News

March 27, 2020

Ongoing COVID-19 Updates

LAMPA will continue to share COVID-19 updates as they are received. LAMPa staff continues to work with partners addressing the needs of all Commonwealth people, especially our most vulnerable residents. We hold all of your communities in prayer as we endeavor to respond faithfully to the presence of COVID-19. We all wrestle with the need to have increased presence and yet isolate ourselves when doing so protects our neighbors. Our advocacy for the vulnerable and the integrity of institutions meant to promote the common good takes on increased urgency at this time. We will continue to update our information and we ask for your assistance acting on alerts as they are forwarded.


Resources for Volunteers & Volunteer Organizations

 

Pennsylvania Voluntary Organizations Active in Disaster (VOAD) Volunteer Messaging

VOAD Volunteer Hours Template

VOAD Volunteer Self Screening Guidelines Reviewed by the PA Department of Health

Pennsylvania COVID-19 Major Volunteer Hubs

 

PA Department of Human Services

Questions from March 17 COVID-19 Webinar
March 22, 2020

General Questions

Where should Pennsylvanians go regarding updates on COVID-19 and information on testing?
The Pennsylvania Department of Health (DOH) is the primary source of up-to-date information on COVID-19 in Pennsylvania. Visit the Department of Health’s COVID-19 website for information on the virus, testing, and resources for the public and stakeholders: https://www.health.pa.gov/topics/disease/coronavirus/Pages/Coronavirus.aspx.

Where should DHS providers go for updates to DHS programs in response to COVID-19?
Resources specific to the Department of Human Services (DHS) can be found at: https://www.dhs.pa.gov/providers/Providers/Pages/Coronavirus-2020.aspx.

How is DHS addressing food insecurity during this crisis?
DHS is working to ensure access to food does not stop during this time of emergency. We know that this pandemic has caused many people and families to find that they are suddenly food insecure and require assistance. DHS has operationalized its Feeding Task Force. The Feeding Task Force is comprised of public, private, and non-profit partners from across the state, including, among others, the Governor’s Food Security Partnership state agencies, the Salvation Army, Feeding PA and other charitable food organizations, and the Pennsylvania Food Merchants Association. This task force is the centralized hub where we identify available resources, determine where needs are, how many meals are needed, how we are getting food to people, and how we are getting volunteers to help charitable food networks across Pennsylvania. This includes ensuring populations like children, older adults, and others with food insecurities are provided with nourishing meals.

We also continue to process SNAP applications. Pennsylvanians can apply online at: www.compass.state.pa.us.

The Pennsylvania Department of Agriculture also has information on its website at: https://www.agriculture.pa.gov/Pages/COVID-19.aspx. If individual food pantries close, individuals can call their regional food bank, all of which are operating. Links are provided that list the regional food bank contact information.

A full list of what is covered and not covered by SNAP can be found in our SNAP Handbook, section 503.3, at: http://services.dpw.state.pa.us/oimpolicymanuals/snap/index.htm#t=503_General_Information%2F503_3_Included_and_Excluded_Items.htm. These are specified in federal regulation and no changes or modifications were made as a part of the COVID-19 bill that Congress passed.

Further, PA 211 is available statewide, and is focused on connecting people who are losing work and struggling to meet their basic needs to resources that may be available to help during the pandemic. Pennsylvanians can dial 211, or text their zip code to 898-211 in order to connect to 211 resource navigators.

What is DHS doing to make sure families and the elderly do not have a disruption of benefits and services?

The Office of Income Maintenance (OIM) is continuing Medicaid in compliance with the Families First Corona Virus Response Act. We will not discontinue other benefits during this period for people who continue to meet eligibility criteria. We will not automatically close cases because we don’t receive necessary paperwork.

The Office of Long-Term Living (OLTL) is working with the Community HealthChoices Managed Care Organizations (CHC-MCOs) to monitor participants more closely and educate them on risk factors and symptoms of COVID-19. CHC-MCOs and Aging Well will be suspending long-term care clinical eligibility redeterminations during the COVID-19 crisis period.

The Office of Developmental Programs (ODP) has extended eligibility redeterminations to 18 months so participants in ODP’s programs will not lose services during this period.

