Intellectual & Developmental Disabilities

ODP Communication Number 085-18 announces that the amendments to the ID/A waivers that were submitted to CMS in August have now been approved by CMS as of September 25, 2018. The approved waivers include changes that were made as a result of public comment. Each full waiver application approved by CMS, as well as a side-by-side of substantive changes made as a result of public comments, is available online.

ODP will hold a webinar on Wednesday October 17, 2018 from 1:00 pm to 3:00 pm. To register for the webinar, follow this link.

Some of the changes include:

  • Clarification that residents of licensed personal care homes, or assisted living residences are excluded from enrollment in the consolidated waiver.
  • Higher numbers of unduplicated numbers of waiver participants due to increase in turnover in waiver in year one, and governor’s budget including an increase of funding for graduates.
  • Level of care criteria for Autism to be consistent across all waivers.
  • Tools used to diagnose autism has been expanded, and the scope of professionals who can diagnose autism and developmental disabilities has also been expanded.
  • Community Participation Support clarification is added regarding when referrals to the Office of Vocational Rehabilitation are required and where prevocational activities may occur. It has been clarified that all participants receiving prevocational services must have a competitive integrated employment outcome in their service plan.
  • Program Specialists and Supervisors of DSPs providing CPS have a six-month period of time to complete certification (CESP or ACRE) requirements.
  • In Consolidated waiver providers of Residential Habilitation, the types of experience that at least one executive level staff must have in order to be qualified has been expanded. The acceptable qualifications now include a minimum of five years’ experience as a manager with responsibility for providing residential services for individuals with an intellectual disability, developmental disability, autism, or serious mental illness. The provider must also notify the ODP Regional office and Administrative Entity within 10 business days of the hiring date of a new CEO. This also applies to Lifesharing Providers.
  • Clarification is added about requirements for Respite in licensed community homes that is dependent upon the size of the home.
  • Clarification that career assessment may be done in a vocational facility in certain circumstances, and that job coaching and support many not be provided in licensed settings.
  • Support Service staff providing supported employment, who work directly with individuals, have six months after hire to obtain certification in CESP, or ACRE, and until that time, must be supervised by a staff who is certified.
  • A standard was added to ensure that Supports Coordination Organizations communicate with AEs when they identify concerns about provider performance and services to participants.
  • Speech and Language therapy now includes issues related to swallowing.
  • Clarification of settings where companion services may be provided.
  • Home accessibility adaptations now include modifications needed to accommodate special sensitivity to light, sound, and other environmental conditions.
  • Clarification was added that service plan teams should make a determination regarding which transportation service best meets the individual’s needs.
  • Individual transportation providers for qualification in the participant directed service model are considered Support Service Professionals and must follow those qualification requirements.
  • Frequency of SC monitoring visits has been redefined to include face to face monitoring shall occur every two months, replacing the former language of every 60 days, in order to reduce the burden of tracking exact days.
  • Alignment of claims review process with the QA&I process to be completed on an annual basis.

Contact Carol Ferenz, RCPA IDD Division Director, with any questions.

The Office of Developmental Programs (ODP) distributed Communication Number 084-18 to announce a revised qualification process for new providers to becomes effective on October 1, 2018..In order to become a qualified provider, new provider applicants must submit acceptable provider qualification documentation designated for new provider applicants as well as supporting qualification documentation. Applicants must review all source documents referenced within ODP’s New Provider Assessment Tool before completing the tool.  While completing the tool, the provider applicant shall ensure that all policies, procedures, processes and/or protocols are developed and aligned with ODP requirements.  The Assigned Administrative Entity (AE) will validate the documentation that applicants submit with the New Provider Self-Assessment Tool.  The Assigned Ae is the AE with whom the provider applicant intends to provide the most service and is chosen by the provider applicant during orientation registration.

New provider applicants must also complete the ODP Provider Qualification Form DP 1059 as well as the Provider Qualification Documentation Record. All supporting documentation required for each service specialty the provider applicant intends to render should be included.

Informational Memos 044-16, 068-12, and 010-14, and ODP Announcement 114-17 are obsolete as of the publication of this announcement. For complete information regarding this process, please refer to ODP Communication Number 084-18.

The Office of Developmental Programs (ODP) Announcement 083-18 provides detailed instructions and clarification on the use of Housing Transition and Tenancy Sustaining Services available through the Intellectual Disability and/or Autism (ID/A) waivers which include the Consolidated, Person/Family Directed Support, and Community Living waivers.

