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Tags Posts tagged with "OLTL"

OLTL

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The Office of Long-Term Living (OLTL) is partnering with the Office of Developmental Programs (ODP), The Institute on Disabilities at Temple University, College of Education and Human Development, and the University of Kansas Center on Disabilities’ State of the States team to host Pennsylvania Technology Summits as part of a statewide initiative called PA Tech Accelerator.

The goal of the Summits is to expand the awareness of, and access to, assistive technology and remote technologies in order to build capacity of technology users throughout the Commonwealth of Pennsylvania.

The Summits will be held on March 6, 2025, in Philadelphia and March 13, 2025, in Pittsburgh. To attend, please register here.

The Summits will feature a keynote address by Rebekah Taussig, PhD; a panel of technology users giving advice, sharing their stories, and answering questions; and vendors showcasing services, devices, and solutions.

Who is invited?

  • People with disabilities and their families.
  • Direct Support Providers and professionals working with people with disabilities, such as Direct Care Workers, Direct Support Professionals, Support Service Professionals, Supports Coordinators, Job Coaches, and healthcare professionals.
  • Organizations and providers who serve people with disabilities.
  • Policymakers, advocates, and allies for people with lived disability experience.
  • Students looking to work in disability-related fields.
  • Anyone interested in technological supports for people with disabilities.

If you have additional questions about the Summit, please contact Kristy Crocetto at (215) 204-1356 or via email.

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Young caregiver helping older lady to stand up

The Office of Long-Term Living (OLTL) recently shared additional guidance for providers related to the Centers for Medicare & Medicaid Services (CMS) Home and Community-Based Services (HCBS) Settings Final Rule.

This clarification applies to Residential Habilitation and Personal Care Home Providers.

Regulations at 42 CFR 441.301(c)(4)(vi)(B) require that participants in residential settings have the ability to close and lock doors within their living units. As a part of the Office of Long-Term Living (OLTL) residential provider reviews, it was found that several sites did not meet this requirement. As remediation, some providers opted to have participants sign a form stating that they do not wish to have a lock on their doors, which OLTL’s settings review panel accepted as compliant.

The Centers for Medicare & Medicaid Services (CMS) has reviewed OLTL’s oversight activities and has deemed that participant sign-off waiving installation of locks does not sufficiently satisfy the requirement. CMS has determined that all doors with access to participant units or private spaces (such as a bedroom) must have locks installed. The participant’s choice is whether to utilize the lock or not. Based on this feedback, as OLTL moves forward with ongoing oversight of HCBS settings requirements, all doors to participant units/private spaces in residential settings will be required to have working locks in order to be deemed compliant for future settings reviews.

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The Long-Term Services and Supports (LTSS) Subcommittee has released its agenda for the February 5 virtual meeting. The meeting will have no onsite options for attendance and will be held via webinar at 10:00 am – 1:00 pm. You can view the agenda, which includes the webinar link, here.

The key agenda items are:

  • Office of Long-Term Living (OLTL) Updates
  • Assisted Living Residences — In Lieu of Services Policy Updates
  • Assisted Living Residences and Personal Care Homes — MCO Updates

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The Office of Long-Term Living (OLTL) Critical Incident Management Unit monitors provider compliance in the application of guidance specific to critical incident management. OLTL has identified compliance concerns and is issuing the following clarification.

This communication focuses on required critical incident notification by provider agencies to the participant’s assigned service coordinator and the documentation of such notification in the Enterprise Incident Management (EIM) entry. The OLTL Critical Incident Management Bulletin, which is also available on OLTL’s website, indicates the following:

  • Within 48 hours, the Managed Care Organization (MCO), Service Coordinator (SC), provider agency that discovers or has independent knowledge of the critical incident is to submit the First Section of the critical incident report to OLTL using OLTL’s critical incident management system. If the critical incident was discovered on a weekend or holiday, the 48 hours begin at 12:00 am on the first business day after discovery of the critical incident.
  • Providers must inform the participant’s SC within 24 hours of discovering or first learning of a critical incident.

