3 Director’s Viewpoint 4 Legislative Affairs 6 Bureaucracy Briefs

9 HIPAA Headlines 9 Resources 10 MR Report

8 Children’s Corner 12 Conferences/Trainings 12 Calendar

Provider News

An informational newsletter compiled by the Pennsylvania Community Providers Association for the MH, MR, and D&A communities

E I N S I D E

E P C PA N E W S

David Meyers, Deputy Chief of Staff for Governor Edward Rendell, will be the guest speaker at the PCPA 2004 Annual Meeting. Mr. Meyers has worked in and around state government for 25 years. Prior to his current key position in the administration, Meyers served as the Policy Director for the House Democratic Whip. He also held several positions in the Casey Administration, including serving as Special Assistant to the Governor and Deputy Secretary in the Department of Environmental Resources. Meyers has also worked in the State Senate and for the Hospital and Healthsystem Association of

E N E W M E M B E R S

Welcome the newest members to the PCPA family.

FULL MEMBEREvergreen BICLuzerne, PA Mark K. Sowcik, Psychologistwww.evergreenbic.com

BUSINESS MEMBERDataquest Harrisburg, PA Chris Rounsville, Presidentwww.dataquestinc.comComputer/Software services

The PCPA Systems Redesign Task Force continues its efforts to proactively develop recommendations for the redesign of the mental health, drug and alcohol, and mental retardation systems. In light of administration changes, deficits in the current system, and the need for a more secure foundation and assurance of future funding, PCPA President Pete Rubel called for establishment of a short-term, time-limited task force to develop recommenda-tions for improvement. Thus far the task force has generated a list of system obstacles/gaps; completed an inventory of system change activities underway; and reviewed previous PCPA position/recommendation papers and resources. The task force is now developing a set of guiding principles. Next steps will include the development of recommendations for system changes, including legislative action and regulatory relief that need to be made to promote the identified principles. F

Guiding Principles Current Task Force Focus

Meyers to Speak at Annual MeetingPennsylvania. Meyers was one of the participants in PCPA’s first gubernatorial forum prior to the 2001 election. F

PCPA Annual MeetingWednesday, March 17

Four Points Sheraton, Harrisburg

11:00 a.m. – 3:30 p.m.

The agenda and RSVP information is available at www.paproviders.org.

M A R C H 2 0 0 4

E P R O V I D E R N E W S MARCH 20042 MARCH 2004 P R O V I D E R N E W S E 3

Executive DirectorGeorge J. Kimes

Director EmeritusRaymond R. Webb, Jr., LSW

Senior Policy SpecialistLynn Cooper

Policy SpecialistRebecca May ColeLinda Drummond, MPAConnell O'Brien, MEd

Director of Legislative AffairsMelissa DiSanto Simmons

Technical & Conference Services CoordinatorKris Ericson, MPsSc

Membership & Marketing CoordinatorJoe Ostrander

Administrative AssistantCindy Lloyd

SecretariesJane GossAbbie HitzLyndsey Wanich

©2004. This newsletter is written by the Pennsylvania Community Providers Associ-ation (PCPA) for the mental health, mental retardation, and addictive disease com-munities. This informational newsletter is published monthly. Deadline for publication is the third Friday of every month.

Pennsylvania CommunityProviders Association2400 Park DriveHarrisburg, PA 17110

717-657-7078—Phone717-657-3552—FAX

www.paproviders.orgmail@paproviders.org

Provider NewsE P C PA N E W S

Never Again! — Dedicated Tax ProposedPennsylvania’s drug and alcohol treatment system has recently faced its most seri-ous threat in decades. Fortunately, most of the funds were restored. We must now be proactive. Drug and alcohol advocates have never been more active and more united. Now is the time — while we have the momentum and the attention of the legislature and the administration — to promote changes to assure that this does not happen to the drug and alcohol program again. We must expand the funding base to pay for desperately needed drug and alcohol treatment.

Now is the time for Pennsylvania to institute a dedicated tax on beer, wine, and spirits to help pay for the unmet treatment needs in the Commonwealth. Pennsyl-vania has one of the lowest alcohol excise tax rates in the country. Currently it is at $.08/gallon. The median is $.185 and the highest state tax is $1.07. Eight other states across the country have passed legislation to support dedicated taxes for treatment. The Center for Science in Public Interest in Washington DC is interested in partnering with Pennsylvania to get dedicated taxes for treatment approved.

