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Tags Posts tagged with "Consolidated Waiver"

Consolidated Waiver

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ODP Announcement 22-061 is to announce that the amendments to the Consolidated, Community Living, and P/FDS waivers (hereafter referred to as the Intellectual Disability and Autism (ID/A) waivers) were approved by the Centers for Medicare & Medicaid Services (CMS) effective June 1, 2022.

The ID/A waiver amendments were submitted to CMS on January 3, 2022. Since that time, the Office of Developmental Programs (ODP) has been engaged in ongoing discussions with CMS. Substantive changes were approved as follows:

  • Eligibility was expanded to include children with a developmental disability due to a medically complex condition. The Family Medical Support Assistance service was added to support the complex medical needs of these children. Provider qualification criteria were enhanced to ensure providers have the needed structure to support these children.
  • Delivery of services while the participant is hospitalized is currently allowed through Appendix K flexibilities. Guidance regarding delivery of services while the participant is hospitalized is contained in the Operational Guide. This guidance should continue to be followed until otherwise notified.
  • Homemaker services include infection control measures and intensive cleaning, such as cleaning medical equipment and disinfecting the home.
  • Home accessibility adaptations support individuals to transition from an institutional setting to a private home (including a Life Sharing home) and clarify covered home accessibility adaptations due to changes in Medical Assistance.
  • Transition to Independent Living payments were added to the Consolidated Waiver to support participants to transition from residential habilitation homes to Life Sharing or Support Living.
  • Changes were made to residential qualification requirements to ensure that all residential providers are adequately prepared prior to delivering a service and prior to the provider going through ODP’s qualification process.

The following rates, as communicated in ODP Announcement 22-051, are also effective June 1, 2022, when authorized on an Individual Support Plan:

  • Family Medical Support Assistance services;
  • Medically Complex Life Sharing services in the Consolidated Waiver; and
  • Transition to Independent Living payments in the Consolidated Waiver. Each full waiver application approved by CMS and the record of change document are available here.

ODP will be scheduling webinars soon to discuss the changes made in these approved amendments, as well as changes made to the July 2022 waiver renewals once they are approved by CMS. ODP will release a communication announcing the webinars when the waiver renewals are approved. Questions about this communication should be directed to the appropriate Office of Developmental Programs Regional Office.

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ODP Announcement 22-051 informs stakeholders that the following Fee Schedule Rates have been published as final in the Pennsylvania Bulletin:

  • Family Medical Support Assistance services funded through the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) Waivers;
  • Remote Community Participation Support/Day Habilitation services funded through the Consolidated, Community Living, P/FDS, and Adult Autism Waivers; and
  • Medically Complex Life Sharing services and Transition to Independent Living payments funded through the Consolidated Waiver.

Read the announcement for further details.

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ODP Announcement 22-026 is to announce that the proposed Fee Schedule Rates and Department-Established Fees for Consolidated, Community Living and P/FDS Waiver services, as well as the Community Intellectual Disability Base-funded program were published at 52 Pa.B. 102 (January 1, 2022).

The Department received comments from 134 stakeholders regarding the proposed changes to the Fee Schedule Rates and Department-Established Fees. After reviewing the comments on the proposed rates, the Department determined that an increase to the Fee Schedule Rates for the Agency With Choice Financial Management Services monthly administrative fee from $285.28 to $311.68 was necessary to cover staff wages and the costs of implementing participant directed services in accordance with requirements in the approved Waivers.

No other changes were made to the rates as a result of public comment.

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The Department of Human Services (DHS) is providing final notice of the Fee Schedule Rates and Department-Established Fees for services funded through the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) Waivers as well as the Community Intellectual Disability Base-Funded Program.

The Fee Schedule Rates are effective January 1, 2022, with the exception of the rates for Agency With Choice Financial Management Services (AWC FMS) and direct Community Participation Support services. The Fee Schedule Rates for AWC-FMS will be effective on March 1, 2022. The Fee Schedule Rates for direct Community Participation Support services will be effective six months after the expiration of the federal novel coronavirus (COVID-19) public health emergency, and the temporary increases to the Fee Schedule Rates that are currently in place will end. The Department-Established Fees are effective July 1, 2022.

