HomeMy WebLinkAboutID Provider Meeting Minutes 11-4-16Franklin/Fulton
Intellectual Disabilities Provider Meeting
Friday, November 4, 2016
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MEETING MINUTES
Welcome & Introductions
Everyone introduced themselves and their agency affiliation.
Fiscal Updates
Friendly Reminders to our Base Funded Providers
» November 15th ~ Quarterly Expenditure Report (July – September)
» December 31st ~ Audited Financial Report for FY ending June 30th
» 15th of each month ~ monthly invoices and debarment & exclusion check
If anyone has any fiscal related questions, please contact Ashley.
Steve Nevada
Administrative Entity (AE) Oversight Monitoring
Franklin/Fulton ID Program had their AE oversight monitoring. Final results are not
back yet but it was stated that everything was fantastic. The program is still doing well
and the auditors were pleased. The state is looking to streamline monitorings.
Marion Rowe
Incident Management: Notification and Target Information
Marion received an email in regards to disapprovals from the region due to not
notifying family of an incident. There are two areas in the incident report where you
indicate notification. It is in the first section submission and the final section of the
report. When doing initial submission, you have to notify the family unless it is in the
individual’s ISP that they chose not to. You cannot wait until there’s an incident to
state that the individual does not want to notify family; it must be in the ISP. Only
other valid reason to not notify family would be if there is no family involvement. The
final section of the report requests the first and last name of the person you spoke to in
the family and the first and last name of the person completing the notification.
In many provider site reports (i.e., emergency closure, fire, vandalism, etc.), family
notifications are included in the report. ODP will now disapprove reports that do not
contain the family notification information. Notification is required for all individuals
associated with that site location.
Target identification – particularly in the site reports, where it is a moving violation or
citation for staff, the staff is the target in that report. When you are entering reports,
you have to notify the family that the individual was involved.
There are a lot of open EIM reports. Look at timelines to check for open reports that
require finalization. Providers should be checking to make sure reports are closed or
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disapproved. EIM still needs a lot of work; such as making sure notifications are
completed. Notifications are not a mandatory field to complete, so it is easy to skip
over (but they will get bounced back without this information). ODP is hoping to make
the notifications field a mandatory field.
Lori Young
Provider Monitoring and Provider Qualification Update
Provider monitoring cycle has started. A letter was sent out in regards to provider
monitoring. Self-review is due by November 30th. It must be completed with the tool
and submitted. NEW this year: when you send Lori a copy of the confirmation email,
you must send her the MCI tracker (spreadsheet will be sent with the final minutes).
This is whether you have onsite monitoring or self-review. Providers must complete the
PM Tool & On-site Guidelines, MCI Tracker and Provider Claims Review tabs.
There are very few changes. One change is in regards to Question #64 regarding 90%
utilization. This is not a regulation but is best practice. The question will be used for
data collection only. There will not be a corrective action plan any longer if the 90%
utilization is not met and it will be deleted from the next cycle. There still needs to be
something in the ISP or provider progress notes if utilization is below 90% though. You
do not need to change the unit utilization.
As for provider qualification (which are every other year), a spreadsheet was sent out
last year (and will be sent with the final minutes). If you are going to use the
spreadsheet, send it when you submit your application in HCSIS. When Lori comes for
on-site review, she will have to initial that she saw the supporting documentation. If
you send it to her prior to the review (which is strongly encouraged), she will know
what she needs to look for.
Regional Collaborative Update
Franklin/Fulton submitted a plan/application for Regional Collaborative. The next
meeting is scheduled for November 22nd from 9:30 a.m. – 11:30 a.m. at the
Administrative Annex (218 North Second Street) if anyone is interested in attending.
For additional information about LifeCourse planning tools, please visit
www.lifecoursetools.com. The start date is set for December 1st.
IM4Q Update
Independent Monitoring for Quality (IM4Q) year has started. The person doing the
monitoring does not have access to ISPs. If you are working on a goal for a
consideration that has come in, the person completing the monitoring does not know
that. The Supports Coordinator (SC) will respond that there is an outcome and goal
and this is what the progress is. For those receiving waiver services, the only person
who can decline is the person themselves not the staff. The reason for this is IM4Q is
one of the indicators used to collect data for ODP’s Quality Management Plan. It will be
used more by the state towards initiatives and how they are performing.
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Jane Cline
SIS
Residential providers should have received an email from Denise Sloand on Wednesday
about SIS scores. ODP has reviewed some and will be requesting new SIS scores. Jane
has received all SIS scores of individuals living at home or in residential for
consolidated. There were some discrepancies on the high end and low end. Some scores
don’t reflect accurately. With residential group homes, this is how the individuals’ rate
will be determined. A suggestion was provided to ODP to do training for Supports
Coordinators and providers about the SIS. The SIS has been in place for at least five (5)
years. There has been discussion about face to face training so the state can show the
importance of the SIS. Virtual rates are starting July 1, 2017 until December 2017 to
see how it works. There has been discussion about getting the information to auto-
populate so it does not need entered into each plan. Actual rates go into effect January
1, 2018.