The Office of Children Youth and Families (OCYF) is working closely with county children and youth agencies and service providers to mitigate risk for children and families served through this system and the workforce. At this time, all visits for children in foster care can be completed through video conferencing. This is also true for families receiving ongoing general protective services where the situation has been determined to be low-risk or where imminent danger to a child is not present. While face-to-face visits are still required for new allegations of child abuse and neglect where imminent danger to a child does appear to be present or risk of abuse or neglect seems to be high, the workforce is encouraged to maintain social distancing practices whenever possible and to implement guidelines recommended by the DOH.

OCYF Regional Offices remain available to work with county agencies to discuss individual situations as they arise.

Is DHS issuing guidance to specific provider fields?
Yes, DHS is regularly issuing and updating guidance as the COVID-19 pandemic progresses. Guidance that has been issued can be found at: https://www.dhs.pa.gov/providers/Providers/Pages/Coronavirus-Provider-Resources.aspx.

Has Pennsylvania requested any waivers from the federal government?

Section 1135 Waiver
DHS is working to identify provisions to be waived for our programs. We have been in contact with CMS to discuss our intent to submit a request to waive provisions related to provider enrollment, prior authorization, copayments, premium payments for some populations, and performance deadlines.

When the President declares a disaster or emergency under the Stafford Act or National Emergencies Act and the Health and Human Services Secretary declares a public health emergency under Section 319 of the Public Health Service Act, the Secretary is authorized to take certain actions in addition to her regular authorities. For example, under section 1135 of the Social Security Act, she may temporarily waive or modify certain Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) requirements to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in Social Security Act programs in the emergency area and time periods and that providers who provide such services in good faith can be reimbursed and exempted from sanctions (absent any determination of fraud or abuse). Examples of these 1135 waivers or modifications include:

• Conditions of participation or other certification requirements
• Program participation and similar requirements
• Preapproval requirements
• Requirements that physicians and other health care professionals be licensed in the State in which they are providing services, so long as they have equivalent licensing in another State (this waiver is for purposes of Medicare, Medicaid, and CHIP reimbursement only – state law governs whether a non-Federal provider is authorized to provide services in the state without state licensure)
• Performance deadlines and timetables may be adjusted (but not waived)

Appendix K
The offices of Developmental Programs (ODP) and Long-Term Living (OLTL) submitted Appendix K waiver applications to CMS. These waivers were approved on March 18 and will expand the capacity for remote services in the long-term services and supports and intellectual disability/autism service systems. We are committed to doing everything we can to ensure continuity of services and facilitate flexibility for our partners providing services across Pennsylvania. Services for these populations cannot stop, but we want to make it easier for providers to provide these services safely. Further operational guidance will be coming from ODP and OLTL and can be accessed on our website at: https://www.dhs.pa.gov/providers/Providers/Pages/Coronavirus-Provider-Resources.aspx.

Child Care Development Fund (CCDF) Plan Amendment
Based on a call with the federal Office of Child Care on March 19, 2020, DHS’s Office of Child Development and Early Learning (OCDEL) will be submitting a waiver request to address issues like professional development, which is not currently available in many instances for staff, and annual inspections, allowing us to suspend annual inspections and focus on complaint investigation during this emergency.

Supplemental Nutrition Assistance Program (SNAP) Waivers
The Office of Income Maintenance (OIM) has submitted three waivers making changes to the SNAP program and are awaiting approval from our federal partners:
• Waiver request for additional issuance of SNAP benefits
• Waiver request for the extension of SNAP certification periods
• Waiver request for the extension of the SNAP expedited interview waiver

What services are considered essential and life-sustaining during this period?
The list of essential, life-sustaining services and businesses is available here: https://www.scribd.com/document/452553026/UPDATED-5-45pm-March-21-2020-Industry-Operation-Guidance. If this link is updated and no longer works, visit www.dced.pa.gov for updated guidance.

What support will the state provide for the consumer directed home care workforce who do not have PTO but are sick or have child care needs?
OCDEL is offering waivers for child care centers that support employees in critical roles including direct care workers. The purpose of the waivers is to support essential personnel including the direct care workforce and to provide flexibility so that these individuals may continue to go to work and support their vulnerable clients.

For direct support workers serving people with intellectual disabilities, the Office of Developmental Programs’ (ODP) self-directed services allow for a benefits allowance to be paid to support service workers. This was in place prior to COVID-19. This was intended to be used to accommodate the fact that workers in self-directed models do not have PTO.

