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hcbs

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Thursday, December 5, 2024
2:00 pm – 3:00 pm ET
11:00 am – 12:00 pm PT
Register Here

This spring, the Centers for Medicare & Medicaid Services (CMS) finalized the highly anticipated “Ensuring Access to Medicaid Services” rule (or the “Access Rule”) that, among other things, updates program standards and processes for Medicaid home- and community-based services (HCBS), including HCBS for people with intellectual and developmental disabilities (I/DD). Individuals with I/DD rely on Medicaid HCBS to support their independence and ability to live at home in their communities. The changes required by the Access Rule—and how states implement those changes—will have far reaching impact on state I/DD systems and the people they serve.

Join the Policy Information Exchange (PIE) for a discussion with state and provider experts who are thinking through their own approaches to Access Rule implementation. During the webinar, they will dive into the Access Rule’s impact on state I/DD programs, HCBS providers, and community partners, and individuals with I/DD and their families and caregivers. Specifically, they’ll discuss:

  • New and updated requirements related to HCBS incident management and grievance systems, payment adequacy and transparency, access and quality reporting and disclosure.
  • The implications for state I/DD systems—including challenges—as they plot a path to full implementation of the Access Rule within required timelines.
  • Strategies for building effective and collaborative engagement with community partners, people receiving services, providers, case management entities, and direct care workers.
  • Immediate steps that state I/DD systems should take now to assess their HCBS programs, processes, and IT infrastructure needs.

If you can’t make the live session on December 5, visit here to register for the free webinar now, and you’ll receive a link to view the program on demand.

More Details

Facilitators

Panelists

  • Pete Cervinka, Acting Director and Chief Deputy Director, California Department of Developmental Services (DDS)
  • Conor O’Dea, HCBS Policy Advisor, The Vermont Agency of Human Services
  • Lydia Dawson, Vice President of Government Relations, ANCOR

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The Office of Long-Term Living (OLTL) has announced new services that will be available as a result of the Community HealthChoices (CHC) Waiver renewal and OBRA Waiver renewal. Effective January 1, 2025, the following services will be available:

Chore Services – CHC Only

  • Provider Type: 59
  • Specialty Code: 431
  • Procedure Code: S5131

Teleservice Cognitive Rehabilitation Therapy – CHC and OBRA

  • Provider Type: 59
  • Specialty Code: 207
  • Procedure Code: W0176

Teleservice Counseling Services – CHC and OBRA

  • Provider Type: 59
  • Specialty Code: 231
  • Procedure Code: W0175

Teleservice Nutritional Consultation – CHC and OBRA

  • Provider Type: 59
  • Specialty Code: 230
  • Procedure Code: W0170

The rates for the OLTL Home and Community-Based Services (HCBS) rates, effective January 1, 2025, are available here.

Additional information on the licensure and certification requirements can be found in the Service Definitions under Appendix C of the waivers. Please note that these documents have not received final approval from the Centers for Medicare & Medicaid Services (CMS). Once approval is received, a ListServ message will be sent with links to the final approved waiver applications.

The Fee for Service rates for Teleservice Cognitive Rehabilitation Therapy, Teleservice Counseling Services, and Teleservice Nutritional Consultation have been added to the fee schedule attached to the ListServ.

For existing OLTL providers to enroll in the services listed above a request must be submitted to the enrollment and certification resource account. The required documentation should include an updated Provider Enrollment Information Form (PEIF), a copy of the required license or certification, and a copy of the job description for the service you are requesting to add to your provider profile. If you have any questions related to the new services you can reach out to the enrollment and certification unit at 1-800-932-0939, option 1, or via email.

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The Department of Human Services (DHS) Office of Long-Term Living (OLTL) has developed a funding opportunity under an approved home and community-based services (HCBS) spending plan that includes the two following HCBS provider types:

  • Adult Daily Living; and
  • Specialized Medical Equipment and Supplies.

OLTL will provide the American Rescue Plan Act (ARPA) funds to these enrolled providers to strengthen HCBS. Consistent with the original announcement, the purpose of the funding opportunity is for the implementation of quality improvement projects by HCBS providers to improve the services available to HCBS participants through the Community HealthChoices (CHC) and OBRA 1915(c) waivers. More specifically, this funding opportunity is focused on supplementing activities in a manner that improves and strengthens the quality of HCBS services. The use of the ARPA funding, however, is limited to those activities that supplement HCBS services rather than supplant the existing services.

