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PA Office of Developmental Programs

Deadline, as Letters on a Clock
On January 14, 2020, the Office of Developmental Programs released an updated version of the Provider Agreement for Participation in Pennsylvania’s Consolidated, Person/Family Directed Support, Community Living Waivers, and Adult Autism Waiver. Providers were informed that a signed copy of this document must be received no later than close of business on March 1, 2020.

As of February 21, 2020, many providers have not submitted their signed agreements. Failure to submit a signed agreement may impact providers’ ability to successfully submit claims for services rendered after March 1, 2020.

View/download the Provider Agreement for Participation in Pennsylvania’s Consolidated, Person/Family Directed Support, Community Living Waivers and Adult Autism Waiver and the accompanying letter from Deputy Secretary for Developmental Programs Kristin Ahrens.

Submit Signed Agreements to:
ra-ODPProvideragreem@pa.gov OR

Department of Human Services Office of Developmental Programs
Attention: Provider Agreement
625 Forster Street
Health and Welfare Building, Room 413
Harrisburg, PA 17120

ODP Bulletin 00-20-02 provides the Office of Developmental Programs’ (ODP) requirements and standardized processes for preparing, completing, documenting, implementing, and monitoring Individual Support Plans (ISPs) to ensure they are:

  • Developed to meet the needs of the individual.
  • Developed and implemented using the core values of Everyday Lives: Values in Action, LifeCourse Principles, Positive Approaches and Practices, and Self Determination to result in an enhanced quality of life for every individual.
  • Compliant with the approved Consolidated, Community Living, and Person/Family-Directed Support (P/FDS) Waivers and MA State Plan as it pertains to Targeted Support Management (TSM).

This bulletin and attachments have been updated to align with the October 1, 2019 amendments of the Consolidated, Community Living, and P/FDS Waivers and provide clarification regarding approved waiver service definitions.

A full ISP is required for any individual who:

  • Is enrolled in the Consolidated, Community Living, or P/FDS Waiver.
  • Receives Targeted Support Management.
  • Is not eligible for Medical Assistance and receives $2,000 or more in non-waiver services in a Fiscal Year.

Or

  • Is eligible for Medical Assistance and in reserved capacity for waiver enrollment.

An abbreviated ISP may be completed for any individual who is not eligible for Medical Assistance and receives under $2,000 in non-waiver services in a Fiscal Year. Base-Funded Case Management services are not included in the $2,000 limit. Administrative Entities or Supports Coordination Organizations still have the option of completing a full ISP and are encouraged to do so.

All ISPs, including abbreviated ISPs, must:

  • Be completed using the standardized format in the Home and Community Service Information System (HCSIS).
  • Be based on assessed needs of the individual.
  • Be developed using a person-centered planning process to capture information including health and welfare and the individual’s preferences and desires, all of which are intended to identify and implement appropriate services and supports.
  • Be updated, approved, and have services authorized at least annually (every 365 calendar days) and when warranted by changes in the individual’s needs.
  • The Consolidated, Community Living, and P/FDS Waivers state that ISPs for individuals enrolled or enrolling in any of these waivers must contain the following additional information:
    • All unpaid natural supports and funded supports to meet assessed needs. The ISP shall include documentation of services provided through other agencies (for example, Insurance, Office of Vocational Rehabilitation, Aging, Drug and Alcohol, and Education).
    • The frequency, amount, type, and duration of each service.

Further, the Consolidated, Community Living, and P/FDS Waivers stipulate that Supports Coordination Organizations (SCOs) must ensure that ISPs are thoroughly reviewed to assure services accurately reflect an individual’s needs prior to submission to the Administrative Entity for approval and authorization. Upon receipt of the ISP, the Administrative Entity is responsible for:

  • Ensuring all necessary services (both paid and unpaid by ODP) are included on the ISP prior to approval.
  • Ensuring the services are eligible for reimbursement prior to approval and making a service authorization decision.

Once the ISP is approved and authorized by the Administrative Entity, the Supports Coordinator is responsible to provide a completed copy of the signature form to all team members and distribute all approved ISPs to all appropriate team members unless otherwise requested. Providers that have access to the approved ISP in HCSIS are responsible for distributing the ISP to all appropriate staff within their agencies.

