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The Pennsylvania Department of Drug and Alcohol Programs (DDAP) is hosting its annual Recovery Month Kick-Off event on September 12 at Soldiers and Sailors Grove in Harrisburg. The focus of the 2024 kick-off will be total wellness in recovery. To participate in the event, complete the survey by June 28 to indicate if you or your agency would like to provide an interactive activity (such as yoga, music therapy, or meditation) or have a resource table. Space is limited, so responses will be accepted on a first-come, first-served basis. The event will take place outdoors, with a rain date of Sept. 13. It will be held at the venue located on the fountain side of the state capitol building between Commonwealth Avenue and State Street.

Photo by Michael Schofield on Unsplash

The While House issued a press release announcing that the Access Final Rule will be released later today. These regulations include:

  • The Nursing Home Minimum Staffing Rule, which will require all nursing homes that receive federal funding through Medicare and Medicaid to have 3.48 hours per resident per day of total staffing, including a defined number from both registered nurses (0.55 hours per resident per day) and nurse aides (2.45 per resident per day);
  • Introducing the requirements of the rule in phases to make sure nursing homes have the time they need to hire staff, with longer timeframes for rural communities;
  • Ensuring adequate compensation for home care workers for HCBS operations of in-home care (both Personal Assistance Services and Community Habilitation) by “requiring that at least 80 percent of Medicaid payments for home care services go to workers’ wages. This policy would also allow states to take into account the unique experiences that small home care providers and providers in rural areas face while ensuring their employees receive their fair share of Medicaid payments and continued training as well as the delivery of quality care;”
  • The state requirement to be more transparent in how much they pay for home care services and how they set those rates, increasing the accountability for home care providers; and
  • The creation of a state home care rate-setting advisory group made up of beneficiaries, home care workers, and other key stakeholders to advise and consult on provider payment rates and direct compensation for direct care workers.

We will continue to monitor the details of these regulations and Pennsylvania’s plans to comply. If you have any questions, please contact Fady Sahhar.

The Office of Developmental Programs (ODP) invites you to save the date for the 2024 Pennsylvania Autism Training Conference! The conference will be held virtually from November 5 – 7, 2024. More details, as well as registration information, is to follow.

Do you know an artist or storyteller? Encourage them to share their talents at PATC!

Call for Personal Stories: Calling all self-advocates with autism! Share your story at the 2024 PA Autism Training Conference. Choose from one of our featured prompts and let your voice be heard! Stories will be displayed virtually during the conference and beyond. Must be 14 or older to participate. Visit here to learn more! Submissions Due: August 2, 2024.

Call for Artists: ODP would like to invite artists with autism to exhibit their work virtually during the 2024 Pennsylvania Autism Training Conference. The art show will consist of images links of artwork supplied by the artists, as well as to their website or email addresses for further information for attendees. Visit here to learn more. Submissions Due: September 6, 2024.

The Department of Human Services (Department) is making available for public review and comment the Office of Developmental Programs’ (ODP) proposed application for a section 1915(b)(4) waiver for a selective contracting program as well as amendments to the Consolidated and Community Living waivers required to implement selective contracting for Residential Habilitation, Life Sharing, and Supported Living services. The selective contracting program will be referred to as Performance-Based Contracting.

The Department is also making available for public review and comment additional proposed amendments to the Consolidated, Community Living, Person/Family Directed Support (P/FDS), and Adult Autism Waivers that are not related to implementation of selective contracting. Changes are proposed to become effective on January 1, 2025.

When performance-based contracting is implemented, all currently enrolled residential providers will have the opportunity to enter into a performance-based contract with ODP. To help support providers with the new requirements and process, ODP will hold provider trainings so that providers have a clear understanding of the process and expectations. As part of this process, providers will submit documentation demonstrating compliance with the performance areas identified by ODP. Additionally, ODP will use data from participant experience surveys, claims, incident management, health risk screening, administrative entities, and a new Performance Analysis Services vendor to evaluate each provider’s performance against the established standards and determine the tier in which the provider will be placed.

Providers will be placed in one of the following tiers based on their performance:

  • Conditional for providers operating under provisional or revoked licenses;
  • Primary for providers that meet current standards and a few additional standards;
  • Select for providers that deliver at least two of the three residential services in the performance-based contracting model and meet enhanced measures; or
  • Clinically Enhanced for providers that offer clinically enhanced medical or behavioral supports and meet enhanced measures.

The Department proposes the following substantive amendments to the Consolidated and Community Living waivers that will support the implementation of performance-based contracting, effective January 1, 2025:

  • Allow for the Department to contract with a Performance Analysis Services vendor that will provide administrative support with data collection, analysis, and reporting functions;
  • Require residential service providers to sign a residential provider agreement, which requires providers to comply with performance standards and reporting requirements outlined in the agreement and ODP policy; and
  • Implement pay-for-performance supplemental payments for residential service providers that meet or exceed performance targets for staff credentialing, employment of individuals served, transition of individuals to Life Sharing or Supported Living services, and reporting on use of technology.

