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The Long-Term Services and Supports (LTSS) Subcommittee meeting was recently held on November 12, 2025. During the meeting, a number of presentations were provided. In addition to the presentations, the agenda and a document that provided follow-up items from the LTSS Subcommittee meeting on October 1, 2025, were provided.

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

The next LTSS Subcommittee meeting is scheduled for Wednesday, December 3, 2025. The meeting will be held virtually only from 10:00 am – 1:00 pm. Register here to participate. Participants also have the option to call in by dialing (415) 655-0052; Access code: 883-556-407#.

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ADvancing States, which represents the nation’s 56 state and territorial agencies on aging and disabilities as well as long-term services and supports directors, has partnered with the Department of Health Policy and Management at UNC Gillings School of Global Public Health to create a first-of-its-kind online training program to support our nation’s Home and Community-Based Services (HCBS) program workforce. The initial Foundational Leadership in HCBS: Building Expertise to Better Support People in their Homes and Communities certificate program launches in September 2025.

The core training sessions deliver essential curriculum covering HCBS systems, policies, and operations — everything participants need to enhance their effectiveness and advance policy advocacy in this critical sector. Fewer than 20 spots remain in the September pilot session, and there will be another session offered in January 2026. The course fee is $600 for government and non-profit employees and $1300 for corporate employees. Group registration opportunities are expected to be available for the January 2026 session.

Quick Registration Links:

The course is offered exclusively online and is self-paced so learners can set their own schedules, but the course will require the equivalent of about two hours per week for 10 weeks. Participants will learn more about populations utilizing LTSS, the organizations and individuals providing LTSS, and the varied sources of funding for LTSS, with a focus on HCBS, plus key policy areas, including the Older Americans Act, the Americans with Disabilities Act, Medicare, Medicaid, and the processes by which individuals access services. Please view the Course Overview and Syllabus for additional details about course topics and learning objectives.

Sign up using the links above; for questions about the HCBS Certificate program, contact Annie Kimbrel via email.

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The Office of Developmental Programs (ODP) has released information related to the FY 2024/2025 ICF Cost Report. The release includes the updated current version of the ID-46 form, along with documentation outlining the changes to be used when reporting FY 2024/2025 costs.

As previously announced by ODP Deputy Secretary Kristin Ahrens, the use of the HCBS fee schedule as a market rate limit for related-party Day Habilitation services has been eliminated for FY 2024/2025. The remaining cost report changes reflect improvements based on prior years’ experience.

ICF providers may now begin completing cost reports for each ICF site. Questions should be directed to Pam Gilbert, Fiscal Manager, ICF/ID Unit.

ODP has indicated that a follow-up email will be sent with more detailed instructions and submission requirements. Providers are reminded that all cost report submissions must be received no later than September 30, 2025.

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The Office of Developmental Programs (ODP) has released a significant update on the status of the Performance-Based Contracting (PBC) framework for Supports Coordination Organizations (SCO). Key changes reflect both public feedback and a shift towards a more unified and outcomes-driven service system. Based on comments from over 140 stakeholders, ODP has confirmed that all SCOs will be held to the same performance standards through a phased approach — eliminating previously proposed tiers. The timeline for tier determination has been adjusted (now set for 8/15/25 – 9/15/25), with performance measure submissions required between 10/1/25 – 11/1/25 to allow time for preparation and systems development.

In terms of payment structure, the transition to a monthly case rate model for all SCOs is scheduled to begin July 1, 2026. The definition of “Intensive TSM” has been revised, and billing guidance will now include qualified tasks for Associate SCs. These changes reflect a broader move away from task-based reimbursement toward an outcome- and quality-focused model, aligning with CMS’s HCBS Quality Measure Set and Pennsylvania’s population health priorities.

Next steps include the submission of 1915(b)(4) and (c) waiver amendments to CMS in late July, publication of finalized documents (including an implementation guide and preparedness toolkit), and SCO forums starting July 28. A new Performance Analysis Services (PAS) vendor is also developing a data system to support outcome tracking and analysis. ODP emphasizes that this transition requires a mindset shift — from measuring quantity to prioritizing quality and individual outcomes such as employment, community living, and health stabilization.

