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Policy Areas

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ODP has announced the wage range tables for specific participant directed services provided to participants utilizing the Agency with Choice (AWC) Financial Management Services (FMS) model effective July 1, 2018. The wage ranges and benefit allowances are unchanged from Fiscal Year 2017-2018.

These wage and benefit ranges will be used to pay Support Service Professionals (SSPs) and to support claims processing in the Provider Reimbursement and Operations Management Information System in electronic format (PROMISe) by the AWC FMS organization.

There are ODP-established wage ranges and an hourly benefit allowance for six participant directed services for participants who are using the AWC FMS model. These services are:

  1. Supports Broker;
  2. Companion Services;
  3. Supported Employment;
  4. In-Home and Community Supports;
  5. In-Home Respite and Unlicensed Out-of-home Respite; and
  6. Homemaker/Chore services.

A modifier and adjusted rates are available for Enhanced Communication Services for individuals who are eligible for the service, are in need of enhanced communication supports, and the SSP has been determined qualified to provide the service by ODP.

The AWC FMS Department established fees are identified in a public notice published in the Pennsylvania Bulletin and are available online.

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The Office of Long-Term Living (OLTL) released the following notice to Service Coordination Entities (SCEs) regarding a procedure code change for Cognitive Rehabilitation Therapy (CRT) Services.

This notice is to advise all SCEs that due to 2018 Healthcare Common Procedure Coding System (HCPCS) updates, the procedure code for Cognitive Rehabilitation in the Independence and OBRA Waivers will change effective 7/1/18. The service procedure code 97532 SE will be end-dated as of 6/30/2018. The new service procedure code for Cognitive Rehabilitation is 97127 and will be effective 7/1/18. The service definition and units of service remain the same. OLTL requires the attention and assistance of SCEs in order to update the service procedure code for HCSIS Fiscal Year (FY) 2018-2019 service plans.

OLTL is systemically removing the service procedure code of 97532 SE from any impacted HCSIS FY 2018-2019 service plans in order to end-date service contracts and offerings as of 6/30/18 for providers enrolled to render the service. A system update must be completed prior to making the new service procedure code of 97127 available for selection onto service plans.  A data fix is scheduled to occur in HCSIS on 6/21/18 to remove the remaining impacted 97532 SE service lines from FY 2018-2019 service plans. Please do not add the service 97532 SE to any additional FY 2018-2019 service plans as this will impact the success of the data fix. The new service procedure code of 97127 will be added to HCSIS and available for selection onto service plans as of 6/25/18. Service Coordinators (SCs) will be required to add the new service code for impacted FY 2018-2019 service plans.

Once the service is available for selection onto FY 2018-2019 service plans, SCs will then submit a Critical Revision to OLTL for review and approval for the addition of the new service procedure code 97127. OLTL’s Service Plan Review Team within the Bureau of Participant Operations will be communicating with SCEs that are directly impacted by this service procedure code change. A separate email communication will be sent to impacted SCEs to provide additional detail and guidance.

If you have any questions regarding the necessary service plan updates, please contact the Bureau of Participant Operations or Stacey Griffiths with the Bureau of Participant Operations at: 717-724-6547.

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In preparation for the launch of Community HealthChoices (CHC) in the Southeast region, this CHC Fact Sheet explains the delivery of service coordination through the program. Under CHC, service coordination is a function of the managed care organizations (MCOs). A service coordinator is the MCO’s designated, accountable point-of-contact for each participant receiving long-term care services, their person-centered service plan, and service coordination. Therefore, the Office of Long-Term Living (OLTL) sees the service coordinators as part of the MCO under CHC.

In addition to the fact sheets, there are now short, easily digestible overview trainings on CHC that can be found here in order to increase stakeholder knowledge in anticipation of the Southeast rollout of the program.

To assist stakeholders in finding answers to questions more quickly, all FAQs have been consolidated into a single CHC Questions and Answers Document. The new document is in searchable PDF format and contains a table of contents that allows the user to easily move to different sections within the document.

The CHC Questions and Answers Document can be found on both the Participant and Provider sections of the CHC website by clicking on “View CHC Publications” or by following this link.

