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hcbs

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Join us on Tuesday, January 4, 2022, at 10:00 am for an “ODP-Administered HCBS Waiver Rates Revisions and Impact Analysis Tool” webinar sponsored by RCPA, PAR, MAX, The Alliance of Community Service Providers, and The Arc of PA.

Speakers will be:

  • Richard S. Edley, PhD, President and CEO, RCPA
  • Chris Elliot, Vice President of Finance, Barber National Institute
  • Diane Conway, CEO, MAX
  • Sherri Landis, Executive Director, The Arc of Pennsylvania
  • Cherie Brummans, President & CEO, The Alliance of CSP
  • Mark Davis, President & CEO, CDI, PAR
  • Scott Spreat, Research Director, CDI, Woods Services

The DHS/ODP revised waiver rates will be presented. Participants will then be trained on an “Impact Analysis Tool” that was designed to help inform ID/A providers of the impact of the revised rates and will also inform organizations representing providers of HCBS services for their comments on the revised rates.

Please register for this Zoom webinar, which will be held on January 4, 2022, from 10:00 am–11:00 am. For more information, please view the flyer for the webinar. We look forward to seeing you there!

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The Office of Long-Term Living (OLTL) has issued Bulletin 59-21-03, which pertains to the Home and Community-Based Settings (HCBS) Heightened Scrutiny process. Also included are the following bulletin attachments:

  • Attachment A: Final Rule Heightened Scrutiny checklist for Day Settings
  • Attachment B: Final Rule Heightened Scrutiny checklist for Employment Skills Development Settings
  • Attachment C: Final Rule Heightened scrutiny checklist for Residential Settings

OLTL is currently working to develop a training for providers on this topic and will host training sessions sometime in early 2022. Questions about the bulletin and/or the attachments should be sent via email. The bulletin is effective December 29, 2021.

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The Office of Long-Term Living (OLTL) has outlined its plan to the Centers for Medicare and Medicaid Services (CMS) to strengthen the workforce and assist Adult Day Services (ADS) providers. This plan is in response to the American Rescue Plan Act of 2021 (ARPA), which provides a temporary 10 percent increase to the federal medical assistance percentage (FMAP) for certain Medicaid expenditures for home and community-based services (HCBS). The funding must be used to enhance, expand, or strengthen HCBS.

The OLTL ARPA plan directs $46.5 million to Personal Assistance Service (PAS), Community Integration (CI), and Residential Habilitation (Res Hab) providers to assist with recruitment and retention of direct care workers. The plan directs an additional $13 million to ADS providers to strengthen ADS. To qualify for these payments, providers must have been in operation as of November 1, 2021.

OLTL sent letters to providers with details about the payments, including information about the approved use of and reporting on these funds. For reference, samples of the letters, a list of qualifying entities and payment amounts, and a blank copy of the Provider Attestation Form are available on the DHS Long-Term Care Providers page under the heading “American Rescue Plan Act (ARPA) Funding.”

To receive a Strengthening the Workforce or Adult Day Services payment, providers must complete the OLTL Provider Attestation form and return via email or fax it to the OLTL Bureau of Finance at (717) 787-2145.  Providers who return completed forms by January 7, 2022, will receive payment in February 2022.

Strengthening the Workforce Payments

  • The total available for a one-time payment to PAS, Res Hab, and CI providers is $46,500,000. Of that, $44 million is allocated to PAS and CI, and $2.5 million is allocated to Res Hab. Amounts allocated to providers in each category were based on fee-for-service claims and managed care encounters for services provided between July 1, 2020, and March 30, 2021.
  • To calculate each PAS and CI provider’s Strengthening the Workforce payment, OLTL first divided the $44 million allocation by the total number of fee-for-service and managed care PAS and CI units billed between July 1, 2020, and March 30, 2021, to determine a per unit amount. Each provider’s payment was then calculated by multiplying the per unit amount by the provider’s number of fee-for-service and managed care PAS and CI units billed during the same period.
  • To calculate each Res Hab provider’s Strengthening the Workforce payment, OLTL first divided the $2.5 million allocation by the total number of fee-for-service and managed care Res Hab units billed between July 1, 2020, and March 30, 2021, to determine a per unit amount. Each provider’s payment was then calculated by multiplying the per unit amount by the provider’s number of fee-for-service and managed care Res Hab units billed during the same period.

