ODP Delays Requirements Regarding the Number of Individuals Served in Licensed Facilities that Provide CPS or Day Habilitation Services

ODP Announcement 19-084 serves to notify providers that due to the continued delay of the publication of the 55 Pa. Code Chapter 6100 regulations, the requirement that Community Participation Support and Day Habilitation services not be provided in a licensed facility that is newly funded that serves more than 25 individuals in the facility at any one time, has been delayed to January 1, 2020. This communication maintains previous clarification contained in ODP Communication 19- 034 regarding the number of individuals that can be served in a newly licensed Adult Training Facility (55 Pa. Code Chapter 2380) or a licensed Vocational Facility¹ (55 Pa. Code Chapter 2390) as well as relocations of these facilities.

The Community Participation Support service definition in the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) waivers, as well as the Day Habilitation service definition in the Adult Autism Waiver, state that services may not be provided in a licensed facility that is newly funded on or after March 17, 2019 and serves more than 25 individuals in the facility at any one time.

Due to the continued delay in the publication of the 55 Pa. Code Chapter 6100 regulations, this requirement is being delayed to January 1, 2020. For the purposes of this requirement, from January 1, 2020 to December 31, 2021, only new licensed Adult Training Facilities and Vocational Facilities will be considered “newly funded.”

Effective January 1, 2022, relocations (facilities that are currently licensed to operate at one physical site that subsequently move to a new physical site) will be considered “newly funded” and will have to meet the requirement to serve no more than 25 individuals at any one time in a licensed setting. New requirements for relocations, which became effective on March 15, 2019 with the release of ODP Communication 19-034, are contained in the relocations section below.

Effective January 1, 2022, Community Participation Support and Day Habilitation services may not be provided in any licensed Adult Training Facility or licensed Vocational Facility that serves more than 150 individuals at any one time. This number includes individuals who receive services funded through a source other than the waivers included in this communication.

New Licensed Facilities

• New licensed Adult Training Facilities and licensed Vocational Facilities that will enroll to render Community Participation Support or Day Habilitation services on or after January 1, 2020 may not serve more than 25 individuals in the facility at any one time. Serving no more than 25 individuals in a facility at any one time is not a requirement for licensure; it is a requirement for reimbursement through the Consolidated, Community Living, P/FDS, and Adult Autism Waivers (hereafter referred to as ODP Waivers). The provider may not receive reimbursement through the ODP Waivers for services any individual receives in the facility during the time that more than 25 individuals are receiving services in the facility.
• When applying for a new licensed facility, applicants will be asked if they wish to limit the licensed capacity to 25 or less. Applicants that choose a licensed capacity of more than 25 individuals will be referred to ODP staff for additional technical guidance regarding the potential impact for ODP Waiver funding for services provided in the facility.
• Providers do not have to request Approved Program Capacity for this purpose.
• Ongoing compliance with the requirement to serve 25 or less individuals at any time will be verified through various methods including onsite visits, claims data reviews, and documentation reviews.

Relocations of Existing Licensed Facilities

Effective January 1, 2022, relocations will be considered “newly funded” and will have to meet the requirement to serve no more than 25 individuals at any one time in a licensed setting.

From March 15, 2019 until December 31, 2021, licensed Adult Training Facilities and licensed Vocational Facilities that relocate an existing service location to a new service location which intend to serve more than 25 individuals at any one time in the new location must submit information in writing (mail or email) to the appropriate ODP staff as identified in Attachment 1.

ODP staff will inform the provider of whether the relocation is approved or denied for the purpose of being eligible for funding through an ODP Waiver. Once approved, ongoing compliance (increases in the percentage of community participation and integration in the individuals’ communities and serving the number of individuals they are approved to serve) will be verified through various methods including onsite visits, claims data reviews, and documentation reviews.

For more detailed information, refer to the Announcement 19-084, and Attachment 1 – ODP Staff to Contact for Relocation Approval. ODP Communication 19-034, Requirements Regarding the Number of Individuals Served in Licensed Facilities That Provide Community Participation Support or Day Habilitation Services, is now obsolete.

Questions about this communication should be emailed here.