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Authors Posts by Cathy Barrick

Cathy Barrick

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The Office of Developmental Programs (ODP) met with stakeholders today, October 30, 2024, to discuss waiver amendments and to provide an overview of Performance-Based Contracting.

Waiver Amendments included:

Waiver Capacity:

  • When an individual is in an acute care hospital and receiving waiver services, ODP will not need to reserve (hold) the individual’s waiver. They will maintain enrollment in the waiver.
  • Language was updated for waiver capacity for high school graduates in the P/FDS waiver. AEs can reserve the waiver capacity for 180 days prior to when services are needed. Students can remain in service until their 22nd birthday.

Assistive Technology:

  • Updated language to explain when an independent evaluation is required and when it is optional:
    • REQUIRED: A device will cost $750 or more.
    • OPTIONAL: A device will cost less than $750.
  • An independent evaluation can be done if the team decides it would be beneficial.
  • Evaluations are included in the $10,000 lifetime limit.

Community Participation Support:

  • The Community Participation Support provider must complete and update an analysis of the following at least yearly to support individuals to experience meaningful community inclusion:
    • Strongest interests and personal preferences for community activities;
    • Skills, strengths, and other contributions likely to be valuable to employers or the community; and
    • Conditions necessary for successful community inclusion and/or competitive integrated employment.

American Sign Language (ASL) – English Interpreter Service:

  • English Interpreter service will be added to ODP’s waivers effective January 1, 2025.

Music, Art, & Equine Assisted Therapy:

  • The cumulative maximum limit of any combination of Music Therapy, Art Therapy, or Equine Assisted Therapy has increased from 26 to 52 hours per fiscal year.

STAT Overview:

  • The Specialty Telehealth and Assessment Team service was implemented in March 2024. This service may also be delivered to the participant during temporary travel, per ODP’s travel policy.

Waiver Corrections:
Life Sharing:

  • The following may not be authorized for participants who receive Life Sharing services: Residential Habilitation; Supported Living; Respite (15-minute or Day) (has been removed).

Supported Living Corrections:

  • The following services may not be authorized for participants who receive Supported Living services: Life Sharing; Residential Habilitation; Respite (15-minute or Day); Homemaker/Chore; In-Home and Community Supports; Behavioral Supports; Therapies; Shift Nursing; Consultative Nutritional Services; Communication Specialist and Specialize.

Benefits Counseling:

  • New billable indirect activities are added. The limit has increased from 15 hours per fiscal year to 24 hours per fiscal year.

The Performance-Based Contracting Review Included:

  • Effective January 1, 2025, Performance-Based Contracting will be implemented for the following services funded through the Consolidated and Community Living Waivers:
    •  Residential Habilitation;
    •  Life Sharing; and
    •  Supported Living.
  • Changes to Enrollment of New Providers.
  • What are Performance Standards?
  • What are Provider Tiers?
  • What Do These Changes Mean to Individuals and Families?

All performance-based contracting questions can be sent electronically.

Please see the distributed PowerPoint for additional information.

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Two dates available (same content in both sessions):

  • Thursday, December 12, 2024, from 1:00 pm – 2:30 pm
  • Thursday, January 16, 2025, from 1:00 pm – 2:30 pm

Registration links will be released in the coming weeks.

Introduction to Charting the LifeCourse (CtLC) is designed to present learners with an overview of the CtLC Person-Centered Framework. It will provide a general awareness of the guiding principles and tools presented by a Certified CtLC Presenter. This training is designed for anyone who is interested in learning about the CtLC Framework and will be led by Lisa Meyer and David Forbes.

After the CtLC training, participants will be able to:

  • Define the core belief of the CtLC Framework.
  • Identify how CtLC principles and tools can enhance decision making, problem solving, and self-advocacy in individuals.
  • Describe ways CtLC is applied.

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The Office of Developmental Programs (ODP) has shared an update to ODPANN-22-083. The purpose of this communication is to provide updated information about ARPA grant fund reimbursement. Updates are in red. The final deadline for a reimbursement request submission is May 31, 2025. The survey closes on May 31, 2025, and no additional requests for reimbursement will be reviewed after this date. All expenses need to be incurred on or before March 31, 2025. Please view the communication for information and instructions.

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The Office of Developmental Programs (ODP) has shared ODPANN 24-106 and its attachment, which provides updates and identifies future plans for SC First Year Training, including a new Landing Page on MyODP as well as topics and training that were previously required in the 2017 SC Orientation. Please view the announcement and its attachment for information and details.

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Photo by Markus Winkler on Unsplash

Due to delays in Individual Support Plan revisions and other factors impacting provider billing, ODP has extended the time period for providers to submit claims for services.

As indicated in ODP Announcement 24-084: Publication of Final Rates Effective Starting Fiscal Year 2024-2025 and Operational Guidance, page 8 noted, “In November, ODP will process a gross adjustment for any fee schedule services billed during the 1st quarter of the fiscal year. This gross adjustment will compensate providers for the rate differential effective July 1, 2024.”

This is a reminder to all providers to bill for any services rendered from July 1, 2024, through September 30, 2024. ODP will be compensating providers, via gross adjustments, for the difference between the rate billed and the updated fee schedule rate for dates of service rendered during the period July 1, 2024, through September 30, 2024. ODP anticipates processing gross adjustments on Remittance Advices dated Monday, December 23, 2024, to ensure all billing for dates of service July 1, 2024, through September 30, 2024, has been completed. Paid claims data in Remittance Advices between July 1, 2024, and November 18, 2024, will be used as the basis for the gross adjustment.

For questions on how to resolve billing errors for services, contact ODP Claims Resolution.

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A webinar was held on October 25 from 10:00 am – 11:00 am for Med Admin Trainers to review how to create new student classes (including Practicum Observer classes), view grader reports of their students, and enter observation and remediation scores. The recording of the session is now available here. A Frequently Accessed Questions document related to the session will be developed and made available within the next two weeks.

You may also access the handouts from the presentation below:

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