Strengthening ADS Payments

  • The total funds available for a one-time payment to ADS providers is $13 million. Amounts allocated to ADS providers were based on fee-for-service claims and managed care encounters for services provided between January 1, 2019, and December 31, 2019.
  • To calculate each ADS provider’s Strengthening Adult Day Services payment, OLTL first divided the $13 million allocation by the total number of fee-for-service and managed care ADS units billed between January 1, 2019, and December 31, 2019, to determine a per unit amount. Each provider’s payment was then calculated by multiplying the per unit amount by the provider’s number of fee-for-service and managed care ADS units billed during the same period.

Acceptable Uses of ARPA Funding

ARPA funding must be used for things such as sign on bonuses, retention payments, COVID-19 related leave benefits and paid time off, vaccination incentives, or the purchase of personal protective equipment and testing supplies. Additionally, ADS providers can use the funding for retrofitting adult day centers, expenses to re-open the centers, and expenses to develop alternative models to provide ADS.

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

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ODP Announcement 21-092 is to inform all interested persons of the availability of the first report that assesses provider compliance with the Home and Community-Based Settings Rule for the Office of Developmental Programs (ODP). The report can be accessed here.

This report contains licensing inspection data gathered during licensing inspections completed in Fiscal Year 2020–2021. As part of ODP’s commitment to ensuring compliance with the HCBS Settings Rule, an annual report containing results from licensing inspections will be released.

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Message from the Department of Human Services (DHS):

FOR IMMEDIATE RELEASE
December 20, 2021 

Department of Human Services Discusses Spending Plan for Home and Community-Based Services Enhanced Federal Funding to Support Mental Health Services, Children 

Harrisburg, PA — Pennsylvania Department of Human Services (DHS) today highlighted Pennsylvania’s spending plan for approximately $1.2 billion in enhanced federal Medicaid funding made available to states through the American Rescue Plan Act (ARPA). This funding will support Medicaid’s home and community-based services (HCBS) system throughout the commonwealth, which helps seniors, people with disabilities, children with complex medical needs, and many other groups safely live in their community among their family and peers. This funding will strengthen Pennsylvania’s home and community-based services system by allowing more Pennsylvanians access to critical services in their communities and supporting service providers that perform this work every day.

“We owe a huge debt of gratitude to the professionals who care for our most vulnerable, including children, seniors, people with disabilities, and those needing mental health services,” said Acting Secretary Meg Snead. “This enhanced funding through the American Rescue Plan Act will allow employers to recruit and retain skilled workers and allows them to plan for the future to provide training, certification, technology access, and much more.”

DHS received conditional approval of its spending plan on December 1 from the Centers for Medicare & Medicaid Services. On today’s call, DHS outlined how funding will be used through the Office of Mental Health and Substance Abuse Services (OMHSAS), the Office of Child Development and Early Learning (OCDEL), and the Office of Medical Assistance Programs (OMAP).

  • OMHSAS will prioritize funding for workforce recruitment and retention to qualifying providers, specifically mobile crisis mental health services, intensive behavioral health services (IBHS), psychiatric rehabilitation, and family-based mental health services. While many mental health services are not considered HCBS under ARPA, within the parameters of this funding opportunity, OMHSAS also will invest in training clinicians in trauma-informed treatment modalities, technology and training for telehealth, and updating the state hospital system’s technology infrastructure and providing staff training for use of electronic health records to facilitate more efficient transitions to community-based placements and services.
  • OCDEL supported a 3 percent rate increase for Infant/Toddler Early Intervention services, which allows all providers of Early Intervention services, including Service Coordination, to receive a 3 percent rate increase for services. This rate increase went into effect on July 1, 2021.
  • OMAP will use the recommendations of its pediatric shift care nursing work group to inform ARPA spending with a focus on achieving the following goals: improve care and service coordination for children with complex medical needs; support training of private duty nurses; leverage health information technology to allow for the sharing of clinical information; use a value-based payment structure for managed care organizations to improve outcomes of children receiving pediatric shift care nursing services; and facilitate co-training opportunities for both shift nurses and families to help improve coordination, continuity, and support among caregivers.

