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Tags Posts tagged with "PA Office of Developmental Programs"

PA Office of Developmental Programs

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Kristin Ahrens, Deputy Secretary for ODP and Ryan Hyde, Acting Executive Director for Office of Vocational Rehabilitation (OVR), signed a joint bulletin on February 14, 2019 to become effective on February 15, 2019. Bulletin 00-19-01 provides updated guidance regarding requirements for when individuals must be referred to OVR to align with the requirements in the current Consolidated Waiver, Person/Family Direct Support (P/FDS) Waiver, Community Living Waiver, and Adult Autism Waiver (the ODP Waivers), and the Workforce Innovation and Opportunity Act (WIOA) (Pub.L. 113-128) and clarifies that the guidance in this bulletin applies to employment-related services funded through base-funding provided for by the Mental Health and Intellectual Disability Act of 1966 (50 P.S. §§ 4101-4704).

In accordance with the Employment First Act (62 P.S. §§ 3401-3409), competitive integrated employment is the preferred outcome for individuals receiving services funded through the ODP Waivers or base-funding and OVR services. An employment outcome is the first and preferred outcome because it provides many benefits to the individual including, but not limited to: increased opportunities for economic self-sufficiency, an opportunity to contribute to the community, a chance to build a network of social relationships, and the creation of opportunities for lifelong learning. An employment outcome is also consistent with the overall goals and recommendations in Everyday Lives: Values in Action, the document that provides guiding principles for the Office of Developmental Programs (ODP).

The employment recommendation in Everyday Lives: Values in Action states: “Employment is a centerpiece of adulthood and must be available for every person. The benefits of employment for people with disabilities are significant and are the same as for people without disabilities.” In addition, Everyday Lives: Values in Action includes the following value statement developed by self-advocates: “I want to work and/or have other ways to contribute to my community. My family, supporters, and community support me to find and keep a real job that I like with good wages and benefits or start and run my own business, and/or volunteer the way I want in my community.”

ODP and OVR have been working closely together to ensure that all individuals enrolled in ODP Waivers or receiving base-funded services have access to experiences and services that will enable them to obtain an employment outcome and receive the benefits that come from being employed. Supports Coordinators must refer an individual to OVR for OVR to determine the individual’s eligibility for services when an individual who is enrolled in an ODP Waiver or is receiving base-funded services indicates an interest in seeking employment or requests that the following employment-related services be added to his or her Individual Support Plan (ISP):

Consolidated, P/FDS, and Community Living Waivers:

  • Advanced Supported Employment;
  • Supported Employment;
  • Small Group Employment;
  • Community Participation Support; and
  • Education Support.

Adult Autism Waiver:

  • Supported Employment;
  • Career Planning; and
  • Transitional Work.

All other services offered by the ODP Waivers do not require a referral to OVR.

Once an individual is referred to OVR, OVR will determine using its own eligibility standards and criteria if the individual is eligible for OVR services. OVR will not make a determination if employment-related services provided through ODP Waivers or base-funded services are needed or appropriate for the individual.

It is critical that OVR staff and Supports Coordinators engage in ongoing conversations during the OVR referral and eligibility determination process to ensure that timely eligibility determinations are made. Ongoing conversations allow OVR staff and Supports Coordinators to discuss the following topics:

  • Whether additional information is needed by OVR staff to make an eligibility determination.
  • If OVR staff has any concerns about the individual. For example, OVR staff may report that the individual has experienced a prolonged illness that has impacted OVR staff’s ability to set up meetings and determine the individual’s eligibility for OVR services.
  • The date that OVR staff expects to make an eligibility determination.
  • Services and supports that OVR staff is exploring with the individual.

In some circumstances, OVR may not have the capacity to serve every individual referred by a Supports Coordinator in a timely manner. In such cases, there are special provisions in the ODP Waivers that allow the Supports Coordinator to access Waiver funding without receipt of an OVR eligibility determination.

Please see the bulletin and:

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

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ODP Announcement 19-017 provides guidance for assisting individuals with transitioning from nursing facilities into waiver services. When an individual is in reserved waiver capacity status, due to requiring hospital and/or nursing home care beyond 30 days, or has been identified as eligible to receive services offered in an ODP waiver upon discharge from the nursing facility, the AE, county MH/ID program, SC, or TSM provider will need to assist the individual in transitioning from the nursing facility. As part of the transition process, a PA 1768 form needs to be completed.

