providernews

Cole Named Pressley Ridge CEOSuzanne Cole has been named president and CEO of Pressley Ridge Cole has been with Pressley Ridge since 1990 beginning as a teacher counselor Most recently she served as executive vice president and COO responsible for overall operations and staff She has been serving as acting CEO since January PCPA congratulates Ms Cole on her appointment

Northwest Region Meeting Is August 4PCPA will host a Northwest Region Meeting August 4 at the Sheraton Erie Bayfront Hotel The agenda includes a networking breakfast for members followed by mini-committee meetings with PCPA policy staff Registration must be com-pleted online at httppcpamemberlodgeorg DefaultaspxpageId=536363ampeventId=340870amp EventViewMode=EventDetails Questions may be directed to Jen Bankard (jenpaprovidersorg)

Safe Harbor Opens Crisis CenterSafe Harbor Behavioral Health in Erie opened a new crisis center in May composed of two sepa-rate departments The previously existing crisis services program was transferred to the new facility on May 13 and provides phone walk-in and mobile services The crisis residential unit opened on May 31 and houses an 8-bed stabi-lization program The expansion has created 20 new jobs including two peer support positions PCPA congratulates Safe Harbor for its response to the needs of the community

Program activities and educational content have been finalized for the 2011 PCPA Conference mdash Hats Off Mark your calendar now and plan to attend the entire event A stellar lineup of presenters and essential workshop topics begins at 100 pm on October 11 and culminates with the Friday plenary on health care reform with politicalpolicy updates and tools to enhance provider readiness The plenary features David R Lloyd MTM Services and Charles Ingoglia National Coun-cil In between are 66 workshops the opening plenary on hope and recovery meetings with state officials from offices and bureaus of the Department of Public Welfare a vibrant Exhibit Hall and the always spectacular array of lunches dinners and receptions Limited space remains for those companies interested in exhibiting mdash infor-mation is available on the PCPA web site or from Kris Ericson (krispaprovidersorg)

Registration opens online August 1 and will include significant discounts at the early bird rate Plan to join PCPA at Seven Springs October 11 ndash 14 as we combine a celebratory ldquotipping of the hatrdquo to providers and industry partners for accomplishing all they do each day and the weaving in of the many hats each person wears in their work and lives

Donrsquot Miss Hats Off

An informational newsletter compiled by the Pennsylvania Community Providers Association for the MH IDD and DampA communities

J U L Y 2 0 1 1

P C P A N E W S

providernews M E N T A L H E A L T H H E A D L I N E S

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Executive DirectorGeorge J Kimes

Deputy DirectorLynn Cooper

Policy SpecialistsLinda Drummond MPAConnell OrsquoBrien MEd Betty Simmonds

Director of Legislative AffairsAnne McHugh Leisure MHA

Technical amp Conference Services CoordinatorKris Ericson PhD

Membership amp Marketing CoordinatorSteve Neidlinger

Director of Training amp Resource DevelopmentJen Bankard

Office Manager Cindy Lloyd

AdministrativeFiscal AssistantTieanna Lloyd

Secretary Kathy Morrow

copy2011 This newsletter is written by the Pennsylvania Community Providers Association (PCPA) for the mental health intellectual disability and addictive disease communities This informational newsletter is published monthly Deadline for publication is the third Friday of every month

Pennsylvania Community Providers Association2101 N Front StBldg 3 Ste 200Harrisburg PA 17110

717-364-3280mdashPhone717-364-3287mdashFax

wwwpaprovidersorg

2 Mental Health Headlines 3 Directorrsquos Viewpoint 4 Legislative Affairs 7 State News Briefs 8 Across the Nation 9 ConferencesTrainings

10 Drug amp Alcohol Action 13 IDD Focus 16 Childrenrsquos Corner 18 Committee Reports 19 On the Autism Spectrum 20 Calendar

I N T H I S I S S U E

MATP and Psychiatric RehabilitationA June Medical Assistance Transportation Program (MATP) Operations Memo-randum ended transportation for psychiatric rehabilitation services The memorandum clarified that psychiatric rehabilitation is not a MATP-covered service even though it is a MA compensable service MATP provides trans-portation for services that are in the Medical Assistance State Plan After a lengthy process the Department of Public Welfare withdrew a request to amend the state plan MATP asserted that transportation was provided for psychiatric rehabilitation with the understanding that it would become an in-plan service When the state plan amendment request was withdrawn MATP could no longer support a non-covered service

The Office of Mental Health and Substance Abuse Services (OMHSAS) is working with managed care organizations counties and providers to de-velop alternative means of transportation Acting Deputy Secretary Sherry Snyder has stated that the cost of transportation can be incorporated into the rate paid for psychiatric rehabilitation services A number of provider and advocacy organizations including PCPA are coordinating advocacy on transportation Psychiatric rehabilitation is a service that many individuals have lauded as a valuable support that has made it possible for a life in the community The 30-day termination of service notice provided by MATP has raised fear among individuals that they will no longer have access to ser-vices Providers and advocates are concerned that psychiatric rehabilitation programs will be severely impacted and that individuals will require more costly services if they do not have access to needed supports

County Plan Review BeginsOffice of Mental Health and Substance Abuse Services (OMHSAS) policy bureau and regional office staff and representatives of the OMHSAS Advisory Committees have begun the process to review county mental health plans A plan review form will be completed by each evaluator for each plan The evaluation will include review of the employment housing and forensic plans Joint meetings will be held to discuss plans based on the individual reviews The regional office representative will complete the final version of the review form for the plan based on discussion at the joint meeting Final review of all county plans is anticipated by July 29 Feedback will be provided by early September

George J Kimes Executive Director georgepaprovidersorg

Member Response Critical for Effective Advocacy

Eleven years ago when I took the job as the executive direc-tor of PCPA my predecessor Ray Webb cautioned me that within six months of start-ing my new position I would forget what it was really like to manage a provider agency Ray was correct and the phenome-non that we often hear about in Washington DC of ldquoinside the beltway thinkingrdquo exists here in Harrisburg too It is easy to lose sight of what is really happening in the field in your programs and in your agency At the association we need input from members about what policy changes being pushed in Harrisburg mean to you We are only effective when we hear from you

The importance of member input and member response to our requests for information and data has never been as essential as it was this week as we fought to understand mdash and turn around mdash the mas-sive rate decreases proposed by the Office of Developmental Programs (ODP) As intellectual disability providers know ODP made a surprise announcement on June 16 regarding non-residential and respite services ODP announced that those services would move to the Medical Assistance fee schedule

We were successful in stopping these changes but we were only successful because we had informa-tion provided by members that gave us the data to make our case

effective July 1 The proposed rates appeared to have signifi-cant cuts from prior yearsrsquo rates Our initial analysis was that this would be a disaster but we needed a better understanding of the issue and better data

Linda Drummond PCPA policy specialist issued an appeal to members for information

After receiving data we were able to formulate a strategy to effectively educate key officials in the Department of Public Welfare and the governorrsquos office about the horrendous potential impact of these pro-posed cuts Effective advocacy led to an immediate suspen-sion of these new rates and a revocation of the bulletin that created these rates

We were successful in stop-ping these changes but we were only successful because we had information provided by members that gave us the data to make our case I would like to single out for thanks the following agencies whose quick response to our request was the cornerstone to our successful

action The responding agen-cies included Intercommunity Action (Interact) Turtle Creek Valley MHMR Family Services of Western Pennsylvania The RedCo Group Youth Advocacy Program Mon Yough Commu-

nity Services Evergreen Elm COMHAR Milestone Centers Barber National Institute Dickenson Center Community Services Group and The Arc of Center County

Your action as members in responding to our request was the reason we succeeded in this latest effort The battle is not over and PCPA will continue to advocate on your behalf as we face ever more difficult times but we cannot do it without your continued support Please continue to help us by making sure we know how changes being generated in Harrisburg impact your programs Thanks again

This column represents my opin-ion not necessarily that of the association

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D I R E C T O R rsquo S V I E W P O I N T

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

For additional information on legislative issues contact PCPA at 717-364-3280 For copies of bills call your local legislator the House Document Room 717-787-5320 or visit the General Assemblyrsquos Electronic Bill Room at wwwlegisstatepaus

