In Pennsylvania, KinConnector Website Connects Kinship Families to Resources

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The Pennsylvania Department of Human Services has launched www.kinconnector.org, a resource designed to help kinship care families connect to services and supports that can help children and their caregivers.

Grandparents raising grandchildren are among the most common type of kinship caregiver, but kinship care families also can include an aunt or uncle, adult sibling, or a non-relative caregiver such as a close family friend raising a child when their parents cannot care for them.  Kinship care arrangements help maintain family bonds and reduce trauma experienced when children cannot be cared for by their own parents.

Kinship caregivers make a selfless choice to care for young loved ones so they receive care and support from a family member they know and trust. As children navigate their own emotions around their family situation, this connection and familiarity can be a grounding force necessary to help children process and heal. While this can be an easy choice for kinship caregivers, navigating this new family situation can have its challenges for both the caregiver and children. KinConnector is here to be a resource and support to ease this process for the entire kinship family.

KinConnector was established through Act 89 of 2018 and is part of a kinship navigator program for Pennsylvania. After a competitive procurement process, The Bair Foundation was selected to administer the kinship navigator program coordinator and will work with kinship care families around Pennsylvania to help them access resources and supports and connect with families in similar situations around the commonwealth.

Kinship caregivers can visit the KinConnector website to find resources in their communities, learn about trainings and services available for kinship families, and find support groups and networks of other kinship care families and family care professionals.

KinConnector also runs a helpline that can be reached by calling 1-866-KIN-2111 (1-866-546-2111) The KinConnector helpline is staffed by knowledgeable, compassionate social service professionals prepared to help kinship care families understand and access resources that may be able to help them. The helpline is available from 9 a.m. to 10 p.m. Monday through Thursday and 9 a.m. to 5 p.m. Friday. The KinConnector helpline can support callers needing assisting in English and Spanish.

More information and resources are available on kinconnector.org. To speak with a trained KinConnector professional, call 1-866-KIN-2111. 

Pennsylvania Governor’s Administration Warns of Heightened Fall Wildfire Dangers

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With hunting and other outdoors activities increasing at a time when woodlands and brush can become tinder dry in just a few days, the Wolf Administration is urging all residents to guard against increased wildfire dangers in Pennsylvania’s 17 million acres of forestlands.

State officials noted a sustained dry period over much of the state comes at a time when wildfire dangers normally are high, and critical conditions can develop almost overnight in many forested areas of Pennsylvania.

“With rainfall varying greatly across the commonwealth, a dry windy span of just a few days quickly can make wildfires a very real threat,” said Department of Conservation and Natural Resources (DCNR) Secretary Cindy Adams Dunn. “Amid the pandemic we know so many are seeking outdoors pursuits. Hunting soon will be popular and fall foliage is a joy to behold, but when the leaves begin dropping and drying, they become added fuel for woodland fires.”

“Amid these conditions, it takes only a careless moment to ignite a devastating wildfires. We know debris burning is leading cause of wildfires throughout the state and more than 95 percent of Pennsylvania wildfires are caused by people,” Dunn said.

“While most Pennsylvanians are used to wildfires being confined to relatively far off places, these catastrophic events pose an escalating risk to communities throughout the commonwealth,” said State Fire Commissioner Bruce Trego.  “Increasingly, our state is being affected by weather patterns that turn fields and forests into accidents waiting to happen.”

The wildfire warning comes amid sparse rainfall and drying conditions, and as drought advisories are widening in Pennsylvania.

DCNR is responsible for administering a grant program paid through federal grants from the U.S. Department of Agriculture Forest Service. This program has awarded more than $14.5 million since it began in 1982. In 2019, more than $617,800 was awarded to 133 volunteer fire companies. Both Dunn and Trego encourage eligible departments to learn more about this important program for future grant opportunities.

With several deer and small-game hunting seasons opening in the coming weeks, both Dunn and Trego urged hunters and other woodlands visitors to be especially careful with smoking and fires amid dry vegetation.

