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Tags Posts tagged with "CHC Waiver"

CHC Waiver

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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 will be effective on January 1, 2025.

The current approved CHC Waiver document is available here. Additional information about the CHC Waiver is located here.

Changes in the approved renewal include:

  1. Amend the following service definitions:
    1. Benefits Counseling
    2. Employment Skills Development Home Adaptations
    3. Telecare
  2. Add teleservices to the following services (details regarding teleservices can be found within each service definition as well as in the Main Module):
    1. Cognitive Rehabilitation
    2. Counseling Services
    3. Nutritional Consultation
  3. Add Chore Services as a new waiver service.
  4. Add language to reinforce that if a participant’s rights in a setting need to be modified due to an assessed need, it must be documented in the Person-Centered Service Plan (PCSP), and if a provider creates a treatment or service plan, that plan must be incorporated into the PCSP.
  5. Remove references to the Organized Health Care Delivery System (OHCDS) and the Participant Review Tool.
  6. Reduce timeframes for developing and implementing Person-Centered Service Plans from 30 days to 15 business days.
  7. Reduce the years of experience needed for Structured Day Habilitation Support Staff from five years to two years.
  8. Update Appendix C-5 to include information about the Home and Community-Based Settings Rule.
  9. Update Appendix E: Participant Direction of Services that Service Coordinators are responsible to inform the participant of the availability of the direct care worker referral and matching system.
  10. Update Appendix G: Participant Safeguards to the current process.
  11. Update the Quality Strategy to current process.
  12. Modify language throughout for better readability.

Questions about the 2025 CHC renewal can be submitted electronically.

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The Office of Long-Term Living (OLTL) has announced new services that will be available as a result of the Community HealthChoices (CHC) Waiver renewal and OBRA Waiver renewal. Effective January 1, 2025, the following services will be available:

Chore Services – CHC Only

  • Provider Type: 59
  • Specialty Code: 431
  • Procedure Code: S5131

Teleservice Cognitive Rehabilitation Therapy – CHC and OBRA

  • Provider Type: 59
  • Specialty Code: 207
  • Procedure Code: W0176

Teleservice Counseling Services – CHC and OBRA

  • Provider Type: 59
  • Specialty Code: 231
  • Procedure Code: W0175

Teleservice Nutritional Consultation – CHC and OBRA

  • Provider Type: 59
  • Specialty Code: 230
  • Procedure Code: W0170

The rates for the OLTL Home and Community-Based Services (HCBS) rates, effective January 1, 2025, are available here.

Additional information on the licensure and certification requirements can be found in the Service Definitions under Appendix C of the waivers. Please note that these documents have not received final approval from the Centers for Medicare & Medicaid Services (CMS). Once approval is received, a ListServ message will be sent with links to the final approved waiver applications.

The Fee for Service rates for Teleservice Cognitive Rehabilitation Therapy, Teleservice Counseling Services, and Teleservice Nutritional Consultation have been added to the fee schedule attached to the ListServ.

For existing OLTL providers to enroll in the services listed above a request must be submitted to the enrollment and certification resource account. The required documentation should include an updated Provider Enrollment Information Form (PEIF), a copy of the required license or certification, and a copy of the job description for the service you are requesting to add to your provider profile. If you have any questions related to the new services you can reach out to the enrollment and certification unit at 1-800-932-0939, option 1, or via email.

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The Long-Term Services and Supports (LTSS) Subcommittee meeting was held yesterday, November 6, 2024. During the meeting, a number of presentations were given. In addition to the presentations, the agenda and a document that provided follow-up items from the October 2, 2024, LTSS Subcommittee meeting were provided.

Members should take time to review the PowerPoint presentations from the meeting below:

The 2025 meeting dates for the LTSS Subcommittee were also shared:

  • January 8, 2025
  • February 5, 2025 (virtual only)
  • March 5, 2025 (virtual only)
  • April 2, 2025
  • May 7, 2025
  • June 4, 2025
  • July 2, 2025
  • August 6, 2025
  • September 3, 2025
  • October 1, 2025
  • November 12, 2025
  • December 3, 2025

The meetings will continue to be held from 10:00 am – 1:00 pm.

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Part of the CHC waiver discussions that began with the Office of Long-Term Living (OLTL) this spring related to mandatory background checks for employees. Since this discussion, OLTL has decided not to move forward with this change in the renewal and amendment submitted to CMS. This change in position was a result of the subsequent public comments and feedback on the collateral impacts.

Also contributing to this reversal were coordinated advocacy efforts by RCPA’s Coalition for Choice partners, resulting in the elimination of the requirement for federal background checks, including FBI fingerprinting, for over 125,000 caregivers and direct care workers for services in the Community HealthChoices and OBRA waivers. The costs for these mandatory background checks would have been in excess of $50 per employee.

The resulting decision will be included in the review and presentation of changes during the LTSS meeting next Wednesday, November 6. At this time, the background check requirements remain under consideration by OLTL for future amendments and renewals.

If you have any questions or need assistance, please reach out to Fady Sahhar.