PCPA is developing a proposal that includes a plan to research, evaluate, and intro-duce legislation for dedicated taxes on beer, wine, and spirits for drug and alcohol treatment. They will present the Single County Authorities and the Drug and Alcohol Coalition with the proposal to generate discussion and support. Next steps include developing a broader group to include the DUI Association, the Underage Drinking Coalition, corrections, probation and parole, the education system, the child welfare system, the business community, the legislature, juvenile justice, and aging to garner support for the plan. The drug and alcohol system in Pennsylvania continues to be in crisis. It is time to take advantage of the momentum to make lasting changes for the system. A more detailed discussion will occur at the next D&A Committee meeting on March 16. F

Feedback on Problem Regulations SolicitedPCPA has worked in collaboration with the Conference of Allegheny Providers to develop a survey identifying problematic regulations. Agencies that have not yet responded, espe-cially mental retardation and drug and alcohol providers, are encour-aged to submit their answers to Rebecca May Cole (rebecca@paproviders.org). F

Health Savings Accounts a Valuable Resource for Employees Health Savings Accounts (HSAs) are available to any individual covered under a high deductible health plan. Under an HSA, a plan is considered high deductible if there is at least a $1,000 individual and a $2,000 fam-ily deductible. Out-of-pocket expenses, however, cannot exceed $5,000 for an individual and $10,000 for a family. HSAs may be funded by both employer and employee contributions and can be rolled over at the end of the year into subsequent years to build up account balances. There is no “use it or lose it” provision as found in the Flexible Spending Accounts. In addition to funding eligible out-of-pocket medical expenses, HSAs may be used to fund long-term care insurance, COBRA coverage, coverage while an individual is receiving unemployment compensation, and retiree health insurance once the individual becomes Medicare eligible. For more informa-tion regarding this topic, please email Dan Thomas at dthomas@waypointbenefits.com. Waypoint Benefits Consulting is an endorsed vendor of PCPA. F

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E D I R E C T O R ' S V I E W P O I N T

I have often used this space at this time of year to address our progress as an

Association. March typically marks the Annual Meeting of the membership and is often a time to reflect on the chal-lenges and accomplishments

of the last year. What a year it has been! A little over a year ago, the Rendell Administration presented a budget that promised to devastate the drug and alcohol treatment system, with spill-over damage to other human service systems. The Association’s usual budget process turned into a battle for restoration of over $100 million. We were successful! Working along with other stakeholders, efforts by many of our members saved the system. Legislative commu-nications and visits, rallies in the Capitol, and numerous other efforts sent a message about the needs of individuals with addictions. A strong message about the effectiveness of treatment was developed and delivered to policy makers.

Other accomplishments helped strengthen the Association. Responding to a priority established by the Board of Directors, we moved to increase our number of members. At a time when many trade associations have seen rapidly dwindling numbers with resulting budget problems, we have succeeded in growing our membership and have exceeded our dues projections. Additionally, we have continued our move toward being an “elec-tronic association.” In an age of “information overload” we have moved to become a source and a “filter” for information flowing to you. We strive to have the right information to you at the right time, with quick connections to more detail if needed. The PCPA web site, with over 60,000 “hits” per month remains the premier source for policy and issue information for our service areas in the Commonwealth.

Other annual highlights include our securing a change in the Medicare intermediaries decisions in regard to the provision of psychotherapy “incident to” the services of a physician, opening access to services for many Medicare recipients at our member agencies. We worked with our methadone providers to increase accessibility, remove burdensome regulations, and provide options for “take home” services. In the mental retardation system we worked cooperatively with others on issues such as apprenticeships, work force development, and regulation revisions. Our children’s system efforts continued with work for our residential provider members, as well as a focus on issues relating to educational services in partial hospitalization programs.

The Annual Review will be distributed at the March meeting and highlights many other accomplishments. I want to urge you to read it since it reports on the work we have done for you. It represents one of our mechanisms of accountability to you, our members.

While this is a time to reflect on our progress it is also a time to think ahead. In April we hold the annual strategic planning retreat for the Board of Directors. Our goals for the upcoming year are formulated at that time. This year we have the opportunity to incorporate the work of our newly established Systems Reform Work Group into our planning. We welcome your input into the planning process. Communicate with us, through a board member, through your regional representative, through any committee chair, or feel free to contact me.