When researched nationally, the error rate of the SIS is that 7% of individuals SIS
scores do not capture correctly. Our numbers look like 5-6%. We want to make sure
the process we put in place is effective. There is a group of administrators that are
working with ODP to make sure we are taking into account the potential challenges
and areas of concern so that when the rates do roll out, there will not be kinks in the
process. ODP has picked 600 SIS scores across the state that does not match up. We are
looking to get the list to see if anyone on it matches our list.
Providers are encouraged to update information during ISP meetings. Some of the SIS
information is old. If there are changes and the SIS information is not accurate, please
note this. If someone wasn’t interested in employment but has changed their mind,
update the information. This information can go wherever the SIS information is
located on the ISP. The information cannot be left as is if it’s no longer accurate. A SIS
is to be completed every three (3) years.
Proposed Waiver Renewal Discussion (Group Discussion)
Employment Service Changes
The state is moving towards community participation supports for umbrella for day
habilitation, pre vocational, hub sites, community participation and in home
community support. There has been discussion the amount of times individuals are out
in the community. Initially, by January 1, 2018, 25% of individual’s time will be out in
the community; by July 1, 2018, 50% should be out in the community; and by July 1,
2019, 75% should be out in the community. There is an upcoming webinar on
November 30th from 9:00 a.m. – 12:00 p.m. to discuss this information. Providers need
to start discussing this change at ISP meetings and this is going to look for the
individuals. Some of the sites that are smaller may be more able to do this; while those
who serve more than twelve (12) individuals may see a huge shift. Hub sites are a big
difference for those who are not familiar. Transportation can become an issue.
Individuals are dropped off at one location and go out into the community. There are a
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lot of providers of day programs and pre vocational programs that are going to have
to figure out how this will look and how to support the individuals.
Advanced supported employment is being added. There is a huge push for those in pre
vocational settings that need more support in obtaining a job. It is likely at a higher
rate. Benefits counseling is being added as a service. Things that were grouped
together before are being separated. Advanced supported employment is more for
discovery piece and job development; for individuals who have been unsuccessful in
supported employment. Individuals must have been found ineligible for OVR services or
have been closed for services. They must meet the following: receiving sub minimum
wage and ISP team would have to determine that the advanced supported
employment service is needed. Providers are going to have to obtain credentialing for
advanced supported employment; certified employment support professionals for pre
vocational is a requirement.
Marion has spoken with John Witt, who has agreed to come speak to local providers of
day services to discuss some of the changes, plan for moving forward and review those
providers who have started making changes to make sure they have made the right
changes. We want to make sure everyone is on the same page and providers are
getting support and heading in the right direction. Marion will reach out to providers
to schedule these meetings with John Witt at a later date.
Residential/Transportation Changes
Proposed change is LifeSharing allows participants to live in their own home or home
of relative, unrelated individual and receive agency managed services. Individual could
be living with a relative who can go under a provider and become a LifeSharing home.
It would be overseen by that provider, fall under all regulations that any other
LifeSharing home must follow and it could also fall under licensing exemptions 6500.3
(f). LifeSharers can access Respite Services through traditional agency models at the
established limits thirty (30) days of twenty-four (24) hours, 480 units of fifteen (15)
minutes (Consolidated) and 1440 units of fifteen (15) minutes (PFDS).
As for Supported Living, an individual is renting or owning their own home, it will be
billed on a daily rate. The rates will be structured depending on how many hours of
support are needed. Currently, Franklin/Fulton ID Program has Independent Living
apartments where individuals live in their own apartments. The lease is in their name.
Right now, they receive home and community based services; this service definition
will no longer exist. Home and community habilitation definition will be replaced with
in home and community supports. Participants will not be authorized for this service if
they live in Residential Habilitation, Supported Living or LifeSharing. Individuals in
Consolidated Waiver are limited to fourteen (14) hours per day for any combination of
In Home and Community Support, Companion and Community Participation Supports.
For transportation, mileage will be paid per trip versus round trip. A trip is from the
point of pick up to the destination as identified in the ISP. For participants under the
age of twenty-one (21), transportation may only be used to and from waiver services
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or a job that meets the definition of competitive integrated employment. Individuals
who receive Residential Habilitation, LifeSharing or Supported Living may only be
authorized for transportation services as a discrete service when the participant
requires transportation to or from a job that meets the definition of competitive
employment.
Autism Waiver
There has been discussion about expanding the waiver to autism. This does not mean
expanding base dollars. It would be for individuals who qualify for the waiver and
meet the three adaptive functioning deficits. We have looked at numbers in our system.
There are thirteen (13) on the autism waiver list; two (2) are already open with ID.
