OCTOBER 2019 2019.pdf · 2020-01-07 · Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19 Aug-19 Sep-19 Oct-19 # 20 Hrs/Wk 4,720 4,607 4,444 4,005 3,773 3,648

MONTHLY DATA REPORT OCTOBER 2019

1

TABLE OF CONTENTS CTRL+Click on one of the major headings below will link you to that section.

MEDICAL ASSISTANCE AND OTHER HEALTH CARE SERVICES .......................................................... 2

MA Eligible Persons .................................................................................................................................................... 2

MA Children and CHIP ............................................................................................................................................... 3

State Hospital Admissions/Census .............................................................................................................................. 4

BENEFIT ASSISTANCE PROGRAMS FOR CHILDREN AND FAMILIES .................................................. 5

TANF Individuals ................................................................................................................................................................ 5

Number and Percent: Non-disabled TANF Adults Working ................................................................................ 6

Number and Percent: Non-disabled TANF Adults Working/Training 20 or More Hours/Week ......................... 6

TANF Workforce Participation Rates ................................................................................................................... 7

TANF Budgets Leaving for Employment………………………………………………………………………...8

Individuals on TANF by Length of Time ............................................................................................................. 9

SNAP Eligible Persons ......................................................................................................................................... 10

Non-disabled SNAP Adults Working ................................................................................................................... 11

SSI Adults and Children ........................................................................................................................................ 12

Child Support Measures ........................................................................................................................................ 12

CHILD WELFARE SERVICES........................................................................................................................ 13

Monthly YDC Admissions .................................................................................................................................... 13

Children in Out-of-Home Care - More or Less than 12 Months ........................................................................... 13

Children Entering/Re-entering Out-of-Home Care .......................................................................................... 13-14

Adoption/ Discharges to Guardianship ................................................................................................................. 14

Settings of Children in Care .................................................................................................................................. 15

Months from Removal from Home to Permanency .............................................................................................. 16

Child Abuse - Cases and Rates ............................................................................................................................. 16

CHILD CARE AND EARLY LEARNING SERVICES .................................................................................. 17

Child Care Subsidies-Enrollment-Waiting List………………………………………………………………….17

Regulated Child Care Usage……………………………………………………………………………………..17

Subsidized Child Care: Regulated vs. Unregulated Settings…………………………………………………….18

Children in STARS 3 or 4………………………………………………………………………………………..19

ITF Waiver and EI: Enrollment ………………………………………………………………………………….19

LONG TERM SUPPORTS FOR PERSONS WITH DISABILITIES AND OLDER PENNSYLVANIANS 19

Waiver Enrollments (OLTL):

Attendant Care (Waiver and Act 150) ............................................................................................................ 19

Aging and Independence ................................................................................................................................ 20

COMMCARE and OBRA .............................................................................................................................. 21

LIFE ................................................................................................................................................................ 21

Community Health Choices ............................................................................................................................ 22

Wavier Enrollments (ODP):

Consolidated and Adult Autism ...................................................................................................................... 23

P/FDS and Community Living ....................................................................................................................... 24

Intermediate Care Facilities: Enrollments ............................................................................................................. 25

Nursing Home Population ..................................................................................................................................... 25

OTHER METRICS ............................................................................................................................................ 26

2

MEDICAL ASSISTANCE AND OTHER HEALTH CARE SERVICES

Data Source: DHS ListServ

NOTE: MA numbers now reflect data pulled on the second Tuesday of the month after the reported month. Previous months are not updated to show

retroactive eligibility.

0

250,000

500,000

750,000

1,000,000

1,250,000

1,500,000

1,750,000

2,000,000

2,250,000

2,500,000

2,750,000

3,000,000

Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19 Aug-19 Sep-19 Oct-19

MA Persons 2,871,518 2,863,920 2,854,435 2,872,114 2,864,885 2,864,707 2,874,375 2,865,172 2,854,427 2,860,494 2,852,801 2,839,166 2,834,779

MA Eligible Persons1% Decrease in MA Enrollment From October 2018 to October 2019

3

Data Source: DHS Data Enterprise Warehouse

Note: Children are those recipients under the age of 21. (EC (eligible child) is no longer used for determining MA children).