Are the Consumer Complaint Lines still operating for DHS’ Medicaid Offices?
Yes, consumer lines run by the ODP, OLTL, OMAP, and OMHSAS are still operative. Callers may experience increased wait times or may have to leave a message, but lines are staffed and inquiries will be returned.

Many of the domestic violence programs are having to place survivors in hotels due to the challenges related to communal living and the needs for social distancing. Placing individuals and families in hotels is much more expensive than sheltering. Will the programs be able to be reimbursed for the extra costs associated?
Under its grant agreement, the Department reimburses grantee and its subgrantees for the costs of providing shelter, including shelter in hotels and motels up to the maximum grant amount. If the grantee’s costs for providing shelter exceed the maximum grant amount, the Department is able to increase the grant amount subject to the availability of funding; however, grantee and domestic violence program should not assume the availability of additional funding. At this time, the Department is still able to process invoices for grant services so grantee and its subgrantees should continue to invoice for the costs of providing shelter, including shelter provided in hotels and motels. DHS continues to explore additional funding opportunities for domestic violence programs for increased costs related to the COVID-19.

Office of Child Development and Early Learning (OCDEL) Questions

How is the COVID-19 situation affecting child care centers?
Child care facilities were closed statewide on March 16, 2020 to support COVID-19 mitigation efforts. Exceptions to this policy are family child care homes and group child care homes operating inside a residence. Closures and operational guidance are communicated directly to child care providers and other early education and early intervention providers through the child care certification listserv and the Pennsylvania early education listserv.

This temporary closure of child care facilities may be a burden for Pennsylvania families who depend on this service. Because it is especially burdensome for essential personnel such as health care workers and first responders who must have safe and stable care options for their children in order to report to work, OCDEL has implemented a waiver process for child care centers and group child care homes that serve these families. Operators of these facilities who seek a waiver from the Commonwealth’s temporary closure order should contact OCDEL at RA-PWDRACERT@pa.gov. Facilities requesting a waiver may continue operating pending waiver approval.

Waiver requests will be processed as quickly as possible. All child care providers will continue to receive Child Care Works payments through April 2020.

How can a child care center get a waiver to continue operating?
Child care programs seeking a waiver from the commonwealth’s temporary closure order should complete the Exemption of Directive to Temporary Close form available at: https://www.pakeys.org/wp-content/uploads/2020/03/Exemption-of-Directive-to-Temporarily- Close.03182020-fillable.pdf. Completed waiver forms should be emailed to OCDEL at RA-PWDRACERT@PA.GOV.

The City of Philadelphia and the Philadelphia Department of Health have developed a separate additional process, requirements, and approval system for facilities operating in Philadelphia. Child care centers and group child care homes operating outside of a residence seeking to remain open in Philadelphia must complete both the OCDEL waiver request linked above and the Philadelphia waiver form available here: https://forms.gle/PTaHHu9Dafg4RxTr9.

There are concerns about parents who will have to continue to pay for child care when their facility is closed, per the governor’s order. Does OCDEL have authority over billing when a child care provider is closed?
The provider agreement is between the child care and the family, and DHS and OCDEL do not have authority over the contents of this agreement. OCDEL only has authority over copays for families that qualify for subsidized child care through Child Care Works. Most provider agreements include payment language in the event of a closure. Typically, this is related to weather or other short-term events. In this mandated closure period, and in the event it could potentially extend longer, families could be economically challenged and unable to fulfill the terms of their provider agreement.

For child care facilities that are closed, OCDEL is strongly recommending providers do not collect ongoing fees for this extended closure duration. We are requesting facilities communicate decisions regarding the provider agreement to enrolled families, including the facilities’ process to suspend or terminate the agreement.

If a child care facility receives Child Care Works (CCW) subsidies, will the employees of those facilities be ensured that they are paid as well?
CCW payments provide compensation for a child’s enrollment, not for staffing costs. Providers can have any number of children enrolled participating in CCW and the payment we are making may/may not cover the cost of paying staff, rent, and utilities. Under the current CCW Provider Agreement, OCDEL does not have authority at this time to mandate how providers who continue to receive CCW subsidies use these funds.

Will the department consider approval of Tele-therapy for Early Intervention services under the Part C/ Birth to 3 Early Intervention program?
Yes, guidance is being developed and will be issued to providers once it is complete and will be available on our website here: https://www.dhs.pa.gov/providers/Providers/Pages/Coronavirus-Provider-Resources.aspx.