Thanks to the hard work and commitment of members PCPArsquos 2011 Capitol Day made a big impact as hundreds of attendees in lime green t-shirts blanketed the State Capitol Members visited their legislators sharing the PCPA budget position and communicating the importance of funding community mental health intellectual disability and drug and alcohol services

The highlight of the day was the legislative press conference in the Capitol Rotunda Attendees filled the steps and the response to the rallylegislative press conference was loud and enthusi-astic Legislative Affairs Committee Co-chair Alan Hartl led the event focusing on the importance of preserving funding for community services and rallying the crowd The press conference was well served by several articulate and passionate legislative supporters including Minority Policy Chair Rep Mike Sturla (D-Lancaster) Rep Tom Murt (R-Montgomery) Rep Pam DeLissio (D-Philadelphia) and Rep Mark Longietti (D-Mercer) All spoke vehemently in support of the importance of community services to their districts and pledged to fight proposed budget cuts

Top Alan Hartl Lenape Valley Foundation served as the event host

Bottom Rep Mike Sturla promised his support of community services

Hundreds of staff and persons in service at member agencies joined in for PCPA Capitol Day

PCPA Capitol Day

Continued on next page

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The final speakers mdash a high point of the event mdash was the appearance of Penndel Mental Health Center staff member Jan Noe and her daughter Sarah who has Downrsquos Syndrome Both eloquently testi-fied to the key role of community services to individual Pennsylvanians All speeches are available on the PCPA web site

Every legislator was visited either by a constituent or PCPA staff delivering informational packets and advocating for the need for ongoing funding support The event was covered by the Penn- sylvania Cable Network Questions can be addressed to Anne Leisure (anne paprovidersorg)

Jan Noe Penndel Mental Health Center looks on as daughter Sarah addresses the Capitol Day crowd

Terminology Updated by Pennsylvania SenateSenate Bill 458 introduced by Senator Dinniman amends the Mental Health and Mental Retardation Act of 1966 The legislation directs that any reference in the act using the term ldquomental retardationrdquo be replaced with ldquointellectual disabilityrdquo The bill also changes the name to the act to the ldquoMental Health and Intellectual Disability Actrdquo On June 22 SB 458 was unanimously passed by the Senate and sent to the House where it has been referred to the House Human Services Committee for consideration Further progress on the bill is likely to be delayed until the General Assembly reconvenes after passage of the state budget

Congressional Negotiations on Debt Limit Threaten Community ServicesThe National Council reports that Congress is debating a federal debt limit compromise that could cut hundreds of billions of dol-lars from the Medicaid program One proposal under discussion is the conversion of Medicaid from an entitlement program to a block grant Currently if more eligible individuals enroll in the Medicaid program federal funding increases to meet the demand If Medicaid were to become a block grant federal funding is fixed regardless of how many new people enter and states take on the risk of funding new enrollees Block granting also eliminates federal requirements now in place regarding eligibility and benefits and allows states to change eligibility standards and eliminate benefits Other cuts are also on the table including caps on federal spending for entitle-ment programs and a repeal of health reformrsquos Maintenance of Effort (MOE) requirement allowing states to reduce Medicaid eligibility and benefits below currently mandated levels

Ongoing negotiations which are taking place out of public view appear to be stalled It may not be too late to influence the out-come PCPA asks members to communicate with Congress to urge them to fight draconian Medicaid cuts Sample language may be found on the PCPA web site Further questions may be addressed to Anne Leisure (annepaprovidersorg) p

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RegistrationOpen

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

Join PCPA for Hill DayJoin PCPA for the National Councilrsquos 7th Annual Public Policy Institute and Hill Day July 19 ndash 20 at the Hyatt Regency Hotel in Washington DC Each year at Hill Day hundreds of behavioral health providers administrators board members consumers and community stakeholders from across the country come for a day of sessions and workshops on federal behavioral health policy followed by visits with elected officials The National Council Public Policy Institute is July 19 and is a wonderful opportunity to hear from key congressional and administration staff and policy experts There are also breakout sessions on advocacy techniques federal grant funding and social media marketing On July 20 PCPA members will meet with elected officials on Capitol Hill PCPA is working with members to coordinate visits to legislators More information can be accessed on the National Councilrsquos Hill Day web site Hill Day is a wonderful opportunity to ensure that federal law-makers understand the importance of high quality and accessible behavioral health services The Pennsylvania presence at Hill Day continues to grow and PCPA hopes that this year is no exception Questions should be directed to George Kimes (georgepaprovid-ersorg) or Anne Leisure (annepaprovidersorg)

State Budget UpdateAs Provider News goes to print budget negotiations are in the home stretch After stalling early the week of June 20 Governor Corbett and legislative leaders have indicated that agreement on budget parameters is close at hand Senate Republicans had come to the table with a request for approximately $200 million in restorations from the House Republican budget The Senate restorations had included the proposed $27 million cut to fixed costs for group homes the Behav-ioral Health Services Initiative and the community mental health base dollars Because negotiations have been held behind tightly closed doors it is not yet known if the restorations of interest to PCPA members have survived the negotiation process Once agreement has been reached the budget package will take several days to implement All reports indicate that the budget will be complete very close to the June 30 deadline Questions and com-ments may be directed to George Kimes or Anne Leisure

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S T A T E N E W S B R I E F S

Mental Health and Justice Center of ExcellenceThe Pennsylvania Mental Health and Justice Center of Excellence is a collaborative effort of Drexel University and the University of Pittsburgh funded by the Pennsylvania Commission on Crime and Delinquency and the Office of Mental Health and Substance Abuse Services The center works collaboratively with the commonwealth and locales planning and implementing programs providing information to promote use of evidence-based practices and serves as a resource for technical assistance and training In addition the center hosts a repository for collected data and information on criminal justice and mental health Services provided by the Center of Excellence include

A Cross-Systems Mapping workshops that visually depict how indi-viduals with mental illness and substance use disorders come in contact with and flow through the criminal justice system at a county level

A Action Planning workshops that allow stakeholders to create spe-cific plans for addressing identified priorities

A Technical assistance with data collection action planning next steps best practices etc and

A An up-to-date comprehensive web site with information on county statistics local initiatives veteransrsquo resources and other relevant materials

For more information access wwwpacenterofexcellencepittedu or con-tact Sarah Filone (saf83drexeledu or 215-762-8275)

Problematic Regulations Project PCPA is moving forward with a problematic regulations project A list of problem regulations was developed in 2004 and presented to the De-partment of Public Welfare (DPW) for consideration Some of the issues were addressed over time through regulatory change bulletins and policy changes but many remain problematic to providers The DPW administration is very interested in finding cost savings and achieving efficiencies by eliminating or changing policies and regulations that add costs but do not add value Industry practices have evolved over time but many regulations have not and create barriers to effective practice and individual choice A listing of policies and regulations will be compiled and presented to DPW Secretary Alexander for review and consideration It is anticipated that additional policies and regula-tions will be identified in the future and more requests will be made for changes Submit information about problematic regulations and policies to Betty Simmonds (bettyparpovidersorg)

Go Green With Electronic MA BulletinsIn an effort to conserve resources and save costs the Department of Public Welfare (DPW) will convert all providers who currently receive paper Medical Assistance (MA) Bulletins to access through the DPW web site Providers may receive email notifica-tion when a new bulletin is available with a link to the bulletin included in the email DPW intends to implement the conversion in late July or in August Providers may opt out of the conversion by contact-ing the Provider Inquiry Line to request an attesta-tion form The provider must meet one of the fol-lowing criteria limited or no Internet access only dial-up access available or the need to purchase com-puters or other hardware in order to receive electronic bulletins Forms must be submitted to DPW before the provider is returned to the paper manual distribu-tion system A bulletin will be issued with instructions on how to register for the preferred method Providers may request notification of the availability of bulle-tins before the conversion through the DPW listserv (httplistservdpwstatepausma-electronic- bulletinshtml)

