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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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The Office of Long-Term Living (OLTL) released the rate study that was commissioned last August after RCPA and other industry associations collaborated to access the information needed to establish rates for services.

For background purposes, HCBS are offered through Medicaid as an alternative to facility or institutional care. Reimbursement rates for these programs are set by DHS and are informed by an actuarial rate setting process and a public comment process. Long-term services and supports (LTSS) help older Pennsylvanians and adults with physical disabilities.

The rate study revealed the need for substantial and immediate rate increases for the services which were evaluated. The study concluded, “Given the comparisons to benchmark rates, it appears that revisions to the rates studied for this report would be appropriate. The tables below show detailed results from the benchmark rate comparison.” The specific rate gaps were:

  • Adult Day                                                                     19%
  • Employment and Training Services                             35%
  • Personal Assistance — Agency                                   23%
  • Personal Assistance — PDS                                       12%
  • Residential Habilitation                                                44%
  • Structured Day Habilitation                                          22%

Findings of the study are used to inform the Commonwealth’s budget and future rate setting processes. View the results here.

If you have any questions, please contact Fady Sahhar or Melissa Dehoff.

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Dear ANCOR Members,

Next week, some Members of Congress will be back in their districts, making it the perfect time to meet with them and urge them to protect Medicaid funding for home and community-based services (HCBS).

The newly released House budget framework calls for 1.5 trillion in cuts over ten years and directs the House committee with jurisdiction over Medicaid to cut at least $880 billion in spending. While the details have not yet been finalized, these reductions would likely result in deep cuts to Medicaid funding. Even if proposals do not specifically target funding for I/DD services, the resulting pressure on state budgets from Medicaid cuts creates an elevated risk of further limits and cuts to services for individuals with I/DD. In-district meetings and site visits are some of the most effective ways to educate lawmakers and their staff on how these cuts would harm people with intellectual and developmental disabilities (I/DD), providers, and families.

To help you prepare, we’ve put together key advocacy resources, including:

Why Your Action Matters:
Studies show that constituent messages are the most effective way to influence lawmakers. When they see firsthand the impact of Medicaid-funded services in their communities, they are far more likely to protect funding.

Take this opportunity to reach out to your Members of Congress while they’re home next week or check their website for an email list signup to make sure you don’t miss any opportunities to engage while they are home — let’s make sure they understand why Medicaid funding must be protected.

Thank you for your advocacy.

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Young caregiver helping older lady to stand up

The Office of Long-Term Living (OLTL) recently shared additional guidance for providers related to the Centers for Medicare & Medicaid Services (CMS) Home and Community-Based Services (HCBS) Settings Final Rule.

This clarification applies to Residential Habilitation and Personal Care Home Providers.

Regulations at 42 CFR 441.301(c)(4)(vi)(B) require that participants in residential settings have the ability to close and lock doors within their living units. As a part of the Office of Long-Term Living (OLTL) residential provider reviews, it was found that several sites did not meet this requirement. As remediation, some providers opted to have participants sign a form stating that they do not wish to have a lock on their doors, which OLTL’s settings review panel accepted as compliant.

The Centers for Medicare & Medicaid Services (CMS) has reviewed OLTL’s oversight activities and has deemed that participant sign-off waiving installation of locks does not sufficiently satisfy the requirement. CMS has determined that all doors with access to participant units or private spaces (such as a bedroom) must have locks installed. The participant’s choice is whether to utilize the lock or not. Based on this feedback, as OLTL moves forward with ongoing oversight of HCBS settings requirements, all doors to participant units/private spaces in residential settings will be required to have working locks in order to be deemed compliant for future settings reviews.

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