Where could I find information regarding rules and laws related to co-pays for parents receiving CCW?
Please see OCDEL announcement: ELRC-20 #04 Child Care Works Payment Modifications Due to Impacts Related to Novel Coronavirus (COVID-19) at:
https://www.dhs.pa.gov/providers/Providers/Documents/Coronavirus%202020/ELRC%2020_04Child%20Care%20Works%20Payment%20Modifications%203-14%20update.pdf.

A child care facility told their employees it is voluntary to work. If someone elects to stay home, are they guaranteed their position when they decide to go back to work?
Employer-Employee relations are not under the authority of OCDEL.

Are Family Centers continuing to operate or are they not determined to be essential?
Family Centers received a communication from DHS indicating they should cease face-to-face meetings. If they have the means to implement telepractice with model fidelity and wish to do so, and clients are willing and able to participate, they may continue their work via telepractice. Each of the evidence-based models communicated to enrolled families their intent to support families through telepractice if families are interested.

Office of Children, Youth, and Families (OCYF) Questions

Can congregate care programs that have school programs continue those programs?
Congregate care programs should contact the Pennsylvania Department of Education for guidance on school programs.

Are there any changes to/interruption to the Kinship Care navigation support line?
The Kinship Navigator hotline continues to operate as normal and can be reached at 1-866-KIN-2111.

Can OCYF waive the requirement for face-to-face check-ins with children in foster care and allow this to happen via video conferencing, or would that require a federal statutory change/address in the national emergency order?
The federal Children’s Bureau released guidance to states permitting use of video or teleconferencing methods for completing the required 30-days caseworker visits for children in foster care. This guidance from the federal government along with the Governor’s emergency disaster declaration will allow OCYF to suspend state regulatory requirements for the check-in to be face to face. Video conferencing is still expected to occur within the normal timelines. OCYF has communicated this guidance to county children and youth agencies and providers.

Young people must meet eligibility requirements related to participation in activities like school and work to remain eligible for extended foster care. Since many of these activities are being disrupted significantly or canceled, are DHS and OCYF willing to direct county child welfare agencies to: 1. waive eligibility requirements during this time period and 2. prohibit agencies from discharging any youth from extended foster care during this time period to ensure their safety and well-being?
While the eligibility requirements for older youth to remain in extended foster care are set forth in statute, OCYF supports broad interpretation of the requirements at this time to allow for these older youth to remain in care. For example, one eligibility option is that a youth be “enrolled” in a post-secondary or vocational education program, which means even if college or vocational classes are suspended, a youth could still be eligible for extended foster care as long as they remain enrolled. It should also be noted that the final determination that the child meets necessary eligibility criteria is made by the court, not the children and youth agency.

Is there a plan for if young children who need to enter foster care have COVID-19 and there is not a foster home willing to accept them or all available foster parents are high risk based on age/health conditions?
OCYF is working with county children and youth agencies and providers to explore contingency models in anticipation that this could become an issue, however it is not something that has been brought to the attention of OCYF as a problem agencies are experiencing at this time.

Pennsylvania Council of Children, Youth, and Family Services members are having trouble hiring new employees because of the closure of federal fingerprinting centers due to COVID-19. How is DHS handling this closure?
This affects numerous fields, so DHS is closely monitoring this issue alongside the Governor’s Office. We will issue guidance if necessary.

Office of Developmental Programs (ODP) Questions

What criteria will be used to reassess closure of day programs at the end of 14 days? When and what type of guidance will be provided?
Providers of day programs have received instruction on continued operations from ODP including: (1) process for receipt of retainer payments, (2) shifting service delivery from facility based to provide essential support to program participants using remote/telephone support and in private homes and (3) redeployment of day program staff to residential programs. Multiple factors will be taken into account in making the determination for reopening these programs. The population served in these facilities is a very high-risk population for COVID-19.

Will there be any cancelation of services for people in the Adult Autism Waiver?
No, ODP is not cancelling any services. ODP is working with stakeholders to identify and remove barriers during the COVID-19 response to maintain services for individuals and families.

On March 18, 2020 CMS approved ODP’s application for Appendix K for the Adult Autism Waiver. This will allow additional flexibility for the system and will help to mitigate financial and staffing strain on providers to keep services active. With this approval, Day Habilitation facility staff can provide services in private homes. We will be issuing Operational Guidance to the field early the week of March 23, 2020.