Notification to the participant’s SC that a critical incident was discovered must not be made using the HHAeXchange system. The required notification to the participant’s SC must be made by telephone call, electronic mail communication, or any other method that is agreed upon by all parties involved, excluding the HHAeXchange system.

In addition, the notification by the provider to the participant’s SC that a critical incident was discovered must be clearly documented in the EIM incident report, specifically within the “Agencies Contacted” page. Instructions are below:

  1. Enter the first name of the SC in the Person Contacted (First Name) Field.
  2. Enter the SC’s last name in the Person Contacted (Last Name) Field.
  3. Enter the contact phone number. Note that the email address field is not mandatory; however, it should be completed when notification to the SC was made via email.
  4. Click the SAVE button when all information has been entered.

See an example of page completion below.

Providers who are experiencing difficulty meeting the Critical Incident Management Bulletin requirements may email concerns to the resource account. Additionally, questions related to critical incidents may be emailed to the Critical Incident Management team member identified in any case-specific communication.

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The Office of Long-Term Living (OLTL) issued a Critical Incident Management Bulletin, with indications that they and the Managed Care Organizations (MCO) will be enforcing these regulations. Per OLTL:

Investigation of critical incidents and its documentation is an integral part of a Service Coordinator’s (SC) responsibilities, not a stand-alone function. During the course of quality reviews, Office of Long-Term Living’s (OLTL) Incident Management staff has found that critical incident investigations are not consistently following the established policy and procedure. OLTL wants to reinforce the following requirements found in various OLTL policy and procedure documents, which remain unchanged. Non-compliance with these requirements is subject to corrective action by OLTL.

1. Investigation of Critical Incidents

a. According to the Critical Incident Management Bulletin dated 2/23/2023, Community HealthChoices (CHC) managed care organizations (MCO) and SC must begin investigating a critical incident within 24 hours of discovery or of learning of the incident. This requirement was also indicated in the 2015 version of the document. The bulletin reinforces the onsite visit requirement for fact finding. The critical incident facts, sequence of events, interview of witnesses, and observation of the participant and/or environment is required. The onsite investigation is not the same as a comprehensive needs reassessment or assessment of need, and it must be completed regardless of participant choice. The participant reserves the right to refuse involvement in the critical incident investigation. However, the onsite visit must be completed. The Telephone Investigation referenced in the Bulletin does not replace the onsite investigation requirement, and is meant for instances when more information is necessary to complete the incident report. For example, when a protective services investigation is occurring and the SC needs to gather details to ensure mitigation measures are in place. Please note that while required to cooperate in the investigation, SCs are not required to investigate reported allegations of abuse, neglect, or exploitation, which are referred to a protective services agency. However, SCs remain responsible for ensuring participants health, safety, and welfare by means of risk mitigation and appropriate service implementation.

b. The 24-hour requirement to initiate an investigation is not to be interpreted as one business day. The only time business days apply is when submitting a critical incident report in Enterprise Incident Management (EIM), which is required within 48 hours excluding weekends and holidays. Please note that while the investigation must be initiated within 24 hours of incident discovery/learning of the incident, the CHC-MCO and SC will still have 30 calendar days to complete the investigation. It is also important to note that the onsite visit does not necessarily have to occur within 24 hours of incident discovery as long as it occurs at a time that enables ensuring the health and welfare of the participant, and within the allotted 30 calendar days or extended due date in the case where a timely EIM report extension was requested.

c. The Critical Incident Management bulletin also indicates the following:
No further action is required when the critical incident report meets all three of the following conditions:

  1. The facts and sequences of events are outlined with sufficient detail; and
  2. Preventative action through the service plan is either not required or is implemented and documented; and
  3. The participant is not placed at any additional risk.