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A C R O S S T H E N A T I O N

ePrescribing UpdateBoth Medicare and Medical Assistance (MA) have established electronic prescribing (eRx) initiatives The Medicare initiative includes negative incentives for eligible pro-viders who are not successful e-prescribers The Medicare 2011 eRx Incentive Program Update is available on the Centers for Medicare and Medicaid Services (CMS) web site (wwwcmsgovERxIncentivedownloads2011eRxIncentiveProgramUpdatefor2012PaymentAdjustment05-09-11pdf) Information about starting eRx is available at wwwcmsgovERxIncentive03_How_To_Get_StartedaspTopOfPage Although the eRx rule is final regulatory change was suggested in a proposed rule published in the June 1 Federal Register (httpwwwgpogovfdsyspkgFR-2011-06-01pdf2011-13463pdf) If finalized this rule would change the requirement that the quality measure document whether an eligible professional or group practice has adopted a qualified eRx system that per-forms the four required functionalities by adding the language or is certified electronic health record technology An eligible professional or group practice that already uses a certified EHR that transmits electronic prescriptions and related material would be able to continue to use that system Hardship exemptions were finalized for the 2012 payment adjustment for eligible professionals or group practices in a rural area with limited high speed Internet access or in an area with limited available pharmacies for eRx The proposed rule adds

A Eligible professionals who register to participate in the Medicare or Medicaid EHR Incentive Programs and adopt certified EHR technology

A Inability to electronically prescribe due to local state or federal law or regulation

A Limited prescribing activity and

A Insufficient opportunity to report the eRx measure due to limitations of the measurersquos denominator

Comments are due to CMS by July 25 Instructions for submitting comments are found in the document

Information about the MA eRx Initiative is available at wwwdpwstatepausproviderdoingbusinesswithdpwpharmacyserviceseprescribinginformationP_002956 and from Surescriptstrade (wwwsurescriptscom) An ePrescribing User Manual is available at httpspromisedpwstatepaus A report on the utilization of eRx throughout the US provides additional information about health information technology The National Progress Report on E-Prescribing and Interoperable Healthcare for 2010 is available at wwwsure-scriptscomabout-e-prescribingprogress-reportsnational-progress-reportsaspx

A new Medicare Learning Network (MLN) Mental Health Services booklet is available in print form The booklet provides information about mental health services covered and not covered by Medicare eligible professionals outpatient psychiatric hospital services and inpatient psychiatric hospital services Order the booklet at no charge from wwwcmsgovMLNGenInfo Select Related Links Inside CMS and MLN Product Ordering Page

You will become as small as your

controlling desire or as great as

your dominant aspiration

ndash James Allen

Reso

urce

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In a proposed rule published in the Federal Register (httpwwwgpogovfdsyspkgFR-2011-06-17pdf2011-14673pdf) the Centers for Medicare and Medicaid Services (CMS) suggested Conditions of Participation (CoPs) for Community Mental Health Centers (CMHCs) that ldquofocus on the care provided to the client establish requirements for staff and provider operations and encourage clients to participate in their care plan and treatmentrdquo The CoPs would enable CMS to survey CMHCs for compliance with health and safety requirements The requirements would address personnel qualifications client rights admission initial evaluation comprehensive assessment and dis-charge or transfer of the individual treatment team active treatment plan and coordination of services quality assessment and performance improve-ment and organization governance administration of services and partial hospitalization services CMS has not proposed deeming authority to accredit-ing organizations and has requested feedback CMS proposed that the regula-tions become effective 12 months after publication of the final rule The CoPs are designed to provide consistent guidance across provider types Comments are due by August 16 Instructions for submitting comments are found in the proposed rule

Medicare Conditions of Participation for CMHCs

A C R O S S T H E N A T I O N

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

N E W M E M B E R S

PROVIDER MEMBERSAlliance Health Wraparound IncSusan Stewart-Bayne DirectorTurtle Creek

Brooke Glen Behavioral Health HospitalNeil Callahan CEOFort Washington

Friends HospitalGeoff Botak CEOPhiladelphia

ASSOCIATE MEMBERBlair HealthChoicesBlaine Smith Executive DirectorHollidaysburg

July 13 Performance Based Case Rates and Mental Health and Sub-stance Use Parity Richard Frank HHS Office of Disability and John OrsquoBrien SAMHSA ACMHA Series on Health Reform Webinar starts at 300 pm Eastern More information at wwwacmhaorg Questions may be directed to Dr Kris Ericson at executive directoracmhaorg

October 11 ndash 14 Hats Off The PCPA Conference Seven Springs Mountain Resort Champion PA Registration opens August 1

Medicaid Provider Enrollment RequirementsThe Patient Protection and Affordable Care Act added many requirements for program integrity Among them are requirements for enrollment of prescrib-ing ordering and referring providers in Medical Assistance (MA) MA must develop monthly automated checks of the

A List of Excluded IndividualsA Excluded Parties List SystemA Master Death FileA Social Security AdministrationA State Sanctions DatabaseA Department of Health License FileA Department of State License FileA Centers for Medicare and Medicaid Services (CMS)

Certification License FileA National Provider Databank andA Termination files from other states and Medicare

Risk levels are assigned for provider types based on level of risk of fraud waste and abuse determined by CMS but states may require higher risk levels The risk level determines the screening procedures needed and may include background checks fingerprinting of persons with control-ling interest and site visits for higher levels of risk Orders referrals and prescriptions from providers not enrolled in MA cannot be accepted by MA-participating providers and reimbursed MA cannot pay for services ordered referred or prescribed by non-MA providerspractitioners This requirement could impact access to needed services

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D R U G amp A L C O H O L A C T I O N

Dan Miller BDAP

The process of recovery is ongoing across the lifespan and as one main-tains his or her course of recovery the reality of physical improvement healthier relationships greater connectedness to the community reduced criminal activity and other personal benefits are realized With increasing science focusing on ad-diction and recovery we are learning that this process can be facilitated by various forms of treatment as well as diverse therapeutic modalities We also know that individuals achieve recovery through the combined help of treatment and support services which include mutual support groups or through support services alone By whatever pathway it is achieved

recovery is a personal journey that we in ldquothe fieldrdquo facilitate through services and supports The fact that people do get well is the ultimate reward of our daily work and effort

For this reason the Bureau of Drug and Alcohol Programs (BDAP) is excited about the STAR (Strengthen-ing Treatment And Recovery) data system for it will assist in facilitat-ing the personal journey and the goal of recovery Providers and Single County Authorities (SCAs) will report into a centralized web-based system that encompasses the full continuum of treatment and recovery support services This new system will afford providers and SCAs the capability of analyzing data in a more complete way to assess needs for individuals and communities the effectiveness of

Recovery Makes STARs of Everyone

PCPA was pleased to have Nikki Blythe Office of Income Maintenance (OIC) present at the Drug and Alcohol Committee meeting regarding a new initia-tive Delayed enrollment in Medical Assistance has caused serious problems in the drug and alcohol program and PCPA has long advocated for providers to have the ability to submit

scanned documents along with the COMPASS application The new initiative mdash COMPASS Attach Scanned Documents (ASD) mdash provides the ability to scan and submit verification documents from within the COMPASS application COMPASS ASD will begin as a pilot program on August 1 with three Community Partners If successful it will roll out to all

Nikki Blythe OIC presents a new initiative during the June Drug and Alcohol Committee meeting

registered Community Partners and in the course of time all citizens When a user accesses the scan application for the first time the DynamicWebTWAIN control will be auto-matically installed on the userrsquos workstation This control allows the COMPASS application to communicate with the scanner and allows the user to review and submit the docu-ment images

To prepare for implementation wait for the lsquogo-aheadrsquo from the department to begin scanning documents via COMPASS If you are purchasing scanners think ahead Make sure they are TWAIN compatible (most are) and they meet your scan-ning needs Make sure scanners have been set up properly and you are able to scan prior to trying to submit docu-ments via COMPASS Assure staff is available for any issues with scanners outside the scope of COMPASS All PCPA mem-bers are strongly encouraged to consider becoming COMPASS Community Partners All questions may be directed to Nikki Blythe (nblythestatepaus or 717-772-7892)

