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Intellectual & Developmental Disabilities

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Senate Bill 906 SB 906, calling for a state center closure moratorium, has passed the House by a vote of 139–55. The bill amends the Mental Health and Intellectual Disability Act, in preliminary provisions, further providing for definitions; and, in responsibilities of the State, providing for a state center closure moratorium. The amendment sponsored by state Representative Lee James passed Tuesday, January 14, 2020. The measure eradicates previous wording on the bill that placed a moratorium on the closure of state centers until all Medicaid waiver-eligible individuals on the waiting list (of over 13,000) received funding for home or community-based care. The moratorium would now have a five-year limit.

The bill calls for the creation of a task force on the closure of state centers. The task force would convene within 60 days and be comprised of the Secretary of Department of Human Services, one representative from each state center, one representative from the Governor’s office, the chair and minority chair of the Senate Health and Human Services Committee and House Human Services Committee, two family members of residents of state centers, and one representative of a nonprofit organization that serves as an advocate for those with intellectual disabilities. The bill now goes back to the Senate as the bill was amended on the floor yesterday.

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You are cordially invited to Representative Joseph Hohenstein’s all-day summit in Philadelphia on Thursday, January 16. The summit will highlight the 30th Anniversary of the Americans with Disabilities Act (ADA). The Democrat Caucus will also be holding two separate policy hearings during January to recognize this occasion.

Register for Rep. Hohenstein’s Philadelphia event here, which will be hosted at Community Behavioral Health. There are a number of confirmed speakers ranging from service providers, the Philadelphia Eagles (discussing the Quiet Room at Lincoln Financial Field), Comcast (discussing technological advances to help people with intellectual disabilities access the internet and communicate), Senator Casey’s and Gov. Wolf’s offices (to discuss federal and state legislative initiatives), as well as others.

If you have any questions, please contact Jack Phillips, RCPA Director of Government Affairs.

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The Centers for Medicare and Medicaid Services (CMS) has approved the Office of Long-Term Living’s (OLTL) Community HealthChoices (CHC) Waiver renewal. The renewal became effective on January 1, 2020.

Key changes in the approved waiver include:

  • Revised the Residential Habilitation service definition by modifying the number of hours that are defined as a day unit from a minimum of 12 hours to a minimum of 8 hours.
  • To the service definitions of Job Finding, Job Coaching, Employment Skills Development, Career Assessment and Benefits Counseling, added language that Office of Vocational Rehabilitation (OVR) services are considered to not be available if OVR has not made an eligibility determination within 120 days; and added language to address when employment services through the CHC waiver can be provided should OVR close the order of selection, thereby creating a waiting list for OVR services.
  • Modified the qualifications for Service Coordinators and Service Coordinator supervisors.
  • Clarified that if a CHC Managed Care Organization (MCO) identifies that a participant has not been receiving services for 5 or more days, and if the suspension of services was not pre-planned, then the CHC-MCO must communicate with the participant to determine the reason for the service suspension within 24 hours. If the participant’s health status or needs have changed, the CHC-MCO must conduct a comprehensive needs reassessment of the participant’s needs within fourteen (14) days of identifying the issue.
  • Added that an emergency back-up plan must be included in the Person-Centered Service Plan.
  • Modified language to reflect that the CHC waiver will be fully operational statewide as of January 1, 2020.
  • Updated language to reflect that the Department utilizes IDEMIA as the data system to process fingerprint-based Federal Bureau of Investigation (FBI) criminal record checks.
  • Updated the OLTL bureau names and responsibilities.

Questions surrounding the CHC Waiver Renewal should be directed to the OLTL Bureau of Policy Development and Communications Management at 717-857-3280.

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The ODP Adult Autism Waiver (AAW) requires Supports Coordinators (SCs) to administer a battery of assessments at intake, annually, and as needs change. Included in that battery of assessments is administering the Scales of Independent Behavior – Revised (SIBr). It has come to the department’s attention that the SIBr software will not be compatible with the most recent versions of Microsoft.

