SUMMER 2009 issue
Pennsylvania State Task Force on Occupational Regulations (PASTF)
Valerie F. Uschock, LCAT, MT-BC, NMT
The following information is current as of July 1, 2009
PEP TALK FROM THE CHAIR!!
As this report is written, Pennsylvania awaits the New Budget for the upcoming fiscal year. News of cutbacks may get us down and make us feel that there is nothing we can do. Many of think THEY will never understand music therapy, so why bother? I beg to differ!! Try to shift your perspective…instead of getting frustrated and defensive when yet another person does not seem to understand “musical therapy”, see this as another opportunity to educate. Do we give up on our clients? No, of course not! So, how do we do this advocacy thing? I am not an expert by any means, but as I have taken on this role to lead the advocacy effort in PA, I am learning and becoming more confident each day. I feel that we advocate through the many hats of knowledge and experience that we wear (i.e. clinical, research, education, artistic).
Advocacy happens on many levels. To me, advocacy is sharing my passion for my profession… sharing clinical experiences and tidbits of research with people on a one to one basis… speaking to a target audience who has a vested interest in advocating for music therapy… developing and maintaining relationships with key decision makers in healthcare, public policy, and government. It can be a small movement or it can be a large movement, but perhaps our creativity and our ability to adapt to the present situation in order to facilitate positive change is our greatest strength!! We do it all the time with our clients, so why not use our creativity and adaptability when it comes to legislation and advocacy?
We have to remember that we are the experts in our field. We should never assume that the people making the decisions know what we are all about. It is up to us to educate, educate, educate. The responsibility is ours. On behalf of the task force, I would like to thank all of the music therapists out there who are advocating on a daily basis. I especially appreciate those who have shared their successes and their challenges with us through phone calls and emails. You may not realize that you are advocating. Please do not think you have nothing to offer. You may just have the piece of information we are looking for. Now is the time to join the larger effort as there is still much work to be done!!!
1. Service Definitions for Person/Family Based Waiver: As you all know, PASTF has been following this issue over the past couple of years. A recent Call To Action was sent to music therapists across PA who work with Developmental Disabilities/Autism. We asked music therapists, parents, and other professionals to send letters to Kevin Casey, Deputy Secretary of the Office of Developmental Programs (ODP), Estelle Richman, Secretary of the Department of Public Welfare (DPW), as well as District Legislators. The final service definitions have been implemented as of July 1, 2009. According to the May 28th meeting minutes of the Medical Assistance Advisory Council, Centers for Medicare and Medicaid Services (CMS) has been concerned with the way the two mental retardation programs have been managed in Pennsylvania, including the consistency of management of the program across the state. The first change, which we have been following, includes the ODP revising the service definitions related to the programs that are available to people served through the waiver. Federal Financial Participation can be requested for this. There are some limitations under federal regulations about the services that can be provided. The second change is the method of payment to providers of services. The state provides the money to the counties and the counties distribute the money to the providers at the county level. Effective July 1, providers will be billing the state directly for services they provide. Their payment will come through Treasury and ODP thinks this will provide for a significantly more consistent payment structure. As we move forward, PASTF will be looking at the finalized service definitions as well as the new payment system. Valerie Uschock briefly met with State Senator Kim Ward (39th District) in June to apprise her of this issue. We are awaiting to hear about our options in moving forward with our advocacy efforts.
2. Autism Insurance Act 62 (HB 1150): Act 62 officially takes effect as of July 1, 2009. It mandates that large group insurers cover the diagnosis and treatment of autism and autism spectrum disorders for persons under the age of 21. More information can be found at www.PAAutismInsurance.org . Services must be provided by an “autism service provider” who participates in the child’s insurance plan in order to be covered. Medical Assistance will not cover autism services for children who have commercial insurance coverage under Act 62 before the $36,000 cap is reached if the family chooses to use a provider that does not participate in the child’s commercial insurance plan. However, a provider that participates in both the child’s commercial insurance plan and Medical Assistance may still be able to bill Medical Assistance if services are first denied by the child’s commercial insurance plan.
Based on the information thus far, it seems that in order to work under Act 62:
1. The music therapist needs be recognized as an “Autism Service Provider”
2. Even if the music therapist is currently an Medical Assistance Provider, they would have to become an eligible provider with specific commercial insurances.
LPC UPDATE
1. Renewal Process: Many of you went through the renewal process earlier this year. We hope that you found the continuing education fact sheet helpful with this process. As a reminder, it will remain on the MAR website for your reference. (www.mar-amta.org). The fact sheet can be found both on the home page announcements section and on the Pennsylvania section. I want to thank those of you who contacted PASTF with questions and comments. The questions really helped us to find the most accurate information.
2. LPC Supervison: Recently, there have been some questions surfacing regarding a change in guidelines for supervision in regards to “additional coursework” that certifies one as a supervisor. Upon looking at the regulations, nothing was found that specifically addresses this concern. For those that are hearing about supposed changes, please contact us and include written source(s) if at all possible. PASTF will actively monitor these concerns and we will update LPCs on any changes.
As always, all questions, concerns, news on PA health legislation, etc. should be sent to the Task Force at: pastate.task.force@gmail.com.
Best to all of you!