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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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Hole torn in a dollar bill with medicaid text

Excerpt from: Pennsylvania Capital-Star, Nov. 23, 2021

The Democratic Wolf administration says it wants to spend $1.2 billion in American Rescue Act funds to shore up home and community-based services offered through the state’s Medicaid program, all with an eye toward allowing more of the commonwealth’s residents to access services closer to home. On Monday, the administration dropped the formal details of a plan to direct the federal relief money toward seniors and adults with intellectual and physical disabilities; adults dealing with such behavioral health needs as substance abuse disorder or mental illness; and children with chronic and complex medical needs, the administration said in a statement.

In its statement, the administration said the money also would be used to pay for:

  • Increasing access to home and community-based services;
  • Providing necessary supplies to safely facilitate services;
  • Additional trainings and learning opportunities through workforce support;
  • Supporting families caring for their loved one;
  • Improving functional capabilities of people with disabilities;
  • Enhancing transitional supports; and
  • Home and community-based services capacity building.

RCPA continues its discussions and advocacy with the Department of Human Services on spending priorities for human services, especially initiatives targeting rate structures and the workforce crisis.

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ODP Announcement 21-081 informs providers that the Heightened Scrutiny Onsite Tools for Non-Residential Service Locations has been finalized and posted for stakeholders to view. The Office of Developmental Programs (ODP) is also using this communication to address some of the comments and concerns that were received through public comment.

While the COVID-19 pandemic resulted in significant delays in performing the onsite visits, ODP will now be continuing with the Heightened Scrutiny process for Community Participation Support (CPS) and Day Habilitation service locations to meet the CMS requirement that all waiver providers must be in full compliance with the Home and Community-Based Services (HCBS) Settings Rule no later than March 17, 2023.

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As ANCOR is analyzing the impact of the Centers for Medicare and Medicaid Services (CMS) mandate released this morning, it is clear that ICF employees are included; however, waiver services are not unless the provider employs 100 or more employees. We are trying to get a handle on how many providers this will impact. Please let Carol Ferenz know ASAP if this will impact your organization.

From the CMS Frequently Asked Questions document:

Q. Does this requirement apply to Medicaid home care services, such as Home and Community-Based Services (HCBS), since these providers receive Medicaid funding but are not regulated as certified facilities?

A. No, this regulation only applies to those Medicare and Medicaid-certified provider and supplier types that are subject to CMS health and safety regulations. CMS’s health and safety regulations do not cover providers of Home and Community-Based Services.

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