George J. Kimes, Executive Directorgeorge@paproviders.org

This column represents my opinion, not necessarily that of the Association. F

Looking Behind, Looking Ahead!

E P R O V I D E R N E W S MARCH 20044 MARCH 2004 P R O V I D E R N E W S E 5

E L E G I S L AT I V E A F F A I R S

For additional information on legislative issues, contact the PA Community Providers Association office at 717-657-7078 or melissa@paproviders.org. For copies of bills, call your local legislator, the House Document Room 717-787-5320 or visit the Gen-eral Assembly’s Electronic Bill Room at www.legis.state.pa.us.

Rendell Unveils 2004-05 State Budget Proposal

The governor highlighted several key areas representing his primary objectives as

he unveiled his 2004-05 budget proposal: increase jobs and economic opportunity,

improve academic achievement, lower local property taxes, improve the quality of

life in communities, maintain the social safety net, and make Pennsylvania more

business-friendly.

Governor Rendell included no general revenue increases in this budget. The general fund of the state budget increased to $22.3 billion, an increase of 4.1 percent. Probably the most significant funding change — not included in the budget — is for property tax reduction. The governor believes that property tax reduction, proper funding for his education initiatives, and gambling expansion are strongly linked together and he indicated that the General Assembly could pass such legislation within the month. Regardless of the exact timing, this will be a prime discussion between the governor and the legislature.

Highlights of the budget proposal include:

E The Department of Public Welfare (DPW) plans to engage in a revenue maximization effort to fund the mental retardation waiting list.

E Drug and alcohol programs under DPW were funded at 100% of the 2003-04 restoration amount. Additionally, the Human Services Development Fund (HSDF) was funded at 100% of the restoration amount.

E There are no cost-of-living-adjustments and no new or increased recruitment and retention monies in the budget for mental health and mental retardation workers.

E According to Secretary Richman DPW will soon be looking at the Behavioral Health Rehabilitation Services system.

E There is no northeast HealthChoices expansion outlined.

Legislative budget hearings are underway. PCPA will monitor these hearings and key elements will be made available to members via the Association’s web site. Visit the Legislative Affairs section of the web site for more detailed information regarding the proposed state budget. Note: As Provider News goes to print deputate budget briefings within DPW have not yet convened. F

Legislative TrackingMembers are encour-aged to visit the Legislative Affairs section of PCPA’s web site to view the new legislative tracking device. Features of the tracking include links to legislation and the bill’s history; a summary of the cur-rent bill status; and direct links to PCPA positions or activity regarding the bill. Please submit any feedback regarding the legislative track-ing to Melissa DiSanto Simmons, Director of Legislative Affairs, so that the tracking device can be as user-friendly as possible. F

E P R O V I D E R N E W S MARCH 20044 MARCH 2004 P R O V I D E R N E W S E 5

E L E G I S L AT I V E A F F A I R S

Update on Home Health Licensure LegislationPCPA attended a stakeholders meeting convened by Sen. Jane Orie’s staff (Orie chairs the Senate Aging and Youth Committee) regarding House Bill (HB) 518. This bill has been under discussion at PCPA committee and board meetings. A preliminary analysis can be viewed in the Legislative Affairs section of the Association’s web site.

As a result of the stakeholders meeting the following language is proposed for insertion in HB518 (under Section 9.03):

Nothing in this act shall apply to:

1) A private contract or arrangement entered into by a consumer and caregiver, provided that the caregiver was not supplied, arranged, scheduled or referred to the consumer by a home care agency.

2) Any services:

A) Authorized or paid for by the Department of Public Welfare, or

B) Provided by or through an entity licensed by the Department of Public Welfare, or

C) Authorized or paid for through a County Mental Health or Mental Retardation Program.

The provisions of the act of October 20, 1966 (3rd Sp.Sess., P.L.96, No.6), known as the Mental Health and Mental Retardation Act of 1966, and all related regulations shall continue to be applicable to such facilities.

Home and community based services performed or provided by a home care agency under a Department of Public Welfare or Department of Aging program.

