HomeMy WebLinkAboutID Provider Meeting Minutes 11-6-15Franklin/Fulton
Intellectual Disabilities Provider Meeting
Friday, November 6, 2015
ID Page 1 of 5 11/6/15
MINUTES
Welcome & Introductions
Everyone introduced themselves and their agency affiliation.
PerformCare
Brian Gannon
› Brian presented a HealthChoices Overview PowerPoint. Please refer to it
for more detailed information.
› To access services, contact the provider in network directly and request an
appointment, contact PerformCare through member services, contact
Case Management or contact Crisis.
› PerformCare has a website that has a Provider Directory you can search by
county, services, etc.: https://pa.performcare.org/. The member line is 1-
866-773-7917. The Provider Specialty listing is based on a report that
comes in through credentialing or re-credentialing. If you have having
trouble with the provider search on the website, call member services.
› There are a lot of providers in network that are not located in Franklin or
Fulton. PerformCare has contracts with these providers. If a provider is not
a PerformCare provider, there is still potential for out of network
agreement if they are a Medical Assistance provider.
› The current provider for mobile mental health treatment for adults is
Summit. It is a very limited service as there is only one therapist that
provides this type of service. To qualify, there has to be a documented
reason why an individual cannot make it into the office for an
appointment. To access the service, contact Summit directly.
› Note: when looking up individuals in PROMISe to see what coverage they
have, PerformCare coverage is still showing up as CBHNP as their
behavioral health coverage.
Fiscal Updates
Friendly Reminders for our Base Funded Providers
› Quarterly Expenditure Report ~ November 15th
› Audited Financial Report ~ December 31st
› Progress Report on Outcomes ~ January 31st
Ed Franchi
› For residential providers: if you are required to submit a cost report, the
deadline was October 29th. If you have not submitted it, please do so
immediately.
On Behalf of Steve
Budget Update
› No major update beyond that there is still an impasse; talk of passing is in
January. We appreciate everyone’s willingness to work with us on the
Franklin/Fulton
Intellectual Disabilities Provider Meeting
Friday, November 6, 2015
ID Page 2 of 5 11/6/15
information we have been collecting on how the impasse is or could
impact you.
Revalidation
› Reminder revalidations are to be completed by March 24, 2016.
Revalidation is a five (5) year cycle. Please try to get your revalidation in as
soon as you can due to a large back log; additional staff has been hired to
assist with the high volume of submission and back log.
Marion
New HCQU Referral
› Please make sure to use the new referral form. Please continue to send
referrals to Marion so she can review them before sending them to
Tammy. Marion checks to make sure there is a clear description of what
providers are looking for in terms of training. HCQU referrals may also be
generated as a result of Risk Management Committee recommendation.
The providers are notified of these referrals.
› The residential medication error training is done on a three (3) month
rotation. However, if any provider needs the training, please submit a
HCQU referral. There are times that direct care staff is unable to make it to
the syllabus trainings. If interested, a nurse can come out to the group
homes to provide training. Please contact the HCQU to do so.
› The HCQU is still receiving referrals for CDCs as they do encourage them
especially for individuals going into residential or family living. CDCs are
good to reassess every couple years for new recommendations.
Six Month Review
› An announcement came out from ODP that bi-annual reviews are no
longer needed for pre voc, employment and residential. Please refer to
announcement: ISP Review Checklist – Elimination of Six Month Review.
ODP Communication Number: Memo 085-15.
Enterprise Incident Management System
› An announcement was received that a new incident management system
will be used at the beginning of the year. Two systems will be used until
everything is transitioned. If you entered reports prior to the start date of
January 2016, you will still have to go into HCSIS to do any finalization of
reports prior to the new system. Any new reports after the new system
starts, you will only have to access the new system. The new system is
supposed to pull better reports. A training session is to take place this
month sometime. Marion will pass on any information as it comes in.
› As for incidents, there is a new nurse at ODP handling the medical related
reviews, death reports, etc. The new nurse is very thorough and may ask
for follow up. Please make sure your reports contain a lot of detail.
Pathways
Franklin/Fulton
Intellectual Disabilities Provider Meeting
Friday, November 6, 2015
ID Page 3 of 5 11/6/15
› Pathways is a new curriculum based day program option that Franklin
County is looking to start sometime in the late spring. It is not a long term
day program; it is short term for individuals looking to increase their
independent living and employment skills. We are still in the early phases
of bringing the program to our area. A presentation may be done at the
next ID Provider Meeting.
› Kathy Seiderer provided an overview of Pathways. The concept was
developed three (3) years ago in Lewistown when UCP was asked to take
over a supported employment program. Diana Steele is the Program
Manager. She developed a program that focuses on skills such as, cooking,
hygiene, nutrition, relationships, etc. The program is a team effort and
everyone involved in the team needs to work together. The program is a
two (2) year term. At the end of the two (2) years, the individual in the
program will be competitively employed. The goal is to have the
individuals advocate for themselves instead of other people making the
decisions for them. Pathways works on travel training and making sure
when the individual is looking for employment that it is somewhere the
individual will be able to get to. If individuals are still in school, they are
able to participate if the IEP list Pathways as a transition (school districts
can do a contract with UCP).
