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Authors Posts by Carol Ferenz

Carol Ferenz

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ODP Announcement 19-014 serves to re-issue the criteria, process, and procedures for Residential Fee Schedule rate exceptions in the Consolidated Waiver. The fee schedule has been developed to provide adequate funding for individuals with varying needs of support.

ODP has instituted a process for identifying potential exceptions to the fee schedule, due to the extraordinary behavioral or medical needs of an individual. The Residential Rate Exception Process is a process to review individuals in Needs Group 4. These individuals, due to extraordinary behavioral or medical needs, require a staffing pattern and/or staff expertise (example, extensive clinical supports) that exceeds the assumptions that are the basis for the rate for individuals in Needs Group 4.

(Providers serving Individuals in Needs Group 1-3 (Needs Level 1-4) should continue to follow the existing processes for questions related to the Supports Intensity Scale (SIS) assessment findings.)

If an individual experiences a significant change in need, the provider should contact the Supports Coordinator to initiate a team discussion on the changes identified. If the team agrees that the current SIS assessment no longer represents the support needs of the individual, an expedited request can be submitted by the Supports Coordinator. This is accomplished via the vendor’s online portal for approval by the AE and ODP Regional SIS lead. The re-assessment will be scheduled upon completion of the approval process. Providers should complete a review of the recently completed SIS assessment for accuracy and changes to the Needs Group/Needs Level. If a provider has disagreements regarding the content and/or determined Needs Group/Needs Level, they should contact the Supports Coordinator to initiate a team discussion.

If discrepancies are identified between the information provided during the SIS assessment and the information captured on the SIS Family Friendly Report, the provider can contact the vendor to discuss these discrepancies. The provider should be prepared to identify and discuss specific areas of the SIS assessment that were not accurately captured. The vendor will facilitate a discussion to understand the requested changes and will consult with the assessor who completed the assessment and the respondents present during completion.

To qualify for consideration for a Residential Rate Exception, the individual must have a Needs Group 4 (Needs Level 5, 6, or 7) as determined by the most recent SIS assessment. The provider must complete the “Needs Exception Allowance Tool” (NEAT) (Appendix A), which provides information on the number of staff needed and the type of specific staff credentials that are needed. Accompanying the NEAT, the provider must submit a signed release of information for the counties who are completing the Life Experience Assessment Protocol (LEAP) to access the individual’s records. The NEAT and signed release of information should be submitted to the ODP rate setting mailbox.

The ODP Bureau of Financial Management and Budget will review the staffing information described in the NEAT (Appendix A) submission and determine if the individual meets criteria for a possible rate exception.

If a determination is made that an exception should be considered, a LEAP will be initiated, which involves a comprehensive record review of information about the individual’s history and current status. The LEAP record review will be sent to the Administrative Entity (AE) by the ODP regional office; the AE will complete the review.

The LEAP currently includes two tools, the “Desk Review” (Appendix B) and the “Assessment Review” (Appendix C), as well as a Findings Report (Appendix D). Following this review, the results will be returned to the ODP Bureau of Financial Management and Program Support to perform rate calculations. The provider will then be notified of the determination regarding the request. The registering AE will use the attached letters (Appendix E) when communicating the LEAP findings with the provider for currently approved requests that are subject to a post-approval LEAP. Appendix F diagrams how this process will operate.

Residential fee schedule rates were effective January 1, 2018. At a minimum, exceptions will need to be approved/re-approved on an annual basis. For individuals and providers with approved rate exceptions, the new LEAP process will be implemented during FY 18/19. It is anticipated that all approved rate exceptions will receive a LEAP review prior to April 1, 2019. Continuation of previously approved requests that conclude on 6/30/19 should include information on how considerations identified during a LEAP review were addressed.

Effective February 1, 2019, ODP will only accept NEAT requests for exceptional residential rates in the following circumstances:

  1. There has been an identified change in need for an individual currently receiving residential services as documented in their ISP and SIS assessment. The change in need requires an increased need for amount of staffing or qualifications of staff that exceed the need identified at the time of the current SIS assessment and are not supported with in the current fee schedule rate.
  2. The individual is new to the Consolidated waiver, new to residential services, or new to the provider and meets criteria for an exceptional rate request (i.e. NG4).

For questions or assistance related to the rate exception process, please email the ODP rate setting mailbox.

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ODP Announcement 19-012 announces new documentation requirements within the Individual Support Plan (ISP). These requirements are part of the implementation of a settlement agreement, which pertains to services received by individuals through the Consolidated Waiver.

Effective immediately, SCs must include in each individual’s ISP all services that the ISP Team agrees are necessary for the individual, regardless of whether a provider is identified for any or all services, and to the extent that the necessary requested service is an available service under the Consolidated Waiver. This means that when an individual enrolled in the Consolidated Waiver has selected a service to meet an assessed need, but has not chosen a willing and qualified provider, the service information must be documented in the individual’s ISP.

