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Tags Posts tagged with "Consolidated Waiver"

Consolidated Waiver

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Today the Department of Human Services (Department) published final notice of Fee Schedule Rates for services funded through the Consolidated, Community Living, Person/Family Directed Support (P/FDS), and Adult Autism Waivers and the Department-established fees for base-funded services as a correction to the rates previously published August 1, 2024.

Due to a calculation error, the Department has made corrections to the Fee Schedule Rates for the following services funded through the Consolidated, Community Living, and P/FDS Waivers and base-funding:

  • Community Participation Support, effective July 1, 2024; and
  • Life Sharing Without Day 1-person needs group 3 and 4, effective October 1, 2024.

Additionally, due to a mistake in aligning the procedure code with the correct Statewide fee, the Department is republishing the Fee Schedule Rates for the following services funded through the Adult Autism Waiver effective July 1, 2024:

  • Residential Habilitation
  • Specialized Skill Development
  • Supported Employment
  • Career Planning
  • Therapies
  • Day Unit Respite
  • 15-Minute Unit Respite
  • Supports Coordination
  • Transportation — Trip

This publication presents an opportunity for providers to appeal these specific rates. The deadline for filing an appeal for these rates is December 2, 2024.

For further information, view ODPANN 24-107 or contact Carol Ferenz, IDD Division Director.

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ODP Announcement 24-096 is to inform all interested parties that the Centers for Medicare and Medicaid Services (CMS) approved the 1915(b)(4) Performance-Based Contracting Waiver and the Consolidated, Community Living, and P/FDS Waiver amendments effective January 1, 2025.

As communicated in ODP Announcement 24-071, the waivers were submitted to CMS on July 26, 2024. Since that time, ODP has engaged in discussions with CMS. No substantive changes were made to the waivers based on those discussions. Information regarding Performance-Based Contracting for Residential Habilitation, Life Sharing, and Supported Living services delivered through the Consolidated and Community Living Waivers can be accessed at Performance-Based Contracting – MyODP. In addition to changes needed to implement Performance-Based Contracting, the following major changes were included in the Consolidated, Community Living, and P/FDS Waivers:

  • American Sign Language – English Interpreter service will be added.
  • Billable indirect activities will be added to the Benefits Counseling service and the fiscal year limit will increase from 15 to 24 hours.
  • Clarification about evaluations will be added to the Assistive Technology service.
  • The fiscal year limit for Music, Art and Equine Assisted Therapy will increase from 26 to 52 hours.

Each full waiver application, as well as a record of all substantive changes, is available online at:

ODP will be holding one webinar to provide a general overview of Performance-Based Contracting and additional major changes made in the approved waivers. There will be time during the session for presenters to answer questions submitted by participants during the webinar.

The date, time, and registration link for these webinars are as follows:
Consolidated, Community Living, and P/FDS Waiver Amendment Overview
Wednesday, October 30, 11:00 am to 12:00 pm — Register Here.

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The Office of Developmental Programs (ODP) has shared an updated version of ODPANN 23-083. This bulletin announces the availability and criteria for Needs Group 5 (NG5) residential fee schedule rates and reissues the criteria, process, and procedures for residential fee schedule rate exceptions in the Consolidated Waiver. Please view the announcement for updated information, which has been highlighted red.

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The Office of Developmental Programs (ODP) has shared ODPANN 24-087, which informs stakeholders of corrections to rates for select services provided through the ODP Consolidated, Community Living, Person/Family Directed Support, and Adult Autism Waivers and base-funding that were published as final in the Pennsylvania Bulletin. Corrections were made to the following rates:

  • Community Participation Support Rates, Effective July 1, 2024; and
  • Life Sharing Without Day 1-Person Needs Group 3 and 4 Rates, Effective October 1, 2024.

The corrected final Fee Schedule Rates and Department-Established Fees for each service can also be found on DHS’s website. Please view the announcement for details.

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ODP Bulletin ODPANN 24-015 provides guidance for implementing changes to Assistive Technology and Remote Supports in the amendments to the Consolidated, Community Living, Person/Family Directed Support (P/FDS), and Adult Autism Waivers. Please note that this communication is being reissued with an update to Attachment B only. The other attachments are being included for reference.

ATTACHMENTS:

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The Office of Developmental Programs (ODP) has shared the announcement Additional Guidance for the End of Appendix K Flexibilities in the Consolidated, Community Living, Person/Family Directed Support (P/FDS) and Adult Autism Waivers. The purpose of the communication is to provide additional guidance on which Appendix K waiver flexibilities have been added to the approved intellectual disability/autism waivers (ID/A), which are the Consolidated, Community Living, and P/FDS Waivers, and the Adult Autism Waiver (AAW), as well as which Appendix K flexibilities will be ending November 11, 2023. You can view a quick guide for ID/A Waivers and a quick guide for the Adult Autism Waiver.

Please review all documents for additional information and details.