Dunn noted the need to guard against wildfires increases each year as more development encroaches on heavily wooded tracts. Homeowners always should be diligent when burning trash and debris, she said.

Property owners should always consider the weather and conditions when burning outdoors. If it’s windy or dry, burning should be postponed until conditions change. A hose, rake, and shovel should be handy when burning outdoors, and any burnable materials cleared within 10 feet of a fire.

The Bureau of Forestry is working through state agencies and local fire companies to educate Pennsylvania citizens on procedures to make their homes in forest environments safer from wildfires. Information can be obtained from the Bureau of Forestry, county Emergency Management Office, or the Office of the State Fire Commissioner.

Details on wildfire prevention can be obtained at local forest districts and the Bureau of Forestry also maintains information on county burn bans in effect.

Child Oral Health Resource Center Releases New Resources

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The National Maternal and Child Oral Health Resource Center (OHRC) released three new resources focusing on the Title V national performance measure on oral health. The first resource, “Title V National Performance Measure 13 (Oral Health): Strategies for Success (2nd ed.),” provides information to help state maternal and child health programs in their implementation of the Title V NPM 13 and oral-health-related state performance measures. The other two resources are infographics that provide information for oral health professionals about benefits of and barriers to preventive dental visits for pregnant women and children.

Click here to view the resources.

CMS Issues New Roadmap for States to Accelerate Adoption of Value-Based Care to Improve Quality of Care for Medicaid Beneficiaries

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The Centers for Medicare & Medicaid Services (CMS) issued guidance to state Medicaid directors designed to advance the adoption of value-based care strategies across their healthcare systems and align provider incentives across payers. Under value-based care, providers are reimbursed based on their ability to improve quality of care in a cost-effective manner or lower costs while maintaining standards of care, rather than the volume of care they provide.  Value-based care arrangements may also permit providers to address social determinants of health, as well as disparities across the healthcare system.  Moving toward a more value-driven healthcare system allows states to provide Medicaid beneficiaries with efficient, high quality care, while improving health outcomes.  Value-based care may also help ensure that the nation’s healthcare system is better prepared and equipped to handle unexpected challenges, including the ongoing COVID-19 pandemic.

This guidance includes an assessment of key lessons learned from early state and federal experiences in implementing value-based care reforms, as well as a comprehensive toolkit of available federal authorities for states to adopt innovative payment reform efforts within their individual programs. It stresses the importance of multi-payer alignment in value-based care to drive care transformation, and supports state efforts to align new payment models in Medicaid with Medicare and other private payers.

CMS has made a strong commitment to advancing value-based care in Medicare for its 61.7 million enrollees. This guidance is designed, with the understanding that many of the providers overlap, to ensure that this same commitment can be made at the state level through Medicaid with its nearly 74 million beneficiaries by aligning strategies and common understanding of effective approaches. While these programs serve different populations, they share common goals of lower costs and improved health outcomes, and reduce burden if payers are aligned with value-based care.

“The Trump Administration has long worked to accelerate the overdue move to value-based care, but for too long these efforts have been piecemeal,” said CMS Administrator Seema Verma.  “Our health care providers need Medicare, Medicaid and private insurance payers to work in tandem with one another, and I am calling on our state partners to use this guidance to develop a plan to improve quality for their Medicaid beneficiaries by advancing value-based care in their own programs.”

With Medicaid costs rising and continuing to consume a greater share of state budgets, and with federal costs forecasted to continue to grow according to the CMS Office of the Actuary[1], CMS has a duty to ensure the program remains sustainable.  Moving toward more value-driven reimbursement models is a critical part of this effort, as fee-for-service payment incentivizes higher volume and greater spending, rather than accountability for costs and outcomes.   This guidance is designed to support states as they develop plans to increase Medicaid provider participation in and adoption of value-based care models.