Data Source: DHS Data Enterprise Warehouse

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

1,400,000


MA Children 1,220,151 1,216,244 1,210,910 1,217,259 1,214,901 1,214,648 1,218,005 1,214,153 1,210,228 1,212,682 1,210,658 1,206,111 1,204,542

MA Children Preliminary Estimates("children" can include persons up to 21 years old)

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000

180,000

200,000


CHIP 178,523 179,981 180,260 179,241 180,902 180,970 181,385 182,971 183,564 183,431 184,333 184,812 183,072

Children's Health Insurance Program (CHIP) Enrollment3% Increase in CHIP Enrollment From October 2018 to October 2019

4

Data Source: Patient Census Information System

Civil: Unduplicated count of civil admissions of patients during the reporting month to: Clarks Summit State Hospital, Danville State Hospital, Norristown State Hospital, Torrance State Hospital, Warren State Hospital and Wernersville State Hospital. Forensic: Unduplicated count of forensic admissions of patients during the reporting month to: Norristown State Hospital and Torrance State Hospital forensic units. Long Term Care: Unduplicated count of admissions of patients during the reporting period to: South Mountain Restoration Center.

Data Source: Patient Census Information System

*February and September 2018 data does not include Norristown State Hospital.

0102030405060708090

Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19

Civil 35 31 25 35 24 30 28 27 23 35 32 33 42

Forensic 40 36 39 46 30 45 42 55 77 66 61 55 57

Long Term Care 1 2 2 2 1 1 2 1 2 4 0 3 2

State Hospital Admissions 33% Increase in State Hospital Admissions from

July 2018 to July 2019

0

200

400

600

800

1000

1200

1400

1600

Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19

Act 21 59 60 60 59 59 59 59 59 58 58 59 60 60

Long Term Care 139 137 137 137 135 136 135 137 135 137 135 137 136

Forensic 281 276 281 282 280 280 288 298 322 336 340 340 340

Civil 989 984 967 970 968 974 961 958 960 958 966 964 960

State Hospitals Census2% Increase in State Hospital Census from July 2018 - July 2019

5

BENEFIT ASSISTANCE PROGRAMS FOR CHILDREN AND FAMILIES

Data Source: DHS ListServ/EDW

NOTE: TANF numbers now reflect data pulled on the second Tuesday of the month after the reported month.

Starting in July 2014, TANF data is calculated using a new methodology that eliminates duplication of persons moving from county to county in a reported

month.

Data Source: AIS32W Report

*Data has been updated to count only those with open cases

0

25,000

50,000

75,000

100,000

125,000

150,000

175,000

200,000

225,000


TANF 121,778 119,754 117,138 115,545 110,764 107,507 107,516 107,527 108,333 109,403 108,442 107,907 106,128

TANF Individuals - 13% Decrease in TANF Enrollment from October 2018 to October 2019

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000


# TANF Working 8,009 7,897 7,468 7,162 6,764 6,237 6,712 6,989 6,404 6,673 6,420 6,702 6,923

% TANF Working 41% 41% 40% 39% 39% 36% 39% 40% 37% 39% 37% 39% 41%

Number and Percent of Non-Disabled TANF Adults Working or in a Training or Work-Related Activity

6

Data Source: AIS32W Report

Data Source: TNF22 Report

0%

5%

10%

15%

20%

25%

30%

0

2,000

4,000

6,000

8,000

10,000


# 20 Hrs/Wk 4,720 4,607 4,444 4,005 3,773 3,648 3,704 3,812 3,581 3,601 3,679 3,707 3,812

% 20Hrs/Wk 24% 24% 24% 22% 22% 21% 21% 22% 21% 21% 21% 22% 23%

Number of Non-disabled TANF Adults Working or in a Training Activity or Work-related Activity 20 Hours or More per Week -

19% Decrease in Total Enrollment from October 2018 to October 2019

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19 Aug-19 Sep-19

TANF WPR 22.9% 23.2% 23.6% 23.2% 21.5% 20.5% 20.8% 20.4% 19.8% 19.9% 19.6% 20.1% 20.3%

Pennsylvania Estimated TANF Workforce Participation Rate

7

Data Source: ARM 240 Report

A budget is one or more related or unrelated individuals who occupy a common residence or would occupy a common residence if they were not

homeless, and whose needs are considered together in determining eligibility for assistance are considered together in determining eligibility for

assistance under one category of assistance.