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The Office of Developmental Programs (ODP) has shared ODPANN 25-067. This communication provides the waiting list report, comprised of individuals who are eligible to receive services and supports through ODP’s four home and community-based services (HCBS) waivers but, due to insufficient waiver capacity, the state cannot currently meet their needs. In this report, you will find information about ODP’s strategies and initiatives to address the problem and see the progress that has been made.

Access the report here ODP_Annual_WL_Report_2024. This report can also be found by visiting the MyODP home page and scrolling to the bottom or by following this path: Everyday Lives > Everyday Lives Publications > ODP’s Waiting List Reports.

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On July 2, the U.S. Department of Labor (DOL) took an important step to restore fairness and flexibility in the home care industry by issuing a proposed rule that would rescind restrictive provisions introduced in 2013 under the Obama administration. Those earlier changes, fully enforced in 2015, significantly narrowed the “companionship services” exemption under the Fair Labor Standards Act (FLSA), adding complex and costly wage requirements for home care agencies and Medicaid-funded services.

The 2013 rule redefined key terms, eliminated the exemption for third-party employers, and imposed overtime obligations on agency-employed direct care workers — contributing to increased costs and administrative burdens. These unintended consequences have strained both providers and public programs, particularly in Medicaid-funded home and community-based services (HCBS).

Now, DOL is proposing to correct course. In its justification, the Department noted that the previous regulations “might not reflect the best interpretation of the FLSA and might discourage essential companionship services by making these services more expensive.”

Why This Matters
This proposed rule is a welcome change for providers, participants, and state Medicaid leaders alike. Overtime costs are a major driver of financial pressure in long-term services and supports. When direct care workers live in the same home as the individuals they serve, current law allows participant-directed employers to avoid overtime pay. However, because of the 2013 changes, agency-employed workers doing the exact same job do not receive the same treatment — creating an inequitable and unsustainable two-tiered system.

If finalized, the proposed rule would allow third-party agency employers to once again access the same companionship exemption. This would create consistency across employer types and make it easier to recruit and retain direct care staff — particularly in shared living or live-in arrangements that are vital to participant independence and stability.

Act Now: Submit a Letter of Support
The DOL is accepting public comments on this proposed rule, and it is crucial that the provider community raise its voice. RCPA encourages home care agencies, managed care partners, and Medicaid stakeholders to submit letters of support highlighting how this change will:

  • Increase flexibility in service delivery;
  • Align federal and state wage policy;
  • Promote cost-effective care models;
  • Support direct care worker retention; and
  • Sustain vital programs that keep individuals in their homes.

Your voice matters. Together, we can ensure federal policy reflects the realities and needs of today’s home and community-based care system. View a sample letter for public comments here.

How to Submit Your Letter of Support
Visit the Regulations government website and search for the DOL proposed rule on companionship services. Comments must be submitted by July 31, 2025

If you have any questions, contact Fady Sahhar, RCPA PD&A Division Director.

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Effective Monday, June 16, 2025, the PA Consumer Service Center (Inspiritec) began accepting Long-Term Care (LTC) and Home and Community-Based Services (HCBS) applications over the phone. Individuals can call 1-866-550-4355 to apply for Medicaid, including LTC and HCBS. This information can be found on the DHS website, as well.

To communicate this change, the Department of Human Services (DHS) publicized this info with external stakeholders, posted banner messaging to multiple DHS web pages, added messaging to the Statewide Customer Service Center (CSC) wait time menu, and shared this information internally. DHS also provided Consumer Service Center staff with additional information needed to accurately capture information specific to LTC and HCBS applications.

Questions regarding this initiative can be directed to the DHS helpline at 800-692-7462.

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TOPIC: Autism Spectrum Disorders: An Overview and Practical Application

REGISTER TODAY

On behalf of the Office of Developmental Programs (ODP), due to a widespread power outage when we were scheduled to conduct the Western Region ASD Seminar in April, we have decided to hold an additional session. We welcome anyone interested to register for this event!