It is important that the PA 1768 form is completed and submitted to the County Assistance Office (CAO) prior to the individual’s discharge, so that there is no interruption in service. The submission of the PA 1768 form in advance of the anticipated discharge date allows the CAO to enter a waiver code in the individual’s record.

The nursing facility will coordinate with the individual and family, the AE, county MH/ID program, SC, or TSM provider as appropriate, to determine an anticipated date of discharge from the nursing facility. The individual must begin to receive waiver services on the day he or she is discharged from the nursing facility.

The AE, county MH/ID program, SC, or TSM provider is responsible to complete the PA 1768 form. The completed PA 1768 form will be sent to the CAO at least two weeks prior to the anticipated date of discharge. For more information about completing the PA 1768, please refer to ODP bulletin 00-18-02, Home and Community-Based Services (HCBS) Eligibility/Ineligibility/Change Form (PA 1768) and Instructions.

The nursing facility is responsible to complete and submit the Long Term Care Admission Discharge Transmittal form (MA 103) to the CAO when the individual is discharged from the nursing facility. During the transition process, if the AE, county MH/ID program, SC, or TSM provider becomes aware that the nursing facility did not complete and submit the MA 103 to the CAO, a request should be made to the nursing facility to complete and submit this form. Enrollment into a waiver cannot be completed until the CAO receives the MA 103. Depending on the individual’s circumstances, the actual discharge date may be sooner or later than the originally anticipated discharge date, or the individual may not be discharged at all.

Please direct questions regarding this Announcement to the appropriate ODP Regional Office.

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ODP Update to Announcement 19-012 is to announce an UPDATE to the new documentation requirements within the Individual Support Plan (ISP). These requirements are part of the implementation of a settlement agreement, which pertains to services received by individuals through the Consolidated Waiver.

UPDATE: To clarify guidance on Page 5 regarding “Frequency and Duration of the actions needed.” The total number of units will NOT be listed on the SD screen since a willing and qualified provider was not chosen.

*Frequency and Duration of the actions needed

Include the frequency (number of times) and the duration (length of time) for each of the needed actions. Include those provided by paid and non-paid people such as family members or friends.

List specific information on total number of units on Service Details

ISP Teams must document an estimate of frequency and duration of actions needed until a willing and qualified provider is chosen.

Please note, total number of units will be NOT be listed on the Service Detail screen since a willing and qualified provider was not chosen.

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

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ODP Announcement 19-014 serves to re-issue the criteria, process, and procedures for Residential Fee Schedule rate exceptions in the Consolidated Waiver. The fee schedule has been developed to provide adequate funding for individuals with varying needs of support.

ODP has instituted a process for identifying potential exceptions to the fee schedule, due to the extraordinary behavioral or medical needs of an individual. The Residential Rate Exception Process is a process to review individuals in Needs Group 4. These individuals, due to extraordinary behavioral or medical needs, require a staffing pattern and/or staff expertise (example, extensive clinical supports) that exceeds the assumptions that are the basis for the rate for individuals in Needs Group 4.

(Providers serving Individuals in Needs Group 1-3 (Needs Level 1-4) should continue to follow the existing processes for questions related to the Supports Intensity Scale (SIS) assessment findings.)

If an individual experiences a significant change in need, the provider should contact the Supports Coordinator to initiate a team discussion on the changes identified. If the team agrees that the current SIS assessment no longer represents the support needs of the individual, an expedited request can be submitted by the Supports Coordinator. This is accomplished via the vendor’s online portal for approval by the AE and ODP Regional SIS lead. The re-assessment will be scheduled upon completion of the approval process. Providers should complete a review of the recently completed SIS assessment for accuracy and changes to the Needs Group/Needs Level. If a provider has disagreements regarding the content and/or determined Needs Group/Needs Level, they should contact the Supports Coordinator to initiate a team discussion.

If discrepancies are identified between the information provided during the SIS assessment and the information captured on the SIS Family Friendly Report, the provider can contact the vendor to discuss these discrepancies. The provider should be prepared to identify and discuss specific areas of the SIS assessment that were not accurately captured. The vendor will facilitate a discussion to understand the requested changes and will consult with the assessor who completed the assessment and the respondents present during completion.

