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Community HealthChoices: Recap Third Thursday Webinar (September 19, 2019)

October 11, 2019
Reimbursement By Fidel Mercado, Analyst

On September 19, 2019, during the Department of Human Services' (DHS) "Third Thursday Webinar," DHS discussed Aging Well PA and the outreach and education for the continuation of implementing Phase 3.

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The Office of Long-Term Living (OLTL) has an agreement in place with Aging Well PA (AWP) to provide outreach and education activities in each region of the Commonwealth as CHC is implemented in three phases. Part of the outreach and education effort for each region is making sure that all participants who will be affected have been contacted and given information regarding what the change to CHC will mean to them. OLTL has determined that Service Coordinators (SCs) are responsible for making these contacts with their participants. These contacts must meet specific criteria and are referred to as “meaningful contact.” OLTL is asking that SCs be aware of the requirements outlined in the memo that was previously sent by AWP in March 2019 and will be receiving in the follow-up email and respond accordingly.

Each Service Coordination Entity (SCE) must send AWP a list of their service coordinators so that they can be registered in AWP’s learning management system.

Once registered, each SC will be given access to the OLTL approved online training for SCs. Once the SC has completed this training, he or she may begin making meaningful contacts. There is a testing at the end of the online training the SC must pass or else they will not be able to add contact numbers and will not get credit for those contacts.

In order to accurately track the meaningful contacts made by each SC, the SCE must enter each contact in AWP’s Outreach and Education online database (O&E DB).The data entered into the O&E DB will be used by OLTL to verify billing from SCEs for meaningful contacts.

Training topics include working with the MCO, billing and invoicing, person-centered service plans and electronic visit verification. Each of the MCOs will conduct various trainings for providers enrolling in the Phase 3 zones. The following three new training Summits have been added for the fall: Northwest Zone, October 8th at Clarion University; Northeast Zone, October 21st at Marywood University and Lehigh/Capital Zone, October 28th at Kutztown University. Registration is now open for the CHC provider workshops in October.

The agenda of the training Summits will include an over of CHC and breakout sessions on the following topics: home and community-based services, service coordination, nursing facilities, behaviorial health, physical health and transportation.

Electronic Visit Verification (EVV) must be implemented for personal care services by January 1, 2020 and for home health care services by January 1, 2023.  OLTL waiver services included in the initial implementation of EVV include:

  • Personal Assistance Services (Agency and Participant-Directed Model)
  • Participant-Directed Community Supports
  • Respite (unlicensed settings only)

Department of Human Services (DHS) is working with DXC and Sandatato develop an EVV system that will integrate with PROMISe, (the existing Medicaid Management Information System.)

  • Providers may use other EVV vendors/systems (Alternate EVV).
  • Alternate EVV systems will need to capture the six required items under the Cures Act and will need to meet DHS system data requirements outlined in the technical specification documents.

Fee-For-Service Providers (OBRA Waiver and Act 150 Program)

The DHS Sandata system training registration is now open for providers electing to use the DHS Sandata system for the OBRA waiver and Act 150 program. Providers using the DHS system must complete this training in order to begin setting up their agency accounts and security permissions. The DHS Sandata system is only available for Fee-For-Service providers.

Three types of training will be available:

  • in-person, class-room style training offered at regional locations
  • instructor-led webinars
  • self-paced on-line training

Current CHC Providers and Aging, Attendant Care and Independence Waiver Providers

If providers are electing to use the HHA eXchange EVV system offered by the MCOs, providers must work with the MCOs to complete training and other onboarding requirements.

Providers using Alternate EVV systems in CHC will need to send their EVV data the CHC-MCOs. Providers should contact HHA eXchange at EDIsupport@hhaexchange.com to complete third-party system integration activities for CHC.

Q&A Session

Q. What if an MCO partner goes to an out of network provider?
A. The MCO will be responsible to pay, MCO can set up a one-time contract.

Q. Updates on employee unique identifier?
A. CHC has implemented contingencies for providers/ participants. You can currently use the last 5 digits of the social security as a contingency until you receive a unique ID number.

Q. Will PA CHC be reaching out to providers as part of the trainings?
A. MCOs will be reaching out to participants as part of the follow up for the trainings they provide.

Q. Are Direct Service Provider that deliver meals required to use EVV?
A. No, Direct Service providers that deliver meals do not need to use EVV. The only providers required to use EVV are Providers who provide Personal Assistance Services (Agency and Participant Directed Model), Participant Directed Community Support, Respite (unlicensed settings only)

Q. Are Service Coordinators required to have degrees in Psychology, Social Work, or Criminal Justice?
A. MCO will determine if SCs candidates are required to have specific qualifications.

 

Does your facility need help with Community HealthChoices implementation? Contact Jennifer Matoushek, Senior Consultant, by calling 717-213-3130 or email JMatoushek@LW-Consult.com.

 

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