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Tags Posts tagged with "Life Sharing"

Life Sharing

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Today the Department of Human Services (Department) published final notice of Fee Schedule Rates for services funded through the Consolidated, Community Living, Person/Family Directed Support (P/FDS), and Adult Autism Waivers and the Department-established fees for base-funded services as a correction to the rates previously published August 1, 2024.

Due to a calculation error, the Department has made corrections to the Fee Schedule Rates for the following services funded through the Consolidated, Community Living, and P/FDS Waivers and base-funding:

  • Community Participation Support, effective July 1, 2024; and
  • Life Sharing Without Day 1-person needs group 3 and 4, effective October 1, 2024.

Additionally, due to a mistake in aligning the procedure code with the correct Statewide fee, the Department is republishing the Fee Schedule Rates for the following services funded through the Adult Autism Waiver effective July 1, 2024:

  • Residential Habilitation
  • Specialized Skill Development
  • Supported Employment
  • Career Planning
  • Therapies
  • Day Unit Respite
  • 15-Minute Unit Respite
  • Supports Coordination
  • Transportation — Trip

This publication presents an opportunity for providers to appeal these specific rates. The deadline for filing an appeal for these rates is December 2, 2024.

For further information, view ODPANN 24-107 or contact Carol Ferenz, IDD Division Director.

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The Office of Developmental Programs (ODP) met with stakeholders today, October 30, 2024, to discuss waiver amendments and to provide an overview of Performance-Based Contracting.

Waiver Amendments included:

Waiver Capacity:

  • When an individual is in an acute care hospital and receiving waiver services, ODP will not need to reserve (hold) the individual’s waiver. They will maintain enrollment in the waiver.
  • Language was updated for waiver capacity for high school graduates in the P/FDS waiver. AEs can reserve the waiver capacity for 180 days prior to when services are needed. Students can remain in service until their 22nd birthday.

Assistive Technology:

  • Updated language to explain when an independent evaluation is required and when it is optional:
    • REQUIRED: A device will cost $750 or more.
    • OPTIONAL: A device will cost less than $750.
  • An independent evaluation can be done if the team decides it would be beneficial.
  • Evaluations are included in the $10,000 lifetime limit.

Community Participation Support:

  • The Community Participation Support provider must complete and update an analysis of the following at least yearly to support individuals to experience meaningful community inclusion:
    • Strongest interests and personal preferences for community activities;
    • Skills, strengths, and other contributions likely to be valuable to employers or the community; and
    • Conditions necessary for successful community inclusion and/or competitive integrated employment.

American Sign Language (ASL) – English Interpreter Service:

  • English Interpreter service will be added to ODP’s waivers effective January 1, 2025.

Music, Art, & Equine Assisted Therapy:

  • The cumulative maximum limit of any combination of Music Therapy, Art Therapy, or Equine Assisted Therapy has increased from 26 to 52 hours per fiscal year.

STAT Overview:

  • The Specialty Telehealth and Assessment Team service was implemented in March 2024. This service may also be delivered to the participant during temporary travel, per ODP’s travel policy.

Waiver Corrections:
Life Sharing:

  • The following may not be authorized for participants who receive Life Sharing services: Residential Habilitation; Supported Living; Respite (15-minute or Day) (has been removed).

Supported Living Corrections:

  • The following services may not be authorized for participants who receive Supported Living services: Life Sharing; Residential Habilitation; Respite (15-minute or Day); Homemaker/Chore; In-Home and Community Supports; Behavioral Supports; Therapies; Shift Nursing; Consultative Nutritional Services; Communication Specialist and Specialize.

Benefits Counseling:

  • New billable indirect activities are added. The limit has increased from 15 hours per fiscal year to 24 hours per fiscal year.

The Performance-Based Contracting Review Included:

  • Effective January 1, 2025, Performance-Based Contracting will be implemented for the following services funded through the Consolidated and Community Living Waivers:
    •  Residential Habilitation;
    •  Life Sharing; and
    •  Supported Living.
  • Changes to Enrollment of New Providers.
  • What are Performance Standards?
  • What are Provider Tiers?
  • What Do These Changes Mean to Individuals and Families?

All performance-based contracting questions can be sent electronically.

Please see the distributed PowerPoint for additional information.

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In order to continue providing residential services after December 31, 2024, residential service providers must complete and return the Office of Developmental Programs (ODP) Agreement for Provision of Residential Services. A copy of the agreement and accompanying cover letter will be sent to your agency within the next 24 hours. The documents will be emailed to your agency’s primary QA&I contact as listed on MyODP. Completed Agreements must be submitted no later than July 31, 2024. If your agency does not receive these materials, or if your QA&I contact has changed, please contact ODP Provider Enrollment.

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ODP Announcement 23-036 announces that the Consolidated Waiver amendment included new qualification criteria for Life Sharing providers that render services to individuals with a medically complex condition. This communication provides initial guidance for the following:

  • Life Sharing providers, SCs, and AEs who have questions about how to determine if an individual has a medically complex condition and how to complete the DP1090 Form;
  • Life Sharing providers currently serving individuals who may now meet the medically complex condition criteria; or
  • Life Sharing providers that are not currently providing services to individuals who have a verified medically complex condition but may do so in the future, and Life Sharing providers that will serve an individual with a verified medically complex condition who enrolls after publication of this communication.

The Office of Developmental Programs (ODP) understands the need for more guidance, which is actively being developed and will be communicated with stakeholders. Please see the following items for current guidance.

Questions about this communication should be directed to the appropriate ODP Regional Office.

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ODP Announcement 23-027 announces that the Residential Habilitation (Life Sharing) Ineligible Rate will be removed from the Adult Autism Waiver (AAW) effective July 1, 2023. The Office of Developmental Programs (ODP) is continuing to align the AAW with the other ODP waivers. This alignment includes the removal of procedure code W7234. This procedure code will be removed from HCSIS, and providers will be unable to bill this procedure code within PROMISe for dates of service on and after July 1, 2023.

For questions, please contact the appropriate ODP Bureau of Supports for Autism and Special Populations (BSASP) Regional Office.

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