Supplemental payments will be calculated for residential providers meeting or exceeding performance standards as a one-time or combined payment up to 3% of ODP-eligible service revenue from the applicable review period or established payment amount per qualifying event. Providers that have been determined to be a Primary, Select, or Clinically Enhanced provider are eligible to receive the supplemental payments.

  • Pay Licensed Residential Habilitation, Unlicensed Residential Habilitation, Life Sharing, and Supported Living providers that meet the requirements to qualify as a select provider or a Clinically Enhanced residential provider a payment that is in addition to the Medical Assistance fee schedule rate. Select providers will receive a rate add-on of 5% per individual served, and Clinically Enhanced providers will receive a rate add-on of 8%.

Other proposed amendments unrelated to Performance-Based Contracting include:

  • Assuring effective communication for individuals who use American Sign Language through implementation of a new American Sign Language — English Interpreter service. Services will be reimbursed as a vendor service based on the cost that the provider charges to the general public.
  • Promoting health, wellness, and safety by clarifying that individuals who receive services in an acute care hospital will not be disenrolled from the waiver.
  • Supporting the quality of Assistive Technology provided by expanding the qualification requirements for a professional who can complete an evaluation of an individual’s need for Assistive Technology and clarifying that evaluations can be completed for technology costing less than $750 if the service plan team believes it will be beneficial.
  • Increasing community participation and employment by requiring providers of Community Participation Support and Day Habilitation services to annually complete an analysis of each individual’s interests, preferences, skills, and strengths that support the individual’s participation in employment or other community activities.
  • Including revisions to align waiver requirements with regulatory requirements, correct errors, and provide clarification requested by stakeholders.
  • Increasing employment of individuals by allowing indirect activities to be billed through the Benefits Counseling service and improving access to Benefits Counseling for individuals who are not eligible for the Federal Work Incentives Planning and Assistance program.

The Department proposes the following substantive amendments to the Adult Autism Waiver that are not related to implementation of performance-based contracting effective January 1, 2025:

  • Support the quality of Residential Habilitation, Community Home, and Life Sharing services, through alignment of provider qualifications with the qualifications included in the Consolidated and Community Living waivers.
  • Promote health, wellness, and safety by clarifying that Residential Habilitation providers must have a licensed nurse available if the provider serves individuals with needs that require care by a licensed nurse.
  • Promote self-direction, choice, and control by clarifying that Community Transition Services can be used to support individuals transitioning from settings such as Residential Habilitation to private residences in alignment with guidance in the CMS instructions, technical guide, and review criteria for 1915(c) waivers.

View Performance-Based Contracting Information:

View Proposed Changes to the Waivers, Including Changes Not Related to Performance-Based Contracting:

Comments received within 45 days of publication of this notice will be reviewed and considered for revisions to the proposed application for a section 1915(b)(4) waiver as well as proposed amendments to the waivers. Comments should be addressed to Julie Mochon, Department of Human Services, Office of Developmental Programs, 625 Forster Street, Room 510, Harrisburg, PA 17120. Comments may also be submitted to the Department via email using the subject header ”Waiver Comments.”

RCPA will be scheduling a meeting for members to develop comments in response to these proposed amendments. Please contact Carol Ferenz with any questions.

The Office of Developmental Programs (ODP) has shared ODPANN 24-037. The purpose of this announcement is to provide guidance for the Fiscal Year (FY) 2024/25 renewal period.

The following topical areas are addressed in this communication:

  • Leap Year to Non-Leap Year;
  • Guidance for Updating FY 2024/25 Renewal Plans with Partial Year Service Segments;
  • FY 2024/25 Waiver Rate Load/Rate Changes;
  • Variance Process for Established Service Requirements;
  • NG5 and Residential Rate Exception NEA Process;
  • Remote Supports;
  • Reserve to Encumbrance; and
  • Resources.

Please view the announcement for information and details.

The newly established Pennsylvania Certification Commission for Addiction Professionals (PCC AP) is now offering certification and training for clinical supervisors and counselors who provide clinical treatment services in licensed substance use disorder (SUD) treatment facilities. Historically in Pennsylvania, the Pennsylvania Certification Board (PCB) has provided these certifications and trainings.

PCC AP, which also offers SUD and mental health peer certification, is affiliated with the Pennsylvania Association of Addiction Professionals and the National Association of Addiction Professionals (NAADAC). Both PCB and PCC AP/NAADAC offer certifications and training beneficial to those in the SUD field.

PCC AP aligns with Pennsylvania regulations and is currently providing a test-exempt period from February 1, 2024, to December 31, 2024. During this time, field licensure or certification holders can obtain PCC AP certification without a test, including certification for peers, counselors, and supervisors.

Detailed information about each certification level, including application processes and fees, can be found on the NAADAC website. Additionally, an FAQ page is available.