ISPs are not required, but are encouraged, for individuals residing in an Intermediate Care Facility for Persons with an Intellectual Disability (ICF/ID). For individuals residing in ICFs/ID, the ICF/ID personnel are responsible for developing the individual plan (outside of HCSIS) in accordance with ICF/ID regulations. This includes ensuring that services in the plan meet the individual’s needs. Although Supports Coordinators are not required to develop an ISP for individuals residing in State Centers and private ICFs/ID, they are responsible for maintaining regular contact with the ICF/ID facility, evaluating the individual, and participating in plan development as required under the County Intellectual Disability Service regulations – see 55 Pa. Code §6201.14 (relating to aftercare services). For individuals residing in State Centers and private ICFs/ID, the County Program is not responsible to authorize the plan.

ATTACHMENTS:

OBSOLETE DOCUMENTS:

  • Bulletin 00-17-03, Individual Support Plans for Individuals Receiving Targeted Services Management, Base Funded Services, Consolidated, or P/FDS Waiver Services or Who Reside in an ICF/ID.
  • ODP Communication 023-18, ISP Manual Update: Life Sharing Codes in the Consolidated and Community Living Waivers
  • ODP Communication 012-18, ISP Manual Update: Respite Camp Codes in the Consolidated, P/FDS, and Community Living Waivers.

ODP Announcement 20-012 announces that in order to build provider capacity statewide, ODP is broadening the provider qualifications of the Benefits Counseling service. As of the date of this communication, ODP will accept the Work Incentive Practitioner credential for staff (direct, contracted, or in a consulting capacity) who will work directly with the participant to provide Benefits Counseling.

The Work Incentive Practitioner credential is obtained by completing the Cornell University Work Incentives Planning & Utilization for Benefit Practitioners Online Certificate course and satisfying requirements to maintain the credential (sixty hours of continuing education units for training approved by Cornell University within 5 years of obtaining the full credential).

To be determined qualified to render the Benefits Counseling service in accordance with this guidance, providers must submit documentation of each staff person’s current Work Incentive Practitioner credentials to their Administrative Entities. Information about the credentialing course can be found here.

ODP will continue to accept the Community Work Incentive Coordinator (CWIC) Certification offered through Virginia Commonwealth University. Changes to the Provider Qualifications section in the Consolidated, Community Living, and P/FDS waivers will be made during the next amendment. For questions, please submit via email.

ODP Announcement 20-011 provides the updated process for providers to request an enhanced communication rate for Consolidated, P/FDS, and Community Living Waiver services for d/Deaf individuals who use Sign Language to communicate. The enhanced communication rate is available for services from providers who have signing staff to serve d/Deaf individuals. In the Consolidated, P/FDS, and Community Living waivers, this rate is available for the following services:

• Small Group Employment
• Benefits Counseling
• Supported Employment
o Career Assessment
o Job Finding and Development
o Job Coaching and Support
• Advanced Supported Employment
o Discovery Profile Outcome
o Job Acquisition Outcome
o Job Retention Outcome
• Respite
• Supports Broker Services
• Housing Transition and Tenancy Sustaining
• Residential Habilitation
• Companion Services
• In-Home and Community Supports
• Community Participation Supports
• Shift Nursing RN
• Shift Nursing LPN
• Therapies
o Physical
o Occupational
o Speech/Language
o Orientation, Mobility, and Vision
• Music Therapy
• Art Therapy
• Equine Assisted Therapy
• Behavioral Supports
• Communication Specialist
• Consultative Nutritional Services
• Family Caregiver Support Counseling (with participant present)
• Supplemental Habilitation
• Supported Living
• Life Sharing

See the announcement to read the full process to request an Enhanced Communication Rate and the updated Enhanced Rate Request form.

