On October 22 PA Governor Ed Rendell signed into law Senate Bill 922, which makes a number of technical changes in the Public Welfare Code and codifies the Pennsylvania Trauma Systems Stabilization Act. The bill also makes changes to the accreditation standards for level III trauma centers to allow additional centers to be accredited. It makes necessary changes to comply with a recent federal court ruling that found the act unconstitutional as it only allowed for payment to Pennsylvania hospitals. For more information on the bill, visit www.legis.state.pa.us. See http://www.pa.gov/portal/server.pt?open=512&objID=3053&mode=2.
In the October 23 edition of the Pennsylvania Bulletin, the PA Department of Public Welfare (DPW) proposed regulations on residential treatment facilities. The purpose of the proposed rulemaking is to codify minimum licensing and program standards, requirements for participation in the Medical Assistance (MA) Program and MA payment conditions for residential treatment facilities (RTFs), which provide behavior health services in a 24-hour setting to children under 21 years of age with a diagnosed mental illness or serious emotional or behavioral disorder, or a drug and alcohol diagnosis in conjunction with a diagnosed mental illness or serious emotional or behavioral disorder. The proposed rulemaking will codify the requirements that apply to RTFs in one chapter, replace the requirements for RTFs currently in Chapter 3800 and Notices of Rule Change. It also proposes to require RTFs to be accredited by the Council on Accreditation (COA), the Commission on Accreditation of Residential Facilities (CARF), the Joint Commission (JCAHO) or other accrediting entity approved by the Department. The proposed rulemaking also proposes to amend § 3800.3 (relating to exemptions) to exempt RTFs and community residential rehabilitation group homes from Chapter 3800, thereby granting eight bed non-accredited RTFs that are not located on a larger campus the option to meet the requirements under Chapter 5310 to become licensed as a community residential rehabilitation group home. DPW says that the increased costs incurred by an RTF to meet the enhanced staffing and training requirements may result in higher per diem rates for some RTFs, but the expected aggregate reduction in lengths of stay due to high quality behavioral health treatment is expected to offset the fiscal impact of the higher rates. In addition, RTFs that are currently not accredited and choose to remain MA providers will incur the costs associated with accreditation. The Department will be able to build the cost of accreditation into the rates. This proposed rulemaking will be effective 12 months from the date the final-form rulemaking is published in the Pennsylvania Bulletin, with the exception of the accreditation requirement, which will be effective 24 months from the date the final-form rulemaking is published in the Pennsylvania Bulletin. Interested persons are invited to submit written comments, suggestions or objections regarding the proposed rulemaking to Shaye Erhard, Office of Mental Health and Substance Abuse Services, 233 Beechmont Building, PA Department of Public Welfare, OMHSAS, BPPD, P.O. Box 2675, DGS Complex, Harrisburg, PA 17105-2675 ra-rtfcomments@state.pa.us by November 22, 2010. Please reference regulation No. 14-522 when submitting comments
In the October 23 edition of the Pennsylvania Bulletin, the PA Office of the Governor published its Executive Order 2010-04 on Consumer-Directed Home Care Providers issued on September 14. The order issued by Governor addresses the Office of Long-Term Living (OLTL) home and community based services, including the Attendant Care Waiver, the Attendant Care Services Act 150 Program, Options and the Aging Waiver, and other programs. The order includes provisions on selection of a provider representative, meeting with the provider representative, a consumer workforce council, relationship between provider and consumer, relationship between provider and the Commonwealth, state action exemption, cooperation by state agencies, and the term of the order. FMI: See www.pabulletin.com. For Executive Order 2010-04 see http://www.portal.state.pa.us/portal/server.pt/community/executive_orders/708.