Scanning Documents Coming Soon to COMPASS

services provided and better manage resources In turn it will provide a more holistic picture of substance use disorders trends and better overall data pertaining to system outcomes across the commonwealth Once STAR is implemented it will help assist Pennsylvanians on their pathway to recovery

BDAP continues to make progress on the data system and is very interested in sharing information as it becomes available Upon launch we will expand our current STAR Committee to a larger group of power users For more information or questions please contact Joe Gallucci STAR project manager or Dan Miller data section chief at 717-783-8200 or wwwhealthstatepausstar

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D R U G amp A L C O H O L A C T I O N

MA Expedited Enrollment for Residential DampAThe Office of Mental Health and Substance Abuse Services (OMHSAS) in partner-ship with the Office of Income Maintenance (OIM) is addressing the Medical Assistance (MA) enrollment issue that impacts individuals being deemed eligible for MA to access drug and alcohol residential (non-hospital) treatment in a timely manner Expedited Plus Plus was developed to expedite clients into HealthChoices once the client gains MA This process provides the opportunity for individuals to access treatment when needed and allows the state to maximize the use of all available funds to support these services As of April 30 1312 non-hospital drug and alcohol service recipients gained MA eligibility and received expedited behavioral health managed care coverage through this process This statewide initiative is available to all Single County Authorities (SCAs) serving as the county drug and alcohol offices or their designees as well as the managed care organiza-tions (MCOs) An applicant information sheet identifying required documentation necessary for the MA enrollment process was developed to assist SCAs Standard procedures for the Expedited Plus Plus process are listed below

A Each SCAMCO user must obtain prior approval before submitting exceptions into the OMHSAS Web Based Exception Site using the Exp Plus Plus rule The Exp Plus Plus agreement form must be completed with the name of the individual who will be designated submitter along with all other approvals noted on the agreement OMHSAS will need a completed agreement in place for all users beginning July 1

A The completed agreement along with all signatures identifies the submitter of requests to the Web Based Exception Site and assures the MCO has agreed to authorize non-hospital drug and alcohol service(s) for any exceptions submitted by the designee upon the individual gaining MA eligibility and expedited enrollment into HealthChoices

A Completed agreements should be sent electronically to HC-EligDiscrepancystatepaus with the subject line marked as SCAMCO User Agreement

A Questions regarding the use of submission into the Web Based Exception Site should be directed to Lisa Page (717-772-6733) The Expedited Enrollment Plus Plus rule within the OMHSAS Web Based Exception Site (httpsereportingmercercomomhsasexception) should be utilized by the designee

Any provider requesting expedited enrollment for a client into HealthChoices for drug and alcohol residential (non-hospital) treatment must request submission through the SCA or their designee to ensure the MCO is aware of the submission and has agreed to authorize if deemed eligible Provider questions relating to recipient eligibilitypayment responsibility for a HealthChoices member should be directed to HC-EligDiscrepancystatepaus or 800-433-4459

Welcome Bahilya McFaddenPCPA would like to welcome Ba-hilya McFadden human services program specialist Division of Substance Abuse Services Bureau of Planning Policy and Program Development Office of Mental Health and Substance Abuse Services McFadden will be involved in a variety of pro-jects that relate to substance use issues such as Act 152MA enrollment process forensic in-itiatives co-occurring services and recovery support issues Her past professional experi-ence includes working with the forensic population and Medical Assistance services PCPA looks forward to continued collabora-tion with its state partners to support individuals seeking ser-vices that lead to recovery

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D R U G amp A L C O H O L A C T I O N

August 24 100 ndash 400 pm

How Substance Use Disorders Affect Physical Health

This webinar will discuss phys-ical health concerns as they relate to the use and misuse of alcohol and other drugs It examines the overwhelmingly negative effects of drug and alcohol abuse on the human body including a discussion of how different categories of drugs affect physical health Effects on pregnant women will be highlighted as a special concern It concludes with an explanation of how behavioral and primary health workers can better intervene to ad-dress these issues

Updates From the Drug and Alcohol CoalitionThe statewide Drug and Alcohol Coalition issued a report to new leadership in April with recom-mendations from the diverse group of stakeholders for improving the addiction care system in Pennsyl-vania The report was received by the executive branch and with the support of the Departments of Health and Welfare the coalition looks forward to resuming its work in the fall The report is available at wwwiretaorg and includes com-mittee work plans overarching recommendations and a listing of accomplishments

Parent Featured on National Juvenile Justice SitesSharon Smith founder of MOMS-TELL and a mother who lost her daughter to addiction offered to do an interview with IRETA describing her experience with Pennsylvaniarsquos juvenile justice system during the 1990s The interview was published on Re-claiming Futures and the Juvenile Justice Information Exchange two national blogs dedicated to help-ing at-risk youth and improving the quality of the juvenile justice system The interview is available at httpjjieorgjessica-williams-one-parents-advice-for-juvenile-justice-system16095

IRETA Announces New Webinar Lineup

September 21 100 ndash 400 pm

You Canrsquot Fool the Bladder Police

Urine drug testing is used by treatment providers to ensure andor confirm drug use andor abstinence of clients in treatment While accurate there are ways to ldquofoolrdquo or in-validate a drug test and there are substances that create false positives This training will aid the provider in under-standing how both ldquoin-houserdquo testing kits and laboratory tests work Additionally it will explore substances that interfere with the validity of these tests

Register for the Institute for Research Education and Training in Addiction (IRETA) monthly Webinar Wednesdays at wwwiretaorg (select ldquotrainingrdquo) Continuing education credit is available Brief descriptions are below Contact Kris Pond (pondkiretaorg) for further information

Lindsay Joins IRETAIRETA welcomes Dawn Lindsay PhD as the program evaluator and devel-opment specialist for the Northeast Addiction Technology Transfer Center Dr Lindsay completed her graduate work in clinical psychology at the University of Cincinnati and was on the faculty at the University of Pitts-burgh until 2010 She has eight years of experience conducting NIDA- and NIAAA-funded research in the area of adolescent substance use disorders and is a member of American Psychological Association and the American Evaluation Association

I R E T A

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I D D F O C U S

SCO State Set RatesPCPA and the Mental HealthMental Re-tardation Administrators Association met with the Office of Developmental Pro-grams (ODP) deputy secretary and staff to address issues with the newly released Supports Coordination Organization (SCO) state-set rates Both associations have surveyed SCO members to determine the impact of the new rates on the ability to continue to provide this service ODP rates indicate that for the 60 SCOs there were 24 to receive higher rates and 36 to receive lower rates in 201112 The lower rate decreases were between 2 ndash 28 per-cent Although 24 are to receive higher rates several have indicated this rate is still too low to cover their costs

Discussion with ODP focused on

A Efficiencies many SCOs have already implemented to cut costs and in-crease productivity

A That travel time is not reimbursable and this creates a loss of staff time and productivity

A That ODP needs to develop a policy to assist SCOs in transitioning con-sumers to their area of residence to reduce the travel and staff time

A ODP indicated they will develop and disseminate a document providing information on the methodology used to develop the new rates

A ODP needs to develop a policy for moving consumers from SCOs that will be unable to continue this service to SCOs that can serve the person and

A ODP needs to develop an ldquoAppealsExceptions to Ratesrdquo procedure for SCOs unable to continue service with their assigned state rate p

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JULY

20

11

13

Friel New ODP Deputy Secretary Kevin Friel has accepted the position as Office of Developmental Programs deputy secretary With over 12 years of experience with the Department of Public Welfare he most recently served as acting deputy secretary for the Office of Admin-istration and the Office of Developmental Programs From 1989 ndash 2004 he was working as an audit specialistauditor-in-charge in the Bureau of Financial Operations from 2004 ndash 2006 he was the director for the Operations Support Group in the Office of Administration In 2007 Friel was appointed director of the Bureau of Financial Operations

ODP Rescinds Moving Most Services to Fee ScheduleOn June 16 the Office of Developmental Programs (ODP) notified direct service providers that many of the services previously paid through the Prospective Payment System use of cost reports would be paid by a Medical Assistance state-set fee schedule effective July 1 Services slated to use the fee schedule included supports coordination and all non-residential and respite services except for respite camp which remains a vendor service Included on the fee schedule (which was rescinded June 22) were licensed day habilitation prev-ocational services supported employment transitional work respite services and home and community habilitation unlicensed This information was dis-seminated in ODP Informational Packet 074-11 Fiscal Year 2011-12 Updates to Consolidated and Person FamilyDirected Support Waiver and Base Services

