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HomeMy WebLinkAboutIDD Provider Meeting Minutes 08-20-21Intellectual & Developmental Disabilities Provider Meeting Friday, August 20, 2021 MEETING MINUTES Welcome & Introductions This meeting was held via Google Meet. Marion Rowe confirmed which providers were present prior to the beginning of the meeting. Jane Cline  Mobile Community Nurse The IDD program has hired Kelly Ellerman as a mobile community nurse. Kelly is stationed in Shippensburg but is available to help families with organizing medication, nursing questions, and act as a liaison with doctors. Nonresidential providers can make a referral by reaching out to the IDD Program Specialists at Franklin/Fulton MH/IDD/EI.  Community Participation Supports (CPS) & Transportation Rate Increase The CPS and transportation rates increased on August 1, 2021. However, the rate increases weren’t retroactive back to July 1, 2021. Based on the new rate, thirty- eight (38) individuals will be over the Person Family Directed Support (PFDS) Waiver cap. Jane had to submit the information to the Office of Developmental Programs (ODP) for Cap Exceptions due to the increase rates. The services will remain in pending until ODP approves the cap exceptions. The rate increases will be in place until June 30, 2021. Individuals starting in CPS programs will need to have services within the PFDS cap of $33,000.  Listening Sessions Jane encouraged providers to sign up for the listening sessions for the renewal of the Consolidated, Person Family Directed Supports (PFDS), and Community Living Waivers. It is a fifteen (15) minute overview but ODP is accepting comments at the end of the listening session. The Administrative Entity’s (AE) comments concerned unbundling services like behavioral supports and increasing the PFDS cap. Lori Young  Quality Assessment & Improvement (QA&I) Interim Review Due to the rising number of COVID cases, all QA&I on-sites will be virtual per the latest guidance from ODP. There are no on-sites scheduled for any of the providers that Lori is the lead for or Administrative Entity (AE). Jessica Martin announced that all parties will need to be present on the video for the virtual entrance and exit conference. Jessica will be sending out more information along with the QA&I process document. Providers are required to select their own sample for self-assessments. The self- assessments need to be filled out by October 31, 2021. Providers only have one (1) question on training. The tool can be found at www.myodp.org but the link to QuestionPro for the training question will not be available until September 1, 2021. Providers will need to select 25% of their staff or no more than twenty-five (25) staff total. IDD Provider Meeting Providers no longer have to send the assigned AE QuestionPro confirmations once it is submitted. Providers should save the confirmation in case ODP has questions about the submission. Marion Rowe  Incident Management Updates Marion has been filtering through the updates to provide information on what to look for and common errors. I. The Provider Information Page There is now a section to enter the immediate contact person information. The immediate contact information will be used by ODP, the County, or incident reviewers as the primary contact for information about that specific incident. Previously, the information pre-populated with the provider’s director’s information. Most directors would not have detailed information about the incident. Please make sure the person listed has detailed knowledge of the incident. II. Target Identifier The Incident Management (IM) Bulletin changed the Target Identifier to the first two (2) initials of the individual’s first name, last name, and last four (4) digits of their Social Security Number (SSN). The change was not coded properly and is currently not working. Due to the issue, please continue to use the individual’s initials and the last four (4) numbers of the SSN. III. Moving Violation Moving Violation is now a secondary category under Neglect regardless if it is an agency or staff vehicle. IV. Emergency Room (ER) Visits An incident report is no longer required for illness related ER visits if discharged the same day. The only time an incident report is needed is if the individual is hospitalized due to a serious illness. A provider can enter the information in an optional report but it is not required. o Dave Pall (PA Mentor) wanted clarification about submitting an EIM for a head injury resulting in an ER visit. Marion confirmed that would be considered an injury and not an illness. A head injury would still fall under serious bodily injury. V. Death Reports Providers no longer need to send the County copies of death certificates or supporting documentation. Providers have the ability to upload documents directly into the incident report. In the past, providers would send the documents to Marion. Marion would send the information to ODP upon the reviewer’s request. This resulted in the submission of duplicate documents. Marion is working on death reports with ODP from 2018. Uploading documents directly into Enterprise Incident Management (EIM) will alleviate a lot of the issues involved in retrieving documents. IDD Provider Meeting VI. Regional Comments and County Initial Comments Please review the regional comments and County initial comments prior to finalizing your incident reports. This will ensure that all required information has been entered for the reviewers. Providers can reach out to Jane, Marion, or Lori if they have questions about filtering through the pages. A new training platform is being developed to help navigate EIM. It will be a great tool for providers and IDD staff. Marion will continue to look for trends or items that providers are having issues with for future discussions. o Tony Fisher (Family Care Services) mentioned there were issues with the new medication errors category. If there are two (2) consecutive misses for any reason it is a medication error. A separate report will need filed for failure to provide med management under neglect. Two (2) incident reports need to be completed in this situation. Another new requirement is the Certified Investigative Report (CIR) and admin review need to be entered in the EIM. The admin reviewer rules are all new. Providers will need to add the admin roles to the Identity Minder. Marion confirmed that the admin reviewer role has to be added to the provider profile. The first admin review was tricky due to a plan of correction being created for all investigative concerns noted by the certified investigator. The information is pre-populated on the corrective action screen for the admin review. A plan of correction is needed for all of the pre-populated investigative concerns. Prior to the changes, Marion would always send the concerns and recommendations to the Supports Coordination Organizations (SCO) to review with the team for county investigations. Tony mentioned that it used to be a manual process but now every single field needs to be completed. Tony couldn’t get the screen to validate the information if it wasn’t completely filled out. Marion is going to look into this further. Cindy Seemiller noticed that the boxes appear to be greyed out and it is tricky. o Cindy Seemiller (Pennsylvania Health Management) had a question about uploading the signature page from the CIR prior to the admin review being submitted. Cindy attempted to upload the signature page but was unable to add it to the CIR. Marion hasn’t had any experience uploading documents prior to finalizing the report. Marion will follow up. Pennsylvania Health Management is an IDD waiver provider and offers service coordination through the Office of Long Term Living (OLTL). There is a bug in the system affecting Providers listed under dual role in EIM. PA Health should not be listed under dual role and shouldn’t be able to see the categories of passive neglect or IDD Provider Meeting assault and neglect. Only the SCO should be entering information into those categories and not the provider. There is an extra question when assigning a certified investigator about who is conducting the investigation. The two (2) choices are SCO or Administrative Entity. If SCO is not selected, the provider investigator will never be triggered. The bug is supposed to be fixed in September. Marion asked Shanna Golden if Service Access and Management (SAM) experienced this issue. Shanna confirmed that SAM has not encountered the issue in EIM. Cindy explained that it was only an issue if listed under two (2) different waivers for the provider’s services. ODP is aware and working on this issue. Please reach to Marion or ODP if you run into any issues with the changes to the EIM system.  Residential Individual Support Plan Ratio Trainings Marion wanted to make sure providers received the information to sign up for the trainings. The last training happened prior to COVID. The trainings are being reissued to residential providers since many providers are struggling with staffing right now. The training information will be included in the handouts along with the meeting minutes. Marion encouraged the residential providers to sign up for one of the trainings even if they had done so in the past.  Certified Investigation Courses The courses through December are full. If there is an emergency and an investigator needs to sign up for a training, email Theresa Toombs with ODP with details about the situation. Marion Rowe and Jane Cline  Back-up Plans Best Practices IDD has been working on a document that Blair County uses as a best practices tool to develop backup plans. IDD modified the document to fit Franklin and Fulton Counties. Providers are not required to utilize it but it is a great resource for creating backup plans for services and to recognize and minimize risk. The document will be sent to providers with the meeting minutes. Marion shared her screen and highlighted certain key points. I. Jane explained that if a provider is unable to provide a service at the agreed upon time, it is technically neglect. A good backup plan will be able to illustrate when the individual is at risk. The plan should include the provider’s policy for additional or replacement staff as needed. II. The highlighted red items deal with planning for call