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Intellectual & Developmental Disabilities

ODP reissued Announcement 19-049 in order to remind providers of the continued opportunity of

Getting Connected to the Community: Practical Skills for Building Person Centered Community Connections and to provide contact information for interested parties.

This interactive, three-hour training serves as a foundation for individuals receiving the Community Participation Support (CPS) service and their support teams. During this training, individuals, families, and their support teams (provider staff, Supports Coordinators) come together to brainstorm about and plan for building/enhancing person centered community connections. Training participants will practice utilizing person-centered thinking resources and techniques in the context of CPS. Information gathered using these skills can help teams develop meaningful plans for the implementation of CPS.

Provider agencies are invited to host this training at their local sites. Trainers will work with the provider agency to schedule the training on a date and time that work for the individuals, families, support teams, agency staff, and trainers. The training is designed for a maximum of 30 participants. The provider agency is asked to provide a space to hold a maximum of 30 people working in small groups. The trainers bring all of the training equipment and supplies.

If you are interested in hosting this training at your agency or have any questions, please submit your request via email. You can also call Jeff Wheeler at 800-446-5607 ext. 6881 or 412-826-6881, or Melissa Mecke at 717-901-2164.

The PA Senate is voting Monday, November 18 on Senate Bill 906, which would institute a moratorium on the scheduled closing of Polk and White Haven State Centers. RCPA supports the closure of the state centers. For further information, please use this link. Questions, please contact Jack Phillips, RCPA Director of Government Affairs.

ODP Announcement 19-150 is to inform stakeholders that Pennsylvania will formally request a Good Faith Effort (GFE) Exemption from CMS to delay the implementation of the electronic visit verification (EVV) mandate. More time is needed in order to allow providers to fully prepare for EVV. ODP has heard from many providers who are using Alternate EVV systems and have been working with Sandata to certify their systems for integration with the DHS Aggregator. Since the time for certification is taking longer than originally projected, the Department is seeking an extension to allow additional time for these systems to go through the necessary testing with Sandata and become integrated to feed EVV data to the DHS Aggregator.

The Department is seeking a GFE to extend the soft launch period and to delay the denial of payments. The timeframe between system launch and the EVV mandate is referred to as the soft launch. The soft launch is an opportunity to:

  • Test and interface Alternate EVV systems
  • Familiarize providers with EVV prior to claims integration. Claims will continue to pay and EVV errors will appear on remittance advice.
  • Inform policy and system development
  • Help the Department identify and develop supplemental training materials
  • Facilitate EVV participation by caregivers and members

If approved by CMS, the GFE will allow the Department to extend the soft launch period and implement a tiered compliance structure before the denial of payments. EVV system implementation, training, and vendor interfacing will proceed on the current project schedule. Since the exemption has not yet been approved, providers are still required to begin using EVV by January 1, 2020. Provider participation will produce valuable data for system modification and policy development.

Please visit the DHS EVV website to view the ODP EVV technical guidance, public meeting notices, training resources, and Frequently Asked Questions (FAQs).

ODP Announcement 19-149 releases data collected from Provider Self-Assessment Reports completed in 2018. The Center for Medicare and Medicaid Services (CMS) implemented a final rule regarding Home and Community-Based Service (HCBS) Settings in 2014. The final rule requires states to assess all residential and non-residential settings which receive funding or payment through an approved HCBS waiver. ODP developed a self-assessment for providers of these services to complete for each location.

In 2018, providers completed the self-assessment of over 6,000 Residential and Non-Residential service locations. The data was analyzed, and two reports were created:

For questions pertaining to these reports, please submit via email.

office black telephone with hand isolated on white

The Arc of Pennsylvania has notified RCPA that the Pennsylvania Coalition for Inclusive Community is hosting the #CommunityStrongPA Call-In Day, to tell your legislators to vote NO on House Bill 1918 and Senate Bill 906, on Tuesday, November 12.