Data Source: ARM 240 Report

-

250

500

750

1,000

1,250

1,500

1,750

2,000

2,250

2,500

2,750

3,000

Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19 Aug-19

TANF Employment 2,370 2,452 2,754 2,387 2,110 1,929 1,979 1,801 2,217 2,089 2,128 2,273 2,166

TANF Individuals that Obtain Employment9% Decrease from August 2018 to August 2019

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

22%

24%

26%


TANF Employment 22% 24% 23% 23% 20% 19% 19% 19% 20% 20% 18% 18% 20%

TANF Budgets Leaving for Employment as Percent of All Budgets that Left TANF

8

Data Source: AIS32W File

Note: Total time on TANF is cumulative, not subsequent (i.e., as a person moves on and off TANF, each time they are on will add to

their total), and also includes time spent on TANF as a child.

< 1Year

1 to 2Years

2 to 3Years

3 to 4Years

4 to 5Years

5 to 6Years

6 to 7Year

7 to 8Years

8 to 9Years

9 to10

Years

10 to11

Years

11 to12

Years

12 to13

Years

13 to14

Years

14 ormoreYears

Sep-18 9,464 3,945 2,954 2,367 1,962 1,617 1,430 1,051 760 677 499 364 356 235 696

Sep-19 8,049 3,322 2,512 1,976 1,663 1,315 1,086 986 736 584 472 350 270 232 668

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

10,000

Adults on TANF by Length of Time

9

Data Source: DHS ListServ/EDW

NOTE: SNAP numbers now reflect data pulled on the second Tuesday of the month after the reported month.

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

1,400,000

1,600,000

1,800,000

2,000,000


SNAP 1,808,1181,799,3251,783,2491,789,0101,756,3281,756,7441,764,0431,757,1141,754,7221,763,2591,763,9361,755,6921,752,648

SNAP Eligible Persons3% Decrease in SNAP Enrollment from October 2018 to Ocotber 2019

10

*Beginning in Jan 2018, SNAP Adults working includes non-elderly only. Data Source: DHS Enterprise Data Warehouse

*Full-time status according to CIS Employment Status Code Data Source: DHS Enterprise Data Warehouse

0%

10%

20%

30%

40%

50%

60%

0

50,000

100,000

150,000

200,000

250,000

300,000


# SNAP Working 271,926 273,897 270,612 267,527 266,282 258,297 261,822 262,902 262,384 261,787 263,090 265,811 264,131

% SNAP Working 48% 49% 49% 49% 48% 48% 48% 49% 49% 49% 49% 49% 49%

Number and Percent of Non-disabled SNAP Adults Working(Excludes Those Receiving TANF)*

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%


% SNAPWorking

19.6% 19.9% 19.8% 19.7% 19.7% 19.5% 19.6% 19.7% 19.8% 19.9% 19.9% 20.0% 20.0%

Percent of Non-disabled SNAP Adults with Full-time Employment*

11

Data Source: DHS Enterprise Data Warehouse

Data Source: DHS Enterprise Data Warehouse

Child Support Measures

Child Support Federal

Target

Pennsylvania Rate

Sept

2018

Oct

2018*

Nov

2018

Dec

2018

Jan

2019

Feb

2019

Mar

2019

Apr

2019

May

2019

Jun

2019

July

2019

Aug

2019

Sept

2019

Child Support - Cases

with Paternity

Establishments**

80%

108%

94%* 95%

96% 98% 99%

100%

101%

102%

104%

105%

107%

108%

Child Support - Current

Supports Collected 80% 84% 85%* 85% 85% 84% 84% 84% 84% 84% 84% 84% 84% 84%

Child Support - Percent

of Cases Paying

Arrears

80%

84%

52%* 62%

67% 71% 73%

78%

80%

82%

83%

83%

84%

85%

Cases with Orders 80% 91% 90%* 91% 91% 91% 91% 91% 91% 91% 90% 90% 90% 90%

Cost Effectiveness

(FFY) $5.00 FFY 2014-15: $5.48

FFY 2015-16:

