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Policy Areas

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After reviewing hundreds of comments from stakeholders, the Office of Developmental Programs (ODP) has made some initial adjustments to the proposed Performance-Based Contracting waiver for Residential Services. Areas with high volumes of comments included:

  • Select/Clinically Enhanced Tiers being reserved for agencies serving 10 or more individuals;
  • Competitive Integrated Employment standards;
  • Populations served with average Needs Level 4.5+ and average Health Care Level 3.5+ (HCL is established using the Health Risk Screening Tool);
  • Primary providers being limited to Needs Group 1-3;
  • The number of measures; and
  • The timeline for implementation.

ODP is now offering Residential providers a choice of when they are assigned into a tier. This will be based on which data they chose for ODP to review and make a tier determination upon. The choices will be:

  • Calendar year 2023 data reviewed with notification of tier assignment occurring in November, to be effective January 1, 2025 – June 2026; or
  • Review of Calendar year 2024 data with notification of tier assignment occurring in May, to be effective July 2025 – July 2026.

ODP plans to continue their review of public comments and intends to publish additional information. On July 19, ODP hopes to submit amended the 1915(c) waivers and 1915(b)4 waiver as well as publish the following supporting documents:

  • Performance Standards;
  • Implementation Plan;
  • Attestation; and
  • Provider Data Submission Tool.

On January 1, 2025, ODP intends to begin Performance-Based Contracting (pending CMS approval).

ODP will conduct a webinar for residential providers on Monday, July 22, 2024, from 3:00 pm – 4:00 pm, to review publications, changes made as a result of public comment, and instructions for tier determination and data submission. Register here. This webinar will be posted on the PBC Resource Page located on the MyODP website.

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ODP Announcement 24-064 is to inform trainers and learners of an upcoming system upgrade for the Medication Administration system. The system will be undergoing an upgrade starting Thursday, July 25, 2024, and ending Friday, August 2, 2024. During this time, it will be completely unavailable to learners and trainers. Please finish any self-paced learning by Monday, July 22, 2024, including online lessons, quizzes, activities, post multiple choice, and post written documentation exams.

If you have questions about this upgrade or if you need assistance during this transition, you may contact the Medication Administration Help Desk website to log a ticket. The help desk will be available to address any concerns during this transition.

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Photo by Christina @ wocintechchat.com on Unsplash

The Office of Long-Term Living (OLTL) has announced that they will be hosting a Home and Community-Based Services (HCBS) provider call on July 18, 2024, from 2:00 pm – 3:30 pm that will include a presentation from Mercer providing an overview of the HCBS rate and wage study.

The Department of Human Services (DHS) contracts with Mercer Government Human Services consulting for actuarial services, Medicaid policy and fiscal analysis, financial monitoring, and other technical support.

Mercer will evaluate the following services categories in this rate study:

  • Adult Daily Living;
  • Residential Habilitation;
  • Personal Assistance (Agency and Participant-Directed);
  • Structured Day Habilitation; and
  • Employment and Training Services.

Because this is an HCBS Provider Call, registration for the call will be limited to providers who are enrolled with DHS to provide any of these particular services to individuals. Participant-Directed Common-Law Employers are also encouraged to attend. If you are not a provider of these services or are unable to attend the July 18 HCBS Provider Call, you are welcome to attend the July 2 Long-Term Services and Supports (LTSS) Subcommittee meeting to hear from Mercer about the HCBS Rate and Wage Study and ask questions.

Everyone is welcome to submit questions about the HCBS Rate and Wage Study electronically to OLTL in advance of the July 18 call. Questions submitted will be read during the call as time allows. Questions and Answers will be compiled into a Q&A document that will be available after the call.

A registration link for the July 18, 2024, HCBS Provider Call will be issued shortly. If you have any questions about the call itself, please contact Kristi Mundis.

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This week is marked annually in honor of leading humanitarian Helen Keller’s birthday on June 27. Being deaf and blind herself, Keller’s work made a large difference in the lives of DeafBlind people. It is much more common than many people realize. Over 15 million people worldwide are estimated to be living with severe DeafBlindness. This week is a chance for us to raise awareness of deafblindness and make Pennsylvania a more DeafBlind-friendly place.

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ODP Announcement 24-062 is to inform all provider agencies employing DSPs that the Human Services Research Institute (HSRI) has extended the deadline for completing the 2023 National Core Indicators® (NCI) State of the Workforce Survey. The portal will now close on Wednesday, July 31, 2024.

HSRI is aiming for a 5% or lower margin of error (MoE) for each participating state. The lower the MoE, the more representative and impactful the data will be. Pennsylvania currently has a 5.5% margin of error, and ODP would like to see it reach the recommended level since it is within reach. Therefore, ODP strongly encourages eligible provider agencies to complete the survey if they have not already done so. A final reminder will be issued via the portal in mid-July.

For questions, contact Ms. Lee Stephens, ODP IM4Q/NCI Statewide Lead.

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Photo by Markus Winkler on Unsplash

Today, both the ISAC Performance Review Subcommittee and the Medical Assistance Advisory Committee (MAAC) meetings were held. During these meetings, the Office of Developmental Programs (ODP) announced that as a result of public comments received regarding Performance-Based Contracting, some adjustments are being made to the plans. Tomorrow, ODP will release an announcement with more details, but for now, we know the following:

  • Residential providers will be offered a choice of when they are assigned into a tier. This will be based on which data they chose for ODP to review and make a tier determination upon. The choices will be:
    • Calendar year 2023 data reviewed with notification of tier assignment occurring in November, to be effective January 1, 2025 – June 2026; or
    • Review of Calendar year 2024 data with notification of tier assignment occurring in May, to be effective July 2025 – July 2026.

ODP plans to submit the proposed waiver to CMS on July 19, 2024.

In addition, the presentation from the MAAC meeting can be found here.

Documents from the Performance Review Subcommittee can be found below:

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