ODP Announcement 20-009 provides an updated Provider Closure Notification Form (DP 1061) and instructions to comply with 55 Pa. Code § 6100 requirements. The Provider Closure Notification Form is used to ensure that all ODP waiver and system requirements are met for any provider who no longer intends to provide ODP Consolidated, Person/Family Directed Support (P/FDS), and/or Community Living Waiver services. This includes ensuring that participants who are receiving services from the closing provider are properly transferred to a willing and qualified provider of their choice, according to 55 Pa. Code § 6100.303, and that the closing provider is properly removed from the ODP systems, including but not limited to HCSIS and PROMISe.

Providers are required to use the Provider Closure Notification Form (DP 1061) to ensure that ODP and all authorizing AEs are notified of their closing, in accordance with 55 Pa. Code § 6100.304. The 11/19 revised version of the DP 1061 can be found on the “Forms” page of MyODP.org and has been formatted to be submitted electronically. This new version of the form (11/19) should be used going forward effective immediately.

This form is not to be used when providers are ONLY discharging individuals. Providers shall adhere to requirements contained in 55 Pa. Code § 6100.304.

With the release of this announcement, ODP Communication Number: 050-17 Provider Closure Notification Form (DP 1061) is obsoleted. COMMENTS relating to the Provider Closure Notification Form (DP 1061) may be directed to the ODP Provider Qualification mailbox.

Certified Investigator class offerings for the Initial Certified Investigator (CI) Courses are available on MyODP.org. The Initial Certification Course includes an online prerequisite course, four days of face-to-face training, and an online exam created to ensure all incidents that require an investigation receive a systematic investigation that meets established standards. In order to perform investigations, the investigator must successfully complete all requirements of the ODP CI Initial Certification Course. Once all activities are completed within the current standards, the participant will be certified for three years. Please review the guide for instructions on how to register.

For assistance with registration, please contact support@myodp.org.
For questions regarding the course or its topic, please contact sarah.naughton@temple.edu.

ODP Announcement 20-008 clarifies how the actions taken by OVR will impact individuals seeking employment services through ODP.  OVR has announced that beginning February 1, 2020, they will open the Order of Selection on an intermittent basis and serve a set number of customers from the waiting list, starting with individuals who have been on the waiting list the longest. The number of customers served will be determined by OVR based on the availability of resources. The customers will be notified that OVR may proceed with services. All other customers will remain on the waiting list.

Individuals who have been receiving ODP-funded services while on the OVR waiting list and are offered services through OVR may choose to receive services from OVR or continue to receive ODP employment-related services.

Individuals who do not have access to ODP-funded employment-related services should continue to be referred to OVR as soon as that individual indicates any interest in seeking competitive integrated employment or requests an employment-related service.

Individuals under the age of 25 seeking Community Participation Support prevocational services that pay subminimum wage must continue to be referred to OVR in accordance with Bulletin 00-19-01, OVR Referral Process for ODP Employment-Related Services.

OVR will continue to take new referrals, determine eligibility, and place eligible customers on the waiting list. Because OVR services are not available for new referrals, Administrative Entities and Supports Coordination Organizations should continue to follow the guidance released in the OVR/ODP joint bulletin 00-19-02, OVR Referrals During a Period when OVR’s Order of Selection is Closed. The bulletin and attachments can be found at https://www.myodp.org/course/view.php?id=1446.

Bulletin 00-19-02 applies to the following services through ODP’s waivers or base funding:
• Consolidated, P/FDS and Community Living Waivers and base-funding:
o Advanced Supported Employment
o Supported Employment
o Education Support
• Adult Autism Waiver:
o Supported Employment
o Career Planning

For questions regarding this communication, please email Gary Smith at smiga@pa.gov.

ODP has developed guidelines for residential settings that are licensed by ODP. The use of cameras in these settings has become more common with the advancements in technology and various stakeholder concerns. Providers may desire the use of cameras in order to ensure that staff are performing their duties as expected, and they can also serve as a record that could be useful in completing investigations. The data could help to clear a staff of wrongdoing, or provide valuable documentation of abuse. Individuals and their families may desire cameras in a home as a way to monitor the well-being of their family member and could assist in increasing independence opportunities.