For the Autism Interest List, they do not check eligibility until the individual is at the
top of the list and the next to be served. Once an individual gets to the top of the list, it
may be realized that they already have services or do not qualify. Expanding the
waiver to autism would expand the target population but not the capacity. We need to
think as a system what sort of things we need to do to prepare for this. There will be an
increase in numbers of individuals with autism. Steve is looking to do trainings with
ASSERT but would also like to see what people locally would like to see, what resources
they have in mind, etc. Staff have reviewed Medicaid numbers; 529 were identified of
individuals under twenty-one (21) receiving services with autism as a primary
diagnosis (if it is a secondary diagnosis, it may not have been captured). We broke
those numbers down by high users of residential, BHRS services, etc. This narrowed the
number down to about forty (40). All individuals are not going to hit the system at the
same time. The reform group is looking at the intake flow and trying to figure out how
administrative work is going to be done. Interesting enough, when analysis was done
on individuals over twenty-one (21) getting services with ASD, there were zero (0).
There is a drop off in the system. It could be the individuals no longer qualify for
Medicaid due to obtaining other insurance. However, staff does not believe this
number truly reflects that age group. For providers, look at what we need to bring to
the table so we can effectively provide services to these individuals.
The PUNS needs looked at. This will determine the next step. Agencies may receive calls
demanding individuals be put on the list. As long as we are still applying the PUNS, we
have to defend that. Concern would be autism individuals could be higher on the PUNS
list than the person who was originally next in line on the ID waiting list. Another
concern is base dollars. Base dollars are based on the MHMR Act of 1966; nowhere in
the act does it state autism. However, if we have an individual that we do not have a
slot for, we are going to have to pay out of base dollars. There are only a discrete
amount of funds.
Also added to the waiver, children under eight (8) with any developmental disability
will be opened. This could be an individual with Down Syndrome. This will allow for
LifeCourse planning. There are times individuals are in the Early Intervention (EI)
system with delays that go to head start then drop off the radar at age 4-5 for a
certain amount of years before reappearing. By opening them in the ID system but not
delivering services, it will allow for better tracking and planning.
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Additional Information
At this point, all changes are proposed. There will be time for comment. The
expectation is that the draft proposal will be completed by the end of
November/beginning of December. It then has to have time for public comment
opportunity.
6100 regulations went out in the beginning of November. There is a forty-five (45) day
comment deadline. State is trying to get everything compiled by December 9th.
Providers are more than welcome to draft their own comment or if they would like
Steve to take any back to the workgroup, please send them to him, Marion or Jane.
Round Table/Provider Updates
Pathways ~ Kathy Siederer
Pathways officially opened August 15th. There are five (5) individuals enrolled; six (6)
as of next week. An invitation email was sent out for open house on Wednesday,
November 16th. Please stop in to see the program and learn of the services provided.
The ARC ~ Lorrie Miller
The ARC Social is November 17th. Holiday Dance and Party is December 15th. The Walk
is March 4th at the Shippensburg Recreation Center, University Campus.
Occupational Services, Inc. ~ Deb Thomas
OSI has started Workforce Innovation and Opportunity Act (WIOA) Career Counseling
and Information Training by Office of Vocational Rehabilitation (OVR). Any individuals
in the OSI facility must participate. After July 22nd, new individuals must participate
twice the first year then annually after.
Service Access & Management, Inc. ~ Matt Yingling
Monday was Justine Greenwood’s last day. SAM will be hiring for her position. Becky
Weaver will be returning Monday (11/7) and Shanna Golden will be returning
Tuesday (11/8).
Angels on Call ~ CJ Weaber & Shelly Rosenberry
Angels on Call offers habilitation services, companionship, respite, etc. in Franklin,
Fulton, Adams, York, Dauphin, Cumberland, Perry, Juanita, Mifflin, Lebanon and
Lancaster counties. Currently, they are serving forty (40) individuals but are looking to
increase this number. They are looking to hire staff and train them to work with
individuals. HCSIS has Angels on Call listed as Harrisburg Health Home Services, LLC.
Angels on Call took the mindset of improving outcomes and keeping individuals at
home as long as possible. They are looking at the employment part of employing
individuals as companions for others who need someone to sit and talk with them.
Services are provided for ages 18 years old and up. There is staff in Franklin for new
referrals. Angels on Call will keep everyone posted on their services. (Please see packet
for additional information or visit the website www.angelsoncallpa.com).
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Events & Info
Upcoming HCQU Trainings
Registration can be submitted via email to Tammy LaGraffe:
» 11/18 ~ Everyday Lives and Recovery: Mental Health Wellness and Recovery
(Official ODP dual diagnosis curriculum, #14 in series)
» 12/9 ~ Understanding the Endocrine System
As a reminder, HCQU can do trainings for individuals, families, staff. Trainings
can be one on one or large groups. HCQU can also do record reviews. If you
have an individual who has increased behavior, hospital visits, etc., the HCQU
can rule out anything medical. Technical assistance is provided. If anyone has
any questions, please contact Tammy. Information can be provided or over the
phone guidance can be given. The HCQU cannot do hands on training, such as
tube feeding. They can teach you about the difficulties, why someone would
need one and the educational part but not hands on.
Next Meeting Date
Friday, February 3rd, 2017 at 10:00 a.m.
at the Administrative Annex – 218 North Second Street
2017 Meeting Dates
February 3rd May 5th August 4th November 3rd
February and May meetings will be held at the Administrative Annex
August and November meetings will be held at the Human Services Building
Minutes by Erin Nye