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HomeMy WebLinkAboutIDD Provider Meeting Minutes 05-17-24 Intellectual & Developmental Disabilities Provider Meeting Friday, May 17, 2024 3³ ¥¥ 0±¤²¤­³Ȁ Jane Cline, John Gerak, Marion Rowe, Lori Young, Zachary Gantz, Angie Alleman 0±®µ¨£¤±² 0±¤²¤­³Ȁ Ariane Warren & Beth Freeman Ȩ/¢¢´¯ ³¨®­ « 3¤±µ¨¢¤²Ǿ )­¢ȁȩ, Tony Fisher & Jessica Coons Ȩ& ¬¨«¸ # ±¤ 3¤±µ¨¢¤²ȩ, Rochelle Mays Ȩ4¤­£¤± (¤ ±³¤£ 3¤±µ¨¢¤²ȩǾ Katie Freeman ((¤ «³§# ±¤ 1´ «¨³¸ 5­¨³ȩ, Lorrie Miller & Wendy Buckwalter Ȩ4§¤ !2#ȩǾ Shanna Golden Ȩ3¤±µ¨¢¤ !¢¢¤²² lj - ­ ¦¤¬¤­³ȩǾ Brianne Leigh Ȩ5#0 ®¥ #¤­³± « 0!ȩǾ Tara Harmening Ȩ3 ¥¤ ¨­ (®¬¤ȩǾ Sarah Guyer-Marshall (AHEDD) MEETING MINUTES Welcome & Introductions This meeting was held via Google Meet. Those present introduced themselves and their agency affiliations during the Provider Updates. Self-Advocates United as 1, Inc. (SAU1) This agenda item was not presented. Office of Vocational Rehabilitation (OVR) Kaylee Young is the new ID/Autism Counselor in Franklin County. She provided an overview of the Office of Vocational Rehabilitation (OVR) services. OVR started reaching out to all counties that the York District Office covers to provide th presentations to Support Coordination agencies. On May 6, a presentation was held at Service Access & Management (SAM). OVR works with individuals with disabilities from ages 16 to retirement that has any form of disability that impacts employment. This could be anyone with an intellectual disability, physical disability, mental health, etc. OVR goes through a process for services. Someone would call in to make a referral or visit the OVR website. OVR staff will meet with that individual within ten (10) days of receiving the referral. They then have to be made eligible within 60 days. The pre-employment transition services are for individuals 14-21 years of age. If individuals are staying in school until 21 (or 22 as of a recent change), OVR is able to work with them. OVR works with them on skills of self-advocacy, independent skills, etc. that will keep their abilities to work in the community. OVR helps them learn and do career exploration such as my work study, work practice skills, look at summer programming such as my work study. These have been held at various locations, such as YMCA. OVR works with the local job coach agencies such as Youth Advocate and Occupational Services, Inc. (OSI). Early Reach Coordinators can go out to the schools and meet with groups of students to go over programs. For adult services, OVR starts with students in high school two (2) years prior to graduating. IDD Provider Meeting Friday, May 17, 2024 Some vocational services OVR can do are diagnostic services, vocational evaluation, guidance and counseling, training, restoration services, etc. Restoration services are great for individuals who want to learn to drive. OVR can do driver individuals may need an adaptation for their vehicles in which OVR can assist with that as well or look at doing an evaluation for it. OVR does placement and assistive technology. Assistive technology can assist with more than just computers. If an individual wears glasses, they can assist with safety glasses for going onto the job, prescription safety goggles, etc. OVR provides supportive services such as working with the job coaching agencies. For each individual OVR works with services are individualized. OVR makes sure they tailor their goals and plans to them. In Franklin County, OVR invites SCs and team members to intake so the entire team is on board and everyone is in agreement to what will happen moving forward. The best way to submit a referral for OVR services for Franklin individuals is to call or email. Please see the referral sent out with the minutes. When the referral is completed by the SCs, they are able to attach the additional documents needed for the referral. Providers can complete the referral and send it to the SC and they can make sure the additional documents are involved or the provider will have to have the documents available for the intake process. Station MD Geoff Must is the Director of Strategic Partnerships from Station MD. He provided a presentation to explain the services they provide now that the medical component has been approved by the Office of Developmental Programs (ODP). Station MD is a telehealth services for individuals with IDD. It is medical advice on demand. Station MD has specialized physicians that go through intensive training and learn how to interact with individuals they are working with. Most of the physicians are emergency room doctors by background. The physicians have a curriculum that they have to