battling the opioid and heroin epidemic.

Delivering better services to those suffering from substance use disorder is just one example of the benefits realized through the creation of a new, unified department.

Senior Benefits and Programs Will Be Bolstered By Ease, Focus of Single Agency
Seniors will also have a single agency as their point of contact within state government to receive health and human services. Instead of receiving prescription assistance from PACE through PDA, applying for an aging waiver through DHS while seeking home and community-based services from PDA, finding where to dispose of unwanted or expired prescription drugs through DDAP, or searching for information on the quality of nursing homes through DOH, seniors would find the services they need through the Department of Health and Human Services. Furthermore, the creation of this department will have no impact on how lottery fund monies are used to support senior programs.

Reducing Complexity and Confusion for Seniors and Individuals with Disabilities
Currently, at least 21 separate services across the departments provide care for seniors and individuals with physical disabilities. The creation of the Department of Health and Human Services will eliminate the unnecessary duplication of effort and confusion among consumers and their families. The Wolf Administration is dedicated to continuing to provide the same quality services for seniors and individuals with disabilities and will dramatically improve the delivery of services like health screenings, programs to allow individuals to remain in their homes and communities, adult protective services, and home health care and housing supports, though the creation of this new department.

Reducing Red-Tape for Providers and Non-Profits Subject to Regulation
Currently, providers ranging from hospitals and child care centers to substance use treatment facilities and nursing homes are licensed by multiple agencies, many times for the provision of the exact same services. Requiring these businesses to subject themselves to multiple, duplicative inspections and audits costs them money. By centralizing facility licensure in one agency we will improve coordination, increase transparency, and promote uniformity for the health and human services field. The state and providers will be able to better focus our resources on our mission to improve the health and quality of life for citizens rather than back office functions.

In 2015, the administration transferred the Children’s Health Insurance Program (CHIP) from the Department of Insurance to DHS. Through this consolidation, the administration has increased the number of kids covered by 10 percent, shortened the average processing time for applications from 40 days to only one day, and saved taxpayers $8 million annually. Additionally, this consolidation resulted in an improved customer experience as many families move between the two programs on a regular basis due to income guidelines. In the same way, combining the Supplemental Nutrition Assistance Program (SNAP) and Women, Infants and Children (WIC) program will result in improved outcomes, shortened application timelines and cost savings to taxpayers.

“Responding to the diverse and sometimes complex needs of older Pennsylvanians often requires interaction with multiple state agencies which can be confusing and incredibly frustrating,” said PDA Secretary Osborne. “The opportunity to create a single, unified, Department of Health and Human Services will reduce fragmentation, eliminate silos, promote accountability, and create a culture of shared responsibility that puts Pennsylvanians first.”

“By working together under Governor Wolf’s leadership, this administration has saved lives by expanding access to naloxone, combatted the stigma of the disease of addiction, and has raised awareness of the severity of this crisis. However, our work is not done,” said Department of Drug and Alcohol Acting Secretary Jennifer Smith. “The creation of the Department of Health and Human Services will help us continue this fight in a collaborative, coordinated manner.”

“The health of all Pennsylvanians is first and foremost to the Wolf Administration,” said Secretary of Health Dr. Karen Murphy. “Consolidating state agencies into one new agency while improving services for Pennsylvanians is not only fiscally responsible, but will ensure that we can continue to meet their needs. The Department of Health team looks forward to working with our sister agencies on the consolidation plan to ensure that Pennsylvanians continue to receive needed services.”

“Consolidation puts the focus where it always should be — on the consumer,” said Secretary of Human Services Ted Dallas. “The Governor’s plan to create HHS will result in a more streamlined and cost-effective agency that delivers better services for Pennsylvania.”

The goal of the Department of Health and Human Services will be to deliver services that will improve the health and quality of life for all Pennsylvanians in an efficient, transparent, and uniform manner.

MEDIA CONTACT:    J.J. Abbott, 717.783.1116

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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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The Department of Human Services (DHS) just announced their decision to lengthen the transition time for the start of the Community HealthChoices (CHC) program. The first phase (southwest part of the state) was originally scheduled to be implemented on January 1, 2017. The implementation date of phase one has now been changed to begin July 1, 2017.

The decision to extend the start date allows more time for the 420,000 Pennsylvanians who will ultimately benefit from CHC to understand the program adjustments that will occur, including how access to and receipt of home- and community-based services will be improved.

All other established CHC timeframes will remain the same. The selection of managed care companies, changes in the Commonwealth’s information technology systems, and other changes are still proceeding on the same timeframe. The implementation of phases two and three (the southeast and remainder of the Commonwealth) also remain on the previously announced timelines of 2018 and 2019, respectively.

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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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Act 153 of 2014 requires the Department of Human Services, in conjunction with the Department of Education and the Pennsylvania Commission on Crime and Delinquency, to conduct a study which includes the analysis and development of recommendations on employment bans for those having contact with children. The study must include recommendations on changes in permanent and temporary employment bans to align and make uniform the provisions under the Child Protective Services Law and the Public School Code. A report of the study’s findings and recommendations must be submitted to the certain committees of the General Assembly by Thursday, December 31, 2015.