HB 1918 and SB 906 seek to halt the closure of Polk State Center and White Haven State Center. The bills include language that would prevent any closure of a state center until the waiting list is fully addressed, which in essence would stop the discussion indefinitely. Individuals with intellectual and developmental disabilities deserve to have the opportunity to live in their own communities and not in segregated settings.

For further information, please contact Katie Yost at The Arc of Pennsylvania. Thank you for your action on this important issue.

ODP Announcement 19-147 serves to clarify the billing process of respite services in a non-residential setting. Respite services are direct services that are provided to supervise and support participants living in private homes on a short-term basis for planned or emergency situations, giving the person(s) normally providing care a period of relief that may be scheduled or due to an emergency. This communication does not apply to services in the Adult Autism Waiver or any services offered by the Bureau of Supports for Autism and Special Populations (BSASP).

The correct procedure code to use for these services depends on the Needs Level of the individual and the site where the respite is provided.

Respite services could be provided as a service at a residential site or in the community under a site enrolled as a Provider Type 51 specialty 513. Services can be provided under this specialty combination in settings such as:

  • A residential site such as a private licensed home in Pennsylvania under the 6400, 6500, 3800, 5310 licensure requirements;
  • An unlicensed residential Life Sharing home in Pennsylvania;
  • A participant’s private home or an unlicensed private home located in Pennsylvania, Virginia, Washington, DC or a state contiguous to Pennsylvania;
  • Other private homes, hotels, or rentals during temporary travel in accordance to ODP’s travel policy;
  • Camp settings that meet applicable state or local codes; or
  • Community settings that maintain the participant’s schedule of activities.

A new billing option has been created for respite services provided in respite-only homes under the 52 / 513 combination:

  • The site would be a respite only home.
  • The site would be licensed under the 55 Pa Code Chapter 6400 and the Approved Program Capacity approved prior to enrollment.
  • This would not be the same as a residential home licensed under the 55 Pa Code Chapter 6400 providing residential services being billed as a site enrolled under the Provider Type 52 specialty 521. You would not enroll the specialty 513 in combination with a specialty 521 at a PT 52 site.
  • The site could also be providing Exceptional Day Respite at a licensed intermediate care facility for individuals with ID (55 Pa Code Chapter 6600) that are owned and operated by private agencies or a Licensed Nursing Home (28 Pa Code Chapters 201, 203, 205, 207, 209 and 211).

When a participant has a Needs Group 3 or 4 that indicates medical or behavioral needs, and the participant is unable to locate a respite provider to render services in a community setting, they may be approved for Exceptional Day Respite. A variance may be requested for Respite services in licensed intermediate care facilities for individuals with an intellectual disability (55 Pa. Code Chapter 6600) that are owned and operated by private agencies, Licensed Nursing Homes (28 Pa. Code Chapters 201, 203, 205, 207, 209 and 211).

And Licensed Community Homes (55 Pa. Code Chapter 6400) located in Pennsylvania within the home’s approved program capacity of 5 to 8 may be requested for approval from the regional office.

For more detailed information, including charts with the appropriate billing codes, please refer to the ODP Announcement.

Press Release from Governor Tom Wolf

Council on Reform Submits Recommendations for the Protection of Vulnerable Populations to Gov. Wolf
> Public Comment Period through December 16, 2019 <

November 1, 2019

Harrisburg, PA – Today, Governor Tom Wolf’s Council on Reform, established through his Protection of Vulnerable Populations Executive Order 2019-05, submitted its recommendations for improving the state’s systems to protect its most vulnerable individuals and families.

In late July, Gov. Wolf charged this diverse group of community leaders, providers, stakeholders, and cabinet members with taking a comprehensive look at needs to best serve the state’s vulnerable populations with a mandate to report those recommendations back to him by Nov. 1.