In the October 23 edition of the Pennsylvania Bulletin, the PA Department of Public Welfare (DPW) published its proposed regulations on psychiatric rehabilitation services. DPW adopted the minimum standards for the issuance of licenses for psychiatric rehabilitation services (PRS) in facilities operated in Pennsylvania. The proposed rules affect facilities that provide PRS and the individuals receiving PRS. The proposed rulemaking will be effective upon final-form publication in the Pennsylvania Bulletin. DPW said that the proposed rulemaking is consistent with the principles established by the United States Psychiatric Rehabilitation Association (USPRA). Under the proposed rulemaking, a certification time frame of 3 years will be required for the International Committee for Clubhouse Certification (ICCD) certification. Among its many provisions, the proposed rulemaking requires that individuals receive a statement of rights. The proposed rules also set staffing requirements which allow for minimum staff qualifications, minimum staff to individual ratios and provision of individual and group service, and for delivery of services within a facility or in the community. The proposed rulemaking allows PRS assistant staff to work independently in the community if the staff person holds a certified psychiatric rehabilitation practitioner (CPRP) credential. The proposed rulemaking also requires the PRS director and a PRS specialist to be CPRP certified and at least 25% of staff to be CPRP certified. The proposed rules require a PRS director or delegated supervisor to meet with a staff member face-to-face on an individual basis no less than two times per month. DPW proposes language that requires staff to complete a 12-hour orientation course and 18 hours of annual training. Under the proposed rulemaking, new staff is required to receive 6 hours of face-to-face mentoring during the orientation period and will receive 8 hours of training on the specific PRS model or approach prior to working independently. The proposed rules provide requirements for facilities concerning the development and completion of the individual rehabilitation plan (IRP). Written comments, suggestions or objections regarding the proposed rules are to be sent to Lisa McMullen, PA Department of Public Welfare, OMHSAS, BPPD, P.O. Box 2675, DGS Complex, Harrisburg, PA 17105-2675. Fax 717-772-7964 or email PsychRehab@state.pa.us by November 22, 2010. In submitting written comments on the proposal please reference Regulation ID# 14-521 (IRRC# 2879) on the correspondence. The proposed regulation is available on the web at http://www.pabulletin.com/secure/data/vol40/40-43/2001.html. The regulation is also available at http://www.irrc.state.pa.us/Regulations/RegInfo.cfm?IRRCNo=2879. FMI: See the IRRC website (www.irrc.state.pa.us).
On October 21 Mercer Human Resource Consulting (Mercer) and the Pennsylvania Office of Long-Term Living (OLTL) released an information request to support the COMMCARE Residential Habilitation rate development. OLTL developed the request as an alternative to the original information request sent on September 28. Organizations already working directly with Mercer on the first information request sent September 28 do not need to complete the request. The new information request was developed in discussions with residential habilitation providers on October 18. OLTL stressed the importance of this request and the supporting documentation that has been requested is critical and necessary to provide assurances that have been requested by the Centers for Medicare and Medicaid Services (CMS). The instructions provide direction on what documentation is acceptable. OLTL said that Mercer will not be able to rely on any analysis that does not document all reported expenditures. Responses are to be sent to Mercer via e-mail and copied to OLTL as appropriate. Providers are to send requested information by November 15. Information sent after November 15 may not be incorporated into the rate setting and verification process. If providers are not able to meet this deadline, they are to contact OLTL immediately. FMI: Contact PARF at parfmail@parf.org
On October 20 Department of Aging/Office of Long-Term Living (OLTL) released a bulletin containing policies and procedures regarding the initial Individual Service Plans (ISP) development, approval, implementation, and monitoring process for OLTL Home and Community-Based Service (HCBS) Waivers and the Act 150 program. OLTL noted that the Centers for Medicare and Medicaid Services (CMS) has required that OLTL assure the timely and individualized development, review and implementation of ISP for program participants in a consistent manner. OLTL has also circulated a CMI, the standard comprehensive assessment tool to be used by all OLTL HCBS programs. The bulletin is effective October 25, 2010. A series of mandated statewide training sessions will be held beginning October 25 through November 12 on the key provisions of this policy. Questions regarding the bulletin should be addressed to the Department of Aging/Office of Long-Term Living, Bureau of Individual Support. Phone (717) 787-8091. OLTL asks providers to share the information with members of their organization as appropriate. OLTL said that it is imperative to notify OLTL of changes that would affect the provider file, especially e-mail addresses, physical addresses and telephone numbers. Providers are urged to contact the BPS Provider Call Center at 1-800-932-0939 to report changes. FMI: See http://www.ltltrainingpa.org/calendar/index.cfm?sm=10&sy=2010. Contact PARF at parfmail@parf.org.