Reminder: This seminar satisfies the basic autism training requirement for Residential Performance-Based Contracting. Please see more details below on Continuing Education Credits.

Over the years the prevalence of autism has increased, Pennsylvania’s service delivery system for individuals with autism has expanded, and best practices to provide quality supports have emerged. To support the individual needs of each person with autism across the lifespan, an understanding of core characteristics must be established. It is also important to learn how the individual’s presentation of autism may change across settings and situations. This seminar will provide attendees with an in-depth presentation on core characteristics of autism and the impact of the characteristics on daily life, routines, and activities. A review of common terms and basic principles used to change behavior, teach new skills, and develop practical application of best practices will be included. Opportunity for discussion and engagement will occur throughout the seminar.

Who should attend?
Direct Support Professionals (DSPs), Front Line Supervisors, and Program Managers supporting individuals with autism in residential and other home and community-based settings. Professionals supporting individuals in the Adult Autism Waiver (AAW), Adult Community Autism Program (ACAP), Consolidated, Person/Family-Directed Support (P/FDS), and Community Living waivers are encouraged to attend.

Where and when will sessions be held?

  • July 9, 2025, PaTTAN West, 9:30 am – 2:30 pm

Continuing Education Units (CEUs)

  • This training satisfies the basic autism training requirement for Residential Performance-Based Contracting measures CN-DD/Bx.01.1S and CN-DD/Bx.01.1CE for all DSPs, Frontline Supervisors (FLSs), and program managers.
  • This training also fulfills 6100 annual training requirements.

*After logging into your MyODP account, completion of the Demographics Form is required before being able to register for a session.

Please contact the Bureau of Autism Training inbox with questions.

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Providers are reminded of the requirement to report the use of American Rescue Plan Act of 2021 (ARPA) funding. The Department of Human Services (DHS) Office of Long-Term Living (OLTL) requires providers who received supplemental funding from the ARPA to report on their use of the funding by Friday, May 30, 2025. Reporting on the use of ARPA funding is critical to ensure compliance with federal requirements as the 2026 spending deadlines approach for the 10% enhanced Federal Medical Assistance Percentage (FMAP) funds for Home and Community-Based Services (HCBS) and State and Local Fiscal Recovery Funds. ARPA funding disbursements subject to this reporting requirement include the initiatives listed below. Please note that you may have reported on the use of ARPA funding received in 2021, including Act 2021–24 and Strengthening the Direct Care Workforce payments; this reporting is in addition to previously reported initiatives.

  • Home and Community-Based Services (HCBS) Quality Improvement Funding
    • Authorized in May 2022
    • Available to HCBS providers
    • Funded by 10% enhanced FMAP funding for HCBS
    • Eligible uses include activities and expenses that expand, enhance, or strengthen HCBS, as outlined in the notice of the funding opportunity as well as the reminder notice

To complete a report, please log in to the ARPA Funding Portal, select the appropriate funding type, and then select “Create a New Funding Report.” The portal will prompt users to select a provider name (for individuals authorized to submit reports for multiple facilities or locations) and the applicable reporting period. Upon selection, review the prepopulated information and complete all required fields in the form.

For additional instructions on completing a report, please refer to the ARPA Funding Reporting Portal Business Partner Guide. For questions about registration and user access, please refer to the ARPA Portal Registration Guide. OLTL has also published a Frequently Asked Questions document and a Summary of ARPA Funding online at Long-Term Care for Providers | Department of Human Services | Commonwealth of Pennsylvania.

Providers that received supplemental ARPA-funded payments must report to OLTL on their use of the funding so that the Commonwealth can produce documentation required by federal audits. Additionally, providers must retain detailed supporting documentation for the eligible use of supplemental ARPA-funded payments for a minimum of five (5) years from the payment date. Failure to submit a report may result in the recovery of funding through collection activities, audits, or legal action.

If you have questions regarding this message, please contact the Office of Long-Term Living via email.

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