CONTACT: If you have any questions, please visit the CHC website or submit comments via email.

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The Office of Developmental Programs (ODP) has announced upcoming course offerings for both the Initial Certified Investigator and the Certified Investigator (CI) Peer Review Courses. Registration is open on myODP.org. The courses posted cover July 2018 to December 2018.

The Initial Certification Couse is a four-day, face-to-face course that was created to ensure all incidents that require an investigation receive a systematic investigation that meets established standards. In order to perform investigations, the investigator must successfully complete all requirements under the ODP CI Training.

The Initial Certification Course consists of three parts:

  1. a) Three online prerequisite modules
  2. b) Four days of face-to-face training
  3. c) Online exam

Once all activities are completed within the current standards, the participant will be certified for three years.

The Peer Review Course was created to support the Peer Review Process. The Peer Review Process is an ongoing evaluation process that is designed to provide information about the overall quality of incident investigations to an organization. The primary objective of the Peer Review Process is to ensure a continued quality improvement of investigatory practices. To support ODP stakeholders in the implementation of the Peer Review practices, ODP, along with Temple University, has created a Peer Review Course. The course is a 3½ hour, face-to-face training.

To register for the Certified Investigator Peer Review course, users can:

  1. a) Navigate to myODP.org
  2. b) Use the following path: Training > Certified Investigator Program > Peer Review Training and Resources > Register for a scheduled Summer/Fall 2018 CI Peer Review training session

OR

  1. c) Click on the Certified Investigator Peer Review Course Information page link

To register for the Certified Investigator Initial Course:

  1. a) Navigate to myODP.org
  2. b) Use the following path: Training > Certified Investigator Program> Initial Certification Instructions > Register for a scheduled CI training Session

OR

  1. c) Click on the Certified Investigator Initial Certification Course Information page link

For assistance with registration, contact the myODP website Helpdesk by clicking on Website Technical Support.

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The Office of Developmental Programs (ODP) distributed Communication 056-18  to instruct AEs, SCOs, and Providers to review and submit updates to their primary and secondary contact information for the Quality Assessment and Improvement (QA&I) Process.

The ODP QA&I Process is designed to conduct a comprehensive quality management review of county programs, AEs, SCOs, and providers delivering services and supports to individuals with intellectual disabilities and autism spectrum disorders. This QA&I Process is one of the tools that ODP uses to evaluate our current system and identify ways to improve services for all individuals.

The identified contact person(s) is the individual(s) whom the entity has designated to receive specific information related to the QA&I Process. Information shall include any unique electronic links, access to QA&I process specific information, ongoing direction and communication from ODP or the AE regarding the QA&I Process, etc. Please note that the primary identified contacts will be the individual persons receiving the electronic link for completion of the self-assessments. For the AEs conducting provider QA&I onsite reviews, the primary contact will receive the unique links necessary to access the tool for completion of onsite review activities.

Please review the document posted on MyODP and submit any changes by using this link.

ODP QA&I Contact Information Form Changes can be submitted throughout the QA&I year. ODP will post an updated version of the QA&I Contact List spreadsheet at least every 2 weeks.

As a reminder, it is the responsibility of the entity to ensure that this information remains up to date.

INQUIRIES: Please direct any questions, issues, or concerns regarding this communication to your QA&I Regional Coordinator and CC the QA&I Process mailbox.

QA&I Regional Coordinators:      
Central Region Northeast Region Southeast Region Western Region
Robyn Seville Rachel Toman Roger Crisanty Renee Bruno

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The Home and Community-Based Services (HCBS) Settings Provider Self-Assessment period closed June 12, 2018. As of close of business on that date, ODP received more than 6,150 Residential Self-Assessments (Residential Habilitation, Life Sharing and Family Living) and over 550 Non-Residential Self-Assessments (Community Participation Supports and Day Habilitation).

In March 2018, ODP conducted a data extraction to track service locations for the HCBS Provider Self-Assessments. ODP received a significant number of Self-Assessments for service locations opened after ODP developed that list of service locations. During the Self-Assessment period, ODP also received a significant number of notices from providers that service locations were no longer active.