Executive Director George Kimes had discussions on June 22 with Tim Costa Department of Public Welfare executive deputy secretary regarding the impact of the ODP action to become effective July 1 Data received from members regarding the negative financial impact of the rates on the ability to continue services provided the necessary detail to verify the deficits and potential service closures impacting individuals served Deputy Secretary Costa stated that the ODP process of moving these services to a state fee schedule would be stopped immediately Simultaneously Lobbyist Morgan Plant was shar-ing the data with the governorrsquos budget secretary and deputy chief of staff They indicated they had no knowledge of these changes or the impact on the provider system

The proposed change to a residential vacancyoccupancy policy will not be incorporated effective July 1 The current ODP therapeutic leave policy will remain in effect until further notice Relevant to the proposed rate changes is ODPs change regarding prudent pay claims Previously providers were exempt-ed from the statersquos prudent pay process This exemption will be eliminated and providers will now receive payment on a 25-31 day schedule after billing for services Information is available in ODP Informational Packet 075-11

I D D F O C U S

The Office of Developmental Programs (ODP) has released the following announcements available at wwwodpconsultingnet

A Announcement 068-11 IM4Q Reports Available at ODP Consulting Website

A Alert 069-11 Year 2 Period 1 Revenue Reconciliation released for waiver direct service providers

A Alert 070-11 Year 2 Period 1 Revenue Reconciliation Supports Coordination Organization Letters Issued

A Announcement 071-11 2011 PA Community on Transition Conference July 20-22 at Penn Stater Conference Center

A Announcement 072-11 ODP Centers for Medicare and Med-icaid Services Waiver Amendments and Service Definitions Approved Effective July 1 2009

A Informational Memo 074-11 Fiscal Year 2011-12 Updates to Consolidated and Person Family Directed Support Waiver and Base Services Proposed rates and fee schedules available in HCSIS to be used to process claims starting July 1 Rescinded June 22

A Informational Packet 075-11 Prudent Payment of Claims Policy Enforced Effective on July 1

A Alert 076-11 Directions to Retrieve the Proposed FY 201112 Service Rates in HCSIS

A Announcement 077-11 Waiver Direct Service Provider Audit Requirements for FY 201011 Reporting Period

A Informational Packet 078-11 Vendor FiscalEmployer Agent Financial Management Services Wage and Benefit Ranges for Specific Participant Directed Services Effective July 1

A Informational Packet 079-11 Agency with Choice Financial Management Services Wage and Benefit Ranges and Corre-sponding Rates for Specific Participant Directed Services Effective July 1

A Alert 080-11 announcing new non-residential services (074-11) which were to be added to the MA fee schedule effective July 1 for the 201112 fiscal year will be withdrawn

ODP PAC NotesThe Office of Developmental Programs Planning Advisory Committee (ODP PAC) met June 2 where Kevin Friel officially announced his acceptance of the deputy secretary position Friel wants greater ODP transparency and communications with stakehold-ers and will conduct a review of the many ODP committees Stakeholders were encouraged to share information regarding what can make the system more efficient financially stable and serve more people Parents and consumers shared life stories and parents with children on the waiting list shared concerns

A new project funded by the Penn-sylvania Developmental Disabilities Council ldquoBeyond Tokenismrdquo was presented The council is interested in talking to providers about the importance of including consumers and families on boards The projectrsquos goal is to increase the participation of individuals with developmental disabilities serving on boards of direc-tors A board training program will be developed

An update was provided by the Bureau of Autism Services Pennslvania Autism Needs Assessment Survey of Individuals and Families Living with Autism Over 35000 responses were received and included topics such as solutions to improve quality of life Future reports will focus on specific recommendations for policy develop-ment and effective service design and delivery

O D P U P D A T E S

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011

14

I D D F O C U S

The Office of Developmental Programs (ODP) has released the following announcements available at wwwodpconsultingnet

A Announcement 068-11 IM4Q Reports Available at ODP Consulting Website

A Alert 069-11 Year 2 Period 1 Revenue Reconciliation released for waiver direct service providers

A Alert 070-11 Year 2 Period 1 Revenue Reconciliation Supports Coordination Organization Letters Issued

A Announcement 071-11 2011 PA Community on Transition Conference July 20-22 at Penn Stater Conference Center

A Announcement 072-11 ODP Centers for Medicare and Med-icaid Services Waiver Amendments and Service Definitions Approved Effective July 1 2009

A Informational Memo 074-11 Fiscal Year 2011-12 Updates to Consolidated and Person Family Directed Support Waiver and Base Services Proposed rates and fee schedules available in HCSIS to be used to process claims starting July 1 Rescinded June 22

A Informational Packet 075-11 Prudent Payment of Claims Policy Enforced Effective on July 1

A Alert 076-11 Directions to Retrieve the Proposed FY 201112 Service Rates in HCSIS

A Announcement 077-11 Waiver Direct Service Provider Audit Requirements for FY 201011 Reporting Period

A Informational Packet 078-11 Vendor FiscalEmployer Agent Financial Management Services Wage and Benefit Ranges for Specific Participant Directed Services Effective July 1

A Informational Packet 079-11 Agency with Choice Financial Management Services Wage and Benefit Ranges and Corre-sponding Rates for Specific Participant Directed Services Effective July 1

A Alert 080-11 announcing new non-residential services (074-11) which were to be added to the MA fee schedule effective July 1 for the 201112 fiscal year will be withdrawn

ODP PAC NotesThe Office of Developmental Programs Planning Advisory Committee (ODP PAC) met June 2 where Kevin Friel officially announced his acceptance of the deputy secretary position Friel wants greater ODP transparency and communications with stakehold-ers and will conduct a review of the many ODP committees Stakeholders were encouraged to share information regarding what can make the system more efficient financially stable and serve more people Parents and consumers shared life stories and parents with children on the waiting list shared concerns

A new project funded by the Penn-sylvania Developmental Disabilities Council ldquoBeyond Tokenismrdquo was presented The council is interested in talking to providers about the importance of including consumers and families on boards The projectrsquos goal is to increase the participation of individuals with developmental disabilities serving on boards of direc-tors A board training program will be developed

An update was provided by the Bureau of Autism Services Pennslvania Autism Needs Assessment Survey of Individuals and Families Living with Autism Over 35000 responses were received and included topics such as solutions to improve quality of life Future reports will focus on specific recommendations for policy develop-ment and effective service design and delivery

O D P U P D A T E S

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14

I D D F O C U S

Disability Rights LawsuitsPennsylvaniarsquos Disability Rights Network (DRN) has filed several lawsuits against the Department of Public Welfare (DPW) addressing institutionalization of individuals with dual diagnoses of developmental disability and mental illness On May 20 Mumford v DPW was filed on behalf of two individuals enrolled in the Consolidated Waiver but admitted to inpatient psychiatric hospitals These individuals remain institutionalized although they no longer require inpatient care DRN brings the lawsuit based on inte-gration mandates of legislation requiring services in the community These individuals are enrolled in the Medical Assistance waiver which provides community residential habilitation services DRN continues to identify additional individuals to add to this litigation

A settlement agreement has been reached between DRN and DPW in the Benjamin law-suit filed on behalf of individuals residing in state mental retardation centers that are appropriate for and interested in community placement In January the court stated DPW violated the integration mandate of the Americans With Disabilities Act Individu-als interested in moving to the community will be placed on a planning list DPW is also required to develop and implement an integration plan to move into the commu-nity 50 ndash 100 individuals each year beginning July 1 until June 30 2016 If there are more individuals on the planning list the state must provide community services to 75 persons each year until all those on this list are in the community For additional information access wwwdrnpaorg