ODP Announcement 19-166 informs that as of January 1, 2020, the Bureau of Supports for Autism and Special Populations (BSASP) expects all SCs to administer the SIBr and send the raw scores to BSASP, as currently designed, with these changes:

  • Since the scores will not be calculated, it is expected that SCs and teams use the raw scores and SIBr response booklet to do an item analysis that will aid in planning for the participant’s supports and services.
  • Identifying those items in the assessment in which the participant’s score is low should be a prompt for the team to consider goals and supports that address the potential area of weakness.

The SIBr response booklet should be kept in the participant’s file and may be reviewed for completion during monitoring activities. Please submit questions here.

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ODP Announcement 20-001 provides information regarding the Modified Medication Administration Training course that is now available. The modified course was designed specifically for those who administer medications in Lifesharing locations or service locations not licensed by the Department. This course does not meet the medication administration training requirements of other service locations licensed by the Department.

With the implementation of the Chapter 6100 Regulations, this course is mandatory for Lifesharers who administer medications or those who administer medications in service locations not licensed by the department. This course is not required for the administration of medication by an adult relative of an individual who receives services in an unlicensed setting. The course is required when an adult relative is supporting a family member in an unlicensed life sharing home.

The Modified Medication Administration Course may be accessed on MyODP. Questions may be directed here.

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On December 24, 2019, DHS announced the approval of the Department’s Good Faith Effort (GFE) Exemption application for the Electronic Visit Verification (EVV) implementation. This GFE does not change DHS’ expectations of providers of personal care services to comply with the requirements of the 21st Century Cures Act. The Department will continue with a soft launch period through June 30, 2020. Throughout this time, providers must begin using EVV and complete any integration and certification activities if they have not been completed already. The Department continues to develop a policy bulletin that will outline additional requirements, including compliance benchmarks for manually edited visits. This bulletin will be released as soon as it is finalized.

During claims processing in PROMISeTM, EVV validation against the EVV Aggregator will continue to be performed and EVV Error Service Codes (ESCs) will set without impacting claim payment. During the extended soft launch period, the expectation is that provider/provider agency/Agency with Choice and Vendor Fiscal/Employer Agent billing staff will note when the EVV edit(s) set and actively make corrections either to the data stored in the DHS EVV Aggregator or the claim itself to ensure errors do not repeat. DHS will be monitoring which EVV edits set and how often.

Regular updates to the stakeholder community will be made on the progress of the implementation. Outreach and technical assistance will be performed based on results and as applicable. As of July 1, 2020, any claims without a corresponding EVV visit or any mismatches between what is found on the claim versus what is found in the EVV Aggregator will be denied.

2020 EVV Implementation Timeline:

  • January 1, 2020: All Providers must begin using EVV for Personal Care Services (PCS).
  • January 2020 – March 2020: All Providers must complete system integration activities with the DHS Aggregator for fee-for-service programs. Providers who are experiencing difficulties in integrating and will not be ready by March 2020 are asked to submit an extension request using this form, documenting the difficulties they are experiencing no later than February 1, 2020. The completed form should be emailed to the EVV resource account.
  • Starting July 1, 2020: Claims submitted for Personal Care Services without a matching EVV visit will be denied.

If providers have not yet completed the necessary steps to implement EVV, please contact the appropriate entity to complete the necessary training and system integration activities.

OLTL and ODP Fee-For-Service Providers

  • The DHS Sandata system training is available for providers electing to use the DHS Sandata system. Providers using the DHS system must complete this training in order to begin setting up their agency accounts and security permissions. Providers may register for the independent web-based training offered through Sandata here.
  • The DHS Aggregator will receive information from Alternate EVV systems being used by providers in fee-for-service programs.
  • Providers using Alternate EVV systems should contact Sandata at 855-705-2407 to complete Alternate EVV system integration activities for fee-for-service programs.

Current Community HealthChoices (CHC) Providers and Aging, Attendant Care, and Independence Waiver Providers

  • If providers are electing to use the HHAeXchange EVV system offered by the Managed Care Organizations (MCOs), providers must work with the MCOs to complete training and other onboarding requirements.
  • Providers using Alternate EVV systems in CHC will need to send their EVV data to the CHC-MCOs.
  • Providers should contact HHAeXchange to complete Alternate EVV system integration activities for CHC.

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HRS, Inc. has announced that their policies will be changing to allow LPNs to complete Clinical Reviews of the Health Risk Screening Tool (HRST). This change was made after a review by HRST clinical staff who determined that the Clinical Review is evolving to function primarily as a quality assurance measure to help ensure accurate screenings. Changes will be made to the current training and documentation and will become effective in January 2020.

