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adult autism waiver

The Office of Developmental Programs (ODP) is informing all interested parties of the submission of the Consolidated, Community Living, Person/Family Directed Support (P/FDS), and Adult Autism Waiver amendments to CMS. The waiver amendments are available on the Department of Human Services (DHS) website. It is anticipated that the amendments will be effective November 1, 2023.

Please review the announcement for additional information and details.

ODP Announcement 22-122 is to remind providers that this is the time of year to being the Provider Qualification process. The Centers for Medicare and Medicaid Services (CMS) require a statewide process to ensure providers are qualified to render services to waiver-funded individuals. The Provider Qualification Process described outlines the steps the Assigned AE and provider must follow to meet these requirements and the steps Supports Coordinators (SCs) must take to transition individuals if needed. This communication does not describe the qualification process for SC organizations

The release of this communication obsoletes ODP Announcement 22-005 Provider Qualification Process. In addition, the qualification process for Providers enrolled in the Adult Autism Waiver can be found in ODP Announcement 20-110.

Providers that are shared across Intellectual Disability/Autism (ID/A) and the Adult Autism Waiver (AAW) must complete the Provider Qualification processes with both the AE for the ID/A waivers and the Bureau of Supports for Autism and Special Populations (BSASP) for the AAW.

Providers must submit the qualification documentation (Posted on MyODP — DP 1059 and the Provider Qualification Documentation Record with all required supporting documentation) by 03/31 of the year that their requalification is due.

Failure to meet this deadline will affect the assigned AE’s ability to requalify the provider by the due date of 04/30. The updated ODP Provider Qualification Documentation Record contains all instructions and qualification requirements.

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

ODP Announcement 22-076 serves to announce that the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) Waiver renewals, collectively known as the Intellectual Disability/Autism (ID/A) waivers, will not be effective on July 1, 2022, as requested.

This extension does not apply to the Adult Autism Waiver (AAW). The currently-approved AAW was most recently amended on April 1, 2022.

Discussions between the Office of Developmental Programs (ODP) and the Centers for Medicare & Medicaid Services (CMS) have been occurring since the submission of the waiver renewals. During recent discussions, it has become clear that the process to renew the waivers will not be complete by July 1. ODP requested a 90-day extension of the currently-approved waivers on June 27, 2022, since the Consolidated and Person/Family Directed Support waivers expire on June 30, 2022. CMS granted the extension request on June 27, 2022.

Until CMS approves the ID/A waiver renewals, the waiver amendments approved with an effective date of June 1, 2022, remain in effect. They can be found on the Department of Human Services website at the following links:

The ID/A waiver renewals submitted to CMS on April 1, 2022, are also available.

Additional changes will be made to the waiver renewals as a result of ongoing discussions with CMS. ODP will inform all stakeholders when the waiver renewals have been approved. The final approved versions of the waivers will be made available online at that time.

ODP Announcement 22-051 informs stakeholders that the following Fee Schedule Rates have been published as final in the Pennsylvania Bulletin:

  • Family Medical Support Assistance services funded through the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) Waivers;
  • Remote Community Participation Support/Day Habilitation services funded through the Consolidated, Community Living, P/FDS, and Adult Autism Waivers; and
  • Medically Complex Life Sharing services and Transition to Independent Living payments funded through the Consolidated Waiver.

Read the announcement for further details.

The Office of Developmental Programs (ODP) has updated the AAW Provider Information Table and published ODP Announcement 22-038 to reflect the April 1, 2022, waiver amendment. Amended sections and new text in the table are highlighted in gray. The updated Provider Information Table includes these highlights:

  • Clarification that the waiver cannot be used to fund home accessibility durable medical equipment that is covered under the Medical Assistance State Plan.
  • Clarification of delivery of services while the participant is hospitalized. The requirements in the waiver will become effective when Appendix K flexibilities expire, six months after the expiration of the federal COVID-19 public health emergency.
  • Extension of timeframes for staff training or credentialing for employment-related service.
  • Increase in the threshold for obtaining an independent evaluation for assistive technology devices.
  • Clarification on the inclusion of physical restraints in the behavioral support plan.
  • Requirements for obtaining criminal history clearances for staff.
  • Aligning level of care reevaluation procedures with current practice.
  • Other changes designed to align the AAW, where practical, more closely with the Consolidated, Person/Family Directed Support and Community Living waivers.
  • Expanded sections on provider qualifications for each service.

