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Authors Posts by Carol Ferenz

Carol Ferenz

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ODP Announcement 23-008 announces that the amendment to the Adult Autism Waiver (AAW), effective January 1, 2023, was approved by the Centers for Medicare & Medicaid Services (CMS) on January 13, 2023. The amendment to the AAW includes the following substantive changes:

  • Adding reserved waiver capacity for individuals who are discharged from a state center or are released from incarceration after a period of at least six consecutive months.
  • Aligning of provider qualifications in the AAW with the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) waivers, whenever possible.
  • Allowing relatives to deliver the Life Sharing component of the Residential Habilitation service.
  • Requiring that agencies that provide Residential Habilitation/Life Sharing be qualified and enrolled to provide Residential Habilitation/Life Sharing in the Consolidated or Community Living waivers.
  • Increasing the annual fiscal limit in the Transportation service to $5,000 per participant’s Individual Support Plan (ISP) year.
  • Allowing one of the four required individual monitorings conducted by the Supports Coordinator each year to be conducted remotely. NOTE: For all individuals receiving Residential Habilitation (Community Homes or Life Sharing), remote monitorings are not permitted. See ODP Announcement 22-085 for additional information.
  • Allowing delivery of direct services using remote technology (teleservices). The requirements in the AAW will become effective when Appendix K flexibilities expire, six months after the expiration of the federal COVID-19 public health emergency.
  • Aligning the Assistive Technology service, where possible, with the Consolidated, Community Living, and P/FDS waivers. This includes adding generators for the participant’s primary residence.
  • Adding a new service, Remote Supports. A separate communication will be published in the coming weeks, providing instructions about how to add new Remote Supports procedure codes to ISPs. Remote Supports should not be added to ISPs until this communication is published.

The waiver application approved by CMS and the record of change document are available here.

ODP will be holding a webinar to discuss major changes made in the approved AAW amendment. Webinars specific to Remote Supports will be scheduled and communicated in the coming weeks. The date, time, and registration link for the general AAW amendment webinar are as follows:

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By The Times-Tribune

Editor: Providers who care for individuals with intellectual disabilities and autism are pummeled by a workforce shortage driven by low wages and high vacancy and turnover rates.

The Arc of Pennsylvania recently partnered with other social service associations to get a better picture of the state’s workforce in the field.

The survey evaluated critical data on pay practices, hourly wages, scheduled positions, filled positions and separations for more than 9,000 employees representing 40 different positions in 52 organizations, including many in Northeast Pennsylvania.

The findings are stark.

Wages for direct support professionals who help children and adults with their basic daily living needs average $16.61 per hour — less than wages at some fast-food restaurants. The turnover rate for direct support workers is 38% with providers reporting a vacancy rate of 28%. The numbers are similar for other residential and program supervisors.

The study also found that 14% of all direct support professionals’ hours are paid at an overtime rate, and 41% of providers now engage in a more costly practice of contracting for staffing services to manage the workforce shortage.

Because human services for those with intellectual disabilities and autism are funded primarily by Medicaid, providers cannot raise prices like private businesses to pay higher wages. So, chronic underfunding by the state only exacerbates these operational challenges.

Service providers simply do not have the staff they need to serve thousands of Pennsylvanians receiving or waiting for critical services. This is a system that is strained past its breaking point, and it needs our support now.

SHERRI LANDIS
THE ARC OF PENNSYLVANIA
HARRISBURG

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Image by Dirk Wouters from Pixabay

Who We Are: Powered by People in PA is one of two Pennsylvania-based teams selected to participate in The National Center on Advancing Person-Centered Practices and Systems (NCAPPS) self-direction learning collaborative. We are a diverse team that includes a supports brokerage, Supports Brokers, a University Center for Excellence in Developmental Disabilities (UCEDD), people with disabilities with expertise and lived experience to share, family members, a representative of our state Office of Developmental Programs, a Pennsylvania Agency with Choice, and a member of our vendor-fiscal advisory committee.

What We Seek to Accomplish: The goal of the learning collaborative is to promote high-quality self-direction on both a state and national level. Our learning collaborative seeks to recruit and train Support Service Professionals, Supports Brokers, and Peer Mentors to support self-direction.

We developed four (4) surveys to gather feedback from stakeholders about the training needs of Supports Brokers. The feedback will be used to inform recommendations to the Office of Developmental Programs (ODP) for a Supports Broker Recertification training curriculum.

