Intellectual & Developmental Disabilities

The State Employment Leadership Network (SELN) announces its Spring 2019 Training Series, SELN Shorts entitled: The 30-Minute Series Case Managers: Guides on the Pathway to Employment.  There are six sessions offered beginning Tuesday, March 26, 2019.

As a member of the SELN, the Office of Developmental Programs (ODP) strongly encourages participation in this opportunity for employment service providers. To learn more about the series, visit this website or submit questions via email.

ODP Communication 19-030 is intended to provide guidance to AEs, SCOs, SCs, and Direct Service Providers for creating Fiscal Year 2019­–2020 renewal plans.

The following topics are included in the communication:

  • Service Changes for Fiscal Year 2019–2020
    • Community Participation Supports
    • Transportation Trip
    • Homemaker
    • Update to Specialties
    • Supported Employment
    • Advanced Supported Employment
    • Benefits Counseling
  • P/FDS Remaining Individual Cap Exceptions
  • Variance Approvals
  • Consolidated Waiver Fee Schedule Residential Rate Exceptions
  • Transportation Mile
  • Leap Year
  • Systems Issues impacting the FY Renewal
  • FY 2019–2020 Waiver Rate Load Activities
  • Reserve to Encumbrance (R2E)

Attachment #1 outlines the new Community Participation Supports (CPS) Services effective July 1, 2019. Contact Carol Ferenz, RCPA IDD Division Director, with questions.

The Office of Developmental Programs (ODP) issued announcement 19-025 with accompanying documents to clarify information regarding the Intellectual Disability/Autism (ID/A) Waiver Employment Service definition. There are two documents to access. The first is the Employment Service Definition Quick Guide for ID/A Waivers and Base-Funded Participants (this was updated on 3/8/19).

Also included in the announcement is the Intellectual Disability/Autism (ID/A) Waiver Employment Service Definition Question and Answer Document Version 2. Included in this document are new questions regarding provider payment guidelines for retention of a job, provider use of a Discovery Portfolio completed as part of the certification process for Outcome Based Payments, acceptable settings for Advanced Supported Employment, guidance for increases and decreases of units of service, etc.

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

ODP Announcement 19-024 proposes changes to the procedure codes and fee schedule for Community Participation Support and changes to the Transportation Trip Service rates to become effective July 1, 2019.

The changes to Community Participation Support include simplifying the procedure codes and changing the staff to individual ratios to make planning, authorizing, and billing for the Community Participation Support service more efficient and to reflect service delivery more accurately. ODP has also proposed adding procedure codes and Fee Schedule Rates to the Community Participation Support service for on-call and remote support. The on-call and remote support component of Community Participation Support is pending approval from the Centers for Medicare and Medicaid Services (CMS). On-call and remote support will be available to participants for whom the provider has coordinated community activities in which the participant is supported through unpaid supports and/or as a component of the fading strategy where on-call and remote is needed as a backup. The provider may bill for on-call and remote support when all the following conditions are met:

  • The activity was coordinated by the provider of Community Participation Support services;
  • The participant does not receive Residential Habilitation services;
  • The participant requires on-call or remote support for health and safety reasons; and
  • Remote support is available immediately to the participant and on-call staff can be available for direct service within a maximum of 30 minutes (less if agreed upon by the individual plan team).

The changes for Transportation Services include adding procedure codes and Fee Schedule Rates for Transportation Trip services in both participant-directed services models. For Transportation Trip providers who do not submit a cost report, the proposed Fee Schedule Rates will be assigned. Additionally, ODP intends to change the zones covered in the Transportation Trip service for cost-based services captured in cost reports effective July 1, 2019.

The proposed Fee Schedule Rates in this communication will also serve as the Department-established fees under 55 Pa. Code § 4300.115(a) for base-funded services managed through county programs for individuals with an intellectual disability under the Mental Health and Intellectual Disability Act of 1966 (50 P.S. §§ 4104—4704), 55 Pa. Code Chapter 4300 (relating to county mental health and intellectual disability fiscal manual), and 55 Pa. Code Chapter 51 (relating to Office of Developmental Programs home and community-based services).