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The Office of Long-Term Living (OLTL) has released a message providing advance notice of the 2024 pre-administration of the home and community-based services (HCBS) Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.

OLTL has the HCBS CAHPS survey administered to participants who receive HCBS through the Act 150 Program as well as the OBRA and the Community HealthChoices (CHC) Waiver Programs in the fall. The department then uses the responses received to assist them with improving the services participants receive. To increase response rates, OLTL is requesting Service Coordinators to begin having conversations with the HCBS participants in order to provide an introduction and encourage participation in the upcoming administration of the survey.

The HCBS CAHPS Survey will be administered from August 1, 2024, to October 31, 2024. This survey will ask questions about the services HCBS participants receive at home or in the community and how well the services meet their needs. Press Ganey, an independent firm, will conduct the survey. They will call participants to set up a time to talk. Member’s participants may also call Press Ganey toll free at 1-800-588-1659 (TTY: 711) if they would like to take the 30-minute survey. The number can also be used to make an appointment to take the survey at a time that works for them. Participants are randomly selected to participate in the survey from a list of all participants receiving HCBS through either the Act 150 Program, the OBRA Waiver, or the CHC Waiver Programs. Language Services can be provided to HCBS participants at no cost.

Members are encouraged to remind participants that their privacy is important. If they choose to participate, any information that they provide will be kept confidential. Participants will not be identified in any report that is released, and their answers will not be shared with their providers, Service Coordinator, or anyone else who assists them. It is the participant’s choice whether to participate, and their decision to participate will not affect any HCBS received through OLTL.

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The Office of Long-Term Living (OLTL) has announced two waiver amendments that are open for public comment. The amendments detail the Community HealthChoices (CHC) waiver renewal and the OBRA waiver amendments. Information on the CHC waiver and OBRA waiver are available individually as well as in the June 15, 2024, PA Bulletin. Comments are due July 15, 2024.

Those interested in submitting comments can do so in the following ways:

  1. For the CHC waiver:
    1. Send a letter to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: Keeley Anglin—CHC Waiver Renewal, PO Box 8025, Harrisburg.
    2. Submit comments to the department via email. Use “CHC Waiver Renewal” in the subject line.
    3. Please use the CHC Waiver Comment Form.
  2. For the OBRA waiver:
    1. Send a letter to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: Keeley Anglin—OBRA Waiver Amendment, PO Box 8025, Harrisburg.
    2. Submit comments to the department via email. Use “OBRA Waiver Amendment” as the subject line.
    3. Please use the OBRA Waiver Comment Form.

Comments received by July 15, 2024, will be considered in subsequent revisions to the proposed renewal and amendment. For more information, please contact Fady Sahhar or Melissa Dehoff.

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Beginning in June 2023, the Office of Long-Term Living (OLTL) will hold Listen and Learn sessions with OLTL program participants across the Commonwealth.

OLTL provides Medical Assistance (MA) coverage and long-term services and supports (LTSS) to seniors and adults with physical disabilities through the Community HealthChoices (CHC), OBRA, Act 150, and Living Independence for the Elderly (LIFE) programs. The office wants to hear from participants who receive services through one of these programs and will be holding Listen and Learn Sessions at the locations and times listed here. These sessions are intended for OLTL staff to hear directly from participants, advocates, and community partners, with the goal of gathering critical feedback on OLTL programs.

Members are encouraged to share this information with their clients and families so they can attend and give their feedback on OLTL programs. Some sessions will be held in-person, and some will be conducted virtually. Space may be limited, so attendees are encouraged to register as soon as possible.

Questions about these sessions should be directed to the OLTL Provider Helpline at 800-932-0939.

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The Office of Long-Term Living (OLTL) has released the transition plans that outline how the Appendix K flexibilities will be phased out on May 11, 2023, with the end of the Public Health Emergency. The transition plans apply to the Community HealthChoices (CHC) Waiver, OBRA Waiver, and Act 150 program.

Since March 6, 2020, the Office of Long-Term Living (OLTL) has been operating under an Appendix K Emergency Preparedness and Response amendment that was approved by the Centers for Medicare & Medicaid Services (CMS). Appendix K allowed temporary changes to the CHC Waiver, OBRA waiver, and Act 150 waiver in response to the COVID-19 Public Health Emergency.

Effective May 11, 2023, OLTL is discontinuing the emergency flexibilities noted in the attached guidance and is returning to pre-emergency operations. Providers should make any changes that are necessary to resume normal operations and be in compliance by May 11, 2023. Service Coordinators have been instructed to work with participants and providers to ensure a seamless transition to normal operations.

The transition plans have been updated to reflect the new expiration date for the flexibilities. In addition, as a general note, resuming pre-emergency waiver operations means the following:

  • All assessments, including the comprehensive needs assessments and reassessments, must be conducted face-to-face;
  • Service Coordinators must monitor participants and Individual Services Plans (ISPs) through face-to-face contacts; and
  • ISP meetings and development must be conducted face-to-face.

Questions about this information should be directed to the OLTL Provider Helpline at 800-932-0939.

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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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