The Housing Transition and Tenancy Sustaining services were established to assist individuals with tenancy in their own homes, whether rented, leased, or owned. This announcement lists all required Provider Qualifications which include knowledge of, and ability to access, several programs and resources in the community such as the various types of housing vouchers and housing services, fair housing, reasonable accommodations, homeownership programs, Olmstead requirements, Prepared Renters Program (PREP), etc., in addition to general waiver provider requirements.

The announcement also lists several resources and their purposes including; Cents and Sensibility by the Pennsylvania Assistive Technology Foundation, Consumer Financial Protection Bureau, Financial Education and Coaching Program by the Pennsylvania Housing Finance Agency (PHFA), Local Lead Agency, Local Referral Network, Medical Assistance Transportation Program, Money Smart by the Federal Deposit Insurance Corporation (FDIC), Nursing Home Transition Tenant-based Rental Assistance, PA Housing Search, PA ABLE Program, Pennsylvania Housing Finance Agency, Regional Housing Coordinators, Section 811 Program, and the US Department of Housing and Urban Development.

The Housing Transition and Tenancy Sustaining Service includes pre-tenancy and housing sustaining supports to assist individuals in being successful tenants in private homes owned, rented, or leased by the individuals. The concepts and philosophy of person-centered planning should be incorporated throughout the development and implementation of individual housing service plans.

Tenancy support services may not be authorized for individuals who have the following authorized services on their Individual Support Plans (ISP):

  • Residential Habilitation;
  • Life Sharing; or
  • Supported Living services.

Housing Transition services may be authorized when the individual has a plan to move from the home where Residential Habilitation or Life Sharing is provided into a private home that the individual will own, rent, or lease. Financial support that constitutes a room and board expense is excluded from federal financial participation in the ID/A waivers.

Contact Carol Ferenz, RCPA IDD Division Director, with any questions.

As we reported at the end of August 2018, The Office of Developmental Programs (ODP) organized a small work group to develop a “simplified rate structure” for the Community Participation Service. Kristin Ahrens and Rick Smith from ODP met with the representative providers who were invited to participate on this work group. The first item of business was to review the Proposed Rate Structure Chart that was originally developed by RCPA’s work group, which met in April and May of this year with the intention to make solid recommendations for improvement in the implementation of this service. The stakeholders that participated all agreed that this proposed structure would be a great improvement in the method utilized to properly bill for services, and to calculate community percentages. A few representatives of RCPA’s committee presented our proposal to ODP staff in June; we are very pleased that our recommendations have been considered for implementation.

At the RCPA IDD Division Meeting this month, Rick Smith reported to the committee that ODP is moving forward to the next stage of assigning appropriate rates to the proposed W-codes that we presented. As ODP works on restructuring the rates, the expectation is to have the new rate structure implemented in July 2019 for fiscal year 19/20. As we learn more about the progress of the work group, we will keep members up to date.

Attached please find the proposal that RCPA submitted to ODP that is now being adopted for the future rate structure.

Thank you to all who participated in the RCPA Community Participation Work Group meetings; it is rewarding to see that our efforts have made a positive impact in our system. For more information contact Carol Ferenz, RCPA IDD Division Director.

Office of Developmental Programs (ODP) Communication number 081-18 outlines draft requirements and best practice recommendations related to human rights and restrictive procedures. The guidance outline in the bulletin reflects regulator and contractual expectations for AEs and providers offering services to people in both licensed and unlicensed settings, and represents ODP’s mission, vision, and values around how we support people. The details contained in the bulletin are intended to support stakeholders in taking a consistent approach to ensure people’s health, safety, and rights. The Human Rights Team guidelines contained in the bulletin also apply to providers that render services through the Adult Autism Waiver (AAW). The functions of the Human Rights Committees for participants enrolled in the AAW, however, are fulfilled through ODP’s Bureau of Autism Services (BAS) instead of AEs.

The Draft Bulletin defines Human Rights Team, Human Rights Committee (led by the AE), Modification of Rights, Physical Restraint, and Restrictive Procedure. It further describes the purpose, scope of work, membership, roles and responsibilities of members of the committee, meeting structure, confidentiality, and general guidelines.

This bulletin is in response to the renewal of the Consolidated and Person/Family-Directed Waivers and the creation of the Community Living Waiver, as well as the requirements written in the Administrative Entity (AE) Operating Agreement, and anticipating the adoption of the Chapter 6100 regulations.

Written or electronic comments will be accepted by October 5, 2018 at 11:59 pm. Electronic comments may be submitted via email. Written comments should be sent to Julie Mochon, Policy Director, Office of Developmental Programs, Room 510, Health and Welfare Building, 625 Forster Street, Harrisburg, PA 17120.