run through before they can provide treatment and assessment with individuals with IDD. The big update is that Station MD is now live as a waiver service in Pennsylvania as of st March 1. There are a lot of individuals signing up. Station MD did have a footprint in PA before due to working with provider agencies that were paying for services for individuals. Station MD was founded by four (4) ER doctors who identified a gap in care. They saw full group homes coming in for one individual to be assessed or individuals being admitted due to their physicians not knowing how to treat or interact with them. They built Station MD around this gap. Station MD has been awarded the 2022 Leadership Award from the American Association on Intellectual and Developmental Disabilities (AAIDD). Station MD is currently in 21 states and growing. They are working on becoming a waiver service in other states as well. IDD Provider Meeting Friday, May 17, 2024 Station MD STAT service is a specialty telehealth and assessment team that provides 24/7 access to doctors who specialize in IDD. If the individual requires a higher level of care after being assessed by the Station MD doctor, they function as care coordination as well. The doctor will call ahead to the ER to have peer to peer conversation if the hands on care is needed. Station MD has over a 90% treat in place rate when individuals call in meaning they have been very successful in the diversion piece. Station MD has nurses who follow up to see how individuals are doing. They will connect individuals with a doctor if they feel a reassess is needed. If an individual is seen by one of the physicians, the visit summary will be faxed or e-faxed to whoever is authorized to see it so they can see what happened during the visit. If there was any scripts were written during the visit that will be shared as well. Many people with IDD have no choice but to go to the ER. There are many reasons behind this but one of the main reasons is due to complexity. Calling into a primary care physician may not mean the person will be seen quickly, it could be a day or two for something that needs addressed in the moment. On the weekends, you may reach an on call service which typically refers you to the ER. If you call Station MD, there are physicians on staff who will take the call and treat how they feel is necessary. When calling into Station MD, it is on demand. You will be connected with a receptionist and technical assistance that will guide you to the physician. This is usually done through a Zoom platform. You would be connected to the physician within minutes. There is a chance you may get the same physician multiple times; however, that is not always the case as it will be the first available physician that will be able to respond as quickly as possible. If it is seen that volume is increasing, other physicians are brought in to decrease any wait time. Ideally, the physicians would like to have eyes on the individual. This could be through a smart phone, tablet, computer, etc. If someone does not have these options, they can call in by phone and be assessed. However, being able to put eyes on the individual is preferred. The emergency room experience for individuals and staff and caregivers includes long wait times, very busy, exposure to infection, etc. One piece of feedback from agencies that Station MD has been provided with is that going to the ER has the ability to disrupt their routine. Individuals miss medications when they go into the ER as well as are subject to a lot of testing which can cause trauma. Station MD tries to divert from the ER if possible. Station MD looks at themselves as more than just doctors who are treating. It is the ability to give individuals a better quality of life as they understand the population and dynamics of it to include the group homes, the staffing shortages, caregivers, etc. Station MD is available 24/7/365 which assists caregivers and individuals so they do not have to make a clinical decision. They are able to get a doctor on the phone right there to help them and work through the situation. Why call Station MD? This can be summed in two blocks everyday questions and potentially service questions. Examples of every day questions pertain to giving the wrong ugh, IDD Provider Meeting Friday, May 17, 2024 blood pressure is high, glucose is high or low, etc. These types of scenarios will be assessed by the doctor and treatment provided. Examples of potentially situation questions pertain to falling, someone hit their head, they keep vomiting, worrying about a fever that is increasing, odd pain that is getting severe, etc. Station MD does provide