Office of Income Maintenance (OIM) Questions

Will individuals and households be able to apply for benefits?
Anyone seeking benefits administered by the Office of Income Maintenance (OIM) can submit an application on-line by using the COMPASS website at: www.COMPASS.state.pa.us. Applicants may also send paper applications via U.S. Mail to their local CAO.

Will applicants for public assistance have access to benefits to provide immediate relief?
DHS currently provides Medical Assistance, SNAP, TANF Diversion, LIHEAP and LIHEAP crisis. All will continue to be available under current policies. People can apply by accessing our online application at www.COMPASS.state.pa.us. If the federal government or state government establishes other programs providing immediate relief under DHS’ purview, we will communicate with stakeholders and the public.

Will clients who are eligible for Medical Assistance for Workers with Disabilities (MAWD) be closed if they are furloughed from their job?
Clients who are eligible for MAWD can be granted Good Cause during periods where they are furloughed from employment. MAWD coverage will not be canceled based on a lack of employment. Additionally, Good Cause can be granted to waive MAWD premium payments for up to two months. Note: This may be extended with the passage of the Families First Corona Virus Response Act.

Should clients report any changes to their circumstances during this time?
Clients should attempt to report any changes in their circumstances during this time. Reductions in income and/or changes in employment should be reported so CAO staff can update benefits accordingly. Policies are being put in place that will allow these changes to be acted on more quickly in response to the impacts of COVID- 19.

Will public assistance recipients be required to go to work or training to meet the employment and training requirements?
Participants are not required to attend brick and mortar Employment and Training (E&T) program facilities or other related physical locations. Participants who are currently in E&T programming will work with providers to discuss opportunities to complete remote activities related to E&T. Examples of remote activities include online job searching, brushing up on interviewing skills, or working on resumes using electronic resources. Participants will be working with program providers to determine if those activities are feasible during this time. Because of illness, lack of internet or phone or other issues, not all parties will be able to participate remotely. One’s ability to participate will be determined on a case by case basis. If remote activities are not an option, there will be no penalty for non-participation.

New TANF recipients who are mandatory for participation in E&T activities will be granted good cause from participation by CAOs until E&T programs reopen.

What proof will people need to provide regarding hours of work, and how quickly can benefits be increased?
DHS will accept the person’s statement. Per program rules, changes are generally effective the month after the month of the reported change. If it is later found that the person’s hours were not reduced or that their statement was otherwise false, the Department will file an overpayment for benefits received based on that false statement.

Are considerations being taken for staff deemed essential and required to work in CAOs?
CAOs have been closed to the public so employees can focus on benefit delivery to clients. The Department of General Services reached out to all landlords to request that they follow CDC recommendations around cleaning. OIM is actively pursuing the purchase of cleaning supplies and hand sanitizers from any source available. We are looking for additional office space for CAO staff as well as other options that would allow for social distancing.

Are CAOs still able to process applications and adequately ensure the integrity/validity of information submitted?
CAOs are staffed and completing the essential work necessary to ensure individuals who are eligible receive benefits. The online COMPASS application tool allows clients to apply for benefits, compete renewals, provide required verifications, and report changes remotely without needing to come to a CAO in-person. CAO staff can accept information provided through COMPASS and take appropriate actions. Additionally, clients with smart phones can access the COMPASS mobile app – myCOMPASSPA – to report changes, upload documents, complete semi-annual renewals, and view benefit status.

Clients are also contacting the customer service centers, which are making changes and updates to client case records as necessary. Clients in Philadelphia with questions or information to report about their case should call the Philadelphia Customer Service Center at 215-560-7226. Clients in all other counties can call the Statewide Customer Service Center at 1-877-395-8930. Call volumes and wait times are likely to be high, and we appreciate the public’s patience with the dedicated commonwealth employees working to assist clients under stressful circumstances.

Clients can also apply for Medicaid benefits by telephone through our contracted consumer service center at 1-866-550-4355.

Some states are loading additional SNAP benefits for March onto participants’ benefit cards. Is DHS considering anything similar?
DHS has submitted a waiver to the Food and Nutrition Services (FNS) to request authorization to issue additional SNAP benefits. FNS must approve the waiver prior to DHS issuing additional benefits. DHS will continue to work with FNS on this waiver.

