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odp announcement

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ODP Announcement 22-015 announces that the Operational Guide for the Adult Autism Waiver (AAW) has been updated to reflect current guidance from the Centers for Disease Control and Prevention (CDC), the Centers for Medicare and Medicaid Services (CMS), and the Pennsylvania Department of Health. Additionally, guidance has been added regarding regulatory compliance during the COVID-19 pandemic.

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ODP Announcement 22-012 provides information regarding the Office of Developmental Programs (ODP) Bulletin 00-21-02, Incident Management, including the specific roles and responsibilities for Supports Coordination Organizations (SCOs). On June 25, 2021, ODP released Announcement 21-049 to clarify that SCOs were not expected to report more than what they were currently reporting until further notice. ODP is clarifying that announcement 21-049 does not apply to the Adult Autism Waiver (AAW).

SCOs serving individuals in the AAW have always been required to report all incidents that occurred in the absence of a provider rendering services at the time of the incident or if the target of an investigation is not an employee or volunteer of a provider organization. There has been no change in those requirements.

This data is critical to evaluating AAW program outcomes. Please note that with the release of ODP Bulletin 00-21-02 that was effective July 1, 2021, two new categories, Passive Neglect and Self-Neglect can be used to report incidents that were previously reported as Neglect when applicable. For further clarification on Passive Neglect and Self-Neglect, refer to the Learning Management System (LMS) for the recorded module on Enterprise Incident Management (EIM) System Changes, County Management and SC Incidents.

The SCO has a responsibility to respond to and assess emergency situations and incidents as well as assure that appropriate actions are taken to protect the health and welfare of participants. Incident management activities that are the responsibility of and completed by the SCO are billable activities. Billable incident management activities are considered part of the SCO’s function of location, coordinating, and monitoring.

SCOs are responsible for checking alerts generated by Enterprise Incident Management (EIM) that identify incidents entered for participants receiving services through their organization. SCOs shall monitor individual incidents in EIM and make recommendations to ODP regarding the appropriateness and effectiveness of the provider’s actions taken to protect the health and safety of the participant as described in the initial incident report. They must also monitor final EIM incident reports to determine if corrective actions are appropriate, revisions to the Individual Service Plans (ISP) are needed, or additional monitoring of the situation is necessary. Monitoring of incidents by the SCO is integral in helping the ODP incident management reviewer in making a determination regarding the approval or disapproval of the incident report.

For targeted technical assistance or questions, please contact ODP’s Bureau of Supports for Autism and Special Populations’ Provider Support mailbox.

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ODP Announcement 22-018 is to make stakeholders aware that the proposed renewals of the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) waivers are available for public review and comment. There is a 30-day public comment period on the information proposed in the waivers that starts on February 12, 2022, and ends on March 14, 2022.

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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:

  • 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 March 1, 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 28, 2022. Compensation will be for the period January 1, 2022–February 28, 2022. The updated fee schedule rates will not be loaded in ISPs for the period January 1, 2022–February 28, 2022. Instead, the current rate will remain for that period, and 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 January 1, 2022–February 28, 2022. This is intended to eliminate the provider’s effort of voiding and rebilling claims.

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.

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ODPANN 22-019 American Rescue Plan Act (ARPA) Funding for Respite and Family Driven Support Services (FDSS) informs stakeholders of ARPA funds that are available to AEs to disperse in order to meet respite and/or the Family Driven Support Services (FDSS) needs of individuals on the waiting list who do not currently receive waiver funded services. This communication is intended to:

  • Describe eligibility criteria for the use of these funds;
  • Describe eligible expenditures;
  • Describe responsibilities of counties in allocating funding; and
  • Reporting requirements.

You can also view the family supports funds tracker here.

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ODP Announcement 22-017 is to announce that Residential ISP Staffing training sessions are now available to Administrative Entities (AEs), Supports Coordination Organizations (SCOs), and Providers of Residential Services in the Consolidated and Community Living Waivers from February 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 participated in delivering training in the fall of 2021, referred to ODP Designated Trainers.

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ODP Announcement 22-014 shares that the United States General Services Administration announced a change for the rate of Transportation Mile reimbursement rate, procedure code W7271, beginning January 1, 2022. The new rate is $0.585 per mile. This communication provides notice of the rate change as well as provides instruction for Supports Coordination Organizations (SCOs) on how to add transportation mileage to the vendor screen. It also instructs direct service providers on how to submit claim adjustments, if applicable.

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ODP Announcement 22-010 announces that the Operational Guide for Appendix K has been updated to align with current guidance from the Centers for Disease Control and Prevention (CDC), the Centers for Medicare and Medicaid Services (CMS), and the Pennsylvania Department of Health (DOH).

Additionally, guidance has been added regarding regulatory compliance during the COVID-19 pandemic. The purpose of the Operational Guide is to provide guidance to Providers (including services rendered under a participant-directed services model), Supports Coordination Organizations, Administrative Entities, and the Office of Developmental Programs (ODP) to ensure adherence with current state and federal guidance.

The Operational Guide applies only to participants impacted by COVID-19. Examples of participants impacted by COVID-19 include participants impacted due to staffing shortages, a COVID-19 diagnosis for the participant or a participant’s housemate or caregiver, and closures of service locations (residential homes, Community Participation Support service locations, etc.). For any requirement not listed in the Operational Guide, refer to the current approved ODP waivers.

ODP is finalizing Version 3 of the Operational Guide for the Adult Autism Waiver and will publish it soon.

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