scripts for emergency at that moment. Why is Station MD important? It is on demand access to specialized doctors who understand the population. It is health equity kind of disparity that Station MD tries to fill to give the proper treatment, understanding and communication with this population and caregivers. The goal is to keep individuals in the community whether that is at home or elsewhere and to avoid spending hours in the ER or being admitted for no reason. Who benefits from using Station MD? Individuals with IDD are the primary focus. It empowers individuals to thrive in the community. Caregivers and support providers also minor or major question. Station MD interacts a lot with nursing teams. In addition, provider agencies benefit. They see it as expanding services for the individual. It also helps with staffing retention and assists financially as they do not have to pay for transportation. Step by step process 1) Phone call: call 1-877-STATMDS; 2) Connect with receptionist who will ask for information which will include vitals (blood pressure, heart rate, temperature, etc.). However, all that information is not needed. 3) Technical Assistant is going to help get individuals connected to the Zoom app and 4) get connected with a clinician to assess! How to enroll individuals for Station MD? This is for individuals who are in a community living, consolidated or person family directed supports waiver. If so, they are eligible for Station MD. There are no other restrictions or things that would allow them not to qualify. Station MD is a STAT service which means a specialty telehealth and assessment team. Station MD will work with SCs, provider agencies, caregivers and whoever is on the team to get individuals signed up. The procedure code is W7032 in HCSIS. Once added to the ISP, Station MD may be accessed 24/7. Geoff will provide a one pager with this information included. Individuals can call an unlimited number of times. Its $55 per unit with one unit being one month (12 units would be annual coverage for the individual to call in.) Clinically, Station MD has a treat in place rate of 93.1% of calls they take. There were about 44,000 calls that came in last year. For the 7% that had to go into the ER, Station MD will make the call to care coordinate. There are also a percentage of individuals who have more complicated situations in which Station MD will do follow up calls. If Station MD provides treatment and there are still questions after, they can call back in. Station MD receives a lot of calls. Geoff provided a chart that includes information on falling, rash, constipation, possible COVID, etc. The chart provided showed the number of calls that resulted in treat in place versus those who had to go to the ER. Instances such as IDD Provider Meeting Friday, May 17, 2024 injury to the head, vomiting, cardiac, etc. may be referred out more versus a couch, conjunctivitis, prescription, etc. Station MD has a telemedicine partnership with Mainstay in Pittsburgh. They published a study where they looked at cost savings and how Station MD functions with individuals. They are on track, even with paying for services prior to Station MD becoming a waiver service, to save about $100,000. Arc Human Services and Mainstay Life Services provided testimonials on the services Station MD has provided. If anyone has any questions they can contact Geoff Musti, Director of Strategic Accounts at Geoffrey.Musti@StationMD.com or Drew Simonik, Member Relations Specialist at Andrew.Simonik@StationMD.com. Does the one pager list when not to call Station MD? Geoff notes that this is not addressed much. Station MD takes all sorts of calls. Waiver services do not cover psychiatric services. However, Station MD does get these calls pretty frequently due to behavior, anxiety has increased, etc. Sometimes there is a medical reason behind the behaviors that needs to be assessed. Station MD does not say when not to call but if there are instances where there is excessive calling and we could educate, Station MD will reach out to the authorized party or even the SC to discuss the situation but this is rare. When you call in, if the receptionist reads the situation as an immediate emergency, they will redirect the call to 911 immediately. We educate the agencies that when you clearly know the situation is immediate such as pulse ox is dropping rapidly, fractures, etc. please go to the hospital. But if there is ever a question, Station MD does have a quick triage to determine such calls. Station MD assesses head injuries. This is an instance where there may be a higher referral to go get treated in person. However, it is a common call. Station