To qualify for consideration for a Residential Rate Exception, the individual must have a Needs Group 4 (Needs Level 5, 6, or 7) as determined by the most recent SIS assessment. The provider must complete the “Needs Exception Allowance Tool” (NEAT) (Appendix A), which provides information on the number of staff needed and the type of specific staff credentials that are needed. Accompanying the NEAT, the provider must submit a signed release of information for the counties who are completing the Life Experience Assessment Protocol (LEAP) to access the individual’s records. The NEAT and signed release of information should be submitted to the ODP rate setting mailbox.

The ODP Bureau of Financial Management and Budget will review the staffing information described in the NEAT (Appendix A) submission and determine if the individual meets criteria for a possible rate exception.

If a determination is made that an exception should be considered, a LEAP will be initiated, which involves a comprehensive record review of information about the individual’s history and current status. The LEAP record review will be sent to the Administrative Entity (AE) by the ODP regional office; the AE will complete the review.

The LEAP currently includes two tools, the “Desk Review” (Appendix B) and the “Assessment Review” (Appendix C), as well as a Findings Report (Appendix D). Following this review, the results will be returned to the ODP Bureau of Financial Management and Program Support to perform rate calculations. The provider will then be notified of the determination regarding the request. The registering AE will use the attached letters (Appendix E) when communicating the LEAP findings with the provider for currently approved requests that are subject to a post-approval LEAP. Appendix F diagrams how this process will operate.

Residential fee schedule rates were effective January 1, 2018. At a minimum, exceptions will need to be approved/re-approved on an annual basis. For individuals and providers with approved rate exceptions, the new LEAP process will be implemented during FY 18/19. It is anticipated that all approved rate exceptions will receive a LEAP review prior to April 1, 2019. Continuation of previously approved requests that conclude on 6/30/19 should include information on how considerations identified during a LEAP review were addressed.

Effective February 1, 2019, ODP will only accept NEAT requests for exceptional residential rates in the following circumstances:

  1. There has been an identified change in need for an individual currently receiving residential services as documented in their ISP and SIS assessment. The change in need requires an increased need for amount of staffing or qualifications of staff that exceed the need identified at the time of the current SIS assessment and are not supported with in the current fee schedule rate.
  2. The individual is new to the Consolidated waiver, new to residential services, or new to the provider and meets criteria for an exceptional rate request (i.e. NG4).

For questions or assistance related to the rate exception process, please email the ODP rate setting mailbox.

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ODP Announcement 19-012 announces new documentation requirements within the Individual Support Plan (ISP). These requirements are part of the implementation of a settlement agreement, which pertains to services received by individuals through the Consolidated Waiver.

Effective immediately, SCs must include in each individual’s ISP all services that the ISP Team agrees are necessary for the individual, regardless of whether a provider is identified for any or all services, and to the extent that the necessary requested service is an available service under the Consolidated Waiver. This means that when an individual enrolled in the Consolidated Waiver has selected a service to meet an assessed need, but has not chosen a willing and qualified provider, the service information must be documented in the individual’s ISP.

To ensure statewide consistency, ODP is requiring that the information be documented and tracked in the Outcome Section of the ISP. The announcement includes specific information regarding the documentation. While the documentation requirements are immediately in effect, SCs should follow ODPs current processes and timeframes when updating ISPs, as outlined in ISP Manual. For further assistance, please reach out to your ODP regional program office.

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ODP Announcement 19-011 is to inform interested stakeholders that the 2018 Everyday Lives: Values in Action – Information Sharing and Advisory Committee (ISAC) Recommendations, Strategies, and Performance Measures booklet is available online at MyODP.org.

Everyday Lives: Values in Action, developed by the PA Office of Developmental Programs (ODP) Information Sharing and Advisory Committee (ISAC), included 13 recommendations to achieve the vision in Everyday Lives. ISAC members, working together as ODP’s Stakeholder Quality Council, followed up on the 2016 publication’s recommendations, strategies, and performance measures to guide ODP and gauge its progress in achieving the 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: individuals with an intellectual disability or autism, their families, administrative entities, support coordination agencies, providers, advocacy organizations, local quality councils, and all entities involved on the ISAC.