Ohiorsquos Remote Home Monitoring Care An article in the May 21 edition of the Dayton Daily News ldquoState to Offer Remote Home Monitoring Carerdquo provides information regarding Ohiorsquos initiative on develop-ing the use of remote monitoring technology Beginning July 15 Medicaid will begin paying for remote home monitoring for Ohio waiver-funded residents with develop-mental disabilities Residents receiving services through Ohiorsquos Medicaid Individual Options Waiver program may participate and it is the individualrsquos decision on select-ing this option The cost of monitoring equipment installation and maintenance is capped by Medicaid at $5000

Remote monitoring is based on each personrsquos needs and can include such options as web-based monitoring systems motion sensors video or live audio personal emer-gency response systems temperature detectors and equipment for two-way commu-nication Cameras may only be installed in common areas such as kitchens and living rooms The intent is to provide more independence for individuals capable of adapting to electronics A 2005 investigation by the University of Wisconsin-Madison of the cost effectiveness of remote monitoring for 138 Wisconsin residents with develop-mental disabilities found a savings of nearly $1 million per year when compared to sending staff to homes

ICFID Task ForceThe Office of Developmental Programrsquos (ODP) Intermediate Care Facilities for the Intellec-tually Disabled Task Force (ICFID) featured several presenta-tions addressing dementia ODP Medical Director Jill Morrow presented on the prevalence causes types and treatment options for dementia ODP Con-sultant Ann Marie Cawley fo-cused on active treatment with changing needs and dementia

There are numerous causes of dementia some irreversible or degenerative and some treat-able or reversible Irreversible causes include Parkinsons Huntingtonrsquos Pick disease Multiple Sclerosis Alzheimerrsquos Lymersquos disease and slow vi-ruses Treatable causes include brain tumors metabolic causes hydrocephalous and effects of medication hypothyroidism and B vitamin deficiencies Alzheimer dementia in persons with intellectual disability shows a prevalence difference which increases with age Active treatment starts with an assessment of memory loss speech gait depression and sleep patterns Staff training is needed to create positive living environments for individu-als with appropriate lighting removal of clutter and busy pat-terns on floors and furnishings creation of safe places inside and outside to allow wandering and tailoring living environ-ments to personal likes and dislikes

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15

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

Pennington Selected for 2011 Mennis AwardPCPA has announced Michael D Pennington as recipient of the 2011 Marilyn Mennis Memorial Award Mr Pennington is director Office of Juvenile Justice and Delinquency Prevention Pennsylvania Commission on Crime and Delinquency (PCCD) Prior to coming to PCCD he worked as a residential treatment provider treatment supervisor assistant director and program director of residential facilities He is responsible for development of policy recommendations and the administration of federal and state funds to support programs to improve the juvenile justice system and prevent violence delinquency sub-stance abuse school dropout and related problem behaviors among children and youth

Mr Penningtonrsquos responsibilities include managing and coordinating Pennsylvaniarsquos Resource Center for Evidence-Based Prevention and Intervention Programs and Prac-tices and developing the juvenile justice and delinquency plan for the governor During the past several years he worked to advance goals of the MacArthur Foundation Models for Change Initiative focusing on developing models for service collaboration between juvenile justice and behavioral health providers Through his efforts Pennsylvania has seen the introduction and expansion of several evidence-based treatment models and the continued advancement of cross-system collaboration and enlightened delinquency diversion and intervention policies and practices The Mennis award is presented during the PCPA conference to an individual or program that reflects Ms Mennisrsquo qualities of dedication caring leadership and advocacy on behalf of Pennsylvaniarsquos children with special needs and their families

Minzenberg to Lead OCDELDr Barbara Minzenberg assumed the position of deputy secretary for the Office of Child Development and Early Learning (OCDEL) in June Prior to her selection Dr Minzenberg worked at the Allegheny Intermediate Unit in various capacities including assistant executive director for early childhood family and community programs senior program director and program director for preschool early intervention Minzenberg also worked for many years with the Pittsburgh School District as a special education specialist and project director for federal and private corporation grants She holds a doctorate in phi-losophy and masterrsquos in education from the University of Pittsburgh PCPA its Childrenrsquos Committee and Early Childhood Mental Health Work Group look forward to working with Dr Minzenberg and staff of OCDEL

NAMI Survey of Child Mental HealthA survey of parents and caregivers by the National Alliance on Mental Illness (NAMI) found that 83 percent wanted to discuss mental health issues with their childrsquos primary care physician even if the parents saw no evidence of problems More than one in three families want the doctor to initiate the conversation and 42 percent of participants do not think physicians give them enough time to answer questions About half of the parents said they didnrsquot feel their childrsquos primary care doctor was knowledgeable about mental illness Some primary care physicians feel uncomfortable discussing mental health issues and identifying mental illness due in part to the lack of training they received on the subject Physicians also struggle to fit conversations about mental health into the limited time they have for each patientrsquos office visit

Childrenrsquos Committee Goals The Childrenrsquos Steering Com-mittee was asked to identify three goals Those goals are

1 Promote evidence-based and promising practices along with efforts to ensure fiscal and sys-temic support to train implement and sustain these practices

2 Advocate for regulation and policy development at the national state and local levels that support the provision of community-based services and programs in an effective and efficient manner

3 Promote the development of cross-system service design delivery and purchase of service that effectively and efficiently integrates behavioral health services with primary care child wel-fare education juvenile justice vocational independent living and intellectual disability services

In addition the Adolescent Forensic Subcommittee will focus on promising and evidence-based approaches to working with the juvenile justice population and ser-vices that enhance diversion of youth from the juvenile justice system

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16

ECMH Work Group ReturnsWith changes in state admin-istration PCPA has decided to re-activate the Early Child-hood Mental Health (ECMH) Work Group The work group will identify and promote policy planning and services related to early childhood social and emotional wellness and prevention assessment and interventions related to the mental health needs of young children and their families Issues likely to be addressed include

A Implementation of the state ECMH Advisory Committee recommendations

A Improvements to Health-Choices Medical Necessity Criteria to better address ECMH

A Promotion of promis-ing practices and the resources necessary to provide those practices in every community

A Engagement with the Pennsylvania chapter of the World Infant Mental Health Association and

A Screening in pediatric and other primary care settings and collabora-tion with mental health providers

Members interested in participating should contact Connell OrsquoBrien (connellpaprovidersorg)

Community Launches Practitioner Lunch and LearnChildrenrsquos Committee members and physical health care colleagues are invited to become an active part of the Pennsylvania Physical HealthBehavioral Health (PHBH) Learning Community Learning community members have already participated in webinars on ldquoLessons from the Pennsylvania Youth Suicide Prevention in Primary Care Projectrdquo and a presentation on ldquoPediatric Mental Health Tools to Enhance Your Mental Health Practicerdquo jointly sponsored by the Pennsylvania Chapter of American Acad-emy of Pediatrics and the University of Pittsburgh School of Medicine The Physical HealthBehavioral Health Learning Community offers providers and practitioners the opportunity to connect with colleagues via email and at the Social Network of Care online Members can view key documents presentations and publications related to PHBH collaboration blog and read what others have to say on recent developments To become involved contact Jen Bankard (jenpaprovidersorg)

OMHSAS Advisory UpdatesThe June meeting of the Office of Mental Health and Substance Abuse Services (OMHSAS) Childrenrsquos Advisory Committee focused on mental health service trend data that showed clear shifts in the kinds of services being provided and the shift in financial resources The data shows a substantial shift away from residential treat-ment services with millions of dollars in cost reduction and the elimination of many hundreds of beds The use of Therapeutic Support Staff and related costs have also diminished substantially with the greatest growth in services shifting to outpatient and evidence-based and promising practices in the community and schools The proposed Residential Treatment Facility regulations were not available for review The Childrenrsquos Bureau is pursuing federal planning and service system grants as they explore ways of reducing administrative complexity and burdens related to behavioral health rehabilitation services

Work Begins for School Based Behavioral Health Work GroupJuly 14 is the first meeting of the School Based Behavioral Health Work Group The meeting will employ both an in-person and conference call format and will be led by Co-chairs Megan Evans Appalachia Intermediate Unit 8 and Barb Saunders Wesley Spectrum Services The agenda will focus on work group organization review of the work group mission and scope meeting frequency location and format role of mem-bers representing providers schools managed care and state agencies and identi-fication of key issues projects and topics Core membership includes PCPA members who are behavioral health and community education providers and representatives of state government managed care organizations and university staff engaged in research and training related to special education student health and behavioral health care Members interested in participating should contact Connell OrsquoBrien (connellpaprovidersorg)