MD will assess, treat in place and will also follow up to see how the individual is doing. How do you get the individuals medical information? Station MD does rely on whoever is calling in to obtain information. They also rely on HCSIS to gather some information if available. If a provider agency is calling in, Station MD often gets read only access to electronic medical record (EMR) systems where they can log in and review their medical information, medications, past medical history, etc. This information is important to ensure Station MD is treating appropriately. If families are calling in, they rely on verbal information to start. If the doctors are unsure if they are getting the right information, they will refer out to be safe. It does. It will be $55 per month to have services so $660 per year. For individuals that live in the community and the team finds this to be a beneficial service to have, is there a best practice to assist the family in getting services set up so Station MD has as much information beforehand? IDD Provider Meeting Friday, May 17, 2024 The one pager will assist on when to call in. However, Station MD has learned that a lot of times a lot of the information is collected on the first call. There is not a great way to gain information in the community. When they are with provider agencies it is a little easier as Station MD can work directly with them. Station MD has an EMR so the information collected will be saved in their system for future calls. For other services, there is a referral process. Station MD does not have a referral process. with Station MD that this person is going to be adding the service to their plan? This is correct. ODP put out an announcement that Station MD is not involved in the team meeting/do not have to be. However, if there is a situation where you feel there is a lot of questions or outlining situation, Geoff or Drew can make themselves available. If a life sharing agency wanted to get the service in the ISP for individuals for the caregivers to use, is there an option for Station MD to speak to caregivers at agencies to talk about what it is for and how to use it? Yes! Station MD would like to get in front of groups and answer any questions. For individuals who have Station MD as an authorized service but they go to a day program or have habilitation services, is this service only for individuals to use when they are at home or would it also be used when they are not at home and having other services? It can be used anywhere. It goes with the individual. Station MD gets calls when individuals are at work, on day trips, etc. Station MD just asks for you to go to a private, quiet area. Provider noted that it would be helpful for provider agencies to be made aware that this service is an option for an individual whether that is through developing a process or what that looks like. Some providers are able to see any service that is authorized in HCSIS in which they could obtain this information. Station MD has had situations where a Business Association Agreement (BAA) is done and the provider agency will share information with them and they can match it up to who is eligible in their system. Where does Station MD fall with incident management when it comes to assessing an injury? ODP has their own bulletin on incident management. Station MD has heard from different agencies on things being addressed differently. There is not incident every time you call ing to follow normal processes. Station MD does not get involved with the bulletin from ODP. This is looked at as a service of support. A lot of calls are not incidents. A provider noted that the bulletin says assessment of injury so any medical professional answering questions about there being no injury is still an incident report. If it is an incident report the provider enters, Station MD will provide documentation if needed. The visit summary is shared each time. Station MD wants to make sure they are not seen as a barrier due to the incident reporting process. They are still working on clarity with ODP. Administrative Entity (AE) Updates - ±¨®­ 2®¶¤ %­³¤±¯±¨²¤ )­¢¨£¤­³ - ­ ¦¤¬¤­³ Ȩ%)-ȩ 5¯£ ³¤² IDD Provider Meeting Friday, May 17, 2024 ODP is going to be looking at the entire EIM process. They call it a transformation. It will not be happening this year but potentially 2025-2026. They are looking for feedback on everything related to incident management from EIM to the bulletin to any little nuisances. Marion encouraged providers to keep a notepad to jot down be asking for feedback from providers as they play a key role. She will reach out for feedback when ODP is ready to capture all the