The next steps in the Self-Assessment process are:

  • Over the next two weeks, ODP will be reviewing all corrected service location data submitted by providers to validate active service locations for which no HCBS Provider Self-Assessment was completed.
  • No later than Saturday, June 30, 2018, ODP will communicate directly with providers regarding any active service location for which ODP does not have an HCBS Provider Self-Assessment on file. After ODP has completed this process, service locations for which ODP has not received a completed self-assessment will be deemed non-compliant and will have an on-site inspection scheduled.
  • ODP is reviewing and analyzing the submitted HCBS Provider Self-Assessments. By September 30, 2018, ODP will provide feedback to providers that identify any areas for any service locations that will require a transition plan. ODP will also notify appropriate Administrative Entities of these findings.

For questions related to this communication, please contact [email protected] or [email protected].

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The Centers for Medicare and Medicaid Services (CMS) has scheduled a call on Thursday, June 21, 2018 at 2:00 pm that will focus on and provide additional information about the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. During the call, CMS will answer frequently asked questions (FAQs) on quality measures, standardized data elements, the CMS data element library, and future directions of the IMPACT Act. Members that wish to participate in the call must register. Send any questions or request assistance with registration via email.

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Transformational Change Requires Transformational Leadership
National Council for Behavioral Health and MTM Services Webinar Series

The move to measurement-based care as well as the operational, clinical, and financial changes ahead for behavioral health providers require transformational leadership. Get equipped to be successful in this changing world — join David Lloyd, founder of MTM Services, in a two-part webinar where he will revisit his popular NatCon18 presentation, share his insights based on more than twenty-five years of implementing transformational change, and take questions from the audience.

About the Webinars
On Thursday, June 21 at 12:30 pm ET, David will address the biggest challenges facing today’s behavioral health care providers and how to assess an organization’s readiness for change, including strengths and areas of risk.

Then on Wednesday, July 11 at 12:30 pm ET, David will discuss tangible strategies for shifting to a sustained Continuous Quality Improvement (CQI) -based change process, including appropriate roles for all team members.

Have a question about one of the topics? Submit your questions at the end of your registration and it will be addressed during the appropriate webinar session.

Register today.

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The Statewide Adoption and Permanency Network (SWAN) Unit of Service Payment Rates and Programmatic Changes Bulletin is now available for viewing. This bulletin rescinds and replaces the payment chart on page 3 of the Office of Children, Youth, and Families (OCYF) Bulletin 3350-17-01, titled Statewide Adoption and Permanency Network Unit of Service Payment Rates and Programmatic Changes, and replaces the unit costs on page 84 of OCYF Bulletin 3140-18-03, titled Fiscal Year 2019-20 Children, Youth and Families Needs-Based Plan and Fiscal Year 2018-19 Implementation Plan Instructions. The programmatic changes outlined in OCYF Bulletin 3350-17-01 remain in effect, with an exception to the finalization unit of service.

The new SWAN payment rates established in this bulletin were developed as a result of actual cost and time data submitted by SWAN affiliate agencies from January 2017 – December 2017. The new rates apply to all services referred on or after July 1, 2018. Any services referred prior to that date will be paid at the existing rate.

As a reminder, cost adjustments for SWAN units of service will be determined by the Office of Children, Youth, and Families on an annual basis, and communicated in an annual SWAN Unit of Service Payment Rates Bulletin, as well as in the annual Needs-Based Plan and Budget Bulletin. Established rates will be based upon actual cost and time data submitted by SWAN affiliate agencies to the SWAN prime contractor.

If you have any questions about the bulletin or payment rates, please contact Carrie Keiser.

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The Pennsylvania Coalition Against Rape (PCAR) is hosting a two-day conference on Wednesday, July 18 & Thursday, July 19, that will provide participants with an opportunity to network and learn about the latest developments in the sexual assault movement. The conference will showcase how different parts of the field are tackling sexual violence. There will be a Prevention track; a track hosted by the PA Chapter of Children’s Advocacy Centers. Other topics include self-care and human trafficking.

Please follow this link for details about registration and contact information for PCAR.

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