To ensure statewide consistency, ODP is requiring that the information be documented and tracked in the Outcome Section of the ISP. The announcement includes specific information regarding the documentation. While the documentation requirements are immediately in effect, SCs should follow ODPs current processes and timeframes when updating ISPs, as outlined in ISP Manual. For further assistance, please reach out to your ODP regional program office.

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Congressman Bobby Scott (D-VA-3), chairman of the House Education and Labor Committee, Senator Bob Casey (D-PA), and Rep. Cathy McMorris Rodgers (R-WA-5) introduced the Transformation to Competitive Employment Act of 2019 (HR 873 / S 260). This Act provides states, service providers, subminimum wage certificate holders, and other agencies with the resources to help workers with disabilities transition into competitive, integrated employment. The Transformation to Competitive Employment Act is legislation designed to strengthen and enhance the disability employment service delivery systems throughout states while subminimum wages, which are currently allowed under Section 14(c) of the Fair Labor Standards Act, are phased out over a six-year period. Currently, under Section 14(c), employers that obtain a certificate are permitted to hire individuals with disabilities at less than minimum wage. The Act would include some grant money to assist states and certificate holders in transforming their organizations.

Chairman Scott’s press release lists the organizations supporting the bill: “American Network of Community Options and Resources (ANCOR), Association of People Supporting Employment First (APSE), Association of University Centers on Disabilities (AUCD), Autism National Committee, Autistic Self Advocacy Network (ASAN), Autism Society of America, Center for Public Representation (CPR), Collaboration to Promote Self-Determination (CPSD), Council of State Administrators of Vocational Rehabilitation (CSAVR), Disability Rights California, Disability Rights Education & Defense Fund (DREDF), Disability Rights Florida, Disability Rights Iowa, Disability Rights New Mexico, Michigan Protection and Advocacy Service, Inc., National Association of Councils on Developmental Disabilities (NACDD), National Association of State Directors of Developmental Disabilities Services (NASDDDS), National Council on Independent Living (NCIL), National Disability Institute (NDI), National Disability Rights Network (NDRN), National Down Syndrome Congress (NDSC), National Federation of the Blind (NFB), National Rehabilitation Association, TASH, Inc.”

ACCSES, on the other hand, strongly supports a full array of employment options for people with disabilities, including Section 14(c), and will continue to advocate for providers and people who chose this option. Contact Carol Ferenz, RCPA IDD Division Director, with any questions.

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ODP Announcement 19-011 is to inform interested stakeholders that the 2018 Everyday Lives: Values in Action – Information Sharing and Advisory Committee (ISAC) Recommendations, Strategies, and Performance Measures booklet is available online at MyODP.org.

Everyday Lives: Values in Action, developed by the PA Office of Developmental Programs (ODP) Information Sharing and Advisory Committee (ISAC), included 13 recommendations to achieve the vision in Everyday Lives. ISAC members, working together as ODP’s Stakeholder Quality Council, followed up on the 2016 publication’s recommendations, strategies, and performance measures to guide ODP and gauge its progress in achieving the important goals put forth in Everyday Lives. These strategies and recommendations developed by the ISAC are intended to serve as a guide for everyone engaged in developing, providing, and advocating for services in the ODP system: individuals with an intellectual disability or autism, their families, administrative entities, support coordination agencies, providers, advocacy organizations, local quality councils, and all entities involved on the ISAC.

Many of the recommendations and strategies have already been incorporated in draft waiver applications, regulations, policies, the Supporting Families Collaborative, employment initiatives, and training. Each of the recommendations represents what is important to people with disabilities and their families and should guide the work of everyone in the system.

The ISAC will continue to serve as the entity that provides sustained, shared leadership and a platform for collaborative strategic thinking for the ODP system. Strategies will continue to evolve as counties, support coordinators, service providers, advocates, and others work in partnership to improve services.

Contact Carol Ferenz, RCPA IDD Division Director, with any questions.

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ODP has issued Announcement 19-010 to provide written notification of the requirement to submit qualification documentation for providers who have an MPI number ending in 3, 4, or 5. Providers within this group are due to become requalified in 2019 and must submit documentation no later than 61 days prior to the expiration of provider qualification. Specifically, supporting documentation must be submitted starting February 1, 2019, but no later than March 31, 2019. Documentation must include a completed DP 1059 form, an updated Provider Qualification Documentation Record, and any required supporting documentation.

Providers who fail to submit qualified documentation by April 30, 2019, will participate in transition planning for the participants currently receiving Home and Community-Based Services (HCBS). As a part of the transition, the assigned Administrative Entity (AE) will commence transition of waiver participants according to the process detailed in ODP Communication 011-18. Providers whose qualifications expire June 30 will not be eligible to receive payment for waiver services rendered after June 30, will no longer be qualified to provide HCBS, and will have their name removed from the list of qualified providers of that HCBS.