In taking this new direction, CMS is building on its experiences and lessons learned from states and other payers.  Since 2010, CMS has engaged in cooperative partnerships with states and providers to test payment and service delivery models that aim to achieve better care for patients, smarter spending, and healthier communities.  The CMS Innovation Center is testing a growing portfolio of various payment and service delivery models.  All of these models have enabled CMS to better understand the opportunities and challenges that states should consider as they move toward a more value-driven system.  Building on the lessons learned from these models, this guidance discusses those considerations, including multi-payer participation, delivery system readiness, stakeholder engagement, and the scope of financial risk to providers.  In addition, this letter describes pathways, including flexibility available under the state plan, towards the adoption of value-based care models in Medicaid.  States are invited to choose the pathway that best meets their reform goals, and do not need to rely only on time-consuming, complex demonstrations or waivers to achieve better value in their programs, where their proposals can be implemented under a state plan or managed authority.  The guidance discusses how states can build payment models that promote value-based care under both fee-for-service and managed care.

The guidance encourages states to consider the adoption of models in the context of their individual circumstances and the lessons learned from implementing previous payment and service delivery models.  Examples of payment models include advanced payment methodologies under fee-for-service, bundled payments, and total cost of care models.  Each of these models, and others described in today’s letter to state Medicaid Directors, reflect the Administration’s priorities for a value-driven health care system, such as by:

  • Improving quality of care for beneficiaries;
  • Rewarding providers for reducing the effects and incidence of chronic disease and for helping patients improve their health;
  • Improving value in the larger healthcare system by aligning provider incentives across multiple payers; and
  • Helping the United States and its healthcare system handle unexpected challenges and disruption, including those experienced from the ongoing COVID-19 pandemic.

Many states have made progress in moving toward value-based payments in healthcare, yet there are still growth opportunities for more states to improve health outcomes and efficiency across payers including Medicare, Medicaid, and private insurance, by ensuring healthcare systems are financially incentivized to deliver the best quality, best value care.  Aligning value-based care programs across payers could reduce the burden on providers who participate with multiple payers and improve the healthcare experience for patients.

To view the Value-Based Care Opportunities in Medicaid SMDL, please visit: https://protect2.fireeye.com/url?k=9c9690c2-c0c399d1-9c96a1fd-0cc47adb5650-e4057606ced02c16&u=https://www.medicaid.gov/Federal-Policy-Guidance/Downloads/smd20004.pdf

Trump Administration Backing Off Medicaid Rule that States Warned Would Lead to Cuts

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The Trump administration will not move forward with a proposed Medicaid rule that states, hospitals, insurers, patient advocates and members of both political parties warned could lead to massive cuts to the federal health care program for the poor.

“The proposed Medicaid Fiscal Accountability Rule (MFAR) was designed to increase transparency in Medicaid financing and ensure that taxpayer resources support the health care needs of our beneficiaries,” Centers for Medicare & Medicaid Services Administrator Seema Verma said in a statement Monday.

“We’ve listened closely to concerns that have been raised by our state and provider partners about potential unintended consequences of the proposed rule, which require further study,” she added.

Verma said the rule is being withdrawn from the agency’s regulatory agenda, but it’s not clear if it will be added to future agendas.

The rule was intended to overhaul the complex payment arrangements states use to raise money for their Medicaid programs — funding that is then matched by the federal government.

The administration argues some states use questionable methods of raising funds so they can leverage more money from Washington. One approach used by states consists of taxing providers that stand to benefit from more Medicaid funds flowing into the state.

But governors and state Medicaid directors argue those long-standing arrangements are both legal and necessary as states look for ways to keep up with escalating health care costs.

Dozens of states wrote public comments to Verma, urging her to withdraw the proposal, including conservative states that are typically supportive of her work.

If finalized, the rule “would have forced states to face larger Medicaid shortfalls and to make bigger cuts harming beneficiaries and providers,” tweeted Edwin Park, a research professor at Georgetown University.

September 2020 CMS National Training Program Update

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Find the care you need — Check Out Care Compare!