This language will now go to the Governor’s Office for concurrence (or further input). It is Chairman Orie’s desire to have this amended bill out of committee by March 10. Members should contact Melissa DiSanto Simmons (melissa@paproviders.org) at the Association with questions or concerns. F

PCP PAC Committee Competition Underway

The Pennsylvania Communi-ty Providers Political Action Committee (PCP PAC) has kicked off its 2004 Commit-tee Competition! This ‘race for contributions’ amongst the standing committees of the Association began at the January meetings. The Committee Competition kick-off followed a direct mail letter to individual committee members and continues through the March meetings. All pro-ceeds will benefit the PCP PAC and contributions to those running for political offices who are in leadership positions and/or who have demonstrated a commitment to PCPA programs, services, and values. If you are a PCPA committee member and have not yet made your 2004 Committee Competi-tion donation be sure to do so during the month of March! Committee members can also contact Melissa DiSanto Simmons, Direc-tor of Legislative Affairs (melissa@paproviders.org) for more details on making contributions. F

E P R O V I D E R N E W S MARCH 20046 MARCH 2004 P R O V I D E R N E W S E 7

PROMISe Q&A Document Available SoonPCPA offered two teleconferences to its members regard-ing the implementation of PROMISe. Questions submitted prior to the calls were compiled into a document and sent to the Office of Medical Assistance Programs (OMAP). OMAP is currently drafting responses to all of these ques-tions, which will be made available to PCPA members. Contact Rebecca May Cole (rebecca@paproviders.org) to obtain a copy of this document. F

PROMISe Questions? Get Answers! Many providers have contacted PCPA with questions about PROMISe. Many of these questions can be answered by reviewing the Frequently Asked Questions document on the PROMISe section of the Office of Medical Assis-tance Programs web site at www.dpw.state.pa.us/omap/promise/omappromise.asp. Agencies may also use the following resources to obtain information, ask questions, and request new provider identification numbers.

Provider Inquiry Lines

Practitioner Unit 800-537-8862

Pharmacy Unit 800-932-0938

Ancillary Unit 800-537-8861

Inpatient Unit 800-822-2901

Long Term Care 800-932-0939

OMHSAS Assistance Line 800-433-4459

Provider Assistance Line For PES software and electronic billing questions only

800-248-2152

Email promise@state.pa.us (Be sure to include the MAMIS provider number and a mailing address if requesting a new PROMISe provider number.) F

E B U R E A U C R A C Y B R I E F S

Richard H. Lee, Deputy Secretary for Quality Assurance, Department of Health (DOH), has organized a work group of managed care orga-nizations (MCOs) and drug and alcohol stake-holders to discuss the issue of confidentiality. The third meeting of the Drug and Alcohol Confidentiality Committee was held January 23. Representatives from numerous managed care companies including Aetna, Highmark, Inc., Independence Blue Cross, and HealthAmerica are participating in the work group. In addi-tion, representatives from the Pennsylvania Association of County Drug & Alcohol Adminis-trators (PACDAA), provider groups, and PRO-A are at the table. The work group also includes the Pennsylvania Insurance Department, Depart-ment of Public Welfare, and the Department of Health.

The work group is charged to find some resolu-tion to the problem of MCOs requesting more information than the current confidentiality regulations allow to be shared. The MCOs expressed a desire to have specific information, such as vital signs. The current regulations do not allow disclosure of that information and providers are cited during licensing if it is given. Some MCOs have been known to refuse to pay if they cannot get the information requested, which places the provider in an impossible situation.

Tensions between the groups have been con-siderable. However, it appears that there is a desire to find some resolution. The Department of Health has stated that there exists flexibility to change guidelines to help resolve some of the problems. All agree that whatever resolu-tion is found the client’s confidentiality and treatment needs must not be jeopardized. Each group has agreed to provide information from their perspective on how the guidelines should be changed. The issue will be discussed at the March 16 PCPA D&A Committee meeting. The next meeting of the work group has been sched-uled for April 2. PCPA members are encouraged to contact Lynn Cooper (lynn@paproviders.org) with specific suggestions for resolving this issue.

DOH Seeks Resolution to Confidentiality Issue

E P R O V I D E R N E W S MARCH 20046 MARCH 2004 P R O V I D E R N E W S E 7

Draft Buprenorphine Criteria Released The federal government has expanded the ability of physicians to use medica-tions-assisted opioid addictions treatment by allowing qualified physicians to prescribe approved Schedule III, IV, and V narcotic medications for the treatment of opioid addiction. The federal Food and Drug Administration has approved the Schedule III narcotic medications Subutex R and Soboxone R tablets (commonly known as buprenorphine) for the treatment of opioid addiction. These actions made buprenorphine the first narcotic drug that a physician can prescribe for the treatment of opiate dependence in an office setting.