Many of the recommendations and strategies have already been incorporated in draft waiver applications, regulations, policies, the Supporting Families Collaborative, employment initiatives, and training. Each of the recommendations represents what is important to people with disabilities and their families and should guide the work of everyone in the system.

The ISAC will continue to serve as the entity that provides sustained, shared leadership and a platform for collaborative strategic thinking for the ODP system. Strategies will continue to evolve as counties, support coordinators, service providers, advocates, and others work in partnership to improve services.

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

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ODP has issued Announcement 19-010 to provide written notification of the requirement to submit qualification documentation for providers who have an MPI number ending in 3, 4, or 5. Providers within this group are due to become requalified in 2019 and must submit documentation no later than 61 days prior to the expiration of provider qualification. Specifically, supporting documentation must be submitted starting February 1, 2019, but no later than March 31, 2019. Documentation must include a completed DP 1059 form, an updated Provider Qualification Documentation Record, and any required supporting documentation.

Providers who fail to submit qualified documentation by April 30, 2019, will participate in transition planning for the participants currently receiving Home and Community-Based Services (HCBS). As a part of the transition, the assigned Administrative Entity (AE) will commence transition of waiver participants according to the process detailed in ODP Communication 011-18. Providers whose qualifications expire June 30 will not be eligible to receive payment for waiver services rendered after June 30, will no longer be qualified to provide HCBS, and will have their name removed from the list of qualified providers of that HCBS.

For inquiries regarding this communication, contact the ODP Provider Qualification mailbox.

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ODP Announcement 19-009 (REISSUE) announces a training opportunity open to providers of employment services:

  • ID/A Waiver Providers: Supported Employment, Small Group Employment, and the prevocational component of Community Participation Support.
  • For AAW Providers: Career Planning, Supported Employment, and Transitional Work.

The Arc of Pennsylvania will host a total of five ACRE certification training sessions to be held in the east, central, and west regions of the state. This ACRE certification training is a combination of both in-person and online training.

Please refer to this flyer for details on sessions scheduled for March 4–6 at Harrisburg PaTTAN, 6340 Flank Drive, Harrisburg, PA 17112. Registration is required and is open until February 28, 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.

Future dates and locations include April 15–17 at PaTTAN Malvern and May 21–23 at Achieva in Pittsburgh. A flyer with registration details and seating capacity for these locations will be sent in the coming weeks. Other locations and dates will be announced once confirmed. Please submit questions via email.

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ODP Announcement 19-006 provides an update to ODP’s Medication Administration Manual, Student Course, and Practicum Observer Access is Now Available. This update regards changes to the course schedule. Four training courses scheduled for March have been rescheduled, and some classes scheduled for April and May have been updated. Please check the announcement to see the updated information.

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ODP Announcement 19-008 announces the cost-of-living adjustment (COLA) to Social Security Supplemental Security Income (SSI) that will impact the Room and Board payments for individuals living in settings that are waiver funded Residential Habilitation, Life Sharing and Family Living Services. SSI is a Federal program that provides benefits to adults and children who meet the Social Security Administration (SSA) requirements for disability, income, and resources. This income benefit is designed to help qualified individuals meet basic needs for food, clothing, and shelter.

Periodically, a COLA affects the maximum monthly allotment. Effective January 2019, the SSA increased the SSI allotment by 2.8 percent to reflect an increase in the cost of living. This raises the maximum monthly income to $771 for an eligible individual, $1,157 for an eligible individual with an eligible spouse, and $386 for an essential person. There is no anticipated increase in the State Supplementary Payment (SSP) for 2019.

To account for the new COLA, Room and Board contracts should be reviewed to determine appropriate adjustment. For more specific information regarding the Room and Board requirements for waiver funded Residential Habilitation, Life Sharing and Family Living services, please see 55 Pa. Code Sections 51. 121-51.128. Room and Board requirements will also be included in 55 Pa. Code Chapter 6100 and will be effective 120 days after the regulations are published. The Room and Board contract is form DP 1051.

This announcement obsoletes Announcement 002-18, effective January 1, 2019, Supplemental Security Income (SSI) Increase for Calendar Year 2018. For more specific information regarding SSI and the COLA, please review the US Social Security Administration website.

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