› The program in Lewistown is on its third year of services. A program was
just opened in Camp Hill one (1) year ago. Jane and Marion toured the
Camp Hill program. Boiling Springs has a Pathways Academy that is a
residential program that is time limited. Pathways is going to be a great
option for individuals who want to live independently and work. The
program goes hand in hand with increasing the independent living
program. Marion and Jane will be reaching out to providers for possible
referrals. A list is being compiled of who would benefit from the program.
The program holds 8-12 individuals. If anyone has any suggestions of
individuals, please let Marion or Jane know.
Lori
Provider Monitoring Update
› Everyone should have received the link. If you have not received it, please
email the Provider Monitoring mailbox to get the link.
› Self-review is due by November 30th. You will receive a confirmation email.
Please make sure to forward that to Lori.
› Lori has notified those that have onsite reviews but will be calling to set up
a time to get them completed between January and May.
Quality Management (QM) Plan Update
› I2I – the goal is to reduce this by 10%. Action steps is a tool kit. It includes
trainings offered to individuals and staff by the HCQU and dual diagnosis
curriculum. It contains guidelines to what it is and some assessments that
can be used to assess, especially if a trend is seen. If you have an individual
Franklin/Fulton
Intellectual Disabilities Provider Meeting
Friday, November 6, 2015
ID Page 4 of 5 11/6/15
who is a target or victim of I2I abuse six (6) times in a Risk Management
quarter, you will be contacted to see what is going on.
› Employment – Pathways program is a new action step. Lori will be starting
to plan for the Employment Fair. She will be reaching out to AHEDD,
Keystone and OSI who provided names of those interested in helping. If
anyone is interested in helping, please let Lori know. A brainstorming
session will be scheduled for early December then after the holidays more
planning, such as, location, employers to come, etc. will be completed. It is
the goal for employers to come do onsite interviews.
Jane
ODP Communication Number: Packet 079-15 – Rate Load
› Residential Providers who are involved in the “Provider Settlement
Agreement Addendum the rates have started to load. If you have billed
have billed passed July 21, 2015 claims will need to be voided. HCSIS
automatically split the authorizations from the last time the provider has
billed. Authorizations should look like 7/1/15 to 7/21/15 and 7/22/15 to
6/30/15. Some providers were in a mass rate change, the system has not
automatically updated every provider yet. Please make sure to check
authorizations and send Jane an email when units have been voided.
Please refer to: ODP Communication Number: Packet 079-15; Partial Year
Rate Load for Eligible Residential Services Related to the Rate Retention
Factor (RRF) Process Resulting from Provider Settlement Agreement.
Additional Individualized Staffing (AIS)
› Any request for Additional Individualized Staffing (AIS)/Supplemental
Habilitation (SH) approval has been taking a while for the state to approve.
AIS/SH cannot be used as a substitute Home and Community Hab or day
program services only if a person retires but individuals can go out in the
community with their AIS/SH staff.
Round Table/Provider Updates
The ARC ~ Angela Glocke
› The ARC has purchased a new van; looking for more referrals.
› The ARC is looking to expand their agency. They have recently hired a
new Human Resources Manager.
› The ARC is also looking at other options of needs in the community and
what programs they can do.
Keystone Human Services ~ Bridget Pugh
› Keystone started to use electronic records. At this point, they are
concentrating on the financial side of it. Residential staff is being trained.
Right now, the focus is on outcomes. It will eventually contain all medical
information as well. It is designed to improve quality of documentation.
› The 20th Anniversary of Chocolate Fest is January 31st at the Hershey
Lodge and Convention. If you need tickets, please let Bridget know.
Franklin/Fulton
Intellectual Disabilities Provider Meeting
Friday, November 6, 2015
ID Page 5 of 5 11/6/15
› Bridget will be meeting with Jane to discuss more types of supportive
independent housing options. Keystone may be working with landlords to
move individuals that are currently in a home or supported living to a
different more independent outcome.
HCQU ~ Tammy LaGraff
› The syllabus was sent out for this quarter. The first quarter of 2016 will be
coming out in a few weeks. If you would like to register, please call or
email the HCQU. If you see anything on the syllabus that you want
brought to your agency, the HCQU is available to do so. A training list can
be sent to agencies interested in additional training. If there is something
not on the list, the HCQU is able to create something specific for your
agency.
› The HCQU has a new Behavioral Health Specialist named Jared.
Occupational Services, Inc. ~ Deb Thomas
› For providers who are picking individuals up at the end of the day, please
bear with OSI as they currently have construction taking place. This should
only be for a short period. OSI will notify providers when the other side of
the building is back open.
› Summer Youth Work Program will be taking place this year. Applications
are ready. If anyone is interested, please contact Michelle Lane.
Person Directed Supports ~ Tim Morris
› There has been a structural change – the Director of the Day Program has
moved into the Regional Director role.
Events & Info
Upcoming HCQU Trainings:
› 11/13 ~ Physical Health and Dual Diagnosis: Older Adults and Dual
Diagnosis (Official ODP dual diagnosis curriculum - #7 in series)
› 12/11 ~ Pneumonia and Flu
Next Meeting Date:
Friday, February 5, 2015 at 10:00 a.m.
In the Human Services Building located at 425 Franklin Farm Lane
2016 Meeting Schedule:
February 5th May 6th August 5th November 4th
Minutes by Erin Nye