On October 14 the PA DPW Office of Developmental Programs (ODP) began to issue to providers two separate letters: (a) last year’s revenue reconciliation letters with final revenue targets, including Period 3 adjustments and final reconciliation payments/recoupments and (b) this year’s rate letter, which states that last year’s rates will be continued through November 14, 2011, and new rates, with a 6% rate adjustment factor (RAF), will be effective on November 15, 2011. ODP indicated that providers will continue to be paid at last year’s (FY2011) rates, which were based on the Year 2 Cost Reports. ODP included a 2.5% rate adjustment factor (RAF) for the first four and a half months of this fiscal year. There will be no retroactive changes to rates paid from July 1st through November 14th of this fiscal year. Beginning on November 15th, rates will be based on the Year 3 Cost Reports and will include a 6% RAF. PARF is asking members to review the rate letters and share their analysis of the impact of the revenue reconciliation letter and the rate letter on their programs and the clients that they serve. PARF is asking that members report the results of their review to PARF by Friday, October 24 at 5:00 p.m.
PARF members representing inpatient rehabilitation facilities will be convening in Washington, D.C. on November 1-2 for meetings with U.S. Senators and Representatives of the PA Congressional delegation. The meetings are being scheduled to present the case against funding reductions and any regulatory changes that will reduce access and support for inpatient rehabilitation services. The visits are in opposition to the proposal of President Obama to disproportionately cut inpatient rehabilitation hospitals and units (IRH/Us) in his deficit reduction recommendations. Of $320 billion President Obama has proposed for Medicare and Medicaid savings, $42 billion would come from post acute care providers. President Obama proposes to decrease market basket updates by 1.1% for IRFs in FYs 2014-2021; implement site neutral payments for three conditions plus those which the Secretary may designate; and reinstate of the 75% Rule compliance threshold. Meetings are being arranged on November 1 and on November 2. FMI: For more information contact PARF at parfmail@parf.org.
Via of the Lehigh Valley has extended an invitation to PARF member providers for customized employment training that it will be offering in up to three new regional locations during federal fiscal year 2012. The training (Thinking Outside the Box Store) will explore how to meld job seeker needs with those of employers and highlight career opportunities for individuals with significant disabilities. CRC credits are available. Via of the Lehigh Valley is working in partnership with Griffin-Hammis Associates to offer the customized employment training and technical assistance for up to three regional areas in Pennsylvania from October 2011 to September 2012. This training is offered as part of the Employment Reform Resource Project funded by the Pennsylvania Developmental Disabilities Council. Organizations participating in Thinking Outside the Box Store will have the opportunity to access up to $10,000 to support entrepreneurial job development. The training on customized employment offered through this project looks at the need for expansive relationships with nontraditional partners and the role inventiveness plays in our daily work life. The training explores customized employment strategies offering an entrepreneurial approach that often goes beyond traditional market-driven supported employment. PARF members are invited to learn more about the Employment Reform Resource Project at http://griffinhammis.typepad.com/employmentreformproject/. FMI: For more information contact PARF at parfmail@parf.org.
On October 12 PARF Head Injury Committee held a special teleconference to discuss the impact of recent changes to service definition for community integration services announced recently by the PA Office of Long Term Living (OLTL). PARF members identified numerous problems resulting from the changes on services to be provided to PA Medicaid waiver participants needing home and community based services, including community integration services. PARF members noted individuals with cognitive impairments would be uniquely and adversely impacted when the announced limits on community integration services are applied. PARF providers noted that the newly imposed limit of six-months of service does not recognize the nature of cognitive impairments. Providers are concerned with the sudden change in the rule, the difficulty in obtaining a suitable alternative service, the varying interpretations offered by service coordinators, the disruptions to service, and the consequence of the withdrawal of the service on current clients in the Medicaid waiver programs. On September 29 PA Office of Living Term Living (OLTL) issued the bulletin on the changes to the definition of community integration services and new limits on community integration services. The bulletin establishes changes to the COMMCARE, Independence and OBRA waivers and Specialized Services / Peer Counseling Evaluation of Durable Medical Equipment Grant Providers. Changes reflected in the bulletin went into effect on October 1, 2011 for new OLTL waiver participants — and will go into effect on January 1, 2012 for participants with current approved ISPs. In order to assist service coordinators and waiver providers in implementing these changes, OLTL’s Bureau of Individual Support set up three informational webinars. FMI: If more information is needed, please contact PARF at parfmail@parf.org.
On October 13 as part of National Disability Employment Awareness Month PARF participated in a program celebrating the 2011 Pennsylvania Art Exhibit at the Capitol honoring the work of Pennsylvania Artists with Disabilities. The Pennsylvania artists featured in the exhibit are: Steve Collins (Erie), Ann Marie Geiger (Ambler), Stephanie Gwitt (Erie), Daniel Neufeld (Holland), Sal Panasci (Devon), Ron Vash (Erie), and Carl Yeager (Montgomeryville). The program featured remarks by Gary Alexander, Pennsylvania Secretary of Public Welfare and Chairperson of the Governor’s Cabinet for People with Disabilities. Secretary Alexander highlighted the achievement of the artists and the efforts at gaining equal employment opportunity for people with disabilities. Lee Steadman, Director, Center City Arts, Stairways Behavioral Health, Inc. in Erie, Pennsylvania commented on the need for self expression and the power of people with disabilities that is displayed in their artwork. Welcoming remarks were made by Ed Butler, Executive Director, Pennsylvania Governor’s Office for People with Disabilities. Closing comments were offered by Gene Bianco, PARF President. The art exhibited in the Capitol this year is made possible by the artists and the support offered by Bryn Mawr Rehabilitation Hospital, Moss Rehab and Stairways Behavioral Health. Their arts programs and exhibits make the arts accessible for the artists and communities throughout Pennsylvania. FMI: Contact PARF at parfmail@parf.org.
On October 13 the PA DPW Office of Developmental Programs (ODP) issued a communication including policy updates and a summary of “considerations, program initiatives, news and announcements” concerning the Consolidated and Person/Family Directed Support (P/FDS) waivers. The communication describes how certain policy changes (which are reported by ODP to have been presented to a workgroup and which ODP describes as “under consideration”) would be implemented in establishing rates for Medicaid waiver services offered in FY 2011-2012. The policy changes that are described in the attached document would: (a) Reduce the total number of reimbursable therapeutic leave, medical leave, and permanent vacancy days per participant per fiscal year that are allowed to a maximum of sixty (60) calendar days per person per fiscal year with no exception process; and (b) eliminate the residential-ineligible-use-allowance-expense so that payment for the expense would no longer be provided. If more information is needed, please contact PARF at parfmail@parf.org.