Therefore, CHC-MCOs and SCs must ensure that, prior to submitting the Final Section of the incident report in EIM, the participant is aware of the critical incident, its resolution, and the measures taken to prevent recurrence. This includes determining whether a comprehensive needs reassessment or assessment of need must be conducted, based on the requirements outlined in OLTL’s policy and procedure documents. The SC must also ensure thorough documentation in the critical incident report of all actions taken to ensure participants health and welfare.

2. Notice to Participant

The Critical Incident Management Bulletin indicates that:

  1. The agency staff that discovered or first became aware of the critical incident is to notify the participant (and representative if requested by the participant) that a critical incident report has been filed. This notice must be provided to the participant within 24 hours and in a cognitively and linguistically accessible format. If the participant’s representative is suspected to be involved in the critical incident, the representative should not be notified.
  2. Within 48 hours of the conclusion of the critical incident investigation, the SC must inform the participant of the resolution and measures implemented to prevent recurrence.

CHC-MCOs and SCs must ensure the required notifications are made to the participant, and document completion within the Referrals and Notifications page in the EIM critical incident report.

OLTL encourages all CHC-MCOs and SCs to review the Critical Incident Management Bulletin to ensure all requirements are met.

If you have any questions, please contact Fady Sahhar.

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The Centers for Medicare and Medicaid Services (CMS) has approved the Office of Long-Term Living’s (OLTL) Community HealthChoices (CHC) Waiver renewal. The renewal will be effective on January 1, 2025.

The current approved CHC Waiver document is available here. Additional information about the CHC Waiver is located here.

Changes in the approved renewal include:

  1. Amend the following service definitions:
    1. Benefits Counseling
    2. Employment Skills Development Home Adaptations
    3. Telecare
  2. Add teleservices to the following services (details regarding teleservices can be found within each service definition as well as in the Main Module):
    1. Cognitive Rehabilitation
    2. Counseling Services
    3. Nutritional Consultation
  3. Add Chore Services as a new waiver service.
  4. Add language to reinforce that if a participant’s rights in a setting need to be modified due to an assessed need, it must be documented in the Person-Centered Service Plan (PCSP), and if a provider creates a treatment or service plan, that plan must be incorporated into the PCSP.
  5. Remove references to the Organized Health Care Delivery System (OHCDS) and the Participant Review Tool.
  6. Reduce timeframes for developing and implementing Person-Centered Service Plans from 30 days to 15 business days.
  7. Reduce the years of experience needed for Structured Day Habilitation Support Staff from five years to two years.
  8. Update Appendix C-5 to include information about the Home and Community-Based Settings Rule.
  9. Update Appendix E: Participant Direction of Services that Service Coordinators are responsible to inform the participant of the availability of the direct care worker referral and matching system.
  10. Update Appendix G: Participant Safeguards to the current process.
  11. Update the Quality Strategy to current process.
  12. Modify language throughout for better readability.

Questions about the 2025 CHC renewal can be submitted electronically.

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The Office of Long-Term Living (OLTL) has announced new services that will be available as a result of the Community HealthChoices (CHC) Waiver renewal and OBRA Waiver renewal. Effective January 1, 2025, the following services will be available:

Chore Services – CHC Only

  • Provider Type: 59
  • Specialty Code: 431
  • Procedure Code: S5131

Teleservice Cognitive Rehabilitation Therapy – CHC and OBRA

  • Provider Type: 59
  • Specialty Code: 207
  • Procedure Code: W0176

Teleservice Counseling Services – CHC and OBRA

  • Provider Type: 59
  • Specialty Code: 231
  • Procedure Code: W0175

Teleservice Nutritional Consultation – CHC and OBRA

  • Provider Type: 59
  • Specialty Code: 230
  • Procedure Code: W0170

The rates for the OLTL Home and Community-Based Services (HCBS) rates, effective January 1, 2025, are available here.

Additional information on the licensure and certification requirements can be found in the Service Definitions under Appendix C of the waivers. Please note that these documents have not received final approval from the Centers for Medicare & Medicaid Services (CMS). Once approval is received, a ListServ message will be sent with links to the final approved waiver applications.