When possible, the Clinical Review should be completed by an RN; however, the following is highly recommended for any agency that uses LPNs to complete Clinical Reviews:

  1. When possible, choose LPNs who have experience working with people with I/DD;
  2. Continue to train RNs to complete Clinical Reviews so that oversight can be given to LPNs as needed; and
  3. When possible utilize LPNs who have obtained I/DD specific credentialing, such as DDC (Developmental Disabilities Certified).

The process and steps within the HRST web-based application required to complete a Clinical Review will remain the same. Clinical Reviewer training will be updated to accommodate LPNs and/or RNs completing the Clinical Review.

Please note that the required training by RNs and LPNs to complete Clinical Reviews remains as follows:

  1. Successful completion of the HRST Online Rater Training
  2. Successful completion of the HRST Clinical Reviewer Training

If you have any questions about these changes, please submit via email.

Also, as a reminder, if you are an RN or LPN and need to register for the live training, the next round of courses is scheduled in January 2020.

Register now to reserve your place:

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ODP Announcement 19-164 advises providers that implementation of this service will not be available until the public comment period on the rates has concluded and notice of the final Fee Schedule Rates is published in the Pennsylvania Bulletin. ODP anticipates this to be in late January 2020 and will notify stakeholders of the publication via listserv. This does not impact the Public Transportation component of the Transportation service. Public Transportation may be utilized beginning January 1, 2020. Questions about this communication should be directed to Laura Cipriani.

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The Office of Developmental Programs (ODP) is pleased to announce (ODP Announcement 19-162) that the amendment to the Adult Autism Waiver (AAW) was approved by CMS on December 10, 2019. As communicated in ODP Announcement 19-136, the AAW amendment was submitted to CMS on October 15, 2019. Since that time, ODP has been engaged in ongoing discussions with CMS. Substantive changes were made as a result of those discussions and are highlighted in orange on the Side-by-Side of the AAW. The full waiver application approved by CMS, and the Side-by-Side of substantive changes, are available on the DHS website.

In Appendix A, Role of Local/Regional Non-State Entities has been changed from Not Applicable to Applicable to include Local/Regional non-state public agencies and Local/Regional non-governmental non-state entities. Language to specify the nature of these agencies has been added. Items A-5, A-6, and A-7 have been revised as well.

In Appendix B, Reserved Capacity was added to serve 15 participants in waiver years (WYs) 4 and 5 who need to be re-enrolled in the Adult Autism Waiver (AAW) after a stay in a hospital or rehabilitative care for more than 30 days.

In Appendix B, the number of unduplicated participants and maximum number of participants served is being updated to reflect current allowable waiver capacity.

Also in Appendix B, Selection of Entrants to the Waiver, Priority 2 status is removed and the Intake Process is revised and Interest List Procedure is revised to change the Interest List to a Wait List. Change in Priority status has been removed.

In Appendix C, a new service, non-medical Transportation, is being added.

Also in Appendix C, validation of provider qualifications for all services is being changed from every 30 months to every 36 months to align with a revised quality management strategy.

In Appendix C, the definitions of Day Habilitation and Residential Habilitation were revised to clarify where new facilities can be located.

In Appendix C, provider qualifications for all employment services are revised and clarification is added as to when employment services can be accessed without a referral to OVR.

In Appendix C, language was updated to reflect that family members can provide Transportation-Trip through an OHCDS.

In Appendix C, the educational qualifications for staff providing Career Planning were revised based on public comment.

Appendix I is revised to include a more detailed description of the rate setting methodology.

Revisions were made based on the new Chapter 6100 regulations, as applicable.

Changes were made to performance measures.

ODP changed all references to Family Living to Life Sharing.

ODP changed all references to Supports Coordination Agencies to Supports Coordination Organizations.

ODP changed the name of Transitional Work Service to Small Group Employment.

ODP changed references to the Bureau of Autism Services (BAS) to the Bureau of Supports for Autism and Special Populations (BSASP) or the Office of Developmental Programs (ODP), as applicable.

Questions about this communication can be directed to Laura Cipriani.

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