$5.10

FFY 2016-17:

$5.43

FFY 2017-18:

$5.02

FFY 2018-19:

$4.78

*Drop from September to October due to starting of new Federal Fiscal Year (compare with previous year) Data Source: OCSE Reports

0

50,000

100,000

150,000

200,000

250,000

300,000

350,000


SSI Adults 291,378 291,445 291,005 290,715 291,852 290,984 290,616 291,179 290,198 290,091 290,832 289,696 289,545

SSI Adults -- 0.6% Decrease in Total Adult SSI Enrollment from September 2018 to September 2019

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000


SSI Children 74,524 74,442 73,785 73,805 73,870 73,661 73,429 73,556 73,017 73,059 72,938 72,533 72,193

SSI Children -- 3% Decrease in Total Child SSI Enrollment from September 2018 to September 2019

12

CHILD WELFARE SERVICES

Category: YDC/YFC’s Current Average

Monthly Admissions 41 (October 2019) Rolling Year Average

44 (Nov 2018 – Oct 2019)

Level of Improvement in Life Skills from Intake to

Discharge for all YDC/YFC participants completing

program

8% (October 2019) Rolling Year Average

8% (Nov 2018 – Oct 2019)

Data Source: Automatic Intake and Incident Reporting System (admissions); Ansell-Casey Life Skills Assessment (life skills)

Data Source: AFCARS Data Source: AFCARS

47

%

47

%

46

%

46

%

45

%

46

%

46

%

46

%

45

%

44

%

42

%

43

%

43

%

Children in Out-of-Home Care 12 Months or Less

53

%

53

%

54

%

55

%

54

%

54

%

54

%

54

%

55

%

56

%

57

%

57

%

57

%

Children in Out-of-Home Care More Than 12 Months

73

%

79

%

77

%

78

%

79

%

81

%

80

%

78

%

77

%

77

%

78

%

78

%

78

%

Children Entering Out-of-Home Care (First Time Entry)

13



10

%

8% 8% 8%

7% 8% 8% 8% 9%

8%

8%

8%

8%

0%

5%

10%

15%

20%

25%

Children Re-entering Out-of-Home Care: >12 Months Since Discharge

17

%

14

%

15

%

14

%

15

%

11

%

12

% 14

%

14

%

15

%

15

%

14

%

14

%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

Children Re-entering Out-of-Home Care: <12 Months Since Discharge

67

%

62

%

65

%

58

%

62

%

62

%

64

% 69

%

64

%

58

%

58

%

56

%

54

%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Discharges to Guardianship in 24 Months or Less

34

%

34

%

29

%

33

%

33

%

33

%

32

%

34

%

30

%

29

%

28

%

25

% 30

%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Adoption: 24 Months or Less

14

Data Source: AFCARS

Jan -Mar2016

Apr -Jun

2016

Jul -Sept2016

Oct-Dec

2016

Jan -Mar2017

Apr -Jun

2017

Jul-Sept2017

Oct-Dec

2017

Jan-Mar2018

Apr-June2018

Jul-Sep

2018

Oct-Dec

2018

Jan-Mar2019

Supervised IL 248 215 222 223 230 216 252 249 249 235 264 259 276

Runaway Status 182 149 127 159 148 166 134 166 166 168 165 162 179

Residential 3,104 2,807 2,540 2,481 2,628 2,588 2,487 2,370 2,453 2,454 2,341 2,302 2,341

Trial Home Visit 132 165 111 80 66 83 84 99 83 84 66 65 65

Pre-adoptive Home 495 561 842 779 805 713 689 679 679 605 643 567 536

Foster Family - Non-Relative 6,934 6,951 6,573 6,490 6,685 6,687 6,857 6,745 6,662 6,909 6,858 6,728 6,795