Are deadlines for applications and certification periods for benefits being extended? For how long are deadlines extended?
OIM will continue to process application and renewal benefits, so people should continue to send in paperwork as usual. But, for anyone who misses a deadline, who is not able to submit the paperwork or complete an interview or provide verifications for any reason during this emergency, we will ensure their benefits continue during this period. In order to maintain program integrity and per current federal law, DHS is not permitted to continue benefits (except for Medicaid) for people who no longer meet the eligibility criteria to qualify.

DHS has requested waivers from FNS to extend certification periods so SNAP benefits will not close during the COVID-19 emergency. The waiver request is pending; however, while we are waiting for approval, cases will not be automatically closed.

DHS already has authority to extend cash assistance and Medicaid in cases of emergency. If, however, a client has everything they need to submit to the CAO to complete their renewal, the client should submit the renewal and supporting documentation. CAOs are staffed and will be processing benefits and supporting documentation.

What is being done or contemplated as a replacement for face-to-face interviews for TANF?
Telephone interviews are being done in lieu of face-to-face interviews for TANF. No other programs under the OIM require face-to-face interviews.

Is there any movement in allowing SNAP to be used for grocery delivery services?
Online grocery shopping with EBT is not available in Pennsylvania and is currently only in pilot through FNS in a handful of other states. It is not an option that states can opt into at this time. If FNS opens an opportunity to participate, DHS will evaluate our ability to do so. More information regarding online pilots can be found at this link: https://www.fns.usda.gov/snap/online-purchasing-pilot.

If someone needs to pick up an electronic benefits transfer (EBT) card while the CAOs are closed to the public, how can they get their EBT card?
During the time that the CAOs are closed to the public, the CAO will send the card via US mail. Clients can contact the Customer Service Center at 1-877-395-8930. If a client needs a replacement card, the client can contact OIM’s EBT vendor, Conduent, at 888-328-7366.

Will DHS make changes to the 2019-2020 LIHEAP season in response to this crisis?
DHS is currently evaluating the best possible way to support the needs of the LIHEAP eligible population with the limited federal funds available. Applications continue to be available online and on paper.

How should KEYS programs function during this period?
KEYS programs are working with their community colleges to provide opportunities for participants to complete online coursework as a result of statewide COVID-19 mitigation efforts being enacted. Some providers have also engaged participants in remote activities that meet participation requirements as
many schools have been on spring break. KEYS providers have been reaching out to participants to ensure that they understand the new expectations as well as engage them in online coursework during this closure period. If participants are unable to do so due to COVID-19 related reasons (i.e. illness, no internet, no computer or laptop, etc.), they will not be terminated from the KEYS program nor be sanctioned due to non-compliance.

Students that are unable to participate may have concerns regarding their financial aid eligibility. Financial aid decisions are still being evaluated by the Pennsylvania Higher Education Assistance Agency (PHEAA) and they have committed to providing additional guidance on or around March 23, 2020. Federal Student Aid currently asks that all inquiries related to an inability to participate be referred to the participant’s community college for additional guidance.

Office of Long-Term Living (OLTL) Questions

Will telehealth requirements and policies be expanded for OLTL?
Telehealth and telephonic supports to OLTL participants are already a part of the CHC and OBRA waivers and will be encouraged during the COVID-19 crisis period. The Appendix K waiver also creates more flexibility for use of telehealth.

Office of Medical Assistance Programs (OMAP) Questions

Does a telemedicine bill need to pass the legislature, or can this be done by executive order? Will DHS require MCOs to utilize and pay providers?
Legislation is not necessary. OMAP is working within the updated and expanded policies announced by CMS to expand our coverage of these services. OMAP has also instructed MCOs to bring their telemedicine coverage into alignment with the coverage being offered in the fee-for-service program. Guidance on telehealth issued by OMAP is available here: https://www.dhs.pa.gov/providers/Providers/Pages/Coronavirus-Provider-Resources.aspx.

Are CHIP MCOs expected to cease CHIP terminations for non-payment of premium?
OMAP expects to issue guidance related to this in the coming days.

Office of Mental Health and Substance Abuse Services (OMHSAS) Questions

If behavioral health providers begin to offer services through telehealth during this time, will there be reauthorization requirements or additional copays?
Behavioral health services delivered through the HealthChoices or fee-for-service programs as part of an existing authorization period do not need to be reauthorized for the purpose of delivering the same services through telehealth. Reauthorization requirements and co-pays apply no differently than if the services were delivered in an office or clinic setting. DHS cannot speak to commercial or employer-sponsored insurance.