CMS launched Care Compare on Medicare.gov to make it easier to find and understand information about doctors, hospitals, nursing homes, and other health care services. Now you can compare location, quality, and price information for health care providers. New features let you filter on the items that are most important to you, so you can personalize your results. It’s now easier than ever to review and compare health care providers, even on your tablet or smartphone. For more information, watch the eMedicare: Improving Compare Tools webinar recording, Medicare Care Compare video or see the latest press release.

New / Updated Training Materials

Spanish 2020:Coordination of Benefits

Spanish 2020: Medicare Prescription Drug Coverage

To check all of our materials, go to CMSnationaltrainingprogram.cms.gov.

New / Updated CMS Products

Medicare Coverage of Durable Medical Equipment and Other Devices

Coordination of Benefits: Getting Started

NTP Virtual Workshops Recordings

Visit CMSnationaltrainingprogram.cms.gov/ntp-courses to access the following workshop recordings:

Medicare Basics, Enrollment, & Eligibility Webinar (Recorded 7/28/20)

Medicare Part A and Part B Webinar (Recorded 7/29/20)

Medicare Supplement Insurance (Medigap) Webinar (Recorded 7/30/20)

Medicare Prescription Drug Coverage (Part D) Webinar (Recorded 8/4/20)

Medicare Advantage Webinar (Recorded 8/5/20)

Medicare Appeals and How Medicare Works with Other Insurance (Recorded 8/6/20)

Programs for People with Limited Income and Resources (Recorded 8/11/20)

Medicare Plan Finder (Recorded 8/12/20)

Medicare Current Topics (Recorded 8/13/20)

CMS’ Actions in Response to COVID-19 (Recorded 8/19/20)

Preventing Fraud, Waste, and Abuse in Medicare and Medicaid (Recorded 8/18/20)

CMS’ Actions to Address the Opioids Crisis (Recorded 8/20/20)

Social Security Benefits (Recorded 8/25/20)

Medicare Plan Finder Demonstration and Tips – Repeat Session (Recorded 8/26/20)

Where Do I Find Online Resources…? (Recorded 8/27/20)

Did You Know?

  • A pneumonia vaccine can help prevent pneumonia, but only 67% of adults 65 and over have ever gotten it. Medicare Part B covers the pneumonia vaccine, which is given as 2 pneumococcal shots.
  • September is Prostate Cancer Awareness Month. Medicare Part B (Medical insurance) covers prostate cancer screening for all men over age 50 (beginning the day after your 50th birthday).
  • You can find the latest news about Medicare by visiting the CMS Newsroom.
  • Save the Date: October 8, 2020 – NTP Getting Ready for Medicare OEP Webinar

Pennsylvania Health Secretary: Technology Can Help Mitigate Spread of COVID-19, Add Your Phone to the Fight

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A Message from Pennsylvania Secretary of Health, Rachel Levine, MD

Technology connects us to resources and plays a powerful role in our lives. And at no time is technology more important than during the COVID-19 pandemic.

Pennsylvanians listen to our press briefings, gather data from our enhanced statewide and early warning monitoring dashboards, and follow us on Facebook and Twitter for the most up-to-date information.

Still, COVID-19 continues to impact our state. Nearly 142,885 Pennsylvanians have been diagnosed with COVID-19 so far, and we are still seeing cases increase each day.

It is upon each of us to help mitigate the spread of COVID-19. Here in Pennsylvania, we are adding another tool in the toolbox residents can use to protect themselves and their loved ones:  COVID Alert PA, an app that uses Bluetooth technology to notify you of a potential COVID-19 exposure.

This app uses Bluetooth technology, the same technology that helps your phone connect with your car to play music or use wireless headphones. This technology does not track or collect any location data or personal data from your phone – only your phone’s proximity to other phones with the app enabled. It is strictly designed to notify you if you may have been in close contact with someone who tested positive for the virus. If you test positive for the virus, and you choose to confirm that information into the app, it will notify those that may have been in close contact with you.