Pennsylvania state regulations, regardless of federal decisions, require any entity that uses a narcotic for maintenance or detoxification to obtain the approval of the Department of Health (DOH) to operate a narcotic treatment program. However, the Department has developed a set of protocols to be used in lieu of requiring non-residential drug and alcohol treatment facilities to become licensed narcotic treatment programs.

DOH has invited providers to send comments regarding the Buprenorphine Approval Criteria. Copies of the criteria have been distributed to PCPA D&A members for input. Comments can be sent directly to the Department of Health, Division of Drug and Alcohol Program Licensure, no later than March 16 or to Lynn Cooper at the Association by March 12 to be included in the PCPA response. F

D&A Assessment Tool Causing HavocThe Bureau of Drug and Alcohol Programs (BDAP) recently released a new assess-ment tool for case management. The new tool, which is approximately 35 pages long, was developed to determine the case management needs of clients. Single County Authorities (SCAs) were given the tool and instructed to use it or to develop a similar form that included all of the same elements. Some SCAs have forwarded the tool on to providers and asked them to use the form and assess for case management needs. Some providers used the form in lieu of the bio-psychosocial and were then cited during licensing because it is does not meet the standards for the bio-psychosocial. It appears that BDAP and the Division of Licensing may be working on a resolution to the problem, such as a form that carries out the functions of both assessment for case management and the bio-psychosocial. In the meantime, members are encouraged not to use the recently released form in lieu of the bio-psychosocial.

This new form comes at a time when providers are already beleaguered with over-whelmingly burdensome paperwork. Further discussions will be occurring in an effort to find a solution that will meet the case management assessment needs while not causing increased burdens on providers. F

E B U R E A U C R A C Y B R I E F S

OMAP Supports Methadone Take Home

PCPA is pleased to report

that the Office of Medi-

cal Assistance Programs

(OMAP) recently released

a bulletin allowing for

payment for take home

methadone for approved

clients. Not allowing take

homes has been a prob-

lem in the treatment of

methadone for some time.

This change will improve

treatment effectiveness,

improve the quality of life

for the client, and will save

the Commonwealth a con-

siderable amount of money.

Providing methadone take

home will significantly

reduce state transporta-

tion costs, eliminate daily

burdensome visits for the

client, and improve the

clients’ ability to work. F

E P R O V I D E R N E W S MARCH 20048 MARCH 2004 P R O V I D E R N E W S E 9

Kirk T. Lawsuit AmendedIn June 2003 the Kirk T. plaintiff’s attorneys acted to reopen the settlement agreement from November 2000. The Kirk T. Settlement Agreement was intended to compel and monitor timely access to children’s Medical Assistance behavioral health services and to increase the labor pool of trained staff available to provide Behavioral Health Rehabilitation Services (BHRS) in the Com-monwealth. An extensive data reporting system impacting the Department of Public Welfare (DPW), HealthChoices Behavioral Health Managed Care Organizations (BH-MCOs) and BHRS providers was established under that agreement. On January 6 the court approved an amended agreement be-tween the parties. The amended agreement substantially reduces DPW’s required data reporting to the Kirk T. plaintiffs.

In the Fee For Service Regions, DPW will now report:

E Total Number of Therapeutic Staff Support (TSS) Services Authorized and

PCPA and the Pennsylvania Council of Children, Youth and Family Services (PCCYFS) Residential Treatment Facility (RTF) Work Group met in mid-February. Members from across the state met to prioritize and clarify critical issues raised at the initial meeting in October. Working in smaller groups, members focused their attention on refining issues and identify-ing strategies and action for further development. The work group’s primary areas for analysis, consensus building, and action include:

E Fiscal Challenges to Service Delivery;

E Government and Community Perception;

E Outcomes Expectations and Service Quality; and

E AfterCare Service Planning and Barriers.

E C H I L D R E N ' S C O R N E R

E Total Number of TSS Paid Claims for each month.

