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Tags Posts tagged with "Office of Long-Term Living"

Office of Long-Term Living

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The Centers for Medicare and Medicaid Services (CMS) recently approved five new employment-related services in the Office of Long-Term Living’s (OLTLs) CommCare and Independence waivers. The services offer providers an opportunity to expand their profiles, particularly those who have been providing prevocational services and supported employment. Listed below are the new services, their credentialing and certification requirements, and rates that will be paid for the services.

  • Benefits Counselors must hold a Certified Work Incentives Counselor (CWIC) certification that is accepted by the Social Security Administration for its Work Incentives Planning and Assistance program. To learn more about CWIC, visit this web page.
  • Employment Skills Development (replaces Prevocational Services), Job Coaching (replaces Supported Employment), Job Finding, and Career Assessment workers must hold one of the following:
  1. A Certified Employment Support Professional (CESP) credential from the Association of People Supporting Employment First (APSE); and
  2. A Basic Employment Services Certificate of Achievement or Professional Certificate of Achievement in Employment Services from an Association of Community Rehabilitation Educators (ACRE) organizational member that has ACRE-approved training. Individuals without one of these certifications must be supervised by an individual holding the above certification until certification is achieved. Certification must be achieved within 18 months of employment.

Information on APSE credentialing can be found here.
Information on how to receive a certificate of achievement from ACRE can be found here.

(NOTE: Employment Skills Development services that are provided in vocational rehabilitation facilities that fall under 55 PA Code Chapter 2390 are not required to have the above credential or certification. Employment Skills Development services provided in the community do require the above credential or certification.)

A complete description of these services and provider qualifications can be found in the CommCare and Independence waivers here.

NOTE: OLTL has scheduled a webinar on Friday, November 18, 2016 at 1:00 pm to review and discuss these new services. Registration is required to participate.

Listed below are the rates for the new employment services:

 
Service PT/Spec CC IW Procedure Code Modifier Region 1 Region 2 Region 3 Region 4 Unit
Benefits Counseling 59/502 X X W1740 $9.78 $10.21 $10.54 10.87 15 mins
Career Assessment 59/503 X X W1732 $11.12 $12.12 $12.39 12.67 15 mins
Employment Skills Development (1:1) 59/505 X X W1728 $9.44 $11.22 $10.07 10.12 15 mins
Employment Skills Development (1:2 to 1:3) 59/505 X X W1729 $3.77 $4.49 $4.03 4.05 15 mins
Employment Skills Development (1:15) 59/505 X X W1741 $6.29 $6.50 $6.96 6.54 15 mins
Job Coaching 1:1 (Follow-Along) 59/504 X X W1733 U5 $9.78 $10.21 $10.54 10.87 15 mins
Job Coaching 1:2 to 1:4 (Follow-Along) 59/504 X X W1734 U5 $3.26 $3.40 $3.51 3.62 15 mins
Job Coaching 1:1 (Intensive) 59/504 X X W1733 U4 $9.78 $10.21 $10.54 10.87 15 mins
Job Coaching 1:2 to 1:4 (Intensive) 59/504 X X W1734 U4 $3.26 $3.40 $3.51 3.62 15 mins
Job Finding 59/530 X X W1735 $11.15 $12.11 $11.98 12.34 15 mins

 

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Late on Friday, October 28, the Office of Long-Term Living (OLTL) released a draft Request for Proposal (RFP) for an Independent Enrollment Broker (IEB) to manage the enrollment processes for all OLTL programs. The RFP includes enrollments for Community Health Choices when implemented, Home and Community-based Services Waivers, the Act 150 program, and the LIFE program. Comments are due no later than 5:00 pm on Monday, November 21, 2016, and should be submitted via email by using the drop down menus within the comment template.

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Today, the Office of Long-Term Living (OLTL) issued communication on changes to four OLTL home and community-based services waivers that were recently approved by the Centers for Medicare and Medicaid Services (CMS).

The changes include:

Aging Waiver amendments (effective 10/1/16)

  • Introduces the department’s intent to transition individuals from the Aging waiver into a managed care delivery system;
  • Revises language to reflect the current practice under the new child abuse clearance laws;
  • Breaks out the home health and therapeutic and counseling service definition into five discreet service definitions; and
  • Adds a new entity to perform waiver enrollments.

Attendant Care Waiver amendments (effective 10/1/16)

  • Introduces the department’s intent to transition individuals from the Attendant Care waiver into a managed care delivery system; and
  • Revises language to reflect the current practice under the new child abuse clearance laws.

Independence Waiver amendments (effective 10/1/16)

  • Adds five new employment-related service definitions* which are replacing one existing employment service definition;
  • Breaks out the Home Health and Therapeutic and Counseling service definition into eight discreet service definitions;
  • Introduces the Department’s intent to transition individuals from the Independence waiver into a managed care delivery system; and
  • Revises language to reflect the current practice under the new child abuse clearance laws.

CommCare Waiver amendments (effective 10/1/16)

  • Adds five new employment-related service definitions* which are replacing two existing employment service definitions;
  • Breaks out the home health and therapeutic and counseling service definition into eight discreet service definitions;
  • Introduces the department’s intent to transition of individuals from the Independence waiver into a managed care delivery system; and
  • Revises language to reflect the current practice under the new child abuse clearance laws.

OBRA Waiver renewal (effective 7/1/16)

  • Renewal of the waiver for an additional five years;
  • Introduces the department’s intent to transition individuals from the OBRA waiver into a managed care delivery system;
  • Breaks out the home health and therapeutic and counseling service definition into eight discreet service definitions; and
  • Revises language to reflect the current practice under the new child abuse clearance laws.

*New employment-related services are benefits counseling, career assessment, employment skills development (replaces prevocational services), job coaching (replaces supported employment), and job finding. For complete service definitions, provider qualifications, and requirements of each waiver, please refer to the approved waiver documents.

Providers of these new services will be paid at the proposed rates. Information on implementation of the new employment services, including transition from current employment services and billing procedures, is forthcoming.

In addition to the above changes, CMS has required OLTL to add limitations to any waiver services that are state plan services and are available to individuals under the age of 21. These services include: assistive technology, counseling, nursing services, nutritional consultation services, occupational therapy, personal assistance services, physical therapy, specialized medical equipment and supplies, and speech and language therapy. These services are only to be provided to individuals aged 21 and over. All medically necessary services for children under age 21 are to be covered in the state plan pursuant to the EPSDT benefit.

Questions on this information may be referred to either OLTL’s Bureau of Quality and Provider Management at 800-932-0939 or Bureau of Policy and Regulatory Management at 717-783-8412.

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