Often, it can be difficult for someone to either name or even know all the close contacts they were exposed to while they were infectious — like a person you spoke to for 15 minutes at the bar or someone you sat next to on the bus. This is where COVID Alert PA becomes extremely useful and augments value to the state’s contact tracing efforts.

When an individual tests positive for COVID-19, a public health professional from the Pennsylvania Department of Health or a county and municipal health department contacts them to begin a case investigation. During the investigation the individual learns about their test results and is asked to recall who they have been in close contact with during their infectious period.

The public health professional also will encourage the COVID-19 positive individual to open the COVID Alert PA and enter a six-digit validation code. After the validation is complete, the app will alert other individuals who were within six feet of the COVID-19 positive individual for at least 15 minutes.

Anyone getting an exposure alert is provided with public health advice and resources to talk to a public health professional about next steps or how to find the nearest testing site.  People with a confirmed exposure are bound to have questions and concerns, and we want to provide the information people need to make informed decisions about their health and the health of the people closest to them.

Remember, all this is done through Bluetooth technology, which means no personal or identifying information will be collected through the app. The person notified will not know the identity of the person to whom they were exposed.

The Wolf Administration has taken additional measures to ensure the safety and well-being of Pennsylvanians. Now that the state is reopened, though mitigation efforts remain in place, there is still an opportunity for COVID-19 to spread, so we need to prepare ourselves by washing hands, wearing masks, practicing social distancing and downloading the COVID Alert PA app. The more people who download the app, the better our chances are of preventing an outbreak and keeping our communities healthy.

When the app is available later this month, please download it through the Google Play or Apple App Store and add your phone to the fight to help stop the spread of COVID-19.

Together, we can help ourselves, our loved ones and our neighbors across the commonwealth stay safe.

COVID-19 in Pennsylvania.: Child Abuse Doctors See Disturbing Trend as the Pandemic Continues

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USA Today

Pennsylvania doctors who treat child abuse say they are seeing a wave of more serious injuries in younger victims.  It’s part of a disturbing trend they first observed in the spring: as the coronavirus continues to spread across the state, so does the number of severe injuries in abused children.

The virus didn’t recede in the summer as anticipated, nor did the abuse.

Penn State Children’s Hospital saw a wave of serious injuries that began in mid-June, according to Dr. Lori Frasier, chief of the hospital’s child abuse pediatrics division.  “We’re seeing a surge of some kind,” she said last month.  The hospital doesn’t provide specific patient numbers, but it is “seeing pretty serious physical abuse injuries,” Frasier said.

The children range in age from “young to very young,” she said, and often end up in critical condition in the intensive care unit.  “What really kills kids is head and abdominal trauma,” Frasier said. “That’s what they die from in those early 1- to 7-day periods.”

Fatal and nearly fatal

At least 155 children died or nearly died this year in Pennsylvania as a result of suspected child abuse or neglect, according to state data from Jan. 1 to July 15.  Those cases were referred to child welfare investigators, according to Ali Fogarty, communications director at the state Department of Human Services.  There were 144 children who died or nearly died in all of 2019 because of substantiated abuse or neglect, according to state data.  But, to clarify, measuring the differences between suspected cases and substantiated cases is not an apples-to-apples comparison.

In the cases last year, most abuse came at the hands of a parent, according to state data. The majority of victims were younger than 4 years old.  Overall, there were more than 5,200 substantiated cases of child abuse in Pennsylvania last year, with more than 40 percent of those cases attributed to sexual abuse. The rate of abuse in rural counties was more than double the rate in urban counties.  During the past five years, the number of fatalities and near fatalities in children has steadily increased from 95 in 2015 to 144 in 2019.