The anxiety around COVID-19 will cause more people to turn to behavioral health providers as a support network. How can we help our workforce who will most likely be overwhelmed?
We encourage people to check on each other and support each other as we navigate this crisis. We would call special attention to making the distinction between social distancing and physical distancing. We can still be social while maintaining safe physical distance. There are ways to interact safely while practicing social distancing. Technology can facilitate meaningful interactions.

More information on managing stress and anxiety through this crisis can be found at: https://www.cdc.gov/coronavirus/2019-ncov/prepare/managing-stress-anxiety.html

 

PA Dept. of Human Services Issues COVID-19 Response, Guidance & Actions

Governor Wolf, Dr. Levine, and local leaders across the commonwealth have taken unprecedented actions to protect the health and safety of Pennsylvanians. These measures, based on the guidance of public health professionals, are necessary to slow the spread of the virus that causes COVID-19. Life has slowed and it has changed, but it has not stopped for the millions of Pennsylvanians who depend on the Department of Human Services (DHS). The essential functions of the department cannot stop. DHS has an obligation to do everything they can to ensure continuity of services and programs for people who need them. Many of these services are critical now more than ever, and they are working internally and with providers and partners around the commonwealth to make adjustments as necessary. They are putting processes in place to ensure continuity of coverage so individuals do not lose their health care, cash assistance or food assistance during this uncertain time.

Medicaid and CHIP Programs

The offices that oversee and administer Medicaid access for the millions of Pennsylvanians who rely on it – the offices of Developmental Programs (ODP), Long-Term Living (OLTL), Medical Assistance Programs (OMAP), and Mental Health and Substance Abuse Services (OMHSAS) – are working closely together to get guidance out to providers to support operational changes while aiming for continuity of services.

COVID-19 Diagnostic Testing and Treatment

OMAP is also working with CHIP and Medical Assistance program-enrolled providers and managed care organizations to ensure that people needing testing and treatment related to COVID-19 are able to get this without copays or prior authorizations.

Home and Community-Based Services

ODP and the OLTL have submitted waiver requests to the Centers for Medicare and Medicaid Services allowing for flexibility around staffing for direct care and direct support workers. DHS is working to create flexibility given the evolving situation but are communicating with participants in these programs to ensure that services are still being rendered when needed. The Appendix K waivers OLTL and ODP submitted were approved on March 18, and they are in the process of drafting guidance to providers pursuant to this.

OLTL has also directed the Community HealthChoices managed care organizations (CHC-MCOs) to not reduce or terminate any personal assistance services or reassess long-term services and supports for at least the next three months. The three CHC-MCOs will also verify service continuity with all long-term care and HCBS participants and to ensure all HCBS participants have an executable back-up plan in place to guard against potential disruptions in service with personal assistance providers and direct care workers.

Telehealth Services

OMAP and OMHSAS issued guidance around telehealth to ease this option for providers around Pennsylvania and Pennsylvanians seeking services while observing social distancing and mitigation guidelines.

County Assistance Offices and Public Assistance Programs

DHS is also doing everything they can to ensure continuity of benefits and application processing for new applications for benefits that come in during this period. This uncertain time is undoubtedly going to create difficult situations for people around Pennsylvania, and DHS needs to continue to administer these vital programs for those who need it most. The department recognizes there may be changes based on federal action that will affect these programs, and they continue to monitor and will adapt if necessary.

CAO Operations

On March 16, the decision was made to continue to operate county assistance offices but close them to the public. This is necessary to ensure continuity of program operations so we may continue to process applications and maintain existing cases.

DHS recognizes the frustration and concern that this decision has prompted. However, these job functions are essential and cannot be performed off-site with existing technological capacity. The department continues to monitor this on a day-to-day, hour-by-hour basis. If additional adjustments become necessary, decisions will be made and communicated, but this work is essential and we cannot abandon the people who need or may need these programs when they need them most.

Medicaid

DHS continues to accept and process Medical Assistance applications. Individuals can notate on the application if they have a health emergency including COVID-19. The department will continue to prioritize Medical Assistance applications where there is an immediate health concern. Self-attestations will be accepted.

SNAP

SNAP certification periods will be extended at least for the next three months so SNAP cases will not be terminated during this period. DHS has submitted a waiver request to the federal Food and Nutrition Service (FNS) for this extension.