In the HealthChoices Regions, DPW will now report:

E Total Number of Hours of TSS Services Authorized, for the full Authorization Period for Authorizations Ending in the Month, and

E Total Number of Hours Authorized TSS for which Claims Were Reported Paid, by County.

This agreement DOES NOT yet change DPW and BH-MCO requirements for provider reporting. It is PCPA’s expectation that in due time this change will substantially reduce the amount of complex data report-ing for which BHRS providers are respon-sible. Comments made by senior Office of Mental Health and Substance Abuse Services (OMHSAS) staff seem to support the expectation that provider reporting requirements will be reviewed and reduced.

The group will meet again in April to ad-dress priority issues, formulate additional information, and frame potential options for resolution of the challenges facing RTFs. Work group leadership hope to meet with representatives of the Office of Mental Health and Substance Abuse Services and the Office of Children, Youth and Family Services to review issues prior to the April meeting. The work group also worked to identify current regulations and standards that tend to impede effective and efficient service delivery. This infor-mation will be included in PCPA’s response to Department of Public Welfare Secretary Richman’s challenge for stakeholders to identify regulatory barriers and inefficien-cies in the system. F

RTF Work Group Refines Issues

E E E

Collaborate.

Be the light

that others come to

with their ideas,

visions and dreams.

Never doubt that

blending your talents

with those of others

can change the world.

– Unknown

E P R O V I D E R N E W S MARCH 20048 MARCH 2004 P R O V I D E R N E W S E 9

E H I PA A H E A D L I N E S

HIPAA Security Training OfferedPCPA and the Pennsylvania Association of Rehabilitation Facilities (PARF) are offering a joint training on the HIPAA Security Rule. The training will be held April 2 in Harrisburg and will provide participants with numerous documents — including policies and procedures and a risk analysis checklist. More information on the training is available on the PCPA web site (www.paproviders.org) or by contacting Abbie Hitz (abbie@paproviders.org) at the Association. F

Use of Local Codes Extended to July 1The Office of Medical Assistance Programs (OMAP) has published MA Bulletin #99-04-04 that replaces MA Bulletin #99-04-02. The new bulletin announces that PROMISe will ONLY ACCEPT LOCAL CODES through July 1. Previous information had indicated that PROMISe would accept both local and standard codes — this is not true. Be sure to access the new bulletin as it also provides further clarification on the Type of Service/Modifier Crosswalk document also known as Attachment A. Bulletins are available at the OMAP web site (www.dpw.state.pa.us/omap/provinf/mabull/omapbullmain.asp). Enter the bulletin number to access the documents. F

Autism Report Prepared for RichmanThe Pennsylvania Autism Task Force has worked hard to meet their March 7 deadline for the submission of all subcommittee reports. Subcom-mittees have been challenged to identify needs and issues in the funding, professional training, and service delivery needs across age groups and across community contexts. It is anticipated that the work of the subcommittees will be refined and compiled into a comprehensive report pre-sented to Department of Public Welfare (DPW) Secretary Richman during March. Once reports have moved from draft to final form they will be available on the DPW web site. PCPA will continue to work with its members and other stakeholders to implement the design, funding, staffing, and delivery of a model system of autism spectrum disorder services across the Commonwealth. F

Cabinet Continues Collaborative WorkThe February edition of Provider News reported on the proposed structure and organization of the state Children and Family Commission and the formation of several regional Children and Family Commissions as part of the development of the Children’s Cabinet. While the cabinet is still refining its plan for broad based stakeholder input, it has been reported that the approach presented to the PCPA Children’s Committee in January has received favorable reactions from the cabinet and the governor. A formal report is expected in early spring that articulates the structure, mission, and leadership of the sate commission and the several regional com-missions. Lance Simmens, Executive Director, Governor’s Cabinet on Children and Families, will attend the March 16 Children’s Committee Meeting to provide an update. F

E R E S O U R C E S

A new tool kit to help promote access to and increase availability of mental health screens and assessments for children through Medicaid and the Children’s Health Insurance Program (CHIP) is available. The kit includes fact sheets, action strategies, and resource guides to improve and expand mental health screens and assess-ments for children. Copies of the resource kit can be found at www.childrensdefense.org/mentalhealthresourcekit.php. F