Foster Family - Relative 5,432 5,679 5,478 5,694 5,847 6,122 6,286 6,248 6,281 6,355 6,165 6,112 6,080

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Child Welfare: Settings of Children in Care

"Supervised Independent Living" = those in an alternative transitional living arrangement where the child is under the supervision of the agency but without 24 hour adult supervision, is receiving financial support from the child welfare agency, and is in a setting which provides the opportunity for increased responsibility for self care."Runaway" = those who have run away from the foster care setting.“Residential Setting” =those placed in a group home or institution"Home Setting” = those placed in pre-adoptive homes, Family Foster Home-relative, Family Foster Home-non-relative and trial home visits.

15

Data Source: AFCARS

Data Source: Childline Data Source: Childline

* Increase due to new statutes requiring County Child Welfare agencies to complete an investigation and submit outcomes within 60

days.

Data for January-March quarter is incomplete due to data conversion to new system

Jan-Mar2016

Apr-Jun2016

Jul-Sept2016

Oct-Dec2016

Jan-Mar2017

Apr-Jun2017

Jul -Sept2017

Oct-Dec2017

Jan-Mar2018

Apr-Jun2018

Jul-Sept2018

Oct-Dec2018

Jan-Mar2019

Reunification 8 9 10 10 10 9 10 9 9 9 10 9 11

Kinship Care 9 10 7 6 7 6 7 5 6 6 7 6 7

Adoption 31 31 32 32 32 31 32 31 32 33 32 33 34

Guardianship 22 24 22 22 24 23 23 22 22 25 27 25 26

0

5

10

15

20

25

30

35

40

Average Number of Months from Latest Removal from Home to Permanency Category

78

4 90

4

87

7

86

0

80

4

82

2

87

2

78

3

81

5

1,1

55

1,1

11

1,1

43

0

100

200

300

400

500

600

700

800

900

1,000

1,100

1,200

1,300

Substantiated Reports of Child Abuse/ Neglect in PA

3.2

3.1

3.0

2.9 3.0 3.2

2.9 3.0

4.3

4.1 4.2

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

Rate per 10,000 Children of Substantiated Reports of Child Abuse/Neglect in PA

*

*

16

CHILD CARE AND EARLY LEARNING SERVICES

Child Care

Subsidies

Number of Children

Receiving* (September 2019)

Encumbrance

(September 2019)

# on Waiting List

(September 2019)

TANF 10,857 99% 0

Former TANF 34,310 103% 0

Low Income 71,188 102% 6,354 Data Sources: PELICAN CCW and PELICAN Child Care DW

*Preliminary Number – final number will be determined as additional data becomes available.

Data Source: PELICAN CCW

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

110%


TANF 96% 96% 96% 95% 95% 96% 96% 96% 96% 96% 96% 96% 96%

Former TANF 92% 92% 92% 91% 91% 92% 92% 92% 92% 92% 93% 92% 93%

Low Income 95% 95% 95% 95% 95% 95% 95% 95% 95% 95% 95% 95% 95%

Percent of Regulated Child Care Usage

17


*Preliminary Numbers – final numbers will be determined as additional data becomes available Data Source: PELICAN CCW

NOTE: Beginning July 2012, number of children being served has decreased due to correction of a contractor error where children on the

waiting list were being counted as receiving services.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Unregulated 6% 6% 6% 6% 6% 6% 6% 6% 6% 6% 5% 5% 5%

Regulated 94% 94% 94% 94% 94% 94% 94% 94% 94% 94% 95% 95% 95%

Percent of Children Receiving Subsidized Child Carein Regulated Versus Unregulated Settings

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000


TANF 12,902 12,861 11,967 11,359 10,954 10,074 9,965 10,051 10,284 10,623 10,871 10,740 10,857

Former TANF 34,585 34,179 33,510 33,664 34,212 33,913 34,638 34,647 34,586 34,929 34,680 34,560 34,310