DHS will provide funding of up to forty thousand dollars ($40,000) per approved request submission to qualified providers. DHS will approve funding on a one-time basis to each qualified provider and will review and approve submissions in the order in which they are received until the total funding allocated has been exhausted. Funding will only be provided for the following improvement projects:

  • Supplemental activities to address the Social Determinants of Health (SDOH). For example, SDOH activities may include:
    • Activities to address affordable and accessible housing. Rent and room and board are not allowable expenditures under this funding opportunity.
    • Activities to improve access to competitive integrated employment for participants. This may include access to benefits counseling, or remote technology to support employment.
    • Activities to improve or enhance transportation for CHC and OBRA participants.
    • Activities to improve food insecurities for participants.
  • Purchase of remote support technology by providers. This can include provider technology initiatives that improve service transparency and quality assurance, such as providing direct care workers with access to tablets and software that support in-home documentation of participant conditions and other related care needs.
  • Payment for the development and implementation of enhanced training for direct care workers, Medical Assistance (MA) providers, or both. This may include enhanced training on infection control practices, which can include the development of videos and online modules to address best practices in infection control. This may also include training for professional development. For example, this funding may be used to promote training or coursework related to the professional advancement or development for direct care workers.
  • Purchase and implementation of new software and technology for electronic health records or quality or risk management functions. This includes funding for providers to contract with a Health Information Organization. Having access to electronic health care records enables HCBS providers to connect with local hospitals and physicians, and ensure real time communication between the HCBS provider and the participant’s medical providers.

Please see the Funding Opportunity document for more information and for the HCBS Quality Incentive Funding Request Form. The document is also available on the Department’s Long-Term Care Providers web page under the heading “Home and Community-Based Services (HCBS) Quality Improvement Funding Opportunity.”

If you have any questions about this message, please send them to the OLTL HCBS Opportunities Resource account.

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In order to gather responses from providers that were not able to submit previously, the Office of Long-Term Living (OLTL) has reopened the Calendar Year (CY) 2023 rate study survey for the following Home and Community-Based Services (HCBS):

  • Adult Day;
  • Structured Day Habilitation;
  • Employment and Training;
  • Personal Assistance (Agency);
  • Personal Assistance (Participant Directed); and
  • Residential Habilitation.

Please complete the survey for CY 2023, which spans from January 1, 2023, through December 31, 2023, unless otherwise specified. Please only complete the survey if you did not previously participate. The reopening of the survey will ensure every provider has ample time to offer input to broaden and improve the resulting analysis. The survey will remain open until Friday, November 15, 2024.

This survey is one piece of the targeted rate review and is intended to collect current provider rate and wage data as well as general feedback on the challenges of providing these services. The information collected in this survey will be used to assist in developing a point of reference for the rate range to evaluate current payment rates. In addition to results from this survey, the review will include payment rate information from Managed Care Organizations (MCO) in OLTL claims data, recent legislative policies, department expectations, and other data obtained from publicly available sources.

HCBS providers that delivered multiple service categories during CY 2023 should fill out this survey separately for each service category you delivered. HCBS providers that did not deliver any of the service categories listed above should disregard this survey. OLTL is partnering with Mercer to perform a rate study exclusive to the service categories listed above at this time.

The information collected for this survey will be used for both this rate study and to meet the requirements of HB 1300 from the 2023–2024 Pennsylvania General Assembly regular session. The information you provide will remain confidential and private and will only be shared publicly through high-level summary reports that do not include provider-level detail. Please comply with the Health Insurance Portability and Accountability Act (HIPAA) and do not share any protected health information (PHI) within your survey responses.

Please note the survey tool does not allow individuals to save and go back to answer questions. Please have all your agency information such as wages, employee information, and financial statements readily available. This will help you to submit accurate information when answering the questions.

HCBS providers can access the survey here.

OLTL and Mercer appreciate your time and this valuable feedback. If you have any questions or need assistance, please reach out via email.