The use of cameras in a residential setting presents challenges to a provider to balance the right to privacy with the benefit of having cameras located in the setting. ODP has developed an 11-step method for evaluating whether camera use constitutes a privacy violation to ensure fairness and consistency in applying regulatory requirements.

It is recommended that providers contract ODP for technical assistance and support when faced with a scenario that may constitute a privacy violation.

The Office of Developmental Programs: Bureau of Supports for Autism and Special Populations (ODP: BSASP), and the Autism Services, Education, Resources, and Training Collaborative (ASERT) are trying to learn more about training needs among providers across all systems that support individuals with autism, intellectual disabilities, developmental disabilities, and their families.

The data collected from this survey will be used by ODP to inform trainings that reflect the needs of provider and professional organizations throughout the Commonwealth of Pennsylvania. The deadline for survey responses has been extended to February 7, 2020. The survey should take less than 10 minutes to complete. If you have any questions, please submit them here.

Office of Developmental Programs (ODP) Announcement 20-002 requests comments regarding Proposed Heightened Scrutiny Information for Residential Services locations. Comments are being sought on attachments #1–#3 until 11:59 pm on Monday, February 17, 2020.

To be compliant with the Centers for Medicare and Medicaid Services (CMS) Home and Community-Based Settings (HCBS) rule, ODP must identify and complete onsite reviews of all service locations that are presumed to have the qualities of an institution. The purpose of these onsite reviews will be to determine whether each service location can overcome the institutional presumption by either showing proof that the requirements contained in the CMS HCBS rule are currently met, or by ensuring the requirements will be met within a timeframe specified by ODP (but no later than March of 2022).

If ODP determines that the service location does not currently meet the requirements but has a plan to meet them within the timeframe specified by ODP, the service location must be submitted to CMS for a heightened scrutiny review. CMS will then determine whether the service location has the qualities of a home and community-based setting and does not have institutional qualities.

Homes that are identified as one of the following will require an onsite heightened scrutiny review by ODP due to having the potential of isolating individuals living in the home from the broader community:

  • Farmstead – These settings are often in rural areas on large parcels of land, with little ability to access the broader community outside the farm. Individuals who live at the farm typically interact primarily with people with disabilities and staff who work with those individuals. Individuals typically live in homes only with other people with disabilities and/or staff. Their neighbors are other individuals with disabilities or staff who work with those individuals. Daily activities are typically designed to take place onsite so that an individual generally does not leave the farm to access HCBS or participate in community activities. For example, these settings will often provide a place onsite to receive clinical (medical and/or behavioral health) services, day services, places to shop and attend church services, as well as social activities where individuals on the farm engage with others on the farm, all of whom are receiving Medicaid HCBS. While sometimes people from the broader community may come onsite, people from the farm do not go out into the broader community as part of their daily life. Thus, the setting does not facilitate individuals integrating into the greater community and has characteristics that isolate individuals receiving Medicaid HCBS from individuals not receiving Medicaid HCBS.
  • Gated Community – These settings typically consist primarily of people with disabilities and the staff that work with them. Often, these locations will provide residential, behavioral health, day services, social and recreational activities, and long-term services and supports all within the gated community. Individuals receiving HCBS in this type of setting often do not leave the grounds of the gated community in order to access activities or services in the broader community. Thus, the setting typically does not afford individuals the opportunity to fully engage in community life and choose activities, services and providers that will optimize integration into the broader community.

* Campus – These settings have multiple co-located and operationally related (i.e., operated and controlled by the same provider) service locations/homes/facilities that congregate a large number of people with disabilities together and provide for significant shared programming and staff, such that people’s ability to interact with the broader community is limited. This could include group homes on the grounds of a private Intermediate Care Facility (ICF) or numerous group homes co-located on a single site or in close proximity (multiple units on the same street or a court, for example).

More information published by CMS on the HCBS rule, including heightened scrutiny requirements, can be found here. Attachment 1 lists locations requiring an onsite heightened scrutiny review from ODP. Attachment 2 and Attachment 3 are the proposed tools for evaluating and reviewing the listed sites. Questions pertaining to this announcement and accompanying attachments may be directed to this email.