Assumption logs used to develop these rates are available online.

There are no changes proposed to rates for any service other than those outlined in this communication since they were published as final in the Pennsylvania Bulletin Volume 48, Number 4 on Saturday, January 27, 2018. The current rates for all other services are available on the Department of Human Services website.

Interested persons are invited to submit written comments within 30 days regarding the proposed rate changes to:

Department of Human Services
Office of Developmental Programs, Division of Provider Assistance and Rate Setting,
4th Floor, Health and Welfare Building
625 Forster Street, Harrisburg, PA 17120

Comments can also be sent to this email. Use subject header ”FY19-20 Rate Changes.” Comments received by 11:59 pm on April 5, 2019 will be reviewed and considered for revisions.

RCPA will be submitting comments based upon member input, including discussion at the IDD meeting March 20, 2019 from 10:00 am – noon. (to register for the meeting use this link). If you are unable to attend the meeting, please share your comments and concerns with Carol Ferenz.

Training Concept. Button on Modern Computer Keyboard.

The Office of Developmental Programs (ODP) announced updates to their schedule of virtual trainings and virtual office hours during the months of January, February, and March 2019. This alignment of the training schedule for all ODP programs provides courses for Supports Coordination Organizations and Agencies, Other Service Providers, and Other Professionals Supporting Individuals with Autism, Intellectual Disabilities, and Other Developmental Disabilities.

Please see the links for updates to the GoToWebinars in ODP Announcement 19-023. The announcement provides detailed information about individual training topics, dates and times, and intended audiences. To register, click on the linked title of each training you plan to attend. Once you preregister, you will receive an email with instructions to participate, including a new link to join the meeting. It is recommended that you register in advance to ensure you receive the meeting reminder. For questions about this announcement, please submit via email.

ODP Announcement 19-022 serves to inform providers of Transportation Trip of the requirement to complete and submit a cost report by March 24, 2019 to help determine future fee schedule changes, as well as to provide information as to the availability of the Year 11 Transportation (Trip) cost report template and supporting materials on MyODP.org. These services will continue as cost-based for at least another fiscal year, while ODP develops rates based on provider’s historical expense data.

To help arrive at the determined rates, ODP is requiring providers who deliver discrete Transportation (Trip) services as Provider Type 26 to individuals enrolled in the Consolidated, Person/Family Directed Support (P/FDS) or Community Living (CL) Waiver programs to complete the Year 11 cost report. Additionally, providers who expended $750,000 or more in combined federal and Commonwealth funds on Transportation Trip services during the FY 2017/2018 must also submit their independent audit with the Year 11 cost report, which can be accessed via this link: Year 11 Trip Cost Report Template.

Provider submissions are due no later than 11:59 pm on Sunday, March 24, 2019. If the provider does not complete the cost report and submit to ODP by this date, ODP will assign the rate for Transportation Trip services, effective 7/1/2019. The Year 11 Transportation (Trip) cost report and/or audit must be submitted to the rate setting mailbox.

All questions about this communication should also be submitted to the rate setting mailbox.

ODP Announcement 19-021 announces upcoming training opportunities to be held in April 2019 and are led by speech-language pathologists to promote better communication for people who do not communicate verbally.

Following the publication of Everyday Lives: Values in Action, the Information Sharing and Advisory Committee (ISAC) has become ODP’s Stakeholder Quality Council. The ISAC created a detailed series of recommendations, strategies, and performance measures to guide ODP and gauge its progress in achieving important goals put forth in Everyday Lives. These strategies and recommendations developed by the ISAC are intended to serve as a guide for everyone engaged in developing, providing, and advocating for services in the ODP system.

ISAC Recommendation 1 is to assure effective communication. Every person has an effective way to communicate in order to express choice and ensure his or her health and safety. All forms of communication should consider and include the individual’s language preferences and use of current technology.