The full announcement with the specific rates can be found here.

These rates will be in effect for the next three years. Providers have the right to appeal these rates to the Bureau of Hearings and Appeals. Any provider who wishes to appeal must do so within 30 days of the notice, and those who do not appeal within that period will lose the right to challenge rates before the Bureau.

RCPA is hosting a “How to File a Rate Appeal” webinar on March 7, 2022, from 1:00 pm–2:00 pm. Otherwise, you should consult an attorney with experience filing such appeals.

Contact Carol Ferenz with any questions.

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ODP Announcement 22-018 is to make stakeholders aware that the proposed renewals of the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) waivers are available for public review and comment. There is a 30-day public comment period on the information proposed in the waivers that starts on February 12, 2022, and ends on March 14, 2022.

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Image by Werner Moser from Pixabay

ODP Announcement 21-095 discusses the availability of a 30-day public comment period for the proposed fee schedule rates for services funded through the Consolidated, Community Living, Person/Family Directed Support (P/FDS), and Adult Autism Waivers as well as Base-funded programs. Please review the announcement for further details on both the rates and the public comment period.

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Changes to the Remote Supports Component of Assistive Technology in the Consolidated, Community Living and Person/Family Directed Support (P/FDS) Waivers

ODP Announcement 21-094 notifies interested parties of changes to Remote Supports in the most recently approved waiver amendments, including the requirement to complete the Variance Form (DP 1086) when an individual needs more than $5,000 of Remote Supports per fiscal year.

Amendments to the Consolidated, Community Living, and P/FDS Waivers approved by the Centers for Medicare and Medicaid Services (CMS) effective November 22, 2021, contain changes to Remote Supports which are a component of the Assistive Technology service (all requirements contained in the waivers prior to the amendments continue to apply). The Office of Developmental Programs (ODP) has updated Variance Form DP 1086 and the related instructions originally found in Bulletin 00-18-06, Variance Form and Process, to reflect the requirements for intensive remote supports in these amendments.

ODP is holding a webinar on February 16, 2022, from 10:00 am–11:00 am to discuss requirements and best practices for the Remote Supports component of Assistive Technology in the Consolidated, Community Living and P/FDS waivers. The date, time, and link for registration to attend the webinar can be found here.

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ODP Announcement 21-087 is to inform all interested parties of CMS’ approval of amendments to the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) waivers (hereafter referred to as the Intellectual Disability and Autism [ID/A] waivers). The ID/A waiver amendments became effective on November 22, 2021, and are available on the Department of Human Services’ website.

The Office of Developmental Programs (ODP) developed a Record of Change document that contains all of the substantive changes in the approved ID/A amendments. Each full waiver application approved by CMS and the Record of Change document are available as follows:

ODP is also holding a webinar to provide an overview of all substantive changes in the approved ID/A amendments. The date, time, and link for registration to attend the webinar are as follows:

ODP is developing two additional communications regarding the provision of remote supports in residential settings and non-residential settings, including information about webinars that will be held regarding the provision of remote supports.

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

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Deadline, as Letters on a Clock
On January 14, 2020, the Office of Developmental Programs released an updated version of the Provider Agreement for Participation in Pennsylvania’s Consolidated, Person/Family Directed Support, Community Living Waivers, and Adult Autism Waiver. Providers were informed that a signed copy of this document must be received no later than close of business on March 1, 2020.

As of February 21, 2020, many providers have not submitted their signed agreements. Failure to submit a signed agreement may impact providers’ ability to successfully submit claims for services rendered after March 1, 2020.

View/download the Provider Agreement for Participation in Pennsylvania’s Consolidated, Person/Family Directed Support, Community Living Waivers and Adult Autism Waiver and the accompanying letter from Deputy Secretary for Developmental Programs Kristin Ahrens.

Submit Signed Agreements to:
[email protected] OR

Department of Human Services Office of Developmental Programs
Attention: Provider Agreement
625 Forster Street
Health and Welfare Building, Room 413
Harrisburg, PA 17120

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