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Tags Posts tagged with "community living waiver"

community living waiver

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The Department of Human Services (DHS) is providing final notice of the Fee Schedule Rates and Department-Established Fees for services funded through the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) Waivers as well as the Community Intellectual Disability Base-Funded Program.

The Fee Schedule Rates are effective January 1, 2022, with the exception of the rates for Agency With Choice Financial Management Services (AWC FMS) and direct Community Participation Support services. The Fee Schedule Rates for AWC-FMS will be effective on March 1, 2022. The Fee Schedule Rates for direct Community Participation Support services will be effective six months after the expiration of the federal novel coronavirus (COVID-19) public health emergency, and the temporary increases to the Fee Schedule Rates that are currently in place will end. The Department-Established Fees are effective July 1, 2022.

The full announcement with the specific rates can be found here.

These rates will be in effect for the next three years. Providers have the right to appeal these rates to the Bureau of Hearings and Appeals. Any provider who wishes to appeal must do so within 30 days of the notice, and those who do not appeal within that period will lose the right to challenge rates before the Bureau.

RCPA is hosting a “How to File a Rate Appeal” webinar on March 7, 2022, from 1:00 pm–2:00 pm. Otherwise, you should consult an attorney with experience filing such appeals.

Contact Carol Ferenz with any questions.

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ODP Announcement 22-018 is to make stakeholders aware that the proposed renewals of the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) waivers are available for public review and comment. There is a 30-day public comment period on the information proposed in the waivers that starts on February 12, 2022, and ends on March 14, 2022.

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Changes to the Remote Supports Component of Assistive Technology in the Consolidated, Community Living and Person/Family Directed Support (P/FDS) Waivers

ODP Announcement 21-094 notifies interested parties of changes to Remote Supports in the most recently approved waiver amendments, including the requirement to complete the Variance Form (DP 1086) when an individual needs more than $5,000 of Remote Supports per fiscal year.

Amendments to the Consolidated, Community Living, and P/FDS Waivers approved by the Centers for Medicare and Medicaid Services (CMS) effective November 22, 2021, contain changes to Remote Supports which are a component of the Assistive Technology service (all requirements contained in the waivers prior to the amendments continue to apply). The Office of Developmental Programs (ODP) has updated Variance Form DP 1086 and the related instructions originally found in Bulletin 00-18-06, Variance Form and Process, to reflect the requirements for intensive remote supports in these amendments.

ODP is holding a webinar on February 16, 2022, from 10:00 am–11:00 am to discuss requirements and best practices for the Remote Supports component of Assistive Technology in the Consolidated, Community Living and P/FDS waivers. The date, time, and link for registration to attend the webinar can be found here.

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ODP Announcement 21-087 is to inform all interested parties of CMS’ approval of amendments to the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) waivers (hereafter referred to as the Intellectual Disability and Autism [ID/A] waivers). The ID/A waiver amendments became effective on November 22, 2021, and are available on the Department of Human Services’ website.

The Office of Developmental Programs (ODP) developed a Record of Change document that contains all of the substantive changes in the approved ID/A amendments. Each full waiver application approved by CMS and the Record of Change document are available as follows:

ODP is also holding a webinar to provide an overview of all substantive changes in the approved ID/A amendments. The date, time, and link for registration to attend the webinar are as follows:

ODP is developing two additional communications regarding the provision of remote supports in residential settings and non-residential settings, including information about webinars that will be held regarding the provision of remote supports.

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

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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

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The Office of Developmental Programs (ODP) released notification on Tuesday, January 14, 2020 of the new Provider Agreement for Participation in Pennsylvania’s Consolidated Waiver, Person/Family Directed Support Waiver, Adult Autism Waiver and Community Living Waiver (“Waiver Programs”) that will serve as the statewide “Provider Agreement” between providers of waiver-funded services and ODP, the Department of Human Services, as the Pennsylvania State Medicaid Agency effective January 1, 2020.

This letter from ODP Deputy Secretary Kristin Ahrens was not included in the original distribution. The letter provides further clarification on the applicability of the new Provider Agreement and includes a due date for submission of the signed agreement. In addition, the Provider Agreement Form and Instructions have been updated. Every waiver provider must complete an agreement.

  • The legal entity of each waiver provider is required to submit only one agreement for that legal entity, regardless of the number of services provided or the number of service locations operated by the legal entity.
  • Each agreement must include the original signature of the provider’s Chief Executive Officer/Director/Owner.
  • Please also provide a copy of your agency’s IRS letter 147C to verify the agency’s legal name and FEIN.
  • Completed agreements may be submitted to ODP as an attachment via email.