information. However, if providers do want to send her things along the way she will keep a running log to send to ODP. Marion did reach out to ODP when she received the original email to see what they we relooking for. They are looking for just about anything at this point. They realize that it is very time consuming. Be honest with your feedback! Target identifiers make sure you are not using oth the program when completing your reports. If you are going to refer to them, please use the target identifier (ABCD1234). Please keep in mind that some family members and others can have access to the actual report so you do not want to put identifiable information in the incident report. For ER and hospital reports make sure you upload the discharge documents or recommendations into the EIM report. Provide detailed information in the first section on what led up to the incident. We have been getting feedback on not having enough information as to what is going on. Review the regional and county review comments before finalizing your report to make sure you are responding to all questions. Incident fidelity Marion has not received any of these recently but ODP will continue to do those reports. ODP is checking MA emergency room billing to determine if there is a corresponding incident report incident report is required. If it is a required report you do have to e provide the feedback to Marion for follow up to ODP. Incomplete reports when you start a report then find out you do not need it you need to delete it yourself but if you submitted it you need to ask the county to delete it. Please go in when you do your process management and look for those reports that you may have started but never finished and go back and delete those. John is reviewing some of that information. There have been some reports that were started and never finished. They either need to be deleted or finished. * ­¤ #«¨­¤ It is time for fiscal year renewals. Marion and Jane requested that the last two (2) weeks in June they will do the authorizations for the waiver individuals. Please start checking your utilization for this year to make sure you have enough authorizations to get through the fiscal year. If not, you will need to complete critical revisions. If they are received prior to the last two (2) weeks of June, Marion and Jane will try to st get them completed. After that, it will most likely not be until after July 1. IDD Provider Meeting Friday, May 17, 2024 Jane has spoken with a couple providers to inform them that ODP has reached out to the Administrative Entities (AEs). Jane noted that it is great that the PFDS and Community Living waivers will be getting a higher cap for next fiscal year. However, services are also increasing. The PFDS and Community Living waiver caps went up 14%. PFDS cap will be $47,000 and Community Living will be $97,000. Some of the new rates are as high as 28%. Even though it looks like more money is coming in these waivers, when you look at the services individuals receive, they may be getting fewer services due to the rate increasing so much. Jane requested that if providers want they can make a comment at the rate setting mailbox up until June st 1. Providers may be cutting staffing hours because someone may not be able to work as many hours as they have previously. The hope is that ODP increases the cap again or bring the service rates down to what is going to get individuals additional services or more hours or individuals will be losing services because of it. AEs do encourage providers to reach out via the mailbox because ODP is not going to be doing cap exceptions. ,®±¨ 9®´­¦ th Lori will be retiring as of June 28 website if you are aware of anyone who may be interested in applying. Supports Coordination Organization (SCO) Updates SCs are working on fiscal year renewals at this time. Shanna Golden believes they have received all crosswalks from providers at this time. Healthcare Quality Unit (HCQU) Updates HCQU no longer has a fax number or a physical office location. All staff in the south central HCQU is remote. Email and phone are the best way to communicate. There is still a mailing address in case anyone would need to mail anything. The HCQU is in the process of change phone providers. Their phone numbers will remain the same. However, if anyone tries to reach anyone in the next day or two they may have some issues. If you do, please email Katie and let her know. The HCQU referral has been sent out. The only revision to the form was removing the fax number. The next syllabus will be sent out with the minutes. Provider Updates /¢¢´¯ ³¨®­ « 3¤±µ¨¢¤²Ǿ )­¢ȁ Ȩ/3)ȩ OSI is getting ready for the fiscal