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Tags Posts tagged with "Agency With Choice"

Agency With Choice

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The Office of Developmental Programs (ODP) has shared ODPANN 24-099. This bulletin is to provide a list of current Agency With Choice (AWC) Financial Management Service (FMS) organizations available to support participants and surrogates who have chosen to self-direct some or all of their Participant Directed Services (PDS) using the AWC FMS model under the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) waivers. Please view the announcement for additional details.

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The Department of Human Services (DHS) published a notice in the Pennsylvania Bulletin for November 12, 2022, that announces revisions to the Medical Assistance (MA) fee schedule for the OBRA Waiver and the Act 150 Program: Personal Assistance Services (PAS) (Agency with Choice) and Respite (Agency with Choice).

DHS proposes the following substantive and technical changes to the OBRA Waiver:

  • Add Agency with Choice as a Financial Management Services model for the participant-directed services of PAS and Respite;
  • Revise the Benefits Counseling service definition;
  • Amend the responsibilities of the Fiscal/Employer Agent;
  • Update the Quality Improvement Strategy to the current process;
  • Add a new performance measure for Agency with Choice; and
  • Remove a performance measure that is duplicative.

The proposed OBRA Waiver amendment and a summary of all revisions are available for review on the OLTL Waiver Amendments, Renewals, and Accompanying HCBS Transition Plans web page under Additional Resources.

The following table provides the procedure code and rates for PAS (Agency with Choice):

Region OBRA Waiver
and Act 150		 Procedure Code Modifier Rate Unit
1 X W0164 N/A $4.02 15 minutes
2 X W0164 N/A $3.89 15 minutes
3 X W0164 N/A $4.12 15 minutes
4 X W0164 N/A $4.58 15 minutes

The following table provides the procedure code and rates for Respite (Agency with Choice):

Region OBRA Waiver
and Act 150		 Procedure Code Modifier Rate Unit
1 X W0165 N/A $4 15 minutes
2 X W0165 N/A $3.90 15 minutes
3 X W0165 N/A $4.12 15 minutes
4 X W0165 N/A $4.59 15 minutes

Interested persons are invited to submit written comments regarding these fee schedule rates and the proposed amendment to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: Robyn Kokus, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments can also be sent via email. Use ”OBRA 2023” as the subject line. Comments received within 30 days will be considered in subsequent revisions to the fee schedule or for revisions to the proposed amendment.

The revisions to the fee schedule and the amendment are proposed to take effect April 1, 2023.

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Image by Werner Moser from Pixabay

The Department of Human Services’ (DHS) Office of Long-Term Living (OLTL) published the proposed amendment to the Community HealthChoices (CHC) Waiver in the Pennsylvania Bulletin for November 12, 2022.

DHS and OLTL are proposing to amend the CHC Waiver by adding Agency with Choice as a Financial Management Services (FMS) model for the participant-directed services of Personal Assistance Services (PAS) and Respite. This would modify Service Coordinator and Service Coordinator Supervisor qualifications to align with the CHC Agreement and to amend the service definitions for the following CHC waiver services:

  • Benefits Counseling;
  • Nursing Services;
  • Physical Therapy Services;
  • Occupational Therapy Services; and
  • Speech and Language Therapy Services.

Also proposed is a technical change to the waiver by revising performance measures.

The proposed CHC waiver amendment and summary of all revisions are available for review on the OLTL Waiver Amendments, Renewals, and Accompanying HCBS Transition Plans web page under Additional Resources.

Interested persons are invited to submit written comments regarding the proposed waiver amendment to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: CHC 2023 Waiver Amendment, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments may also be submitted to the Department via email. Use ”CHC 2023 Waiver Amendment” as the subject line. Comments received within 30 days of publication of this notice will be reviewed and considered for revisions to the proposed waiver amendment.

The proposed amendment will be effective April 1, 2023.

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On June 7, 2022, the Pennsylvania Statewide Independent Living Council (PA-SILC), along with the Pennsylvania Council on Independent Living (PCIL), will be holding a rally titled “Our Lives, Our Services, Our Agencies, Our Choice,” at the Capitol Building on Commonwealth Avenue from 11:00 am – 12:00 pm. The primary focus of the rally is to discuss the issues surrounding major changes regarding the Agency With Choice (AWC) aspect of in-home care, which is being rushed into implementation. A number of speakers are scheduled, including Fady Sahhar, President/CEO of ProVantaCare.