When processing changes to hours worked, DHS is exercising flexibility as they recognize that this may be difficult to verify as business operations shift across the private sector as well. DHS is also closely monitoring developments related to the Able Bodied Adults Without Dependents (ABAWD) rule at the federal level. Last week, we submitted a waiver request to FNS to delay implementation of this rule. On Friday night, the DC Federal District Court issued an injunction for the rule. The Commonwealth is exploring ways to ensure ABAWDs do not lose benefits due to the time limits.

DHS also submitted a request for a SNAP Issuance Waiver that would allow the department to issue a payment of 50 percent of a household’s maximum SNAP grant to ensure food security and the ability of SNAP recipients to comply with CDC guidelines calling for households to have two weeks’ worth of food available. If this is granted, DHS will communicate this broadly.

TANF

DHS is encouraging employment and training providers to provide remote services where possible and, if not, exercise flexibility for participants. The department also suspending face-to-face interviews and will not terminate or sanction recipients based on RESET requirements.

LIHEAP

DHS is evaluating the best possible way to support the needs of the LIHEAP eligible population with the limited federal funds available.

Protective Services

Protective services also continue to be administered by DHS. The Office of Children, Youth, and Families (OCYF) and OLTL continue to operate both ChildLine and Adult Protective Services and will continue to work with their partners at the county level to ensure these vulnerable populations are protected and referrals are investigated.

State-Run Facilities

The offices that oversee the state-run facilities – ODP, OMHSAS, and OCYF – are restricting access to these facilities, exercising increased cleaning and sanitation efforts, and screening staff to protect the health of people we serve. The departments recognize that this may create challenges for individuals under the care of these facilities and their loved ones, and they are working to facilitate visiting and interactions through programs like FaceTime and Skype.

Licensing Operations

DHS’ routine annual licensing visits are on hold at this time. DHS’ licensing offices will continue to monitor facilities and are prepared to respond to and investigate complaints as they are received.

Child Care Operations

Child care facilities were closed statewide on March 16 to support COVID-19 mitigation efforts. Exceptions to this policy are family child care homes and group child care homes operating inside a residence. All child care providers will continue to receive Child Care Works payments through April. Closures and operational guidance are communicated directly to child care providers and other early education and early intervention providers through the child care certification listserv and the Pennsylvania early education listserv.

This temporary closure of child care facilities may be a burden for Pennsylvania families who depend on this service. Because it is especially burdensome for essential personnel such as health care workers and first responders who must have safe and stable care options for their children in order to report to work, the Office of Child Development and Early Learning (OCDEL) has implemented a waiver process for child care centers and group child care homes that serve these families. Operators of these facilities who seek a waiver from the Governor’s temporary closure order should contact OCDEL at RA-PWDRACERT@pa.gov. Waiver requests will be processed as quickly as possible.

Coordinated State Response

The Office of Administration’s Division of Emergency Preparedness and Safety Operations (DEPSO) team has been working closely with state agencies and partners around the state to support the COVID-19 response across Pennsylvania since the beginning of February. DEPSO has provided ongoing support to DOH and PEMA at the CRCC through coordination and communications as needed. We have responsibility for Emergency Support Function #6, which is to provide for mass care, shelter and human services including food distribution.

Currently, the Mass Task Force is coordinating multiple food distribution programs to ensure appropriate food availability to our children, older Pennsylvanians and families. The Sheltering Task Force is supporting quarantining and sheltering coordination. The Disabilities Integration Task Force is working to ensure that those with access or functional needs are supported during these trying times.

 

Pennsylvania Utility Commission Provides Update

The Pennsylvania Utility Commission (PUC) issued an Emergency Order directing a moratorium on terminations including gas, electric, water, wastewater, and steam heat, in addition to telephone. The Order also requested that utilities restore service to previously terminated customers, where possible and considering safety. Note that this is only for utilities over which they have jurisdiction. The Commission does not regulate cooperatives or municipal authorities, with one exception – Pittsburgh Water and Sewer Authority. However, the PUC has spoken with the Pa Rural Electric Association (electric CO-Ops) and they indicated they have strongly advised their members to follow the same guidelines. The PUC has also heard from the PA Municipal Authority Association (water and wastewater authorities), and they indicated that they have provided guidance on the issue and encouraged their members to consider moratoriums on terminations.

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