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Tags Posts tagged with "OBRA Waiver"

OBRA Waiver

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The Long-Term Services and Supports (LTSS) Subcommittee meeting was held yesterday, November 6, 2024. During the meeting, a number of presentations were given. In addition to the presentations, the agenda and a document that provided follow-up items from the October 2, 2024, LTSS Subcommittee meeting were provided.

Members should take time to review the PowerPoint presentations from the meeting below:

The 2025 meeting dates for the LTSS Subcommittee were also shared:

  • January 8, 2025
  • February 5, 2025 (virtual only)
  • March 5, 2025 (virtual only)
  • April 2, 2025
  • May 7, 2025
  • June 4, 2025
  • July 2, 2025
  • August 6, 2025
  • September 3, 2025
  • October 1, 2025
  • November 12, 2025
  • December 3, 2025

The meetings will continue to be held from 10:00 am – 1:00 pm.

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Part of the CHC waiver discussions that began with the Office of Long-Term Living (OLTL) this spring related to mandatory background checks for employees. Since this discussion, OLTL has decided not to move forward with this change in the renewal and amendment submitted to CMS. This change in position was a result of the subsequent public comments and feedback on the collateral impacts.

Also contributing to this reversal were coordinated advocacy efforts by RCPA’s Coalition for Choice partners, resulting in the elimination of the requirement for federal background checks, including FBI fingerprinting, for over 125,000 caregivers and direct care workers for services in the Community HealthChoices and OBRA waivers. The costs for these mandatory background checks would have been in excess of $50 per employee.

The resulting decision will be included in the review and presentation of changes during the LTSS meeting next Wednesday, November 6. At this time, the background check requirements remain under consideration by OLTL for future amendments and renewals.

If you have any questions or need assistance, please reach out to Fady Sahhar.

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The Department of Human Services (DHS) Office of Long-Term Living (OLTL) has developed a funding opportunity under an approved home and community-based services (HCBS) spending plan that includes the two following HCBS provider types:

  • Adult Daily Living; and
  • Specialized Medical Equipment and Supplies.

OLTL will provide the American Rescue Plan Act (ARPA) funds to these enrolled providers to strengthen HCBS. Consistent with the original announcement, the purpose of the funding opportunity is for the implementation of quality improvement projects by HCBS providers to improve the services available to HCBS participants through the Community HealthChoices (CHC) and OBRA 1915(c) waivers. More specifically, this funding opportunity is focused on supplementing activities in a manner that improves and strengthens the quality of HCBS services. The use of the ARPA funding, however, is limited to those activities that supplement HCBS services rather than supplant the existing services.

DHS will provide funding of up to forty thousand dollars ($40,000) per approved request submission to qualified providers. DHS will approve funding on a one-time basis to each qualified provider and will review and approve submissions in the order in which they are received until the total funding allocated has been exhausted. Funding will only be provided for the following improvement projects:

  • Supplemental activities to address the Social Determinants of Health (SDOH). For example, SDOH activities may include:
    • Activities to address affordable and accessible housing. Rent and room and board are not allowable expenditures under this funding opportunity.
    • Activities to improve access to competitive integrated employment for participants. This may include access to benefits counseling, or remote technology to support employment.
    • Activities to improve or enhance transportation for CHC and OBRA participants.
    • Activities to improve food insecurities for participants.
  • Purchase of remote support technology by providers. This can include provider technology initiatives that improve service transparency and quality assurance, such as providing direct care workers with access to tablets and software that support in-home documentation of participant conditions and other related care needs.
  • Payment for the development and implementation of enhanced training for direct care workers, Medical Assistance (MA) providers, or both. This may include enhanced training on infection control practices, which can include the development of videos and online modules to address best practices in infection control. This may also include training for professional development. For example, this funding may be used to promote training or coursework related to the professional advancement or development for direct care workers.
  • Purchase and implementation of new software and technology for electronic health records or quality or risk management functions. This includes funding for providers to contract with a Health Information Organization. Having access to electronic health care records enables HCBS providers to connect with local hospitals and physicians, and ensure real time communication between the HCBS provider and the participant’s medical providers.

Please see the Funding Opportunity document for more information and for the HCBS Quality Incentive Funding Request Form. The document is also available on the Department’s Long-Term Care Providers web page under the heading “Home and Community-Based Services (HCBS) Quality Improvement Funding Opportunity.”

If you have any questions about this message, please send them to the OLTL HCBS Opportunities Resource account.

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The Office of Long-Term Living (OLTL) has released a message providing advance notice of the 2024 pre-administration of the home and community-based services (HCBS) Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.

OLTL has the HCBS CAHPS survey administered to participants who receive HCBS through the Act 150 Program as well as the OBRA and the Community HealthChoices (CHC) Waiver Programs in the fall. The department then uses the responses received to assist them with improving the services participants receive. To increase response rates, OLTL is requesting Service Coordinators to begin having conversations with the HCBS participants in order to provide an introduction and encourage participation in the upcoming administration of the survey.

