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Office of Developmental Programs

ODP Announcement 108-18 provides Update 5 regarding HCBS Settings Provider Self-Assessments. As of December 6, 2018, all residential providers were emailed their self-assessment reports and guidance for any needed corrective actions. Providers are encouraged to email here if a report has not been received for a residential service location for which a self-assessment was submitted.

ODP is now working on developing the self-assessment reports and guidance that will be sent to non-residential providers (Community Participation Support and/or Day Habilitation). ODP will start emailing this information to providers on December 31, 2018. It should take about a month for all reports and guidance to be sent for every service location. Non-Residential providers should email this address if a report has not been received by January 31, 2019, for a service location for which a self-assessment was submitted.

On October 1, 2018, ODP contacted residential and non-residential providers for which a self-assessment for an active service location was not submitted and informed them that an onsite assessment would be scheduled. Their current analysis shows four residential service locations and 19 non-residential service locations that meet this criterion. Staff from ODP will be completing the onsite assessments for residential service locations and Administrative Entity staff will be completing the onsite assessments for non-residential service locations. Providers who will receive an onsite assessment should be contacted by staff from ODP or an Administrative Entity soon to discuss and schedule the assessment. It is their goal to complete all onsite assessments by March 31, 2019.

Through the HCBS Settings Provider Self-Assessment process, there have been some frequently asked questions and concerns regarding corrective actions and documentation that ODP wanted to clarify to all providers involved that are addressed in this announcement.

Please be advised that ODP has received a large quantity of emails and phone calls from providers. As a result, it has been taking longer than expected to respond to each provider individually. ODP wants to thank you for your ongoing patience throughout this HCBS Settings Provider Self-Assessment process. For any questions related to this communication, please submit them via email.

ODP Announcement 109-18 announces that the Fair Hearing Request Form (DP 458) has been updated. The form is used by individuals and families to object to the following actions taken by the Administrative Entity (AE), County Program, Supports Coordination Organization (through the auto authorization process), or ODP and to request a fair hearing before the Department of Human Services, Bureau of Hearings and Appeals:

  • An individual is determined likely to meet an Intermediate Care Facility for persons with an Intellectual Disability (ICF/ID) or Other Related Conditions (ICF/ORC) level of care and is enrolled to receive Medical Assistance but is not given the opportunity to express a service delivery preference for either Waiver or ICF/ID services.
  • An individual is denied preference of Waiver, Targeted Support Management, or ICF/ID services.
  • Based on a referral from the AE or County Program, a Qualified Developmental Disability Professional (QDDP) determines that an individual does not require an ICF/ID or ICF/ORC level of care and eligibility for services denied or terminated.
  • An individual is denied Waiver service(s) of their choice, including the amount, duration, and scope of service(s).
  • An individual is denied the choice of willing and qualified Waiver or Targeted Support Management provider(s).
  • A decision or an action is taken to deny, suspend, reduce, or terminate a Waiver service authorized on the individual’s Individual Support Plan (ISP).

If an individual or family needs assistance completing the form, the AE, County Program, Supports Coordinator, or Targeted Support Manager may help.

The Fair Hearing Request Form should not be completed for actions taken by the County

Program regarding base-funded services. Base-funded services are services that are not paid for through a waiver and do not include Targeted Support Management. Denial of eligibility for base-funded services and individuals who have had base-funded services denied, reduced, or terminated have the right to appeal under the Local Agency Law.

The Fair Hearing Request Form should not be completed for actions taken regarding services in the Adult Autism Waiver or Adult Community Autism Program at this time. Individuals who would like information about how to request a fair hearing for an action regarding the Adult Autism Waiver or Adult Community Autism Program should talk to their Supports Coordinator. The updated Fair Hearing Request Form and accompanying instructions are here.

Questions about this communication should be directed to the appropriate Office of Developmental Programs Regional Office.

The Office of Developmental Programs (ODP) Communication 106-18 announces that the final public notice for fee schedule rates and Department-established fees for Fiscal Year 2018-2019 have been published in the Pennsylvania Bulletin Volume 48, Number 50 on Saturday, December 15, 2018. The title of the notice is Fee Schedule Rates and Department-Established Fees for Consolidated, Community Living and Person/Family Directed Support Waivers Services, Targeted Support Management and the Community Intellectual Disability Base-Funded Program. You may obtain the public notice by following this link.

The Fee Schedule Rates effective July 1, 2018, were developed in accordance with 55 Pa. Code Chapter 51 using a market-based approach. The Fee Schedule Rates represent the maximum rates that the Department will pay for each service.

There have been no changes to the Fee Schedule Rates since they were published as final in the Pennsylvania Bulletin Volume 48, Number 4 on Saturday, January 27, 2018. The current Fee Schedule Rates can be accessed on the Department of Human Services website.

There have been no changes to the Department-established fees that have been in effect July 1, 2018 through December 31, 2018, since the fees were published as final in the Pennsylvania Bulletin, 48 Pa.B. 688 (January 27, 2018). The Department-established fees effective July 1, 2018 through December 31, 2018 can be viewed as historical rates on the Department of Human Services website.