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ECMH Work Group ReturnsWith changes in state admin-istration PCPA has decided to re-activate the Early Child-hood Mental Health (ECMH) Work Group The work group will identify and promote policy planning and services related to early childhood social and emotional wellness and prevention assessment and interventions related to the mental health needs of young children and their families Issues likely to be addressed include

A Implementation of the state ECMH Advisory Committee recommendations

A Improvements to Health-Choices Medical Necessity Criteria to better address ECMH

A Promotion of promis-ing practices and the resources necessary to provide those practices in every community

A Engagement with the Pennsylvania chapter of the World Infant Mental Health Association and

A Screening in pediatric and other primary care settings and collabora-tion with mental health providers

Members interested in participating should contact Connell OrsquoBrien (connellpaprovidersorg)

Community Launches Practitioner Lunch and LearnChildrenrsquos Committee members and physical health care colleagues are invited to become an active part of the Pennsylvania Physical HealthBehavioral Health (PHBH) Learning Community Learning community members have already participated in webinars on ldquoLessons from the Pennsylvania Youth Suicide Prevention in Primary Care Projectrdquo and a presentation on ldquoPediatric Mental Health Tools to Enhance Your Mental Health Practicerdquo jointly sponsored by the Pennsylvania Chapter of American Acad-emy of Pediatrics and the University of Pittsburgh School of Medicine The Physical HealthBehavioral Health Learning Community offers providers and practitioners the opportunity to connect with colleagues via email and at the Social Network of Care online Members can view key documents presentations and publications related to PHBH collaboration blog and read what others have to say on recent developments To become involved contact Jen Bankard (jenpaprovidersorg)

OMHSAS Advisory UpdatesThe June meeting of the Office of Mental Health and Substance Abuse Services (OMHSAS) Childrenrsquos Advisory Committee focused on mental health service trend data that showed clear shifts in the kinds of services being provided and the shift in financial resources The data shows a substantial shift away from residential treat-ment services with millions of dollars in cost reduction and the elimination of many hundreds of beds The use of Therapeutic Support Staff and related costs have also diminished substantially with the greatest growth in services shifting to outpatient and evidence-based and promising practices in the community and schools The proposed Residential Treatment Facility regulations were not available for review The Childrenrsquos Bureau is pursuing federal planning and service system grants as they explore ways of reducing administrative complexity and burdens related to behavioral health rehabilitation services

Work Begins for School Based Behavioral Health Work GroupJuly 14 is the first meeting of the School Based Behavioral Health Work Group The meeting will employ both an in-person and conference call format and will be led by Co-chairs Megan Evans Appalachia Intermediate Unit 8 and Barb Saunders Wesley Spectrum Services The agenda will focus on work group organization review of the work group mission and scope meeting frequency location and format role of mem-bers representing providers schools managed care and state agencies and identi-fication of key issues projects and topics Core membership includes PCPA members who are behavioral health and community education providers and representatives of state government managed care organizations and university staff engaged in research and training related to special education student health and behavioral health care Members interested in participating should contact Connell OrsquoBrien (connellpaprovidersorg)

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C H I L D R E N rsquo S C O R N E R C O M M I T T E E R E P O R T S

Childrenrsquos Committee

Glynn Chase presented Co-chair Tammy Marsico with a certificate of appreciation for her leadership of the Childrenrsquos Com-mittee and Childrenrsquos Steering Committee The committee heard a presentation by Brittany Rhodes Penn State Evidence-Based Prevention and Intervention Sup-port Center (EPISCenter) whose mission is to provide support consultation and

tools that will enable juvenile justice-related evidence-based and promising practices to be established and maintained Michael Pennington provided updates from the Pennsylvania Commission on Crime and Delinquency announced the funding of 13 new juvenile justice diversion initiatives and described the Juvenile Court Judges Commission ldquoSystem Enhance-ment Strategyrdquo project that weaves together a range of policy practice and data analysis projects Office of Mental Health and Substance Abuse Services staff provided an update on the status of the Residential Treatment Facility regulations Updates were also provided about the Systems of Care and High Fidelity Wraparound initiatives Money Follows the Person and informa-tion and data on mental health service utilization related to budget reduction goals and strategies Presentation materials from the June meeting are available on the PCPA web site The next meeting is September 20

IDD Committee

The June 14 Intellectual and Developmental Disabilities Com-mittee meeting provided system updates discussion on Cent-ers for Medicare and Medicaid Services waiver rules proposed revisions and committee goals The committee approved the five goals which focus on influencing ODP policies recommen-dations on the ODP financial work group development of fiscal regulations training topics needed by providers and advocacy with state legislators ODP Deputy Secretary Kevin Friel Joe Church fiscal director and Patty McCool bureau chief offered discussion on a variety of issues ODP wants to increase com-munications with stakeholders provide quicker turnaround for questions expand web site options and implement a scorecard for stakeholders to let the office know how they are doing PCPA Legislative Affairs Director Anne Leisure provided an update on the current status of the proposed state budget PCPA has made numerous visits to the legislature House and Senate leader-ship and the Appropriations Committee to address the need to restore proposed cuts to the ODP provider system Commit-tee members were encouraged to visit and contact their local legislators

Outpatient Fails to Keep Children From the ERResearchers from Johns Hopkins Childrenrsquos Center found that 12 percent of children and adoles-cents treated at the centerrsquos emergency room (ER) for mental health crises over the course of eight years had a repeat trip to the ER within six months of their first visit The study pub-lished in Psychiatric Services also found that the majority of the children who repeatedly end up in the emergency room do not actually have life-threatening emergencies The researchers found that most of the children went to the ER seeking medical attention for behavioral problems or minor psychiatric problems such as disruptive classroom behavior verbal disputes and run-ning away Only three percent of visits involved severe psychotic episodes and 10 percent were suicide attempts For the 338 patients who had at least two visits to the ER about two-thirds of them reported having an outpatient mental health provider at both visits and 85 percent stated during their second trip to the ER that they had a regular mental health provider The researchers concluded that this could be a sign that patients are not receiving the care they need on an outpatient basis

State Conference on Youth Suicide Prevention ModelPennsylvaniarsquos Garrett Lee Smith Youth Suicide Prevention in Primary Care Grant Project in col-laboration with the Pennsylvania Youth Suicide Prevention Initiative Monitoring Committee will host a conference focused on youth suicide prevention and the Pennsylvania model being developed and researched The conference is Sep-tember 21 at the Central Hotel and Conference Center Harrisburg There is no charge Continuing education credits will be available for a process-ing fee The conference will feature national speakers from the Substance Abuse and Mental Health Service Administration and the Suicide Prevention Resource Center with workshop tracks in primary care behavioral health school nurs-ing and school and community issues

Brittany Rhodes EPISCenter

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Mental Health Committee

The Mental Health Committee recognized the leadership of Paul DeNault Northern Tier Counseling as he ends his service as co-chair Committee members heard a very detailed presentation Patient Protection and Affordable Care Act High-lights of Program Integrity Provisions by Laurie Rock director Bureau of Program Integrity Providers will face increasing scrutiny from multiple sources combating fraud waste and abuse of public funds The committee was directed to develop goals Members discussed a variety of possibilities and submitted priority selec-tions Results will be tallied and reported Problem regulations and policies were discussed Jason DeManincor OMHSAS provided an update on the Medical Assistance Transportation Program termi-nation of service for psychiatric rehabili-tation and information that satellite site locations will be listed on community residential rehabilitation facility licenses in the interest of public safety should the need for emergency evacuation or other event arise Members discussed the need for guidance on HCSIS reporting require-ments for individuals discharged from state hospitals Ian Mattis Highmark Medicare Services indicated that there were few CERT errors in behavioral health provider categories He stressed the need for providers to prepare for HIPAA 5010 implementation The Medicare ePrescrib-ing Incentive Program has begun but the Centers for Medicare and Medicaid Services issued a clarification that may be helpful to providers if it is finalized In July the Medicare Physician Fee Sched-ule proposed rule will be released and comments are encouraged Mattis also reported that CMS is reprocessing claims and providers may receive refund re-quests A committee meeting focused on outpatient services is scheduled July 26 from 130 ndash 330 pm at PCPA Members of the Drug and Alcohol and Childrenrsquos Committees are invited The next commit-tee meeting is September 20