Waves of trauma

Penn State Children’s Hospital has seen waves of child abuse trauma in the past, even before a public health crisis changed American life.   But families are facing added pressure as the virus has a systemic effect in Pennsylvania, and that’s leading to more abuse, Frasier said.  Unemployment or having one parent at home to take care of the kids is a big source of stress, she said.  “They don’t feel like the pandemic has passed,” Frasier said.

There were 835 additional positive cases of Covid-19 and 20 deaths reported in Pennsylvania on Friday, bringing the statewide total to nearly 132,000. More than 7,600 state residents have died.  The state can track the number of positive cases and deaths, but the overall effect the virus is having on vulnerable children is unclear.   I don’t think we’ll have the full picture for a year,” Frasier said. “We’re right in the middle of it.”

‘A lot of stress’

St. Christopher’s Hospital for Children in Philadelphia saw an increase in severe injuries in the spring.  In July, Dr. Norrell Atkinson, section chief of the child protection program at the Level 1 trauma and burn center, started seeing an increase of toxic ingestions in young children.   “They come in with illegal substances in their system — opiates, marijuana, amphetamines,” she said.   Close to a third of the hospital’s cases are ingestions, and the patients are generally younger than 5 years old, Atkinson said.   “I’ve been at this hospital for two years,” she said, “and I haven’t seen a cluster like this.”

In most cases, the child lives in a home where the drugs are present and they are left unsupervised long enough to ingest the substances.  During June and July, the hospital saw cases often in which there were “supervision issues, and (parents and guardians) were more stressed and medicating differently,” Atkinson said.  The hospital doesn’t disclose the number child trauma cases treated, but all of the ingestion patients have survived, she said.  “We’re busier this year, and that could be due to a variety of factors, including the pandemic,” Atkinson said. “We’re not seeing decreased rates of abuse or neglect. We see a lot of stress.

Hidden dangers

The trend in Pennsylvania is in line with what’s occurring nationwide.  Doctors across the country are seeing more severe injuries in children in a week than they’re used to seeing in a month, according to medical providers at the American College of Emergency Physicians.  “The current pandemic is changing all of our lives in ways we can see, but the unseen may be even more vital than the seen,” said Dr. Jacque Johnsen, vice chair of the American College of Emergency Physicians. “Knowing additional risks to the most vulnerable patient populations at this time may save even more lives.”

The U.S. Centers for Disease Control and Prevention cited safety issues among its reasons that students should return to school in the fall.  “Extended school closures deprive children who live in unsafe homes and neighborhoods of an important layer of protection from neglect as well as physical, sexual, and emotional maltreatment and abuse,” the CDC reported.  Teachers and educational staff report suspected child abuse more than any other type of mandated reporter, according to state and federal data.

When students weren’t in classrooms in the spring, child abuse reports decreased. But severe child injuries increased, according to emergency room doctors.  The CDC cited an example of that in Washington, D.C.: The Washington, D.C. Child and Family Services Agency recorded a 62 percent decrease in child abuse reporting calls between mid-March and April this year compared to the same time period in 2019, but saw more severe presentation of child abuse cases in emergency rooms.

In Pennsylvania, Frasier said she’s “hoping against hope” the trend changes soon.  “I hope families reach out to resources and know they’re not alone,” she said. “I don’t want families to feel so isolated and stressed.”  And she doesn’t want to see another child with an injury that can’t be healed.

Candy Woodall is a reporter for the USA Today Network. She can be reached at 717-480-1783 or on Twitter at @candynotcandace.

Pennsylvania’s Statewide Kinship Navigator Program, KinConnector, Launches New Website

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Kinship care is the full-time care, nurturing and protection of children by relatives or any adult who has a “kinship” bond with the children. These caregivers may include grandparents, aunts or uncles, siblings of the children requiring care, cousins or non-blood “relatives,” such as a teacher, coach or family friend.

Kinship care has been on the rise in Pennsylvania and the Pennsylvania Courts have produced this new video to help potential kinship providers learn about and understand kinship foster care, navigate the dependency court system and take the necessary steps to become a kinship parent.

Access the newly designed website here.