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ISP

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ODP Announcement 23-050 announces the release of the Individual Support Plan (ISP) Manual that includes information from the Consolidated, Community Living, and Person/Family Directed Support waiver renewals that were effective on January 1, 2023. In addition, the Waiver Service Request Form (DP 1022-S) has been translated into Spanish and can be found on MyODP.

Attachment 1 and Attachment 8 should be used effective immediately and have been uploaded as the current attachments to ODP Bulletin 00-22-05 on the DHS Bulletin web page.

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The Office of Developmental Programs (ODP) has shared ODPANN 23-040: FY23-24 Renewal Guidance. This communication will provide guidance for the FY 2023/24 renewal period. The following topical areas are addressed in this communication:

  • Federal COVID-19 Public Health Emergency Ending;
  • Leap Year;
  • Person/Family Directed Support (P/FDS) Cap Exceptions;
  • Waiver Rate Load;
  • Needs Level/Needs Group Clean-up;
  • Variance Process for Established Service Requirements;
  • Consolidated Waiver Fee Schedule Residential Rate Exceptions;
  • Reserve to Encumbrance; and
  • Resources.

For information related to special considerations, please contact the ODP Regional Program Office assigned to your region. For questions related to the participant-directed services (PDS rate table or calculator), please contact your ODP Regional Financial Management Services (FMS)/PDS Lead.

See the resource ODP-ID/A: SC100I Supports Coordination > Chapter 17: Fiscal Year Renewal: ISP – v8.0 9/21/13 in the LMS for information on how to perform a FY Renewal.

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ODP Announcement 23-032 announces three half-day virtual training sessions regarding implementation of the Residential Individual Support Plans (ISP) Staffing approach for Administrative Entity (AE) staff. The pre-requisite requirements and training dates are available on MyODP.

The sessions are geared toward AE staff and supervisory staff who routinely review and approve ISPs. The training focuses on AE expectations and ensuring consistent, statewide implementation of the Residential ISP Staffing approach.

Please review the communication for complete information.

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ODP Announcement 23-017 provides information regarding Remote Supports as a separate, discrete service in all four of the Office of Developmental Programs’ (ODP) waivers. Remote Supports is no longer covered as a component of the Assistive Technology service in the Consolidated, P/FDS, and Community Living waivers.

Guidance in the announcement includes how to add remote supports to the ISP, necessary provider qualifications, and enrollment process. Please refer to Attachment A for more instructions on how to add Remote Supports services for the P/FDS, Community Living, or Consolidated Waiver. Please refer to Attachment B for more instructions on how to add Remote Support Services for the AAW. Additional information about the qualification of a new specialty is contained in ODP Announcement 22-122 “Provider Qualification Process.”

Existing providers must submit the approved DP 1059 (ID/A) or DP 1088 (AAW) along with the “PROMISe™ Provider Service Location Change Request,” which can be found on the MyODP website, to the ODP provider enrollment inbox and/or AAW provider enrollment inbox in order to add a new Specialty 364 to an EXISTING active service location with the same Provider Type. Providers that do not have a Provider Type 51 service location open in PROMISe will need to submit an application through the Provider Enrollment system.

Questions regarding ISP requirements should be sent to the appropriate ODP Regional Office. Questions regarding provider qualification requirements should be sent to the ODP Provider Qualification inbox and the AAW Provider Enrollment Lead.

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From the Office of Developmental Programs:

The Office of Developmental Programs (ODP) will be renewing all existing exceptional residential rates for individuals who have a current NEA, approved through 12/31/22, for the second half of the fiscal year. Providers should ensure that all individuals with exceptional rates have a current Health Risk Screening Tool (HRST).

This extension will require a critical revision to the individual’s ISP. The rate segment has been entered into PROMISe and is available for use. Please work with Supports Coordinators and Administrative Entities to ensure the ISP is updated and approved.

Thank you,

Rick Smith  l  Director
PA Department of Human Services, Office of Developmental Programs
Bureau of Financial Management and Program Support
625 Forster Street Room 412, Harrisburg, PA 17120
717-783-4873
MyODP

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The PA Family Network will be hosting a series of workshops focused on different topics and audiences over the next several weeks. A list of the workshops is below. Visit the workshop title to learn more and register.

Sibling Good Life Group
September 19 at 6:30 pm
This group of adult siblings will have the opportunity to guide the group’s direction and teach how to network with other siblings, talk about your lived experience, hear from experts on topics relevant to sibling life, have open and informative discussions, and plan for a future that holds true potential for you and your family. Anyone thought of like a sibling or in a sibling-like role is welcome!

Peace of Mind
September 20 at 11:00 am – 1:00 pm
September 21 at 6:00 pm – 8:00 pm
Join the PA Family Network in this interactive workshop to network and meet other adult siblings. Get information and strategies on handling Long-Term Planning, and identify services/supports so you and your loved one can live a good life

Healthy Relationships and Sexuality (L.E.A.D.)
September 26 at 11:00 am – 1:00 pm
Learn practical strategies and skills that encourage healthy relationships and sexuality while mitigating risk. Discuss boundaries, relationships, risks, and self-advocacy skills. Learn 4 steps to healthier relationships.

Using LC to Plan and Problem Solve
October 3 at 10:00 am – 12:00 pm
Identify service/supports so your loved one can live an Everyday Life. You will learn to use the LifeCourse framework and tools to plan for your Individualized Support Plan (ISP) and Individualized Education Plan (IEP).

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ODP Bulletin 00-22-05, dated August 9, 2022, is to provide the Office of Developmental Programs’ (ODP) requirements and standardized processes for preparing, completing, documenting, implementing, and monitoring Individual Support Plans (ISPs) to ensure they are:

  • Developed to meet the needs of the individual;
  • Developed and implemented using the core values of Everyday Lives: Values in Action, LifeCourse Principles, Positive Approaches, and Practices and Self Determination to result in an enhanced quality of life for every individual; and
  • Compliant with the approved Consolidated, Community Living, and Person/Family Directed Support (P/FDS) Waivers and Medical Assistance (MA) State Plan as it pertains to Targeted Support Management (TSM).

A summary of major changes made to information in the attachments is included as attachment 8.

ATTACHMENTS:

  • Attachment 1: ISP Manual for Individuals Receiving Targeted Support Management, Base-Funded Services, Consolidated, Community Living or P/FDS Waiver Services or Who Reside in an ICF/ID
  • Attachment 2: ODP Role Expectations and Required Timeline for ISP Activities
  • Attachment 3: DP 1032 Individual Support Plan Signature Form (Spanish form: DP 1032-S)
  • Attachment 4: Annotated Individual Support Plan
  • Attachment 5: The Basics of the LifeCourse Framework to Guide the Development of the ISP
  • Attachment 6: Questions to Help Facilitate the Development of the ISP
  • Attachment 7: DP 1022 Waiver Service Request Form
  • Attachment 8: Summary of Major Changes Made to ISP Requirements or Processes

OBSOLETE DOCUMENTS:

  • Bulletin 00-20-02, Individual Support Plans for Individuals Receiving Targeted Support Management, Base-Funded Services, Consolidated, Community Living or P/FDS Waiver Services, or Who Reside in an ICF/ID

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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.

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ODP Announcement 22-017 is to announce that Residential ISP Staffing training sessions are now available from January through June 30, 2022. Residential ISP Staffing trainings described in ODP Announcement 21-057 have been completed, but additional training can be provided by agency professionals who have volunteered to provide training and have participated in delivering training in the fall of 2021, referred to ODP Designated Trainers.

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