The Department has examined current federal housing data across the Commonwealth and determined that a differential of approximately 10% exists between the costs in the counties of Bucks, Carbon, Chester, Delaware, Lehigh, Monroe, Montgomery, Northampton, Philadelphia, and Pike, and those in the rest of the Commonwealth. Unlike wage costs, which are typically standardized across multiple counties through use of a single wage scale across counties, housing costs tend to be specific to a particular county and are therefore difficult to standardize. For these reasons, the Department has decided that the differential in housing costs warrants an increase to the Department-established fees, comparable to the cost differential, for residential habilitation ineligible services provided in the aforementioned counties, effective January 1, 2019.

The changes in rates will be automatically reflected in each impacted individual’s ISP. Providers of residential habilitation services and supports coordinators are not required to do anything to implement this change.

The Department-established fees for residential habilitation ineligible services can be accessed in the Pennsylvania Bulletin and on the Department of Human Services website.

Interested persons are invited to submit written comments by January 14, 2019 regarding the final Fee Schedule Rates and Department-established fees to the 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 ”PN Fee Schedule.” The Department will consider comments received in reviewing future adjustments to the Fee Schedule Rates and the Department-established fees.

November 15 is Pressure Injury Prevention Day. ODP Medical Director Dr. Gregory Cherpes, MD released a Health Alert with important information for those who provide care to individuals at risk of developing pressure injuries.

The skin is the largest organ of the body. Skin protects the body by creating a barrier to the environment, regulates the body’s temperature, supports peripheral circulation, and helps maintain fluid balance. Skin also is a reservoir for the formation of Vitamin D. The nerves in the skin provide sensations that detect changes in the environment such as heat, cold, touch, and pain. The skin is made of two layers, the epidermis and dermis, which cover the underlying tissues, muscles, and bones. “Skin integrity” refers to the intact, unbroken nature of healthy skin. Open wounds to the skin, such as those that occur with pressure injuries, make an individual more vulnerable to infection, sickness, and death.

This document provides information defining pressure injuries, why prevention is important, who is at risk of developing pressure injuries, signs and stages, treatment, and prevention of these injuries.

Due to the serious nature of pressure injuries, the pain associated with these injuries, and the additional conditions that may result from pressure injuries, prevention and immediate action at the first sign of pressure injuries are of utmost importance. In addition to skin, muscle, and bone loss, bacteria entering the sore can cause infection. In some cases, infection in the tissue can lead to bone infection, also called osteomyelitis. Infections can worsen and result in sepsis (when infection enters the blood), which can lead to shock and even death.

IMPORTANT: Notify the health care practitioner (HCP) if there are concerns for a pressure wound. Because pressure injuries can have many different appearances, the HCP should be alerted to any skin changes that are noted, particularly in areas at risk for pressure injury. Notify the HCP at the first sign of redness that does not resolve within 15 minutes after relieving the pressure.

The Office of Developmental Programs (ODP) has released Communication Number 095-18 with updated Questions and Answers regarding the Community Participation Supports (CPS) Service. The first Q&A documentation 066-17 published in June 2017 is now obsolete. This document covers a variety of situations submitted to ODP from providers of service who have been implementing Community Participation Supports (CPS) and encountering questions such as use of SE modifier, billing practices, variances for individuals who will not meet the goal of 25% community time, how CPS differs from other waiver services, transportation issues, and how to calculate the percentage of time in the community.

The concern regarding some providers not meeting the requirement that at least 25% of individuals’ time is spent participating in community activities, excluding variances as averaged over a year’s time, is addressed — ODP will request a plan for coming into compliance from the agency who has not met this requirement. All waiver settings must meet the federal HCBS settings rule standards no later than March 2022. The 25%+ requirement is one of the objective measures in Pennsylvania’s assurances that prevocational and adult training facilities are compliant with the rule.

In total, there are fifty questions addressed in the Question and Answer Document, Version 2 Updated 10/19/18 that will serve as guidance to providers of service. Contact RCPA IDD Division Director Carol Ferenz with questions.

Temple University’s Institute on Protective Services is the entity contracted to deliver the ODP Certified Investigators (CI) Program. ODP and Temple University are conducting Certified Investigator Forums, which provide an opportunity for current Certified Investigators and other interested parties to receive up to date information about the Investigatory Process. This call will also allow participants to network, share best practices, and receive technical assistance in an effort to improve the quality of all investigations.

The next session is scheduled for Friday, November 2, 2018 — there will be two sessions available during the day. If desired, participants may register for both sessions. CI program updates will be the same but other content will be dependent on participant inquiries. Participants can submit questions prior to the session via email. For instructions on registering for the call, see ODP Communication Number 094-18.

ODP Communication Number 089-18 invites People with Disabilities, Family Members, Supports Coordinators (SCs) and SC Supervisors, Provider Staff, Administrative Entity Staff, and Organizational Leadership to participate in ODP-approved Dual Diagnosis Training curriculum.  The Dual Diagnosis Curriculum is part of a joint initiative of The Commonwealth of Pennsylvania, Office of Mental Health and Substance Abuse Services (OMHSAS) and ODP to address the needs of people who have an intellectual disability as well as mental health challenges.

