National Council Shares White Paper and Recommendations on HR1 Work Requirements

From our partners at the National Council for Mental Wellbeing:

As part of our ongoing efforts to assist you with implementation of H.R. 1, the National Council for Mental Wellbeing’s Policy and Advocacy Team is preparing a series of white papers on several of the bill’s Medicaid provisions. The first in this series is, “H.R. 1 and the Impact of Medicaid Work Requirements.”

H.R. 1 introduces significant changes to Medicaid, including new community engagement (work) requirements for Medicaid expansion enrollees. With implementation beginning in most states on Jan. 1, 2027, and state systems under pressure, we wanted to equip you with a clear, practical resource for navigating the new requirements.

“H.R. 1 and the Impact of Medicaid Work Requirements” provides background information on the requirements delineated in H.R. 1, lessons learned from previous work requirement implementation efforts by several states, and recommendations for clinics and the Centers for Medicare and Medicaid Services (CMS) on best practices for implementation.

We recognize that many of your organizations serve people who are most directly affected by these changes, including people living with mental health and substance use challenges who may qualify for exemptions under the law. While we await work requirements guidance from CMS, our goal is to make sure you have the most up-to-date information and tools available to help protect continuity of care for your clients.

We hope this white paper serves as a helpful resource as you plan for implementation. Please don’t hesitate to reach out via email with any questions related to this resource or any other issues regarding H.R. 1.

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ODP Updates the MAAC on Paid Relative Caregiving & Travel Limitations

By Tim Sohosky • May 29, 2026

On Thursday, May 28, the Office of Developmental Programs (ODP) provided an update to the Medical Assistance Advisory Committee (MAAC) regarding current policies and upcoming regulatory changes following a recent Commonwealth Court decision. On February 17, 2026, the PA Commonwealth Court issued a decision in Dunkelberger v. Department of Human Services that determined that ODP’s limitations on provider model services (specifically the 40/60-hour caps and 90-day travel maximums) were null and void. The decision was based on process rather than policy validity; the Court found that these limitations were not properly promulgated as regulations in accordance with the Commonwealth Documents Law and Regulatory Review Act. To maintain a balanced approach between flexibility and oversight, ODP is moving forward with the following actions: Regulatory Amendments: ODP will amend regulations to establish formal authority for setting service delivery limits that support individual welfare and program integrity. Self-Directed Model Agreements: ODP has already modified agreements for self-directed models to clarify limits on overtime, combined relative service provision, and travel restrictions. Travel Restrictions: Due to the inability to monitor services effectively over long distances, service provision will now be limited to Pennsylvania and contiguous states. Waiver Changes: ODP will seek modifications through the amendment process to the Consolidated, P/FDS, Community Living, and Adult Autism Waivers to include: New requirements for agencies providing IHCS and Companion services to disclose a DSP's relationship to participants; and Strengthened programmatic oversight and integrity measures. Life Sharing Alternative: For participants requiring more than 60 hours of paid care from a relative, the Life Sharing (24/7) service model remains the recommended alternative. ODP anticipates a public comment period for these proposed waiver changes beginning in January 2027.

Two men with intellectual disabilities working happily on a tablet.

Shapiro Administration's Strategic Investments in ID/A Community Lead to Highest Number of Pennsylvanians Ever Served in HCBS

By Tim Sohosky • May 28, 2026

Press Release from DHS : Published May 27, 2026

ODP Provides Updates to PBC 2026/27 Residential Pay-for-Performance

By Cathy Barrick • May 28, 2026

The Office of Developmental Programs (ODP) has shared ODPANN 26-039 . The purpose of this communication is to provide updated details about the Residential Performance-Based Contracting (PBC) Pay-for-Performance (P4P) initiatives for Fiscal Year 2026/27. Updates are provided in red . Please review the announcement for more details. Visit here to access the Pay for Performance (P4P): Residential Rural Capacity Expansion Plan template .