What We Need from You: We are asking stakeholders to complete the survey that is relevant to their role. The survey is anonymous and will take less than 10 minutes to complete.

Select the appropriate link below to complete the survey:

The surveys will open on January 2, 2023, and close on February 3, 2023.

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ODP Announcement 23-005 is to inform stakeholders that the United States General Services Administration announced a change to the Transportation Mile reimbursement rate, procedure code W7271, beginning January 1, 2023.

The new rate is $0.655 per mile. This communication provides notice of the rate change, as well as provides instructions for Supports Coordination Organizations (SCOs) on how to add transportation mileage to the vendor screen. It also instructs direct service providers on how to submit claim adjustments, if applicable.

Questions regarding this announcement should be addressed to the appropriate ODP Regional Program Managers.

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ODP Announcement 23-003 serves to inform all waiver providers and vendors whose last digit of their Master Provider Index (MPI) number is 6, 7, 8, or 9, as well as new providers who enrolled in the 2021/2022 fiscal year, that they must submit their qualification documentation to their assigned AE and/or the Office of Developmental Programs’ (ODP) Bureau of Supports for Autism and Special Populations (BSASP). This documentation is due from February 1 through March 31, 2023.

If the provider is enrolled to provide services in BOTH an ID/A waiver and the AAW, providers should submit all supporting documentation to both their Assigned AE and BSASP via email. If your agency is enrolled to provide services in an ID/A waiver only, providers should submit all supporting documentation to their Assigned AE.

For reference to provider qualification, please see PA Code Chapter 6100, Subsections 6100.83-84, which contains provider qualification citation specifications. Inquiries about this communication regarding the ID/A qualification process should be sent to the ODP Provider Qualification inbox.

Inquiries about this communication regarding the AAW qualification process should be sent to the AAW Provider Qualification inbox.

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ODP Announcement 23-002 reports that the renewals for the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) Waivers have been approved by the Centers for Medicare & Medicaid Services (CMS) with an effective date of January 1, 2023. CMS approves waivers for a five-year period. The current Consolidated, Community Living, and P/FDS Waivers expired June 30, 2022, but were extended twice as discussions continued between the Office of Developmental Programs (ODP) and CMS.

Major changes in the renewals include:

  • Remote Supports has been added as a separate, discrete service in all three waivers.
  • Clarification about the activities that can be performed under the Communication Specialist service has been added, the amount of Communication Specialist services that participants can receive each year has increased from 40 hours to 60 hours, and effective January 1, 2024, the communication specialist will be required to successfully complete training provided by ODP.
  • The amount of Benefits Counseling services that participants can receive each year has increased from 10 hours to 15 hours.
  • The amount of tuition that can be covered through Education Support services has increased from $35,000 to $40,000.
  • Companion services have expanded to support additional participants at their place of employment.
  • Supported Employment services can now support participants during work-related trips.
  • Participant Directed Goods and Services have been added to the Consolidated Waiver.
  • The purpose of the Supports Broker service has been clarified, and recertification requirements for Supports Brokers have been added.
  • The Specialized Supplies service will continue to cover personal protective equipment once Appendix K flexibilities end.
  • Music, Art, and Equine-Assisted Therapy are available to individuals who receive residential services.
  • Staff working for, or contracting with, Residential Habilitation, Life Sharing, or Supported Living providers must complete Department-approved training on the common health conditions that may be associated with preventable deaths.
  • Clarification about requirements for using technology in the provision of waiver services has been added with a focus on protecting individual privacy when using technology.
  • Clarification about experience and education requirements for Supports Coordinators and Supports Coordinator Supervisors has been added, and Supports Coordinators will continue to be allowed to use teleservices to perform some of the required face-to-face monitoring per year.

A list of all major changes made in the renewals is available in the record of change document and each full waiver application approved by CMS, which are available at:

ODP will be holding a webinar to discuss major changes made in these approved waiver renewals on February 9, 2023, from 1:00 pm – 2:00 pm. You can register for the webinar here.

Questions about this communication should be directed to the appropriate Office of Developmental Programs Regional Office.

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The Pennsylvania office of the US Department of Labor’s Wage and Hour Division is offering a free webinar as a part of their commitment to educate employers and workers about the pertinent laws and the rights of care workers. This webinar will focus on the Fair Labor Standards Act for Home Care Industry Employers, Registry Services, and Staffing Agencies and Associations.

The webinar will be held on Thursday, January 19, 2023, from 10:00 am – 11:30 am.

Register here. For questions about this event, contact Karen Welton.

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