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Tags Posts tagged with "Community Participation Support"

Community Participation Support

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RCPA, along with The Alliance CSP, The Arc of Pennsylvania, MAX Association, PAR, and The Provider Alliance, submitted a joint letter to ODP Deputy Secretary Kristin Ahrens outlining recommended improvements to Community Participation Support (CPS). The letter highlights policy and regulatory barriers affecting person-centered services, workforce stability, and provider sustainability, and urges ODP to pursue near-term solutions through policy clarification or regulatory waivers.

Key recommendations include:

  • Planning and Coordination Billing: Allow billing for planning and coordination while CPS services are delivered and permit billing at ratios aligned with individuals’ actual support needs (e.g., 1:1, 1:2, 1:3). Associations recommend a new billing code/modifier or a statewide ODP announcement.
  • Program Specialist Education Requirements: Align education requirements for program specialists in Chapters 2380 and 2390 with Life Sharing and unlicensed residential models by permitting a high school diploma plus six years of ID/A experience, ideally through a blanket waiver announced via ODP Bulletin.
  • Dual Licensure for Chapter 2380 Programs: Eliminate dual licensure with the Department of Aging for providers billing exclusively to ODP when serving individuals age 60 and over, and remove the age cap of 59 in Chapter 2380 through regulatory change or waiver.
  • Rounding of 15-Minute Units: Allow rounding of 15-minute service units to reduce administrative burden and align with Office of Long-Term Living practices.

The associations stress that these changes are essential to sustaining safe, meaningful, and person-centered CPS services. RCPA will continue advocacy with ODP and provide updates as they are available.

For Questions or Additional Information
Please contact Tim Sohosky for any follow-up or inquiries related to this update.

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The Office of Developmental Programs (ODP) has shared ODPANN 25-087. This communication is to inform 100% community location-based Community Participation Support (CPS) providers (Specialty 525) of CPS Facility procedure codes available in HCSIS to permit billing for groups of more than 3 individuals as well as to provide guidance on the planning and coordination component of the CPS service.

Please view the announcement for additional information and details.

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The Office of Developmental Programs (ODP) met with stakeholders today, October 30, 2024, to discuss waiver amendments and to provide an overview of Performance-Based Contracting.

Waiver Amendments included:

Waiver Capacity:

  • When an individual is in an acute care hospital and receiving waiver services, ODP will not need to reserve (hold) the individual’s waiver. They will maintain enrollment in the waiver.
  • Language was updated for waiver capacity for high school graduates in the P/FDS waiver. AEs can reserve the waiver capacity for 180 days prior to when services are needed. Students can remain in service until their 22nd birthday.

Assistive Technology:

  • Updated language to explain when an independent evaluation is required and when it is optional:
    • REQUIRED: A device will cost $750 or more.
    • OPTIONAL: A device will cost less than $750.
  • An independent evaluation can be done if the team decides it would be beneficial.
  • Evaluations are included in the $10,000 lifetime limit.

Community Participation Support:

  • The Community Participation Support provider must complete and update an analysis of the following at least yearly to support individuals to experience meaningful community inclusion:
    • Strongest interests and personal preferences for community activities;
    • Skills, strengths, and other contributions likely to be valuable to employers or the community; and
    • Conditions necessary for successful community inclusion and/or competitive integrated employment.

American Sign Language (ASL) – English Interpreter Service:

  • English Interpreter service will be added to ODP’s waivers effective January 1, 2025.

Music, Art, & Equine Assisted Therapy:

  • The cumulative maximum limit of any combination of Music Therapy, Art Therapy, or Equine Assisted Therapy has increased from 26 to 52 hours per fiscal year.

STAT Overview:

  • The Specialty Telehealth and Assessment Team service was implemented in March 2024. This service may also be delivered to the participant during temporary travel, per ODP’s travel policy.

Waiver Corrections:
Life Sharing:

  • The following may not be authorized for participants who receive Life Sharing services: Residential Habilitation; Supported Living; Respite (15-minute or Day) (has been removed).

Supported Living Corrections:

  • The following services may not be authorized for participants who receive Supported Living services: Life Sharing; Residential Habilitation; Respite (15-minute or Day); Homemaker/Chore; In-Home and Community Supports; Behavioral Supports; Therapies; Shift Nursing; Consultative Nutritional Services; Communication Specialist and Specialize.

Benefits Counseling:

  • New billable indirect activities are added. The limit has increased from 15 hours per fiscal year to 24 hours per fiscal year.

The Performance-Based Contracting Review Included:

  • Effective January 1, 2025, Performance-Based Contracting will be implemented for the following services funded through the Consolidated and Community Living Waivers:
    •  Residential Habilitation;
    •  Life Sharing; and
    •  Supported Living.
  • Changes to Enrollment of New Providers.
  • What are Performance Standards?
  • What are Provider Tiers?
  • What Do These Changes Mean to Individuals and Families?

All performance-based contracting questions can be sent electronically.

Please see the distributed PowerPoint for additional information.

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Photo by Markus Winkler on Unsplash

The Office of Developmental Programs (ODP) has shared an updated version of ODPANN 23-025. This update provides guidance for individuals who previously indicated they wanted to resume Community Participation Support (CPS) services but have not yet continued with the service. Please review the announcement for more information.

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