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Authors Posts by Carol Ferenz

Carol Ferenz

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Congress Resumes Informal Talks on Budget Reconciliation Legislation

Last week, President Biden delivered his first State of the Union address. In the speech, he acknowledged that a priority for his domestic policy agenda was to support home-based and long-term care. This is consistent with the President’s original Build Back Better plan, which included funding for the Medicaid Home and Community Based Services (HCBS) program, and was included in the House-passed budget reconciliation bill [read full update here].

ODP Announcement 22-025 is to inform individuals that the Office of Developmental Programs (ODP) updated the data used in establishing rates that impacted the hourly wage and benefits rages effective March 1, 2022.

While the rate setting process resulted in minor decreases to the Upper Bound of the Hourly Wage and Benefits Ranges for several services in Attachment #1, ODP has decided to continue the Upper Bound at the levels that were in effect prior to March 1, 2022, for those services. The Hourly Wage and Benefits Ranges in Attachment #1 have been updated and should be used to pay SSPs and to support claims processing in the Provider Reimbursement and Operations Management Information System in electronic format (PROMISe™) by the VF/EA FMS organization.

This communication will only be updated when changes occur to the information contained within.

The 2022 RCPA Conference, Together, will be held October 11–14 at the Hershey Lodge as a premier statewide event. The Conference Committee is seeking workshop proposals in every area for possible inclusion. The deadline for submissions is Monday, March 14 at 5:00 pm. Encouraged presentations are those that assist providers in developing and maintaining high-quality, stable, and effective treatments, services, and agencies in an industry where change is constant. The committee looks for presentations that:

  • Highlight new policy, research, and treatment initiatives, such as telehealth innovations;
  • Provide specific skills and information related to individual and organizational leadership development and enhancement;
  • Address system changes that affect business practices, including value-based purchasing and alternative payment models;
  • Provide guidance on recruiting and developing a committed workforce;
  • Offer concrete skills and tools to operate more efficient, effective agencies; and
  • Inspire ideas for organizations to work Together.

Workshop ideas for 2022 include:

  • Workforce shortage solutions;
  • The changing health care landscape, including telehealth changes;
  • Executive leadership;
  • Integrated care strategies for implementation and reimbursement;
  • Managed care models for people with intellectual/developmental disabilities, including other state experiences;
  • Advanced ethics topics;
  • Acquisitions/mergers and consolidations;
  • Value-based purchasing and alternative payment options; and
  • Employing people with disabilities.

The committee welcomes any proposal that addresses these and other topics essential to rehabilitation, mental health, substance use, children’s, aging, physical disabilities, and intellectual/developmental disabilities & autism. Members are encouraged to consider submitting and to forward this opportunity to those who are exceptionally good speakers and have state-of-the-art information to share.

The Call for Proposals (featuring a complete listing of focus tracks) and accompanying Guidelines for Developing Educational Objectives outline requirements for submissions. Please send RCPA your proposal by Monday, March 14 at 5:00 pm. Proposals must be submitted electronically on the form provided; confirmation of receipt will be sent. Proposals submitted after the deadline will not be considered.

If the proposal is accepted, individuals must be prepared to present on any day of the conference. Workshops are 90 or 180 minutes in length. At the time of acceptance, presenters will be required to confirm the ability to submit workshop handouts electronically four weeks prior to the conference. Individuals unable to meet this expectation should not submit proposals for consideration.

Individuals are welcome to submit multiple proposals, and we encourage members to share this information with speakers and presenters who they believe would be a good fit for the conference. Notification of inclusion will be made via email by May 13, 2022. Questions may be directed to Sarah Eyster or Carol Ferenz, Conference Coordinators.

We look forward to coming together again this October!

ODP Announcement 22-021 provides guidance on the upcoming rate increases for the Adult Autism Waiver. Compensation is beginning March 1, 2022; the new rates will be implemented in the Home and Community Services Information System (HCSIS) on March 1, 2022. All Individual Support Plans (ISPs), including ISPs in draft, pending review, or pending approval status, will be updated with the new rates for each of the applicable services. An additional fiscal segment will automatically be added on each ISP for each service that is impacted by the rate change.

Providers are strongly encouraged to review Service Authorization Notices or the Provider Service Detail report in HCSIS to confirm the new rates were loaded, authorized, and that they are billing the increased Fee Schedule Rate before attempting to bill for any services rendered March 1, 2022, and after.

Compensation for the Period July 1, 2021, through February 28, 2022

Providers should bill normally for any services rendered from July 1, 2021, through February 28, 2022. 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, 2021, through February 28, 2022. This is intended to eliminate the provider’s effort of voiding and re-billing claims.

ODP anticipates processing gross adjustments during the April to May 2022 timeframe to ensure all billing for dates of service July 1, 2021, through February 28, 2022, has been completed. Because the rates will be loaded into HCSIS effective July 1, 2021, and the gross adjustment compensation will be issued by ODP, providers should not adjust any claims after April 1, 2022, submitted for services rendered on July 1, 2021, through February 28, 2022.

Adjustment of a claim(s) for services delivered during these dates will result in a duplication of payment that will need to be repaid. Providers are strongly encouraged to bill in a timely manner to minimize the need for corrections.

For questions on how to resolve billing errors for services that were rendered on July 1, 2021, through February 28, 2022, contact Amber Bennett.

Correction to Rates for Small Group Employment and Residential Habilitation Ineligible Fees

Because of an internal editing error, the rates for Small Group Employment and Residential Habilitation: Community Home Ineligible published in the Pennsylvania Bulletin (52 Pa.B. 1326, February 26, 2022) were incorrect. The correct rates, with the corresponding procedure codes, are higher than what was published. The corrected rates are also available on the Department of Human Services’ website.

Positive Behavioral Supports: Meaningful, Everyday Application

We are always looking for better ways to support someone to achieve the quality of life they desire. This requires a social, behavioral, and biological understanding of that person. Positive Behavioral Support (PBS) is an empirically documented, person-centered approach that can be used in day-to-day supports for all people across all systems. For those of you who are not familiar with PBS, ODP will provide an overview of this framework, sharing examples and ways that this has been implemented. For those of you who have a general understanding of the essential elements of PBS, ODP will provide you with tools and ways to infuse PBS into your programs and supports to strengthen your focus on supporting a positive quality of life.

Please join ODP on one of the following dates and times:

  • Wednesday, April 6, 2022, from 12:30 pm–4:30 pm
  • Thursday, April 7, 2022, from 10:00 am–2:00 pm
  • Tuesday, April 12, 2022, from 2:00 pm–6:00 pm
  • Thursday, April 21, 2022, from 9:00 am–1:00 pm
  • Tuesday, April 26, 2022, from 11:00 am–3:00 pm

To register for a session, you must follow these steps:

  1. Visit this link and log in to MyODP OR create a new account.
  2. Complete and submit the Spring 2022 ASD Seminar Demographics Form.
  3. Return to the main course page to register directly through Zoom.

Notes:

  • You will receive an email confirmation of your registration directly from ASERT Collaborative when you complete all steps mentioned above.
  • Content is repeated for all five dates, so you only need to register for one session.

Image by photosforyou from Pixabay

The LEAD Center will host a webinar entitled “How Blended, Braided, or Sequenced Funding Can Help Drive Employment, Equity, and Inclusion” on Tuesday, March 22, 2022 from 3:00 pm–4:30 pm ET. This federal interagency webinar will feature state practitioners across the workforce system discussing how they successfully applied innovative and collaborative resource sharing to benefit both businesses and jobseekers with disabilities.

Register here for the webinar.