The statewide Residential Strategic Thinking Workgroup, Regional Clinical Directors and Benjamin Settlement implementation leads have recommended that this training be broadly available in order to ensure that the ODP stakeholder community is more knowledgeable and equipped to meet the needs of individuals and ensure ongoing health and safety. This training is now also required for newly enrolled Residential Habilitation providers in order to expand the clinical capacity of community providers.

ODP Announcement Number 091-18 informs stakeholders that an additional Waiver Amendment Webinar has been scheduled in order to accommodate the amount of interested parties requesting attendance in the first webinar that was announced for October 17,2018.  Due to that session being full, a second session will now be available on Tuesday, October 23, 2018 2:00 pm to 4:00 pm.  Use this link to register.

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

ODP Communication Number 088-18 states that since the HCBS Provider Settings Self-Assessments due date of June 12, 2018, ODP staff have been analyzing and reviewing completed self-assessments.  ODP received over 6,518 HCBS Provider Settings Self-Assessments from Residential Providers, as well as over 676 self-assessments from Non-Residential Providers. ODP appreciates the cooperation of all the providers who have completed the self-assessment by the deadline.

ODP staff have been reaching out to providers that did not complete a self-assessment for an active service location, providers who completed a self-assessment but ODP staff could not match it to a service location, or providers who completed multiple self-assessments for one service location.  ODP previously stated that all providers that completed a self-assessment would receive a report by September 30, 2018 that identifies any areas indicated in the self-assessment that require a transition plan.  Due to amount of outreach and analysis needed, ODP needs additional time to create these reports and will send them to providers by October 31, 2018.

Providers for which ODP has no record of receiving a self-assessment for an active service location were emailed on October 1, 2018 to inform them that an on-site inspection would be scheduled.
scheduled.  This aligns with the latest ODP Announcement, Home and Community Based Services (HCBS) Settings Self-Assessment Status Update 1, ODP Communication Number 054-18, which states that service locations for which ODP has not received a completed self-assessment will be deemed non-compliant and will have an on-site inspection scheduled.

For questions related to this communication, please contact RA-OWODPHCBSSETTINGS@pa.gov

ODP has announced that effective immediately, SCOs should submit all expedited requests via KEPRO’s scheduling portal at the KEPRO website. AEs and ODP regional SIS leads will be contacted to review and give final approval before scheduling occurs.  This portal will also be used for SCs to enter information for 5-year reassessments.

An expedited SIS assessment is scheduled when an individual experiences a significant life change lasting a minimum of six (6) months, such as a change that will cause a permanent lasting impact on an individual’s needs. Examples of major changes that would justify an expedited Request for a new assessment include:

  • Change in Health Status –An individual’s health status may be permanently changed due to a major health event such as a stroke. This change in status impacts their need for assistance
  • Behavioral Issues – An individual starts to engage in self-injurious behavior and needs additional support in maintaining his safety and behavioral supports and other interventions have been ineffective
  • Skills and Ability – An individual lives alone and has shown signs of early onset dementia. Among other faculties, they lose the ability to monitor medications and may need increased hours of support to remain in the home
  • Availability of Assistive Technology – An individual recently purchased a communication device and no longer needs to depend on others to speak for him

The Supports Coordinator (SC) is responsible for submitting the request, which once submitted will go through an approval/confirmation process by the Administrative Entity (AE) and a Regional ODP Lead.  Additional information can be found at the website, such as recent announcements, updated information, and training resources.  KEPRO’s website is:  http://mysupport.kepro.com/

When ready to request an expedited assessment, click on “Schedule an Assessment” and then choose “Expedited Request”.  Complete all of required information in the Portal. KEPRO will contact you with the outcome of the request. Further detail can be found on KEPROs SIS Scheduling Portal resource document.

When it is time for an individual’s 5-year assessment, you will receive an encrypted email from KEPRO’s general email, paodpassessments@kepro.com to initiate scheduling.  The email will include the individual’s name and a link to our Scheduling Portal.   After clicking on the link provided, simply choose “5 yr Re-Assessment” and fill out the form with all of the information required to begin the scheduling process.

If you have any questions about the process, you can contact the KEPRO team or by selecting “Contact Us” on the web site for a list of our Program Managers, Regional Supervisors, and certified Assessors.

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

The Office of Developmental Programs issued Announcement 090-18:  College of Employment Services ACRE Update – Unlimited Seats Available today.  This certification is available to providers of the following employment services under ODP and or Autism (ID/A) waivers, including the Consolidated, Person/Family Directed Support (P/FDS), and Community Living Waivers; as well as Base-Funded services:

  • Supported Employment – Support Service Professionals under the Agency with Choice (AWC) Financial Management Service (FMS) and Vendor Fiscal/Employer Agent (VF/EA) FMS Models; Individual Providers, and Agency Staff
  • Small group employment – Agency Staff
  • Community Participation Support – Prevocational Services Component – Program Specialists and Supervisors of Direct Support Professionals

In order to obtain the complete ACRE Basic Certificate of Achievement, the participant must complete both Part 1 and Part 2 of the CES Certified Training.  There continues to be a discounted cost available through December 31, 2018.