The Home and Community Services Information System (HCSIS)/Enterprise Incident Management (EIM) Quarterly Release goes live on January 14, 2023. For additional information about this release, please refer to the latest newsletter.
ODP Announcement 22-103 serves to inform Adult Autism Waiver (AAW) providers that there are specific regulations regarding restrictive procedures that must be followed. The Office of Developmental Programs (ODP) has been made aware that some AAW providers are implementing restrictive procedure plans for individuals being served in AAW without a corresponding BSP documented in the ISP in HCSIS. This practice is not allowed.
A restrictive procedure must always be part of the behavioral support component of the ISP as required by the AAW. In the AAW, the BSP is included in the ISP in HCSIS. The Desired Behavioral Outcomes (DBOs) of the BSP must be consistent with the Behavior Support Specialist service goals and objectives.
There must be an active Behavior Support Specialist goal for each DBO, and each Behavior Support Specialist goal must have a DBO. Additionally, every Behavior Support Specialist goal must have a corresponding Goal Attainment Scale (GAS) chart and be reported on at least quarterly in a Quarterly Progress Note (QPN).
To have a restrictive procedure plan in place for an AAW participant, the Behavior Support Specialist service must be in the ISP Service Details so that a BS qualified to provide services in the AAW can develop, implement, and train staff on the participant’s BSP and CIP with the goal of fading all restrictive procedures over time.
In the AAW, the Behavioral Specialist Service (BSS) is not bundled with the Residential Habilitation service as it is with other ODP waivers. Therefore, to meet the requirements above, AAW participants who are receiving residential habilitation services and have a restrictive procedure plan in place must also have active BSS authorized in their ISP. This ensures an AAW qualified BS is working with the participant when a restrictive procedure plan is in place.
Please refer to Chapter 6100 regulations § 6100.341 – 6100.346, Bulletin 00-21-01 Guidance for Human Rights Teams and Human Rights Committees and Attachment 2 — Individual Plans and Informed Consent for additional information. Any questions should be sent to the AAW Provider Support Inbox.
ODP Announcement 22-102 announces that the Home and Community Services Information System (HCSIS) 90.05 Release Newsletter is available under the HCSIS Communique hyperlink found on the Learning Management System (LMS) located on the HCSIS home page.
Work items to highlight in this release include:
It is important to note that the Due Date and Time is only displayed for the First Section document. For all other documents, the system only displays the Due Date. The number of report extensions filed for the Final Section is under the Incident Final Section document information.
Please review the HCSIS Release 90.05 Newsletter as part of this Announcement and also located on the secure LMS Home and Community website for more information. If you do not have an LMS Login ID and Password, contact your Business Partner Administrator (also known as your “BP Admin”).
ODP Announcement 22-065 is to inform all HCSIS users and stakeholders of the upcoming disablement of Internet Explorer and the redirection to Microsoft Edge browser. Beginning June 15, 2022, Internet Explorer will no longer be a supported browser for HCSIS. Users will need to use Microsoft Edge to run the application.
Microsoft Edge with IE mode is officially replacing the Internet Explorer 11 desktop application on Windows 10. As a result, the Internet Explorer 11 desktop application will go out of support and be retired on June 15, 2022, for certain versions of Windows 11.
For further outreach, please refer questions to HCSIS.
The Office of Developmental Programs (ODP) shared a recent communication regarding the transition of the HCSIS Help Desk to a new vendor. As of May 2, 2022, the HCSIS Help Desk responsibilities will transition from the Public Consulting Group (PCG) to the new vendor, InspiriTec.
The Office of Long-Term Living (OLTL) recently issued a reminder for Service Coordination Entities (SCEs) regarding the annual review process in HCSIS for the Act 150 Program and OBRA Waiver. Included in this reminder are the procedures and instructions for entering these service plans in HCSIS beginning April 4, 2022. OLTL encourages SCEs to use this annual review process to review caseloads and finalize any dis-enrollments or inactive service plans. The Waiver/Program Transfer instructions are here for reference. Please also reference the “OLTL Fiscal Year 2022/23 Annual Review Instructions for HCSIS” for additional information on how file closures may impact the current Annual Review process.
If you have any additional questions or wish to receive the above forms in alternate formats, please contact Brian Lester at (717) 346-0716 or via email.
ODP Announcement 22-021 provides guidance on the upcoming rate increases for the Adult Autism Waiver. Compensation is beginning March 1, 2022; the new rates will be implemented in the Home and Community Services Information System (HCSIS) on March 1, 2022. All Individual Support Plans (ISPs), including ISPs in draft, pending review, or pending approval status, will be updated with the new rates for each of the applicable services. An additional fiscal segment will automatically be added on each ISP for each service that is impacted by the rate change.