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The Office of Long-Term Living (OLTL) is presenting a live, interactive, 6-session webinar series on housing issues from November 5, 2024, to December 10, 2024, every Tuesday, from 11:00 am – 12:30 pm. The webinars will include targeted content as well as Q&A sessions with housing experts and OLTL staff.

The webinar series targets Service Coordinators, Managed Care Organizations, and Service Coordination Entity support staff who assist program participants in securing and maintaining affordable, accessible housing through Home and Community-Based Services (HCBS). The target audience for these webinars includes individuals and organizations who provide long-term services and supports for older Pennsylvanians and people with physical disabilities.

Register Here

Presenters

  • Leigh Howard, President of DMA, Inc.
  • Carolyn Steinhofer of Housing Equality Center of PA
  • Wendy Davis of PATF

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The Office of Long-Term Living (OLTL) has announced that they are reopening the calendar year (CY) 2023 rate study survey in order to gather responses from providers that were not able to submit previously. The rate study survey is for the following Home and Community-Based Services (HCBS):

  • Adult Day;
  • Structured Day Habilitation;
  • Employment and Training;
  • Personal Assistance (Agency);
  • Personal Assistance (Participant Directed); and
  • Residential Habilitation.

Access the survey here. Please complete the survey for CY 2023, which spans from January 1, 2023, through December 31, 2023, unless otherwise specified. Please only complete the survey if you did not previously participate. The reopening of the survey will ensure every provider has ample time to offer input to broaden and improve the resulting analysis. The survey will remain open until Friday, November 15, 2024.

It is highly recommended that you review the survey questions before starting the survey. This survey tool does not allow individuals to save and go back to answer questions. Have all your agency information such as wages, employee information, and financial statements readily available. This will help you to submit accurate information when answering the questions.

This survey is one piece of the targeted rate review and is intended to collect current provider rate and wage data and general feedback on the challenges of providing these services. The information collected in this survey will be used to assist in developing a point of reference for the rate range to evaluate current payment rates. In addition to results from this survey, the review will include payment rate information from Managed Care Organizations (MCO) in OLTL claims data, recent legislative policies, department expectations, and other data obtained from publicly available sources.

HCBS providers that delivered multiple service categories during CY 2023 should fill out this survey separately for each service category you delivered.

HCBS providers that did not deliver any of the service categories listed above should disregard this survey. OLTL is partnering with Mercer to perform a rate study exclusive to the service categories listed above at this time.

The information collected for this survey will be used for both this rate study and to meet the requirements of House Bill 1300 from the 2023–2024 Pennsylvania General Assembly regular session. The information you provide will remain confidential and private and will only be shared publicly through high-level summary reports that do not include provider-level detail. Please comply with the Health Insurance Portability and Accountability Act (HIPAA) and do not share any protected health information (PHI) within your survey responses.

If you have any questions or need assistance, please reach out via email.

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The Centers for Medicare and Medicaid Services (CMS) has released an informational bulletin, as well as a slide presentation, that are related to continuity of coverage for individuals receiving home and community-based services (HCBS). The purpose of the bulletin is to highlight the federal renewal requirements and available flexibilities to promote continuity of coverage.

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Photo by Chris Montgomery on Unsplash

The President’s Committee for People with Intellectual Disabilities (PCPID) will be hosting its next meeting on Thursday, September 26, 2024, from 9:00 am – 4:00 p.m. ET, and Friday, September 27, 2024, from 9:00 am – 3:00 pm ET. Register for the meeting here.

The meeting is open to the public and will be hosted at the U.S. Department of Health and Human Services. The meeting will take place in the Switzer Building Conference Room 1400, located at 330 C Street, SW, Washington, DC 20201. Members of the public can observe the meeting in person or virtually. To observe the meeting in person, seating will be available for the first 25 individuals to reserve seats due to space limitations. In order to observe the proceedings in person or virtually, you must register in advance.

The Committee will discuss the 2024 PCPID Report focused on home and community-based services (HCBS) as it relates to direct support professionals, employment, community living, and federal support programs. The Committee will also discuss emerging issues facing people with intellectual disabilities.

Comments and suggestions, especially from people with intellectual disabilities, are welcomed. If there are comments that you would like to inform the PCPID, please share them using ACL’s comment form. Comments received by Friday, September 13, 2024, will be shared with the PCPID at the meeting.

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