“When we invest in the caring workforce, Pennsylvania benefits both socially and economically,” said Acting Secretary Snead. “Having care provided in your own home or within your community allows family caregivers to be part of the workforce themselves and it allows those needing home and community-based services to stay safe, healthy, and to thrive.”

More information about Pennsylvania’s home and community-based services spending plan is available on DHS’s website.

RCPA continues to meet with DHS advocating for members on the spending plan and distribution strategies to ensure the workforce issues are front and center of the plan. If you have any questions, please contact your RCPA Policy Director.

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The Office of Long-Term Living (OLTL) has updated the Home and Community-Based Services (HCBS) Medical Assistance (MA) Fee Schedule. The updates reflect the fee schedule rates for Personal Assistance Services (PAS) procedure codes W1793, W1793 TT, W1792, and W1792 TU in the referenced Pennsylvania Bulletin below.

The updated OLTL HCBS MA Fee Schedule (effective January 1, 2022) may be found here. The new rates for the OBRA Waiver and Act 150 Program were announced in the Pennsylvania Bulletin on November 6, 2021, in the Volume 51, Number 45 issue and can be found here.

Questions related to this update should be directed to the OLTL Provider Inquiry Line at 800-932-0939, option 2, Monday–Friday between 9:00 am–12:00 pm and 1:00 pm–4:00 pm.

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RCPA joined with other disability service associations representing disability service providers and individuals with intellectual disabilities and autism (ID/A) in Pennsylvania urging Senator Toomey to support the investment included in the Build Back Better Act. The BBB Act, as passed by the House of Representatives, will strengthen the direct support professional workforce and sustain and expand access to Medicaid Home and Community-Based Services (HCBS).

The longstanding direct support professional (DSP) worker shortage has grown during the pandemic and decreased access to HCBS for people with disabilities in Pennsylvania as well as negatively impacted the quality of supports those individuals receive. Supporting this historic investment is crucial to strengthening and growing the DSP workforce so that all people with disabilities may lead safe and fulfilled lives. It is critical for Senator Toomey to vote in favor of this legislation to strengthen and expand the Medicaid HCBS program.

Additionally, we ask that members join us in this advocacy. This letter can be utilized as a template for your efforts. Please join us in this advocacy effort.

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American Rescue Plan Act: One-Time Supplemental Payment to Address Recruitment, Retention, and COVID-19 Related Staff Expenses

ODP Announcement 21-086 is to provide guidance about the process to request one-time payments to cover COVID-19 related expenses for high staff vacancy. The American Rescue Plan Act of 2021 (ARPA) provides a temporary 10% increase to the federal medical assistance percentage (FMAP) for certain Medicaid expenditures for home and community-based services (HCBS). The funding is to be used to enhance, expand, or strengthen HCBS beyond what is available under the Medicaid program as of April 1, 2021, and through March 31, 2024.

As part of the Office of Developmental Programs’ (ODP) ARPA spending plan to strengthen HCBS, providers can receive a one-time supplemental payment to address recruitment, retention, and COVID-19 related staffing expenses for direct support professionals or supports coordinators to include funding for hazard pay, costs of recruitment efforts, sign-on bonuses, retention bonuses, and other incentive payments. Providers will be required to complete and submit the attached Provider Attestation Form for One-Time Supplemental Payment and submit it to ODP for consideration.

Providers will be subject to recoupment of funds if it is identified in a state or federal audit or any other authorized third-party review that the provider has inappropriately billed for services or received duplicative payments for services provided or if expenses were reimbursed by duplicative funding streams. No portion of the supplemental payment can be utilized to increase executive compensation.

Providers will be required to continue providing services from December 1, 2021, through June 30, 2022, obtaining written consent from ODP for any discontinuation of a service line or closure of a service setting. Additionally, providers will comply with all reporting requirements related to the use of the supplemental payment.

Requests submitted by December 17, 2021, will be processed for payment prior to the end of December. Requests for supplemental payments may be submitted through January 31, 2022.

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