Providers are reminded that they are responsible for being aware of any changes to definitions of services they provide and ensuring that individuals furnishing direct services are fully qualified before providing services to AAW participants.

The AAW amendment effective April 1, 2022, is available on the Department of Human Services’ website or here.

Questions or comments about this communication can be sent to ODP via email.

ODP Announcement 22-012 provides information regarding the Office of Developmental Programs (ODP) Bulletin 00-21-02, Incident Management, including the specific roles and responsibilities for Supports Coordination Organizations (SCOs). On June 25, 2021, ODP released Announcement 21-049 to clarify that SCOs were not expected to report more than what they were currently reporting until further notice. ODP is clarifying that announcement 21-049 does not apply to the Adult Autism Waiver (AAW).

SCOs serving individuals in the AAW have always been required to report all incidents that occurred in the absence of a provider rendering services at the time of the incident or if the target of an investigation is not an employee or volunteer of a provider organization. There has been no change in those requirements.

This data is critical to evaluating AAW program outcomes. Please note that with the release of ODP Bulletin 00-21-02 that was effective July 1, 2021, two new categories, Passive Neglect and Self-Neglect can be used to report incidents that were previously reported as Neglect when applicable. For further clarification on Passive Neglect and Self-Neglect, refer to the Learning Management System (LMS) for the recorded module on Enterprise Incident Management (EIM) System Changes, County Management and SC Incidents.

The SCO has a responsibility to respond to and assess emergency situations and incidents as well as assure that appropriate actions are taken to protect the health and welfare of participants. Incident management activities that are the responsibility of and completed by the SCO are billable activities. Billable incident management activities are considered part of the SCO’s function of location, coordinating, and monitoring.

SCOs are responsible for checking alerts generated by Enterprise Incident Management (EIM) that identify incidents entered for participants receiving services through their organization. SCOs shall monitor individual incidents in EIM and make recommendations to ODP regarding the appropriateness and effectiveness of the provider’s actions taken to protect the health and safety of the participant as described in the initial incident report. They must also monitor final EIM incident reports to determine if corrective actions are appropriate, revisions to the Individual Service Plans (ISP) are needed, or additional monitoring of the situation is necessary. Monitoring of incidents by the SCO is integral in helping the ODP incident management reviewer in making a determination regarding the approval or disapproval of the incident report.

For targeted technical assistance or questions, please contact ODP’s Bureau of Supports for Autism and Special Populations’ Provider Support mailbox.

ODP Announcement 21-084 announces that the renewal of the Adult Autism Waiver (AAW) was approved by the Centers for Medicare & Medicaid Services (CMS) on November 18, 2021. As communicated in ODP Announcement 21-067, the renewal of the AAW has no substantive changes from the previously approved waiver.

The renewal was submitted with no substantive changes because some previously proposed changes to the AAW conflicted with the requirements of Section 9817 of the American Rescue Plan Act and CMS guidance that was published in May of 2021. The renewal is effective July 1, 2021, and can be found on the DHS website.

Because the Office of Developmental Programs (ODP) is not making the changes it originally planned to the AAW, ODP will not be implementing the proposed rates published in the Pennsylvania Bulletin on May 22, 2021. Any new proposed changes to rates will be published in the Pennsylvania Bulletin for a public comment period prior to implementation.

Message from the Office of Developmental Programs (ODP):

Good Afternoon AAW Stakeholder:

The purpose of this email is to inform all interested parties that the Centers for Medicare and Medicaid Services (CMS) has granted the Office of Developmental Programs a second 90-day extension on the currently approved Adult Autism Waiver through December 27, 2021.

Questions about the extension can be directed to ODP.

This meeting will provide updates on COVID-19 activities, answer questions, and offer support. These meetings are held for all Office of Developmental Programs (ODP) providers of Adult Autism Waiver (AAW) services. The virtual office hours (VOH) start with an overview of any new ODP announcements and also include a) highlights of new practices, b) a review of topics and questions sent in advance, and c) a discussion of any concerns that have come up within the past few weeks. Providers will be able to ask questions directly of AAW Regional Office (RO) representatives.

Please register for this session here.

February 8, 2021

10:00 am – 11:30 am

Virtual office hours (VOH) provide attendees with an opportunity to interact and ask questions related to a specific topic. They occur one time and are not recorded or posted on MyODP.

Preregistration is required. Please use the link above to register for the session. Once registered, you will receive an email with instructions describing how to participate, including a new link to join the session. You can join the audio portion of the webinar by telephone or computer.

For questions, please email this contact.