The Fee for Service rates for Teleservice Cognitive Rehabilitation Therapy, Teleservice Counseling Services, and Teleservice Nutritional Consultation have been added to the fee schedule attached to the ListServ.

For existing OLTL providers to enroll in the services listed above a request must be submitted to the enrollment and certification resource account. The required documentation should include an updated Provider Enrollment Information Form (PEIF), a copy of the required license or certification, and a copy of the job description for the service you are requesting to add to your provider profile. If you have any questions related to the new services you can reach out to the enrollment and certification unit at 1-800-932-0939, option 1, or via email.

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Image by StockSnap from Pixabay

The Long-Term Services and Supports (LTSS) Subcommittee meeting was held yesterday, November 6, 2024. During the meeting, a number of presentations were given. In addition to the presentations, the agenda and a document that provided follow-up items from the October 2, 2024, LTSS Subcommittee meeting were provided.

Members should take time to review the PowerPoint presentations from the meeting below:

The 2025 meeting dates for the LTSS Subcommittee were also shared:

  • January 8, 2025
  • February 5, 2025 (virtual only)
  • March 5, 2025 (virtual only)
  • April 2, 2025
  • May 7, 2025
  • June 4, 2025
  • July 2, 2025
  • August 6, 2025
  • September 3, 2025
  • October 1, 2025
  • November 12, 2025
  • December 3, 2025

The meetings will continue to be held from 10:00 am – 1:00 pm.

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Image by Markus Winkler from Pixabay

Message from the Office of Long-Term Living (OLTL):

The Commonwealth is working collaboratively — Governor Shapiro’s office and the health hub agencies (Health, Human Services, Drug and Alcohol Programs, and Insurance) — to develop a statewide maternal health strategic plan. We need your help to make it a robust, comprehensive, collaborative, living, and most importantly, active plan.

As you are likely aware, Pennsylvania, like the nation, is experiencing a maternal health crisis.

According to the Pennsylvania Maternal Mortality Review Committee report, in 2020, Pennsylvania residents experienced a pregnancy-associated mortality ratio of 83 deaths per 100,000 live births with large disparities identified. In total, 107 individuals lost their lives during pregnancy, delivery, or up to one year postpartum.

Those numbers are far worse for Black women, where the rate was twice as high at 163 deaths per 100,000.

We also know that women and birthing people with disabilities experience unique challenges and needs on their health journey, so we are inviting you to join us for a 90-minute Zoom listening session where members of the Commonwealth’s health agencies and members of the statewide maternal health strategic plan can engage with you to learn what specific needs you have and how you feel the Commonwealth should address those needs.

We want our strategic plan to address all Pennsylvania women and birthing people, and sharing your voice at this listening session will help inform our plan.

The Zoom listening session is scheduled from 10:00 am – 11:30 am, on Friday, December 6, 2024. Please RSVP electronically by December 1 if you plan to attend. We will send the Zoom link by end of day December 4 to those who RSVP.

Thank you for considering spending 90 minutes with the disability community and state health team members to share your thoughts and needs around maternal health.

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Part of the CHC waiver discussions that began with the Office of Long-Term Living (OLTL) this spring related to mandatory background checks for employees. Since this discussion, OLTL has decided not to move forward with this change in the renewal and amendment submitted to CMS. This change in position was a result of the subsequent public comments and feedback on the collateral impacts.

Also contributing to this reversal were coordinated advocacy efforts by RCPA’s Coalition for Choice partners, resulting in the elimination of the requirement for federal background checks, including FBI fingerprinting, for over 125,000 caregivers and direct care workers for services in the Community HealthChoices and OBRA waivers. The costs for these mandatory background checks would have been in excess of $50 per employee.

The resulting decision will be included in the review and presentation of changes during the LTSS meeting next Wednesday, November 6. At this time, the background check requirements remain under consideration by OLTL for future amendments and renewals.

If you have any questions or need assistance, please reach out to Fady Sahhar.

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