Low Income 65,570 65,239 65,850 67,405 68,600 68,270 70,354 70,282 70,170 73,437 71,198 71,206 71,188

Children Receiving Subsidized Child Care

*

18

Keystone STARS Current Historical

% of Keystone STARS Providers at STAR 3 or STAR 4 26% (September 2019) 26% (August 2019) Data Source: PELICAN KTQ


Infants, Toddlers, and Families Waiver and Early

Intervention (0-3) Current Historical

Early Intervention Enrollment (1-day Count) 27,372 (Sept 2019) 27,116 (Aug 2019)

Early Intervention Enrollment (Unduplicated Total) 20,078 (Aug 2019) 16,305 (Jul 2019)

Waiver (Monthly Average) 3,279 (Sept 2019) 3,416 (Aug 2019)

Children Who Met EI Goals Prior to 3rd Birthday 255 (17%) (Sept 2019) 303 (14%) (Aug 2019) Data Sources: HCSIS DW, EI Ad Hoc Reporting Tool

Early Intervention Enrollment – The total number of children currently receiving services and supports through the EI program. The count of children (birth to three) who have a 25% delay in one or more of the following areas: cognitive development; physical development including vision and hearing; communication development; social or emotional development; or adaptive development. ITF Waiver Enrollment – The total number of children currently receiving services and supports through the Infants, Toddlers, and Families Waiver. The count of children (birth to three) who are eligible for Medical Assistance, have a 50% delay in one area or 33% delay in two areas, and receive services in the home or a community setting. Early Intervention Children Who Met EI Goals Prior to 3rd Birthday – Of children receiving early intervention services between the ages of zero and three, the number who meet their developmental goals by their 3rd birthday.

38

%

38

%

37

%

37

%

37

%

38

%

40

%

40

%

40

%

42

%

42

%

41

%

41

%


Percent of PA Children in STARS 3 or 4 Providers

19

LONG TERM SUPPORTS FOR PERSONS WITH DISABILITIES AND OLDER PENNSYLVANIANS

Source: DHS Enterprise Data Warehouse

*Preliminary Number – will be updated as additional data becomes available

This data is for those in the T Region Fee for Service enrollment (Lehigh, CAP, Northeast, and Northwest) Point-in-time (last day of month) count of unduplicated participants with an Approved Service Plan in DHS’s case management system.

This waiver provides service coordination, personal assistance and personal emergency response system to individuals with physical

disabilities, age 18 through 59, who are mentally alert. This waiver also provides community transition services. Participants must be

Nursing Facility Clinically Eligible (NFCE).



Data is for statewide Fee for Service enrollment only.

Point-in-time (last day of month) count of unduplicated participants with an Approved Service Plan in DHS’s case management system.

The Act 150 provides service coordination, personal assistance and personal emergency response system to individuals with physical

disabilities, age 18 through 59, who are mentally alert. This waiver also provides community transition services. This is a state funded

program. Participants must be NFCE but are not financially eligible for Medicaid.

0

500

1,000

1,500

2,000

2,500

3,000


A.C. 2,416 2,421 2,431 2,434 2,574 2,564 2,563 2,489 2,491 2,491 2,462 2,477 2,497

Attendant Care Waiver Enrollment3% Increase from September 2018 to September 2019

Data shows non-CHC only *

0

500

1,000

1,500

2,000

2,500


Act 150 1,348 1,348 1,339 1,338 1,408 1,402 1,395 1,315 1,306 1,303 1,247 1,244 1,244

Act 150 (Attendant Care) Enrollment8% Decrease in Enrollment from September 2018 to September 2019

*

20



This data is for those in the T Region Fee for Service enrollment (Lehigh, CAP, Northeast, and Northwest) Point-in-time (last day of month) count of unduplicated participants with an Approved Service Plan in DHS’s case management system.

This waiver provides Home and community-based services for individuals 60 years of age or over who are NFCE.



This data is for those in the T Region Fee for Service enrollment (Lehigh, CAP, Northeast, and Northwest)


This waiver provides services to disabled adults age 18 through 60, who are NFCE. The individual’s disability must result in at least

three substantial functional limitations and expected to continue indefinitely.