In order to complete this work, staff from the Department of Human Services have been conducting research specific to the employment bans within other states as they relate to child care service and school employees along with foster and adoptive parents. RCPA, along with other child serving and child advocacy organizations, has been invited to participate in a process to relate the recommendations to the General Assembly. This group will be meeting under the leadership of the Deputy Secretary for the Office of Children, Youth and Families over the next several months.

RCPA will be requesting that our members who provide services in the areas of child behavioral health, child welfare, pediatric rehabilitation, education, and juvenile justice, provide information regarding current employment bans on program operations, and service capacity and delivery in the communities served by members. Information requested can be sent to Connell O’Brien.

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On July 22, the Departments of Human Services and Aging announced the next steps in Governor Wolf’s plan to improve care coordination and move to Medicaid Managed Long-Term Services and Supports (MLTSS). These updates are a result of overwhelming response to the public comment period and stakeholder input.

Along with feedback on how MLTSS should be implemented in the Commonwealth, the departments heard feedback on changes that can be made today to improve the current system. They will take the following steps:

 

Doubling the number of staff who work on Nursing Home Transition (NHT)
PDA and DHS recognize that current processes to move individuals who are able to be better served in the community from institutional settings are lengthy and complicated. To address this, the departments will:

  • Increase the number of staff assigned to NHT from 5 to 10;
  • Identify and implement strategies intended to
    • improve the process
    • enhance program outcomes
    • advance the opportunities for individuals to either avoid premature placement and/or transition back into the community;
  • Evaluate and redesign the entire NHT process; and
  • Increase training for all current NHT staff and providers.

 

Creating an advisory committee with at least 50 percent representation by participants and caregivers and conducting monthly webinars
Throughout the MLTSS public input sessions, participants, advocates, and providers made it clear that more education, involvement, and communication are necessary as the Commonwealth moves to MLTSS. In order to accomplish this, the departments will:

  • Host monthly webinars on the third Thursday of every month.
  • Create an MLTSS Advisory Committee that will meet under the federally mandated purview of the Medical Assistance Advisory Committee (MAAC).
    • MLTSS program participants will comprise half of the membership, with the remaining half representing provider communities
    • Opportunities for participation via telephone for increased accessibility and convenience
    • This committee will meet bi-weekly
  • Encourage open communications; questions can be submitted via email.

 

Restructuring existing contracts to provide more choice for participants
Issue a procurement for a home modification quality improvement program in August 2015: In some cases, the transition from a nursing home to living in the community can be accomplished through a simple home modification such as the installation of a ramp for wheelchair access. The new procurement will streamline the current process to make this easier to complete these modifications, while at the same time ensuring that only high-quality contractors complete the work. The contracts will include two providers in each part of the state to provide choices in completing the work.

Issue a financial management services procurement in November 2015: There is currently one statewide vendor that acts on behalf of the consumer to make payroll, withhold and report taxes, and pay bills for individuals in home- and community-based waiver programs. Moving forward, multiple vendors will be awarded the contracts to ensure choice, and they will be required to maintain a regional presence throughout the state.

Award New Contracts for Independent Enrollment Broker (IEB) Services in November 2015: One of the most significant barriers to serving individuals in the community is the length of time it takes to enroll someone in home- and community-based services. The new contracts will be awarded in four regional lots and include new, strong performance standards, to ensure that the vendors are held accountable and participants are not stuck waiting for services.

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The Department of Human Services has announced the July training schedule and related information for the approved and required Medication Administration Training. Training will be available online and at various locations across the Commonwealth. Future classroom training sessions are being scheduled throughout the year; announcements will be released when finalized. Classroom training sites have limited capacity, and training candidates from agencies with no certified medication administration staff are required to complete the online course work before they are permitted to attend the classroom training.

Medication administration training is required for designated staff working in: adult training facilities, adult day services, personal care homes, assisted living residences, child residential and residential treatment and day treatment facilities, community homes for individuals with an intellectual disability, and intermediate care facilities. Questions about the information in the training document can be directed to (717) 221-1630 or email.

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The Department of Human Services Bureau of Human Services Licensing (BHSL) has released a draft Regulatory Compliance Guide (RCG) for Chapter 3800, relating to child residential and day treatment facilities. The RCG provides guidance about how the Department of Human Services will interpret and apply the chapter’s regulatory requirements during licensing inspections and investigations.

BHSL is inviting the Rehabilitation and Community Providers Association to work with members to review and comment on this draft guide. Please review the draft document and send your comments, suggestion and recommendations to Connell O’Brien. RCPA will collect provider input and share that information with the leadership of BHSL. Comments are due to RCPA by July 10 for submission to BHSL by July 17. The leadership of BHSL has communicated their clear interest in provider input and plans to take all comments into consideration prior to issuing a final RCG later this summer.

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