For inquiries regarding this communication, contact the ODP Provider Qualification mailbox.

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ODP Announcement 19-009 (REISSUE) announces a training opportunity open to providers of employment services:

  • ID/A Waiver Providers: Supported Employment, Small Group Employment, and the prevocational component of Community Participation Support.
  • For AAW Providers: Career Planning, Supported Employment, and Transitional Work.

The Arc of Pennsylvania will host a total of five ACRE certification training sessions to be held in the east, central, and west regions of the state. This ACRE certification training is a combination of both in-person and online training.

Please refer to this flyer for details on sessions scheduled for March 4–6 at Harrisburg PaTTAN, 6340 Flank Drive, Harrisburg, PA 17112. Registration is required and is open until February 28, 2019. The project will reimburse attendees up to $25 for travel expenses they incur to attend and participate in the training upon successful completion of the ACRE certification.

Future dates and locations include April 15–17 at PaTTAN Malvern and May 21–23 at Achieva in Pittsburgh. A flyer with registration details and seating capacity for these locations will be sent in the coming weeks. Other locations and dates will be announced once confirmed. Please submit questions via email.

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ODP Announcement 19-006 provides an update to ODP’s Medication Administration Manual, Student Course, and Practicum Observer Access is Now Available. This update regards changes to the course schedule. Four training courses scheduled for March have been rescheduled, and some classes scheduled for April and May have been updated. Please check the announcement to see the updated information.

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ODP Announcement 19-008 announces the cost-of-living adjustment (COLA) to Social Security Supplemental Security Income (SSI) that will impact the Room and Board payments for individuals living in settings that are waiver funded Residential Habilitation, Life Sharing and Family Living Services. SSI is a Federal program that provides benefits to adults and children who meet the Social Security Administration (SSA) requirements for disability, income, and resources. This income benefit is designed to help qualified individuals meet basic needs for food, clothing, and shelter.

Periodically, a COLA affects the maximum monthly allotment. Effective January 2019, the SSA increased the SSI allotment by 2.8 percent to reflect an increase in the cost of living. This raises the maximum monthly income to $771 for an eligible individual, $1,157 for an eligible individual with an eligible spouse, and $386 for an essential person. There is no anticipated increase in the State Supplementary Payment (SSP) for 2019.

To account for the new COLA, Room and Board contracts should be reviewed to determine appropriate adjustment. For more specific information regarding the Room and Board requirements for waiver funded Residential Habilitation, Life Sharing and Family Living services, please see 55 Pa. Code Sections 51. 121-51.128. Room and Board requirements will also be included in 55 Pa. Code Chapter 6100 and will be effective 120 days after the regulations are published. The Room and Board contract is form DP 1051.

This announcement obsoletes Announcement 002-18, effective January 1, 2019, Supplemental Security Income (SSI) Increase for Calendar Year 2018. For more specific information regarding SSI and the COLA, please review the US Social Security Administration website.

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ODP Announcement 19-007 states that the department’s report, “Improving the Quality of Residential Services,” is now available. This report shares with stakeholders ODP’s commitment toward improved service quality, as the Department works to maintain the health and well-being of individuals residing in community-based homes. This report includes both planned initiatives and activities already in progress, demonstrating ODP’s continued efforts to improve residential service quality. ODP has worked internally and in partnership with stakeholders to identify gaps in service delivery. Improvement activities are either tied to the four model practices outlined in the Joint Report: Ensuring Beneficiary Health and Safety in Group Homes Through State Implementation of Comprehensive Compliance Oversight (Joint Report) or recommendations from the ODP Residential Strategic Thinking Group (STG).

The Joint Report was published by the US Department of Health and Human Services Office of the Inspector General (OIG), in response to congressional requests concerning abuse and neglect of individuals residing in group homes. The OIG conducted a series of audits based on a review of practices in several states and found that “residents often experienced serious injuries and medical conditions that resulted in emergency room visits.” This publication provides guidance on model practices in four areas: (1) State Incident Management and Investigation, (2) Incident Management Audits, (3) State Mortality Reviews, and (4) State Quality Assurance.

In November 2017, ODP convened the Residential STG to develop recommendations for new or revised policies, guidance for provider practice, methods for incorporating person-centered practices, modifications to ODP licensing practices, and technical assistance and training.

This report focuses on three principles of residential services:

  • It is home, a place where we feel most comfortable, safe, and where we feel we belong;
  • Every individual has the capacity to engage in lifelong learning; and
  • Person-centered practices inform how we support people.

The Residential STG identified six key domains for residential services improvement and recommended change actions for each domain. Please refer to the report for more detailed information about ODP’s plan for continued efforts to improve the quality of residential services. Please submit questions via email.

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