The HCBS CAHPS Survey will be administered from August 1, 2024, to October 31, 2024. This survey will ask questions about the services HCBS participants receive at home or in the community and how well the services meet their needs. Press Ganey, an independent firm, will conduct the survey. They will call participants to set up a time to talk. Member’s participants may also call Press Ganey toll free at 1-800-588-1659 (TTY: 711) if they would like to take the 30-minute survey. The number can also be used to make an appointment to take the survey at a time that works for them. Participants are randomly selected to participate in the survey from a list of all participants receiving HCBS through either the Act 150 Program, the OBRA Waiver, or the CHC Waiver Programs. Language Services can be provided to HCBS participants at no cost.

Members are encouraged to remind participants that their privacy is important. If they choose to participate, any information that they provide will be kept confidential. Participants will not be identified in any report that is released, and their answers will not be shared with their providers, Service Coordinator, or anyone else who assists them. It is the participant’s choice whether to participate, and their decision to participate will not affect any HCBS received through OLTL.

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The Office of Long-Term Living (OLTL) has announced two waiver amendments that are open for public comment. The amendments detail the Community HealthChoices (CHC) waiver renewal and the OBRA waiver amendments. Information on the CHC waiver and OBRA waiver are available individually as well as in the June 15, 2024, PA Bulletin. Comments are due July 15, 2024.

Those interested in submitting comments can do so in the following ways:

  1. For the CHC waiver:
    1. Send a letter to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: Keeley Anglin—CHC Waiver Renewal, PO Box 8025, Harrisburg.
    2. Submit comments to the department via email. Use “CHC Waiver Renewal” in the subject line.
    3. Please use the CHC Waiver Comment Form.
  2. For the OBRA waiver:
    1. Send a letter to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: Keeley Anglin—OBRA Waiver Amendment, PO Box 8025, Harrisburg.
    2. Submit comments to the department via email. Use “OBRA Waiver Amendment” as the subject line.
    3. Please use the OBRA Waiver Comment Form.

Comments received by July 15, 2024, will be considered in subsequent revisions to the proposed renewal and amendment. For more information, please contact Fady Sahhar or Melissa Dehoff.

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From June through August 2023, the Office of Long-Term Living (OLTL) held Listen and Learn Sessions across Pennsylvania. There were a total of sixteen in-person sessions and three virtual sessions where Community HealthChoices (CHC), OBRA, Act 150, and Living Independence for the Elderly (LIFE) participants, family members, and community members were able to offer input on how OLTL could improve its programs.

A summary of the input provided is now available and can be viewed here.

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Beginning in June 2023, the Office of Long-Term Living (OLTL) will hold Listen and Learn sessions with OLTL program participants across the Commonwealth.

OLTL provides Medical Assistance (MA) coverage and long-term services and supports (LTSS) to seniors and adults with physical disabilities through the Community HealthChoices (CHC), OBRA, Act 150, and Living Independence for the Elderly (LIFE) programs. The office wants to hear from participants who receive services through one of these programs and will be holding Listen and Learn Sessions at the locations and times listed here. These sessions are intended for OLTL staff to hear directly from participants, advocates, and community partners, with the goal of gathering critical feedback on OLTL programs.

Members are encouraged to share this information with their clients and families so they can attend and give their feedback on OLTL programs. Some sessions will be held in-person, and some will be conducted virtually. Space may be limited, so attendees are encouraged to register as soon as possible.

Questions about these sessions should be directed to the OLTL Provider Helpline at 800-932-0939.

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The Office of Long-Term Living (OLTL) has released the transition plans that outline how the Appendix K flexibilities will be phased out on May 11, 2023, with the end of the Public Health Emergency. The transition plans apply to the Community HealthChoices (CHC) Waiver, OBRA Waiver, and Act 150 program.

Since March 6, 2020, the Office of Long-Term Living (OLTL) has been operating under an Appendix K Emergency Preparedness and Response amendment that was approved by the Centers for Medicare & Medicaid Services (CMS). Appendix K allowed temporary changes to the CHC Waiver, OBRA waiver, and Act 150 waiver in response to the COVID-19 Public Health Emergency.

Effective May 11, 2023, OLTL is discontinuing the emergency flexibilities noted in the attached guidance and is returning to pre-emergency operations. Providers should make any changes that are necessary to resume normal operations and be in compliance by May 11, 2023. Service Coordinators have been instructed to work with participants and providers to ensure a seamless transition to normal operations.

The transition plans have been updated to reflect the new expiration date for the flexibilities. In addition, as a general note, resuming pre-emergency waiver operations means the following:

  • All assessments, including the comprehensive needs assessments and reassessments, must be conducted face-to-face;
  • Service Coordinators must monitor participants and Individual Services Plans (ISPs) through face-to-face contacts; and
  • ISP meetings and development must be conducted face-to-face.

Questions about this information should be directed to the OLTL Provider Helpline at 800-932-0939.

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The Centers for Medicare and Medicaid Services (CMS) has approved the Office of Long-Term Living’s (OLTL) OBRA Waiver Amendment. Changes in the approved OBRA Waiver Amendment include:

  • Revised the Benefits Counseling service definition;
  • Amended the responsibilities of the Fiscal/Employer Agent;
  • Updated Appendix H Quality Improvement Strategy to the current process; and
  • Removed performance measure AA-6, as the data in AA-6 is being collected by AA-5.

The current approved OBRA Waiver document can be viewed here. If you have any questions, please contact the OLTL Bureau of Policy Development and Communications Management at (717) 857-3280.

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