Completed agreements may also be submitted by traditional mail to:

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

Questions relating to the provider agreement process may be directed to the ODP Provider Enrollment Unit. Please note; this agreement is effective as of January 1, 2020. Agreements must be returned by March 1, 2020 to the ODP Provider Agreement resource account. Questions regarding this notification should also be directed to this account.

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ODP Announcement 19-126 provides information regarding the Adult Autism Waiver Amendment webinar recording that is now available. This webinar discussed the proposed amendment to the Adult Autism Waiver and obtained public comment on the proposed changes. This webinar was held on September 16, 2019. The webinar was recorded and is now available online along with the PowerPoint presentation. You may find this link on MyODP.org by following this path:

Resources > ODP Information > Waiver Renewals & Amendments > Proposed AAW Amendments

The waiver amendment is also accessible online. An online document containing a side-by-side comparison of the waiver in its previous and amended forms is available.

Questions about this communication should be directed to this email.

ODP Announcement 19-130 serves to announce that the amendments to the ID/A waivers communicated in ODP Announcement 19-102 were approved by CMS on September 24, 2019. These  amendments were submitted to CMS on July 19, 2019. Since that time, ODP has been engaged in ongoing discussions with CMS. One substantive change was made as follows, to allow indirect activities to be rendered on behalf of an individual as part of the Housing Transition and Tenancy Sustaining Service in all ID/A waivers based on those discussions:

Housing Transition services are direct and indirect services provided to participants. Indirect activities that cannot be billed include driving to appointments, completing service notes and progress notes, and exploring resources and developing relationships that are not specific to a participant’s needs as these activities are included in the rate. The following direct and indirect activities are billable under Housing Transition:

  • Conducting a tenant screening and housing assessment that identifies the participant’s preferences and barriers related to successful tenancy. The assessment may include collecting information on potential housing transition barriers, and identification of housing retention barriers… (There was no change to the list of activities covered under Housing Transition. Please see the service definition for the full list of activities).

Each full waiver application approved by CMS is available as follows:

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

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ODP Announcement 19-102 provides information regarding the amendments submitted to the Centers for Medicare and Medicaid Services (CMS) regarding the Consolidated, Community Living, and P/FDS waivers. It is anticipated that the amendments will become effective October 1, 2019.

CMS has 90 days to review the amendments and changes may occur to the content based upon discussion with CMS during the approval process. Each full waiver application, as well as a side-by-side of substantive changes made as a result of public comment is available online here.

The amendments align with 55 Pa. Code Chapter 6100 regulations when effective, ensure compliance with the Home and Community-Based Settings regulations, and align with the Office of Developmental Programs’ Everyday Lives recommendations.

The amendments include a plan to serve medically complex children in a community home when transitioning from an extended hospital stay if they are unable to return to their family home. Also, the scope of professionals who can diagnose intellectual disability has been expanded.

ODP is adding the expectation that all providers of Community Participation Support services must offer individuals opportunities to participate in community activities that are consistent with the individual’s preferences, choices, and interests. On-call and remote support is proposed in order to support the fading of service and dependence on paid staff. The number of procedure codes and staffing levels has been decreased to more accurately reflect service delivery.

Starting January 1, 2022, CPS services may not be provided in any facility required to hold a 2380 or 2390 license that serves more than 150 individuals at any one time, including individuals funded through any source. All participants receiving prevocational services must have a competitive integrated employment outcome included in their service plan. There must be documentation in the service plan regarding how and when the provision of prevocational services is expected to lead to competitive integrated employment. CPS may not be provided in newly funded (on or after January 1, 2020) licensed 2380 or 2390 locations which serve more than 25 individuals in the facility at any one time.

Residential Habilitation, Life Sharing, and Supported Living Services will be required to utilize the recommendations provided in the Health Risk Screening Tool. SCs will be expected to monitor the implementation of the recommendations and incorporate them into the Individual’s Plan. Also, clarification is provided regarding the location parameters for newly funded sites.

ODP is proposing that respite can be provided by nurses for children with medical needs to assure the appropriate level of care is available.

Qualifications required for Support Service Professionals, Individuals, and Agency Providers have been clarified, including timelines for completion of certification requirements. Additionally, supported employment can be provided to individuals until OVR services are available, particularly when OVR has established a waiting list.

For a side-by-side comparison of substantive changes made as a result of public comment, see this online document. Questions about this communication should be directed to the appropriate ODP Regional Office.

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