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The Office of Developmental Programs (ODP) has shared a list of current Agency With Choice (AWC) Financial Management Service (FMS) organizations that are 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 and are in the Consolidated, Community Living, or Person/Family Directed Support (P/FDS) waivers. Please view the announcement for additional information and to see the listing.

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ODP Announcement 23-002 reports that the renewals for the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) Waivers have been approved by the Centers for Medicare & Medicaid Services (CMS) with an effective date of January 1, 2023. CMS approves waivers for a five-year period. The current Consolidated, Community Living, and P/FDS Waivers expired June 30, 2022, but were extended twice as discussions continued between the Office of Developmental Programs (ODP) and CMS.

Major changes in the renewals include:

  • Remote Supports has been added as a separate, discrete service in all three waivers.
  • Clarification about the activities that can be performed under the Communication Specialist service has been added, the amount of Communication Specialist services that participants can receive each year has increased from 40 hours to 60 hours, and effective January 1, 2024, the communication specialist will be required to successfully complete training provided by ODP.
  • The amount of Benefits Counseling services that participants can receive each year has increased from 10 hours to 15 hours.
  • The amount of tuition that can be covered through Education Support services has increased from $35,000 to $40,000.
  • Companion services have expanded to support additional participants at their place of employment.
  • Supported Employment services can now support participants during work-related trips.
  • Participant Directed Goods and Services have been added to the Consolidated Waiver.
  • The purpose of the Supports Broker service has been clarified, and recertification requirements for Supports Brokers have been added.
  • The Specialized Supplies service will continue to cover personal protective equipment once Appendix K flexibilities end.
  • Music, Art, and Equine-Assisted Therapy are available to individuals who receive residential services.
  • Staff working for, or contracting with, Residential Habilitation, Life Sharing, or Supported Living providers must complete Department-approved training on the common health conditions that may be associated with preventable deaths.
  • Clarification about requirements for using technology in the provision of waiver services has been added with a focus on protecting individual privacy when using technology.
  • Clarification about experience and education requirements for Supports Coordinators and Supports Coordinator Supervisors has been added, and Supports Coordinators will continue to be allowed to use teleservices to perform some of the required face-to-face monitoring per year.

A list of all major changes made in the renewals is available in the record of change document and each full waiver application approved by CMS, which are available at:

ODP will be holding a webinar to discuss major changes made in these approved waiver renewals on February 9, 2023, from 1:00 pm – 2:00 pm. You can register for the webinar here.

Questions about this communication should be directed to the appropriate Office of Developmental Programs Regional Office.

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ODP Bulletin 00-22-05, dated August 9, 2022, is to provide the Office of Developmental Programs’ (ODP) requirements and standardized processes for preparing, completing, documenting, implementing, and monitoring Individual Support Plans (ISPs) to ensure they are:

  • Developed to meet the needs of the individual;
  • Developed and implemented using the core values of Everyday Lives: Values in Action, LifeCourse Principles, Positive Approaches, and Practices and Self Determination to result in an enhanced quality of life for every individual; and
  • Compliant with the approved Consolidated, Community Living, and Person/Family Directed Support (P/FDS) Waivers and Medical Assistance (MA) State Plan as it pertains to Targeted Support Management (TSM).

A summary of major changes made to information in the attachments is included as attachment 8.

ATTACHMENTS:

  • Attachment 1: ISP Manual for Individuals Receiving Targeted Support Management, Base-Funded Services, Consolidated, Community Living or P/FDS Waiver Services or Who Reside in an ICF/ID
  • Attachment 2: ODP Role Expectations and Required Timeline for ISP Activities
  • Attachment 3: DP 1032 Individual Support Plan Signature Form (Spanish form: DP 1032-S)
  • Attachment 4: Annotated Individual Support Plan
  • Attachment 5: The Basics of the LifeCourse Framework to Guide the Development of the ISP
  • Attachment 6: Questions to Help Facilitate the Development of the ISP
  • Attachment 7: DP 1022 Waiver Service Request Form
  • Attachment 8: Summary of Major Changes Made to ISP Requirements or Processes

OBSOLETE DOCUMENTS:

  • Bulletin 00-20-02, Individual Support Plans for Individuals Receiving Targeted Support Management, Base-Funded Services, Consolidated, Community Living or P/FDS Waiver Services, or Who Reside in an ICF/ID

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ODP Announcement 22-084 informs all interested parties that the Office of Developmental Programs (ODP) is offering a webinar regarding the approved Consolidated, Community Living, and Person/Family Directed Support (P/FDS) waivers effective June 1, 2022. Information and the link to register for the webinar is as follows:

August 19, 2022
1:00 pm – 2:00 pm
Register here.

To access the current waivers that contain the changes that will be discussed during the webinar, please use the following links:

For each waiver, you will have the option to review the full waiver or the “Record of Change” document that contains a concise version of the substantial changes that were made.

CONTACT: Questions about this communication should be directed to the appropriate Office of Developmental Programs Regional Office.

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