This waiver provides services to disabled adults age 18 through 60, who are NFCE. The individual’s disability must result in at least

three substantial functional limitations and expected to continue indefinitely.

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000


Aging 10,353 10,469 10,563 10,668 10,740 10,805 10,856 10,997 11,141 11,284 11,399 11,564 11,578

Aging Waiver Enrollment12% Increase from September 2018 to September 2019

Data shows non-CHC only

*

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000


Indep. 5,917 5,985 6,056 6,129 6,229 6,265 6,287 6,398 6,480 6,528 6,424 6,540 6,647

Independence Waiver Enrollment12% Increase from September 2018 to September 2019

Data shows non-CHC only

*

21



Starting in January 2019, individuals in this waiver were moved into the Community Health Choices Waiver in the Southeast. Point-in-time (last day of month) count of unduplicated participants with an Approved Service Plan in DHS’s case management system.

This waiver provides services to recipients who have developmental physical disabilities which results in at least three substantial

functional limitations, age 18 through 59; disability manifested prior to age 22, and the disability is expected to continue indefinitely;

requires ICF/ORC level of care.


*Preliminary Number – will be updated as additional data becomes available.

Unduplicated count of recipients which had claims in the month requested. LIFE is a managed care program and provides a

comprehensive all-inclusive package of services for Pennsylvanians age 55 or older who meet the level of care needs for a Skilled

Nursing Facility or a Special Rehabilitation Facility to enable them to maintain independence in their homes for as long as possible. Be

age 55 or older, meet NFCE or a special rehabilitation facility, reside in an area served by a LIFE provider and be able to be safely

served in the community as determined by a LIFE provider.

0

200

400

600

800

1,000

1,200

1,400


OBRA 1,173 1,188 1,203 1,137 819 821 822 831 852 854 846 889 903

OBRA Waiver Enrollment23% Decrease from September 2018 to September 2019

*

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000


LIFE 6,527 6,600 6,638 6,653 6,715 6,911 6,911 6,830 6,818 6,761 6,913 6,975 7,018

Living Independence for the Elderly Enrollment 8% Increase in Enrollment from Sept 2018 to Sept 2019

*

22


CHC includes individuals who are 21 years of age or older and dually eligible for Medicare and Medicaid, and Individuals who

are 21 years of age or older and eligible for Medicaid (LTSS) because they need the level of care provided by a nursing facility.


CHC includes individuals who are 21 years of age or older and dually eligible for Medicare and Medicaid, and Individuals who

are 21 years of age or older and eligible for Medicaid (LTSS) because they need the level of care provided by a nursing facility.

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000


CHC SW 80,876 81,123 81,071 81,483 81,002 80,683 80,741 80,577 80,752 80,737 80,829 80,897 81,029

Community Health Choices Southwest Enrollment0.2% Increase from September 2018 to September 2019

*

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19 Aug-19 Sep-19

CHC SE 132,638 132,643 133,278 133,375 133,635 134,171 134,692 134,686 135,070

Community Health Choices Southeast Enrollment

*

23


Provides home and community services, including supports coordination and environmental accessibility adaptations, for individuals

with intellectual disabilities who require an intermediate care facility level of care.


Provides home and community services to persons, age 21 and over, with autism spectrum disorder to help them participate in their

communities.

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000


ConsolidatedWaiver

17,757 17,801 17,807 17,807 17,813 17,827 17,841 17,863 17,892 17,906 17,892 17,901 17,913

Consolidated Waiver1% Increase in Enrollment from September 2018 to September 2019

0

100

200

300

400

500

600

700

800


A.A. 711 713 715 714 714 714 711 711 711 710 711 709 709

Adult Autism Waiver0.3% Decrease in Enrollment from September 2018 to September 2019

24


Provides a limited array of services and supports, such as therapy and nursing and personal support, to individuals with intellectual

disabilities who require an intermediate care facility level of care. Aimed primarily at those residing in their homes or with family

members.