year end and a building inspection next week. Keith with SITES will be going out on leave. Some of the job coaches will be covering the SITES program. The best contact for referrals will be Ariane Warren and Beth Freeman. OSI is getting ready to start up student programs for the summer in about a week and a half. 5#0 ®¥ #¤­³± « 0! IDD Provider Meeting Friday, May 17, 2024 UCP closed their Chambersburg Community Participation Supports program in mid- February. Everyone who wanted to was able to transfer to the Shippensburg location. This is working out well. UCP is still looking for staff due to adding ten (10) additional individuals to the Shippensburg program. Referrals are being accepted but there is a wait list due to not having staff. & ¬¨«¸ # ±¤ 3¤±µ¨¢¤² Ȩ&#3ȩ Family Care Services has their inspection scheduled for the first week of June. st Life sharing is changing to with day and without day rates starting July 1. How are they to report anticipated units? There can be a total of 400 units between the two then add the additional units to make it 400 in the other. If you have someone who goes out more frequently, you will want to give us a ballpark of what you think they require a meeting for that; we just need to know an adjustment is needed. For someone who is close to budget cap, it will need to be looked at more closely. 4§¤ !2# ®¥ &± ­ª«¨­  ­£ &´«³®­ #®´­³¨¤² th . This is the annual picnic held at the Grand Point Church pavilion at 6:30 p.m. 4¤­£¤± (¤ ±³¤£ 3¤±µ¨¢¤² Tender Hearted Services is still looking for staffing for on the weekends. But overall, things are going well. AHEDD AHEDD is fully staffed. They continue to take referrals and do not have a waiting list. If anyone wants a job and needs help in the community, please send them to AHEDD. 3 ¥¤ ¨­ (®¬¤ Tara is waiting for formal communication from marketing and leadership to push st out formal notice. As of April 1, due to the changes with the notice of Assistive Technology being short term, Safe in Home is no longer going to provide Assistive Technology. Short term has been defined as six (6) months. Someone has up to six Home is only going to be providing services. They will only be a standalone remote support provider. Safe in Home will not be doing consultations to try out the technology. They will focus on the remote support which can be billed through the waiver. Safe in Home has made some changes on how they will bill for services. For non- provider individuals in the community, we used to bill for the remote support services under the W code 6088 and for all the equipment it would be billed to st 6087. Effective July 1, Safe in Home is going to do an inclusive billing. It will switch from using two (2) codes to billing everything through remote support W 6088. Due IDD Provider Meeting Friday, May 17, 2024 to being inclusive, instead of being $9 plus the equipment cost, it will just be a flat inclusive rate of $13 per hour for services. If there are any providers interested in remote support services, Tara will have a separate conversation as its more in detail. If Safe in Home is providing remote support, they invoice that directly to the provider. If Safe in Home is providing the remote support, they are able to bill the waiver long term to provide the devices to the waiver. Jane asked if the $13 an hour is for 24 hour remote support or can they specify in the ISP it would be 5 pm to 9 pm? Tara said yes. Safe in Home can do sign on and supports specifically to monitor. It is based on the need. There are individuals who have two (2) hours a day and they have the platform that is on demand services. This is billed at 21 hours a week regardless of the usage. If someone called after the 21 hours, it will only ever be charged for 21 hours. This gives access to Safe in Home 24/7. Individuals who are frequent callers or have safety issues at home may just want a life alert and tablet and may want to reach out to remote support on their own. Reports Friendly reminders of due dates for our Base funded providers - (See Procedure Statement MHIDDEI-416) - ¸ ΐΔ³§ Quarterly Report of Expenditures (Jan-March) *´­¤ ΒΏ³§ Audited Financial Report (for calendar year ending 12/31) *´«¸ ΐΏ³§ Audit Engagement/Extension Letter (for FY ending 6/30) *´«¸ Βΐ²³ Progress Report on Outcomes in Appendix A !´¦´²³ ΐΔ³§ Property Purchased/Property Leased Report and Fixed Assets Purchased with MH/IDD/EI Funds (for FY ending 6/30) ΐΔ³§ ®¥ ¤ ¢§ ¬®­³§ Monthly Invoices If anyone has any fiscal related questions, please contact iddfiscal@franklincountypa.gov. Upcoming Trainings See HCQU Syllabus .¤·³ 0±®µ¨£¤± -¤¤³¨­¦ &±¨£ ¸Ǿ !´¦´²³ ΐΕǾ ΑΏΑΓ at 10:00 a.m. in virtual format.