Providers are strongly encouraged to review Service Authorization Notices or the Provider Service Detail report in HCSIS to confirm the new rates were loaded, authorized, and that they are billing the increased Fee Schedule Rate before attempting to bill for any services rendered March 1, 2022, and after.
Compensation for the Period July 1, 2021, through February 28, 2022
Providers should bill normally for any services rendered from July 1, 2021, through February 28, 2022. ODP will be compensating providers, via gross adjustments, for the difference between the rate billed and the updated fee schedule rate for dates of service rendered during the period July 1, 2021, through February 28, 2022. This is intended to eliminate the provider’s effort of voiding and re-billing claims.
ODP anticipates processing gross adjustments during the April to May 2022 timeframe to ensure all billing for dates of service July 1, 2021, through February 28, 2022, has been completed. Because the rates will be loaded into HCSIS effective July 1, 2021, and the gross adjustment compensation will be issued by ODP, providers should not adjust any claims after April 1, 2022, submitted for services rendered on July 1, 2021, through February 28, 2022.
Adjustment of a claim(s) for services delivered during these dates will result in a duplication of payment that will need to be repaid. Providers are strongly encouraged to bill in a timely manner to minimize the need for corrections.
For questions on how to resolve billing errors for services that were rendered on July 1, 2021, through February 28, 2022, contact Amber Bennett.
Correction to Rates for Small Group Employment and Residential Habilitation Ineligible Fees
Because of an internal editing error, the rates for Small Group Employment and Residential Habilitation: Community Home Ineligible published in the Pennsylvania Bulletin (52 Pa.B. 1326, February 26, 2022) were incorrect. The correct rates, with the corresponding procedure codes, are higher than what was published. The corrected rates are also available on the Department of Human Services’ website.
ODP Announcement 22-007: UPDATE provides information to providers in order to prepare for upcoming rate increases that are scheduled to be published in the Pennsylvania Bulletin on February 26, 2022.
Per the final public notice for Fee Schedule Rates, Department-established fees, and the AWC FMS Department-established fees rendered through the Consolidated, Community Living (CLW), and Person/Family Directed Support (P/FDS) waivers:
ODP anticipates processing gross adjustments during the April to May 2022 timeframe to ensure all billing for dates of service January 1, 2022–February 28, 2022 has been completed. Providers are strongly encouraged to bill in a timely manner to minimize the need for corrections.
Since the new rates will have a begin date of March 1, 2022, two service/rate segments in authorized status will be present on ISPs, assuming no errors set. One service/rate segment will reflect the period July 1, 2021, to February 28, 2022, or the begin date of the service when it was initially authorized on the plan during Fiscal Year (FY) 2021–2022. The second service/rate segment will reflect the period March 1, 2022, to June 30, 2022.
Authorized units on the first service/rate segment, July 1, 2021–February 28, 2022, will reflect 67% of total authorized units for the FY 2021–2022. The second service/rate segment will reflect 33% of total authorized units for the remainder of FY 2021–2022. If an individual requires more than 33% of the total annual authorized units for the remainder of FY 2021–2022, a revision to the plan will be necessary to move units from the first service segment to the second service segment on the ISP. For the period July 1, 2021, to February 28, 2022, providers should bill normally for any services rendered.
See the ODP Announcement for the full instructions.
A message from the Office of Developmental Programs (ODP):
Due to an extended time frame for approving and loading rates into the Home and Community Services Information System (HCSIS), ODP is notifying stakeholders that several dates contained in Announcement 22-007 are no longer effective. The date for the rate load will occur after February 15, 2022.
ODP anticipates re-releasing this Announcement with updated time frames and encourages providers, Supports Coordination Organizations, and Administrative Entities to be familiar with its technical content in preparation for the pending rate load.
ODP Announcement 22-007 informs providers that the new Fee Schedule Rates and Department-established fees are anticipated to be visible on Individual Support Plans (ISPs) in HCSIS on February 14, 2022.
The anticipated effective date for the increased Fee Schedule Rates is January 1, 2022; however, the effective date in the Home and Community Services Information System (HCSIS) will be February 15, 2022. The anticipated effective date for the Department-established fees for residential ineligible services is July 1, 2022, and HCSIS will reflect the same effective date. Both the Fee Schedule Rates and Department-established fees for residential ineligible services will be visible in HCSIS on February 14, 2022.
Of note, on January 6, 2022, the P/FDS cap was increased to $41,000, and the Community Living Waiver cap was increased to $85,000.
This communication provides guidance and addresses Individual Support Plan (ISP) related impacts.
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