July 19th, 2019
Office of Developmental Programs
Department of Public Welfare
P.O. Box 2675
Harrisburg, PA 17105-2675
Submitted via electronic mail to:
Re: Comments on Chapter 6400 Regulatory Compliance Guide
Dear Ms. Mochon,
MAX Association appreciates the opportunity to submit comments and suggestions to the Chapter 6400 Regulatory Compliance Guide (RCG) published by the Office of Developmental Programs (ODP) on May 7, 2019.
This cover letter identifies some broad concerns MAX has with the RCG. There is also an attachment that holds specific recommendations and comments.
While not specifically referenced in the RCG, it was suggested that the Health Risk Screening Tool (HRST) would satisfy many components of the assessment requirements indicated in regulation 6400.181. After close review of both, it became evident the HRST will not satisfy the majority of the items listed on pages 101-104 of the RCG. This will result in a significant administrative and financial burden for provider organizations. While HSA is doing the evaluations complimentary for the first 6 months, MAX believes all assessments will not be able to be completed in the first 6 months. Additionally, best practice would indicate this is an assessment that needs to be updated as the person’s condition changes. This will require providers to have a system for updating and maintaining these evaluations. All the above factors will require resources that were not identified. Finally, MAX believes this is a good supplemental medical record but should not replace a comprehensive medical history. Since this is a significant change, MAX strongly recommends a pilot be done before it is rolled out in its entirety. This will enable ODP and providers to identify barriers and challenges as well as gather information about realistic timeframes.
Furthermore, it is noted that throughout the RCG are references to providers “needing to,” “must,” or “are required to” utilize unregulated, promulgated or otherwise non-regulatory documents, tools, manuals, and/or bulletins such as the Administrative Review Process manual, Peer Review manual, Certified Investigator manual etc. By making these statements, and attempting to tie utilization to a regulatory reference outside of any regulatory process, ODP goes beyond its regulatory authority and creates for themselves the opportunity to change at will, any of said documents or others not in regulation, and attempts to hold providers accountable to the requirements which in many cases far surpass the regulatory requirements and regulatory intent. MAX recommends that all wording of this type be changed to “ODP considers this optional because it is not required by regulation. While ODP does not prescribe the use of…and will not cite providers, ODP does considers it best practice to follow”.
Finally, MAX requests that ODP not move forward to finalize this guide until after the 6100’s are promulgated as final and after providers have an opportunity to review the guide and the final regulations together in order to provide complete comments. This will allow all stakeholders the optimal opportunity to identify areas of question or concern. Without the final regulations fully informed comments on this guide are not possible.
We appreciate once again the opportunity to submit comments and recommendations concerning this draft. We are happy to discuss specifics further and offer our expertise as a resource in the process and would welcome the opportunity to meet with you to discuss any questions or clarifications on our comments. Thank you.
Diane Conway, Ph.D.