Surviving July 4 Celebration TipsPhilhaven and the Central Pennsylvania Autism Service Education Re-search and Training Center have prepared a brief ldquoto dordquo list for families and other caregivers working with individuals on the spectrum

A Invest in a set of headphones or earplugs Earplugs to block noise mdash not those used for swimming Or use a set of headphones You can even play soothing or patriotic music through them

A Turn up the TV Some live near a venue that hosts a fireworks display or neighbors decide to create their own show Try playing predictable music or a favorite TV show that will cover sound

A Preview the show Fireworks are unpredictable But we can try to prepare children to better help them know what they can expect Sparklers may not have much sound but they look like mini fire-works Watch videos of fireworks displays

A Watch from far away A grocery store nearby parking lot or the side of the road with the windows rolled up may provide a comfortable distance

A Take comfort items Pack items that help soothe the child such as a weighted vest favorite toy snacks or handheld game

A Be mindful of the entire dayrsquos schedule Before the fireworks show is there a party or a picnic Are there breaks for down time in the day If itrsquos an overloaded day fireworks may put the child over the edge If fireworks are the priority activity consider limiting other planned activities

A Give that safety speech Donrsquot miss this perfect opportunity to talk with kids about fire safety and the dangers associated with explosive devices

Autism STAP Manual from Western ASERTCollaborators and partners in the Western Region Autism Service Educa-tion Research and Training (ASERT) Center are in the final phase of developing a ldquouserrsquos guiderdquo for Summer Therapeutic Activities Programs (STAP) for children on the autism spectrum The manual is based on the experience and outcome measures for over 600 children and ado-lescents who completed summer treatment programs in 2009 and 2010 The manual includes sections on rationale for summer treatment types of summer treatment programs core components of a STAP operational components of a STAP evidenced-based assessment referral processes for STAP intake processes best practice evaluations treatment planning processes components of a positive behavior support plan crisis plan-ning collaboration with parents documentation and progress notes psychosocial treatment and interventions discharge planning and quality improvement

O N T H E A U T I S M S P E C T R U M

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Wednesday July 13 1000 am ndash 300 pm Executive CommitteePCPA

Thursday July 14 830 ndash 1130 am Southwest Region MeetingUniontown

Wednesday July 27 1000 am ndash 200 pm Training Committee PCPA

Tuesday August 2 1030 am ndash 330 pm Childrenrsquos Steering Committee PCPA

Thursday August 4 830 ndash 1130 am Northwest Region MeetingErie

Wednesday August 17 1000 am ndash 300 pm Executive CommitteePCPA

Pennsylvania CommunityProviders Association2101 N Front StBldg 3 Ste 200Harrisburg PA 17110

C A L E N D A R

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PRSRT STDUS POSTAGE

PAID Harrisburg PAPermit No 24

Mental Health Committee

The Mental Health Committee recognized the leadership of Paul DeNault Northern Tier Counseling as he ends his service as co-chair Committee members heard a very detailed presentation Patient Protection and Affordable Care Act High-lights of Program Integrity Provisions by Laurie Rock director Bureau of Program Integrity Providers will face increasing scrutiny from multiple sources combating fraud waste and abuse of public funds The committee was directed to develop goals Members discussed a variety of possibilities and submitted priority selec-tions Results will be tallied and reported Problem regulations and policies were discussed Jason DeManincor OMHSAS provided an update on the Medical Assistance Transportation Program termi-nation of service for psychiatric rehabili-tation and information that satellite site locations will be listed on community residential rehabilitation facility licenses in the interest of public safety should the need for emergency evacuation or other event arise Members discussed the need for guidance on HCSIS reporting require-ments for individuals discharged from state hospitals Ian Mattis Highmark Medicare Services indicated that there were few CERT errors in behavioral health provider categories He stressed the need for providers to prepare for HIPAA 5010 implementation The Medicare ePrescrib-ing Incentive Program has begun but the Centers for Medicare and Medicaid Services issued a clarification that may be helpful to providers if it is finalized In July the Medicare Physician Fee Sched-ule proposed rule will be released and comments are encouraged Mattis also reported that CMS is reprocessing claims and providers may receive refund re-quests A committee meeting focused on outpatient services is scheduled July 26 from 130 ndash 330 pm at PCPA Members of the Drug and Alcohol and Childrenrsquos Committees are invited The next commit-tee meeting is September 20

Surviving July 4 Celebration TipsPhilhaven and the Central Pennsylvania Autism Service Education Re-search and Training Center have prepared a brief ldquoto dordquo list for families and other caregivers working with individuals on the spectrum

A Invest in a set of headphones or earplugs Earplugs to block noise mdash not those used for swimming Or use a set of headphones You can even play soothing or patriotic music through them

A Turn up the TV Some live near a venue that hosts a fireworks display or neighbors decide to create their own show Try playing predictable music or a favorite TV show that will cover sound

A Preview the show Fireworks are unpredictable But we can try to prepare children to better help them know what they can expect Sparklers may not have much sound but they look like mini fire-works Watch videos of fireworks displays

A Watch from far away A grocery store nearby parking lot or the side of the road with the windows rolled up may provide a comfortable distance

A Take comfort items Pack items that help soothe the child such as a weighted vest favorite toy snacks or handheld game

A Be mindful of the entire dayrsquos schedule Before the fireworks show is there a party or a picnic Are there breaks for down time in the day If itrsquos an overloaded day fireworks may put the child over the edge If fireworks are the priority activity consider limiting other planned activities

A Give that safety speech Donrsquot miss this perfect opportunity to talk with kids about fire safety and the dangers associated with explosive devices

Autism STAP Manual from Western ASERTCollaborators and partners in the Western Region Autism Service Educa-tion Research and Training (ASERT) Center are in the final phase of developing a ldquouserrsquos guiderdquo for Summer Therapeutic Activities Programs (STAP) for children on the autism spectrum The manual is based on the experience and outcome measures for over 600 children and ado-lescents who completed summer treatment programs in 2009 and 2010 The manual includes sections on rationale for summer treatment types of summer treatment programs core components of a STAP operational components of a STAP evidenced-based assessment referral processes for STAP intake processes best practice evaluations treatment planning processes components of a positive behavior support plan crisis plan-ning collaboration with parents documentation and progress notes psychosocial treatment and interventions discharge planning and quality improvement

O N T H E A U T I S M S P E C T R U M

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19

Wednesday July 13 1000 am ndash 300 pm Executive CommitteePCPA

Thursday July 14 830 ndash 1130 am Southwest Region MeetingUniontown

Wednesday July 27 1000 am ndash 200 pm Training Committee PCPA

Tuesday August 2 1030 am ndash 330 pm Childrenrsquos Steering Committee PCPA

Thursday August 4 830 ndash 1130 am Northwest Region MeetingErie

Wednesday August 17 1000 am ndash 300 pm Executive CommitteePCPA

Pennsylvania CommunityProviders Association2101 N Front StBldg 3 Ste 200Harrisburg PA 17110

C A L E N D A R

AUG

UST

JU

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20

PRSRT STDUS POSTAGE

PAID Harrisburg PAPermit No 24

Wednesday July 13 1000 am ndash 300 pm Executive CommitteePCPA

Thursday July 14 830 ndash 1130 am Southwest Region MeetingUniontown

Wednesday July 27 1000 am ndash 200 pm Training Committee PCPA

Tuesday August 2 1030 am ndash 330 pm Childrenrsquos Steering Committee PCPA

Thursday August 4 830 ndash 1130 am Northwest Region MeetingErie

Wednesday August 17 1000 am ndash 300 pm Executive CommitteePCPA

Pennsylvania CommunityProviders Association2101 N Front StBldg 3 Ste 200Harrisburg PA 17110

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PAID Harrisburg PAPermit No 24