Please see the following documents for additional information:

If you have any questions, please contact Jeffrey Iseman, Public Policy and Outreach Coordinator for PA SILC.

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The Office of Long-Term Living (OLTL) recently released the Request for Information (RFI) to gather feedback regarding the implementation of Agency With Choice (AWC) services for the participants of Medical Assistance (MA) managed care programs, the 1915(c) MA home and community-based services (HCBS) waiver program, and a state-funded program.

Through these programs, eligible participants receive long-term services and supports (LTSS) and other benefits, depending on the particular program. Specifically, this RFI seeks information to assist OLTL in determining how it may improve options for LTSS participants to self-direct their services in the Community HealthChoices Program (CHC), OBRA Waiver, and the state-funded Act 150 Attendant Care Program through the procurement and implementation of AWC.

Through this RFI, OLTL is seeking to become more aware of and knowledgeable about current efforts to increase opportunities for self-direction and feedback on the implementation of AWC through a potential, future procurement. OLTL encourages interested parties, including vendors and stakeholders, to provide feedback in response to this RFI or any part of it. An interested party may respond to all or any of the specific questions or topics included in this RFI.

RFI responses are due by12:00 pm on March 25, 2022. Responses must be submitted electronically with “OLTL Agency With Choice RFI” in the email subject line. While OLTL does not intend to respond to questions or clarifications during the RFI response period, interested parties and individuals may submit administrative questions related to this RFI electronically using “OLTL Agency With Choice” in the email subject line. OLTL may or may not respond based on the nature of the question.

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ODP Announcement 19-104 provides a list of current AWC FMS organizations that are available to support participants and surrogates who have chosen to self- direct some or all their Participant Directed Services (PDS) using the AWC FMS model and are in the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) waiver

ODP requires each AE to have at least one qualified AWC FMS organization to provide AWC FMS. The table at the end of this document provides a complete listing of the AWC FMS organizations and the area in which they provide services across the state.

If there are any changes to the information contained in the table, the AWC or AE should notify the regional FMS lead.

These AWC FMS organizations are not to be confused with the statewide Vendor Fiscal/Employer Agent (VF/EA) FMS organization. Currently, ODP contracts with Palco Inc. to provide FMS to waiver participants who elect to use the VF/EA FMS model.

For more information, regarding the two FMS models (AWC and VF/EA), please visit
MY ODP.org.

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ODP released two announcements regarding Wage Ranges and Benefit Allowances for Specific Participant Directed Services that will become effective with the new fiscal year beginning July 1, 2019.

ODP Announcement 19-075 is in regard to Agency with Choice (AWC) for AWC Financial Management Services (FMS), participants utilizing the AWC FMS model, managing employers, Support Service Professionals (SSPs), Administrative Entities (AEs), and Supports Coordination Organizations (SCOs). The announcement includes wage ranges and hourly benefits allowances attachments and tables.  There is guidance regarding enhanced communication and a new procedure code for the Chore Service. Homemaker is a separate service. The wage ranges for both services are the same and remain unchanged from FY 2018/19.

ODP Announcement 19-076 applies to the Vendor Fiscal/Employer Agent (VF/EA) services. This announcement also contains wage ranges and hourly benefits allowances attachments and tables, as well as guidance regarding enhanced communication.

Contact Carol Ferenz, RCPA IDD Division Director, with questions.

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The Office of Developmental Programs (ODP) has issued updated provider agreements that must be completed and returned to ODP by May 1. All providers of Waiver Services in Pennsylvania, including Supports Coordination Organizations (SCO) and Agency With Choice (AWC), must sign and return the ODP IDA Waiver Provider Agreement. Each waiver provider only needs to submit one provider agreement for the legal entity, regardless of the number of services provided or the number of service locations operated by the legal entity.

The provider agreement is essentially the same as the current agreement with the addition of the Community Living Waiver, with an effective date of January 1, 2018, and the addition of condition number two. Condition number two states that the provider agrees “To comply with the approved waiver; including all standards enumerated in the service definition(s) which the Waiver Provider will be rendering, provider qualification requirements and other requirements established by the Department as outlined in the approved waivers.” The letter that was sent to providers from Deputy Secretary Nancy Thaler can be found here.

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