E C H I L D R E N ' S C O R N E R

E P R O V I D E R N E W S MARCH 200410 MARCH 2004 P R O V I D E R N E W S E 11

E M R R E P O R T

ICF/MR License to Be GrantedIn 1992 Woods Services, Inc. a non-profit agency located in Lang-horne applied to the Pennsylvania Department of Health for a Certificate of Need (CON) for a proposed 102 bed Intermediate Care Facility for the Mentally Retarded (ICF/MR). The Department of Health issued the CON. The Office of Mental Retardation endorsed the CON, but restricted Woods to serving residents of New York, New Jersey, and Maryland. By endorsing the CON the Department of Public Welfare (DPW) certified that there was a need for the proposed ICF/MR. Woods applied to DPW for the necessary licenses to operate two ICF/MR facilities on their campus. DPW declined to act on the applications stating, “...the Department has decided not to act on these applications since no benefit to the citizens of the Commonwealth would result from such action.”

In 1995 Woods sought court direction ordering DPW to consider its applications. In 1996, the Court ordered DPW to consider the appli-cations. They did and denied the licenses on the grounds that state and federal law require integration of persons with disabilities and favor small homelike residences over large institutional facilities.

According to the court, Pennsylvania has adopted the federal regulations in their entirety (55 PA Code Chapter 6600.3) with regard to ICFs/MR. These regulations contain no provisions stating a preference for either integrated facilities over segregated facilities or smaller facilities over larger ones. Woods Services v. Department of Public Welfare (DPW) was originally litigated in July 2002. It was appealed by DPW to the Supreme Court of Pennsylva-nia who issued a final opinion in December 2003, upholding the lower court’s decision that Woods receive the requested licens-ing. For a copy of this decision access www.courts.state.pa.us/OpPosting/Cwealth/out/2396CDOI 7-17-02.pdf. F

Spending Data ReleasedFiscal year 2000-02 data from state agencies that service people with mental retardation and developmental disabilities show an increase in the numbers of people living in smaller out-of-home residential settings and fewer living in public and private institu-tional facilities. In Pennsylvania, community service revenue in 2002 was $747.7 million in state funds and $781 million in federal funds, with 6% for ICF/MR and 67% in Home and Community Based Services Waiver (HCBS). There were 22,916 waiver participants with an average spending per person of $42,000. Family support spend-ing was $39.8 million, supported employment spending was $30.5 million, and supported living and personal assistance spending was $20.7 million. Details are available in the newly released The State of the States in Developmental Disabilities 2004. To order a copy for $15 call 303-735-0252. Copies are also available for download at www.cu.edu/ColemanInstitute/stateofthestates. F

Incident Management BulletinThe Office of Mental Retardation has issued the final Incident Management (IM) Bulletin (#6000-04-01) effective February 28. The bul-letin establishes the policy processes that ensure health and safety, enhance the dignity, and pro-tect the rights of individuals receiving supports and services. The processes include uniform practices for:

E Building organizational policies and structures to support incident management,

E Taking timely and appropriate action in response to incidents,

E Reporting incidents,

E Investigating incidents,

E Taking corrective action in response to incidents, and

E Implementing quality improvement, risk management, and incident management processes for the analysis and interpretation of individual and aggregate incident data.

All reportable incidents are to be submitted elec-tronically via the Home and Community Services Information System (HCSIS). If HCSIS is unavail-able, agencies are to follow the directions in the Incident Management Contingency Plan. Mental Retardation bulletins that are now obsolete are:

E #00-01-05 Incident Management issued August 27, 2001;

E #00-02-02 Announcement of the IM Implemen-tation Schedule and Contingency Plan issued March 1, 2002;

E #00-02-14 IM Interpretive Guideline issued October 29, 2002; and

E #00-02-15 IM Interpretive Guideline: Hospital Discharge Instructions issued November 27, 2002.