Findings from the Independent Monitoring for Quality (IM4Q) in Fiscal Year 2016/2017 show that for those individuals who do not communicate using words, there is a formal communication system in place for 30% of the people interviewed. ODP considers this sample group as a reflection of a wider audience. As one way to help increase the number of individuals with a formal communication system in place, ODP is offering this capacity-building opportunity.

The Consider Communication training to promote better communication for people who do not communicate verbally will be held in five different locations across the state. After the in-person training, participants will be invited to attend a virtual session. These virtual sessions will allow participants to apply the concepts from the in-person training to particular individuals they support. Each person who completes the face-to-face session and the virtual session will receive a Certificate of Completion.

Please visit this website for dates, locations, and times and to register. Please direct questions to the ODP Deaf Services Mailbox.

A Colourful 3d Rendered Concept Illustration showing Training written on a Blackboard

The Arc of Pennsylvania will host ACRE certification training sessions in Malvern, PA from Monday, April 15 – Wednesday, April 17, 2019. This ACRE certification training, a combination of both in-person and online training, is for providers of supported employment services.

Registration is required and is open until April 1, 2019. The project will reimburse attendees up to $25 for travel expenses they incur to attend and participate in the training, upon successful completion of the ACRE certification.

*Priority will be given to ODP and OVR-approved Supported Employment Providers. Small Group Employment and Community Participation Support–Prevocational Services providers may register and attend as space allows.

Please refer to the flyer for details on the sessions scheduled for April 15–17, at the office of PaTTAN, 333 Technology Drive, Malvern, PA 19355.

Future dates and locations include May 21–23, 2019, at Achieva in Pittsburgh, and June 11–13, 2019, in State College. A flyer with registration details and seating capacity for these locations will be sent in the coming weeks. The fifth session location & dates will be announced once confirmed.

For questions, see ODP Announcement 19-019 or submit via email.

Office of Developmental Programs (ODP) Communication 19-020 is intended to provide current information to external stakeholders regarding the Electronic Visit Verification (EVV) Federal mandate established by the 21st Century Cures Act. This is also to request that you complete a DHS survey to help inform their EVV system development and implementation.

EVV is a technology solution which electronically verifies that home and community-based services are delivered to the individuals needing those services. EVV includes multiple technologies, such as telephonic, mobile, and web portal verification inputs. The 21st Century Cures Act requires that all state Medicaid agencies implement an EVV solution to manage their personal care services by January 1, 2020, and home health care services by January 1, 2023.

As a reminder, the EVV system must collect and verify:

  1. Type of service performed;
  2. Individual receiving the service;
  3. Individual providing the service;
  4. Date of the service;
  5. Location of service delivery; and
  6. Time the service begins and ends.

DHS is working with DXC and Sandata to develop an EVV system that will integrate with their existing Medicaid Management Information System (MMIS), PROMISe™. However, Pennsylvania is using an open EVV system model and providers may use their own EVV vendor/system, as long as it captures the six required items and is able to submit EVV data into the state’s system. Third party EVV systems will need to meet Sandata’s technical specifications and DHS’ Addendum, both of which will be made available once finalized. Providers serving participants covered under one of the Community HealthChoices Managed Care Organizations (CHC-MCOs) will be able to use the MCO’s EVV system, HHAeXchange. If a provider participating in CHC already has their own internal EVV system, they must work with the CHC-MCO to ensure their system is able to send information to HHAeXchange. For participant-directed programs in the Office of Long-Term Living (OLTL) waivers, the vendor fiscal agent Public Partnerships LLC (PPL) will be utilizing their EVV system, Time4Care, to satisfy EVV requirements.

DHS is developing the state EVV system with a full go-live date of August or September 2019, with a soft implementation of the system and outreach and training beginning this spring through the fall. DHS is also asking that you complete a quick survey to help inform EVV system development and implementation by March 8, 2019. You can access the survey directly at this link.

DHS will continue to provide you with guidance and updates as they move through this process. Updated information will be sent to you and will also be included on the DHS website. Questions or comments can be submitted to the EVV resource account email.