offs, no shows, contact for the family, and steps the provider will take to find replacement staff. These items should be discussed and included in the backup plan. The more detailed the information, the more comprehensive the plan will be. III. The plan should be person centered and focus on the individual’s needs. The backup plan can change as the individual’s needs change. IDD Provider Meeting Marion hopes providers will utilize the tool to help mitigate risks involved when individuals do not get the proper supports or needed services. Jane stated that when an incident happens, ODP and the AE can look at the backup plan to determine if it was a viable plan for the individual. Shanna Golden  Supports Coordination Organization (SCO) Updates/Refresher SAM is hiring their twelfth SC. It is a new hire position and a caseload is being built for the new SC. There is going to be some growing pains and pulling some people that don’t want to be pulled. SAM is currently using a hybrid version for visits based on the preference of the individual and their family. All protocols for visits are COVID safe. Please contact SAM if there are any issues or there is an individual that really needs SAM’s services. The SC’s are being required to turn on their away messages more frequently. Please don’t be alarmed if it seems like the SC’s are never available. If there is an urgent situation please reach out to Shanna or Matt Yingling. The SC’s have a flexible schedule and there have been times where the SC’s emails were not correct. It is possible that an away message could be sent, but the SC will be available thirty (30) seconds later. The idea is that individuals contacting SAM get some form of response right away. Please reach out to Shanna or Matt with any concerns or issues. Please be specific about any issues that are reported to Shanna and Matt. Shanna will send the updated roster to Marion once the new SC is hired but it could take longer to determine the caseload. Stacey Brookens  Resource Update Stacey has been having conversations with Garrett, Rich, Rob, and Tyler at the Chambers’ Apothecary. The Chambers’ Apothecary has been working with IDD on some issues with families in the community. The Apothecary has plenty of personal protective equipment (PPE) including masks, face shields, cleaning products, gloves, and sanitizer. If any providers are in need of PPE, the Chambers’ Apothecary can supply the products. The Chambers’ Apothecary can make five (5) gallon buckets of hand sanitizer and provide the dispensers. Stacey asked for a pricing list and some contact information. Tyler is working on it and hopes to get it to Stacey by early next week. The cleaning supplies can be delivered by the pallet full and orders can be fulfilled in a couple of days. Health Care Quality Unit (HCQU) Updates Marion provided the updates on behalf of Katie Freeman. The HCQU office has officially moved to Mechanicsburg. The HCQU phone number and email have not changed. The nurses and staff will continue to work virtually for now due to the rising COVID numbers. Currently, the new offices are not set up to hold conference meetings. The HCQU has access to another location for large meetings but their new office is only set up for one (1) to two (2) people. IDD Provider Meeting Any provider can generate a HCQU referral. It is encouraged that providers go through the SC for referrals. A County representative will review the referrals and approve them for submission to the HCQU. It is a lot easier to track referrals if it goes through the SC but the referral process is the same. If providers want to email a referral make sure to carbon copy (Cc) someone from the County and the SC. The HCQU will make sure the County is okay with the referral. Referrals are being submitted electronically to the HCQU. They will then reach out to the contact person to coordinate the education and training sessions. The HCQU is still the point of contact for Health Risk Screening (HRS). Marion has noticed that some HRS information is being recorded in the Individual Support Plan (ISP). Marion asked residential program providers if the information in the Health Risk Screening Tool (HRST) was helpful. o Tony stated that the HRST is great but the initial implementation process was difficult. The initial HRST’s took a lot of time but the updates don’t take as much time. There are a ton of reports on the HRST and it is a powerful database. Tony utilizes the due dates report the most. It can generate email reminders each month. HRST information can be organized by field, generate reports, email reminders, and has great medication tracking. o Chuck Nussbaum (Keystone Human Services) uses the HRST as a basis for risk mitigation planning. It was a lot of work to get everything set up. Reports  Friendly reminders of due dates for our Base funded providers (See Procedure Statement MHIDDEI-416) o August 15th – Quarterly Report of Expenditures (April – June) o August 15th – Salary Review (FY ending 6/30) o August 15th – Property Purchased/Leased Report (FY ending 6/30) o August 15th – Fixed Assets Purchased with MH/ID/EI funds (FY 6/30) o September 30th – MCR Report (Program Funded