The Community Living Waiver is a new wavier that became effective in January 2018. It will support individuals to live more

independently in their homes and communities through the provision of a variety of services that promote community living,

employment, communication, self-direction, choice and control.

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000


P/FDS 12,468 12,353 12,370 12,389 12,424 12,472 12,517 12,578 12,475 12,284 12,377 12,403 12,373

Person/Family Directed Support Waiver1% Decrease in Enrollment from September 2018 to September 2019

0

500

1,000

1,500

2,000

2,500

3,000


CommunityLiving

1,636 1,824 1,910 1,975 1,990 2,001 2,011 2,023 2,196 2,683 2,722 2,771 2,837

Community Living Waiver73% Increase in Enrollment from September 2018 to September 2019

25

Source: DHS Enterprise Data Warehouse and Mapper/FACT system

Source: EDW PROMISe Claims

*Based upon paid claims data with a first date of service within the reporting period (i.e. numbers show persons actually receiving

services during that month). Lower numbers are due, in part, to a time lag for paid claims; providers have up to six months to bill.

Numbers may, therefore, be understated for a period of six months.

Starting in January 2019, individuals in this waiver were moved into the Community Health Choices Waiver in the Southeast.

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000


Private 1,754 1,743 1,733 1,730 1,732 1,727 1,724 1,724 1,722 1,720 1,716 1,715 1,712

Public 757 754 748 746 740 738 734 729 723 719 714 713 712

Residents in Intermediate Care Facilities for Persons with Intellectual Disabilities (Last Day of Month)

Private ICFs/ID: 2% Decrease in Enrollment from Sept 2018 to Sept 2019Public ICFs/ID: 6% Decrease in Enrollment from Sept 2018 to Sept 2019

0

10,000

20,000

30,000

40,000

50,000


NH Actual 45,094 45,362 45,120 44,868 31,415 31,167 31,079 30,663 30,107 29,358 28,421 27,096 24,625

NH Projected 31,339 31,338 31,337 31,335 31,334 31,332

Nursing Home Population in Fee for ServiceDoes not include CHC*

31% Decrease in Enrollment from Sept 2018 to Projected Sept 2019

NH Actual

NH Projected

Due to time lag for paid claims, numbers may be understated for up to six months.

*

26

Source: EDW PROMISe Claims

*Facility Bed Days are calculated as facility days + leave days + 1/3 hospital days. Based on paid claims first date of

service. Due to the 6 month billing lag, this number is not mature yet. This number will continue to increase as data is

refreshed each month. Starting in January 2019, individuals in this waiver were moved into the Community Health Choices Waiver in the Southeast.

OTHER METRICS

Third Party Liability

Previous Month Current Month FYTD

Recoveries (Casualty, Estate, Health

Insurance and HMS) $12,645,626 (July 2019) $18,115,766 (August 2019) $30,761,392

Cost Avoidance (HIPP and Health

Insurance) $26,017,767 (July 2019) $22,625,257 (August 2019) $48,643,024

Data Source: TPL Financial Accounting System

Bureau of Program Integrity

Current Month FYTD

Provider Review Overpayment Recoveries $633,342 (August 2019) $1,441,937

Audit Contractor (RAC-CGI) Provider Review Recoveries N/A (August 2019) N/A

Recipient Restriction Cost Avoidance* $1,901,700 (August 2019) $3,831,300

Data Source: DHS Executive Dashboard

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

1,400,000


Actual Bed Days 1,248,014 1,294,008 1,249,033 1,284,790 882,890 795,059 871,730 836,935 853,649 811,837 818,174 790,039 704,210

Projected Bed Days 825,674 825,639 825,603 825,566 825,529 825,490

Nursing Facility Bed Days (Bed Days Paid Based on First Date of Service) (Fee for Service Only)* (Does not include CHC)

34% Decrease in Projected Enrollment from Sept 2018 to Projected Sept 2019

*

Documents

OCTOBER 2019 2019.pdf · 2020-01-07 · Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19 Aug-19 Sep-19 Oct-19 # 20 Hrs/Wk 4,720 4,607 4,444 4,005 3,773 3,648