A copy of the bulletin is available electronically from the PCPA web site (www.paproviders.org) or the February 28 Pennsylvania Bulletin (www.pabulletin.com). F

E P R O V I D E R N E W S MARCH 200410 MARCH 2004 P R O V I D E R N E W S E 11

E M R R E P O R T

PCPA has added a section to the Mem-bers Only web site

(www.paproviders.org) to share new, innovative, and creative programs and ser-vices being developed and implemented by member agencies to enhance the lives of clients, consum-ers, and their families. In the constantly changing state and federal service systems provider agencies are searching for new ser-vices and supports, ways to further increase consumer self-determination, sugges-tions for quality enhance-ment, and alternative funding resources. Shar-ing agency successes and implementation strategies benefits others by assisting in the creation of a quality system of care for indi-viduals receiving services in the drug and alcohol, mental health, and mental retardation systems. The criteria for submitting information for “Promis-ing Practices” are available from the PCPA web site. The article below is the first in this series. The ex-panded version is available at www.paproviders.org. F

“The Lighthouse” “I did all the stenciling in the kitchen area. I was trying it here before doing it at my home,” beams Mitzie, a crafter at ReDCo Group’s Lighthouse Garden and Gift Shop in Frackville. Mitzie was one of the first consumers to enter the pro-gram and was instrumental in the decorating and preparation of the business for opening. She takes pride in being a mentor to new program consumers and is an inspiration to all of her co-workers.

“Every payday I buy a gift here for my Mom,” said crafter Gene. “She really likes the things I make.” A licensed vocational rehabilitation program, The Lighthouse is not a typical training program for persons with developmental disabilities. The staff consist of local crafters and artisans who teach their skills to consumers. All the design and decorating, including selecting crafts to be made, shopping for supplies, and maintaining and stocking inventory at The Lighthouse is done by consumers working in the program. Started by ReDCo Group as an alternative to typical training options, the program has also generated income to help supple-ment declining county and state funds and to offer an hourly wage to consum-ers. The goals of the program are to rely on county funding for habilitation supports and allow the rest of the sales business to support the program.

ReDCo Group is a manage-ment firm specializing in the administration of human services, community behav-ioral health services, special-ized residential services, and rehabilitative services. Programs are operated in Berks, Schuylkill, Carbon, Pike, Luzerne, Monroe, and Northumberland counties. For additional information regarding this program contact:

Patrice Zanis Vice President Mental Retardation Services

570-628-5215 or pzanis@redcogrp.com

Lighthouse crafter Ken Felty shares some of the crafts made at the program.

Promising Practices Added to PCPA Web

E P R O V I D E R N E W S MARCH 200412

M A R C H

Monday–Tuesday, March 8–9 GRI© Green Room, Forum Building, Harrisburg

Wednesday, March 1010:00–3:00

Annual Conference CommitteePCPA

Tuesday, March 169:30–12:009:30–12:3011:30–2:0011:30–12:301:00–3:301:00–4:00

Mental Health CommitteeMental Retardation CommitteeExecutive CommitteeGovernment Relations CommitteeChildren’s CommitteeDrug & Alcohol Committee

Four Points Sheraton, Harrisburg

Wednesday, March 179:30–11:0011:00–3:30

Membership CommitteeAnnual Meeting

Four Points Sheraton, Harrisburg

Tuesday, March 231:00–3:00 Forensic Subcommittee

PCPA

A P R I LFriday, April 29:00–4:00

HIPAA Security StandardsHarrisburg-Hershey Marriott

Monday–Tuesday, April 5–6 GRI©PCPA

Wednesday, April 2110:00–3:0010:00–3:00

Executive CommitteeAnnual Conference Committee

PCPA

Wednesday, Thursday, FridayApril 21–233:30–5:00

Board RetreatHarrisburg-Hershey Marriott

Tuesday, April 271:00–3:00

Forensic SubcommitteePCPA

March 30–31. Psychiatric Rehabilitation: Building on Skills and Community Supports; PAPSRS Annual Conference. Harrisburg-Hershey Holiday Inn. Grantville, PA. For more information contact Arlene Solomon at 215-386-3838, Ext. 109.

April 2. HIPAA Security Standards—What Is Required? Harrisburg-Hershey Marriott. Harrisburg PA. Access www.paproviders.org for more information.

June 1–4. 128th Annual AAMR Annual Meeting. Philadelphia Marriott Hotel. Philadelphia, PA. More information is available at www.aamr.org.

June 15–18. Leading the Way: Recovery Now; 16th Annual Statewide Consumers' Conference. Hilton Scranton & Conference Center. Scranton, PA. More information is available from PMHCA at www.pmhca.org.

October 5–8. Focus on the Future. PCPA Annual Conference. Seven Springs Mountain Resort. Champion, PA. More information at www.paproviders.org. F

E C O N F E R E N C E S / T R A I N I N G S