Only) o November 15th – Quarterly Report of Expenditures (July-September) If you have any fiscal questions, please contact Ashley McCartney (almccartney@franklincountypa.gov). Round Table/Provider Updates  Keystone Human Services – Chuck Nussbaum Chuck’s successor has been selected but it is not yet official. Once it is official, the name of the individual will be released. Jennifer Miller has just finished week three (3) and will be taking over half of the homes from Adrienne High. Chuck’s last day is August 27, 2021. A home, with a capacity for two (2) but only one (1) individual in it, was consolidated due to staffing concerns. Keystone has been advertising a hiring bonus on local billboards. It has not been as effective as hoped. IDD Provider Meeting Community Participation Supports (CPS) has been reduced. There was a little bump in the ability to get out in the community. Staffing is becoming an issue and there is a small waitlist. CPS will be back up and running soon.  Family Care Services (FCS) – Tony Fisher COVID has created a lot of staffing issues. The staff and their families have experienced increased stress due to COVID. The Lifesharing Conference has been changed to virtual only. It was originally scheduled to take place in the fall at the Kalahari Resort. It will cost $75 for the virtual two (2) day training. ODP has developed new codes for respite for LifeSharing due to problems with the old codes. Tony attended the LifeSharing Coalition meeting on August 19th. There were a lot of LifeSharing providers struggling with the Approved Program Capacity (APC) change. LifeSharing providers need to bill the APC not the capacity of the home. Any LifeSharing providers that want more information can reach out to the AE. Tony is willing to the share the ODP information with any interested LifeSharing providers. The APC can’t be changed just because a client moves out of the residence. o Ron Molesky and Katie Marie were present at the Lifesharing Coalition meeting. Ron and Katie gave a presentation on bedroom and entry door locks. ODP is looking at it very closely during inspections. ODP wants more information in assessments and ISP’s if the individual doesn’t have a bedroom door that locks. ODP will require additional information if the individual doesn’t have a key for the front door. Lifesharing regulations were updated in February of 2020. The new regulations did not have a regulatory compliance guide (RCG) like group homes. The chapter 6400’s have a compliance guide. It appears that ODP is using the chapter 6500 regulations for Lifesharing. It has been recommended that providers look at the 6400 RCG information.  Occupational Services, Inc. (OSI) – Gabby Snider OSI is accepting referrals for the CPS in-facility program. OSI is facing a support crisis with staffing and is in desperate need of job coaches. An ad for the positions is on Indeed.  Volunteers of America(VOA) – Jane Merolla VOA started in Pennsylvania in 1894. Most of the historical services have been with homeless or disabled populations. The services have been expanded in the last five (5) years to include IDD services up in the northeast. In recent months the services have been introduced statewide at all VOA locations. VOA is thrilled to be in Franklin County and providing in home and community supports. VOA could potentially offer 6400’s and day programs in Franklin County at some point. VOA is also dealing with the staffing issues that all providers are facing. As soon as there is a positive COVID case, the staff issues start up again. IDD Provider Meeting  Person Directed Supports (PDS) – Rachel Travis PDS is experiencing staffing issues and getting applicants in the door. Applicants are not showing up for interviews or finishing the process. This is affecting providing for new referrals for CPS and day services. PDS is getting ready to open a new home in the fall for an individual they have been working with for over a year. Walgreen pharmacies statewide have the third dose of vaccines for the immunocompromised population. It is not available to everyone at this time.  Pennsylvania Health Management – Cindy Seemiller Pennsylvania Health Management provides IDD in home and community supports, companion, respites, behavioral supports, nursing, and waiver eligible transportation through a contract with Uber. Pennsylvania Health Management is a service coordination agency for the OLTL waiver and a drug and alcohol program for about the last eight (8) or nine (9) years. The IDD program started in February of 2019.  Tender Hearted Services – Ashley Poole Ads have been placed for open positions and people are applying. It seems like individuals are filling out the applications just to meet the unemployment guidelines and not following through with the process. Marion encouraged providers to notify IDD about staffing issues and IDD will try to assist if possible. Some providers have ads that are being sent out with the County’s mailing list. Please notify the office if it is impacting services for individuals. Upcoming Trainings  See attached HCQU trainings Next Provider Meeting Friday, November 19, 2021 at 10:00 a.m. Minutes by Larry Reed