“I took action in July to address long-standing issues with the state’s systems designed to protect our most vulnerable,” Gov. Wolf said. “The first task for the newly formed Council on Reform was to buckle down and develop a comprehensive list of recommendations for how we can best protect vulnerable Pennsylvanians.

“My thanks to all of the council members who shared their expertise and considerable time, and to those who participated by meeting with council members or submitting information and recommendations. Your tireless commitment to this process demonstrates your passion for protecting all Pennsylvanians, especially our most vulnerable. I look forward to reading and analyzing these recommendations and to our next steps to make much-needed changes.”

The 25-member council held its first meeting immediately following the governor’s announcement. In determining its charter and scope, the council defined populations and subpopulations, established committees, and adopted values.

The council determined it would look at protecting vulnerable populations from three perspectives with a separate committee for each: prevention and diversion, protection and intervention, and justice and support.

Populations were broken out by age with subpopulations to ensure vulnerabilities unique to each were considered:

Ages 0-17
Subpopulations – African Americans, Asian American & Pacific Islanders, Latinos, LGBTQ+ children, young women, children experiencing mental illness, children with intellectual disabilities/autism, children with physical/sensory disabilities, delinquent children, and dependent children

Ages 18-59
Subpopulations – African Americans, Asian American & Pacific Islanders, Latinos, LGBTQ+ adults, veterans, women, adults experiencing mental illness, adults with intellectual disabilities/autism, adults with physical/sensory disabilities, adults with Alzheimer’s or a related dementia, and domestic violence victims

Ages 60+
Subpopulations – African Americans, Asian American & Pacific Islanders, Latinos, LGBTQ+ seniors, women, veterans, seniors experiencing mental illness, seniors with intellectual disabilities/autism, seniors with physical/sensory disabilities, seniors with Alzheimer’s or a related dementia, and domestic violence victims

The council recommended two overarching goals for Pennsylvania to better protect vulnerable populations:
• Empower and strengthen the workforce serving vulnerable populations by providing comprehensive training, livable salaries and benefits, and support for staff experiencing vicarious trauma.

  • Empower communities and vulnerable populations by ensuring access to services for all Pennsylvanians and conducting culturally appropriate and diverse outreach efforts.

The council adopted values they believe to be relevant to protecting and serving vulnerable populations – these values are reflected throughout the recommendations:

Cultural Competence – Recognizing and honoring diversity

Person-Centered Approach – Focusing on the individual’s best interest

Community Engagement – Hearing from vulnerable populations, families, experts, and stakeholders

Context & Awareness – Understanding current environment and avoiding past failings

Trauma-Informed – Utilizing trauma-informed approaches across all systems

Workforce Empowerment – Ensuring the workforce is equipped and supported

Members heard from a wide array of existing oversight and advisory bodies, stakeholders, legislators, and constituents. Information was provided through in-person meetings, letters, emails, and a webform that council members distributed to their networks. These contributors provide recommendations for the council to consider and essential insight and context to ensure the council was fully informed. Many council members also served on advisory bodies connected to this work.

The council compiled the recommendations submitted by others along with recommendations from existing reports and assigned them to the appropriate committee for review and consideration. Committee members reviewed all that was submitted, identified common trends, eliminated duplication, and developed new recommendations.

After committees finalized their lists of recommendations, themes were identified that spanned all populations and committees. The result is the comprehensive list of recommendations presented to Gov. Wolf today.

The council advised Gov. Wolf that it “fully recognizes the funding implications of the recommendations that have been developed and the substantial amount of time and work it takes to carry out these recommendations. It is our hope that Pennsylvania will rise to the occasion and put its best effort into driving this much needed change – our most vulnerable are counting on it.”

The council asked that the governor direct the appropriate agencies, organizations, branches of government, and advisory bodies to carry out the recommendations he would like to move forward.

As the council carried out its process, they believed more could be done to engage with constituents. To achieve this, the council added an online public comment form available today through Dec. 16.

View press release online