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ODP

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The Office of Developmental Programs (ODP) held a listening session today, August 6, 2021 to hear public comments regarding future waiver programs in Pa. The Consolidated and Person/Family Directed Waivers are due for renewal in June 2022, and ODP is also looking to align dates of the Community Living Waiver renewal with the others.  The slides from the webinar are available here. There are several additional sessions scheduled in August. You may also still submit any comments by the close of business August 31, 2021 using email or paper mail.

Email
Physical Address:
Julie Mochon, Department of Human Services, Office of Developmental Programs
625 Forster Street, Room 510
Harrisburg, PA 17120

ODP will review the information received during this time period to consider when developing the draft waiver amendments. There will be another public comment period when the draft documents are published.

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ODPANN 21-061 ISP Staffing Virtual Training Sessions 2021 announces that registration is open for a full-day virtual training session occurring in August, September, and October 2021 on Residential ISP Staffing as described in ODP Announcement 21-057. Please note: This announcement contains a new session date, September 27, inadvertently excluded from the original announcement document.

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ODP Announcement 21-059 is to inform stakeholders of the rate load timeline and to provide guidance for the temporary enhanced rates associated with Community Participation Supports (CPS) and Transportation Trip services.

The enhanced rates are anticipated to be visible on Individual Support Plans (ISPs) in the Home and Community Services Information System (HCSIS) on August 1, 2021 with an effective date of August 1, 2021. For the most part, services should auto-authorize, and there should be no need for manual intervention. However, if errors set, see the section of this communication titled “Manual Review Process in HCSIS For a Mass Rate Change,” which is found on the next page. Providers are strongly encouraged to review Service Authorization Notices or the Provider Service Detail report in HCSIS to confirm the enhanced rates were loaded and authorized before attempting to bill for any CPS or Transportation Trip services rendered August 1, 2021 and after.

Compensation for Temporary Enhanced Rates for the Period July 1, 2021 – July 31, 2021

The enhanced CPS and Transportation Trip rates will not be loaded in ISPs for the period July 1, 2021 through July 31, 2021. 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 temporary enhanced rate for CPS and Transportation Trip services that were rendered during the period July 1, 2021 through July 31, 2021. This is intended to eliminate the effort of voiding and re-billing claims. ODP anticipates processing gross adjustments during October 2021 to ensure all billing for the month of July 2021 has been completed. Providers are requested to bill in a timely manner to minimize the need for corrections.

Rate Load Impact on ISPs in Draft and Pending Approval Status

Plans in draft or pending approval status will be updated with the temporary enhanced rates for CPS and Transportation Trip services. If there are any exceptions that set on the draft or pending approval plan as a result of the rate load, these plans will be “locked” and the AEs must resolve the issue using the View Modifications screen found in the Mass Rate Change tab in HCSIS.

Two Service Segments on ISPs for CPS and Transportation Trip Services

Since the temporary enhanced rates for CPS and Transportation Trip services will have a begin the date of August 1, 2021, 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 July 31, 2021 and the second service/rate segment will reflect the period August 1, 2021 to June 30, 2022.

Rate Load Causing Cap Limitation to be Exceeded

It is possible that once the temporary enhanced rate load occurs in HCSIS, cap limitations may be exceeded for individuals not currently approved for a cap exception. Plans associated with individuals approved for a cap exception should not experience an enhanced rate load issue. If a cap limitation prevents the enhanced rate to update, the service will be in a pending authorization status until AEs modify the plan accordingly or a cap exception is put in place.

Manual Review Process in HCSIS for a Mass Rate Change

Once the rate change is initiated, if one or more plans are not updated automatically by HCSIS, AEs may review the errors that set the exception and fix the errors accordingly. Administrative Entities may view the impacted service contracts, impacted claims, impacted plans, and exceptions, resulting from a mass rate change, via the View Modifications screen in HCSIS. All line items with a status of “Updates in Progress” will need to be addressed by the AE before the rate change is finalized.

See ODP Announcement 21-059 for full details.

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The Office of Developmental Programs (ODP) is reissuing Bulletin 00-21-01 to correct errors reported in Attachment 1: Services that Require Access to a Human Rights Team.

The corrections in this document are as follows:

  • In the list of services that require a provider to have access to a Human Rights Team:
    • Supports coordination has been removed from the list of services funded through the Consolidated, Community Living, or Person/Family Directed Support Waivers or base-funding.
    • Transitional Work Services has been removed from the list of services funded through the Adult Autism Waiver and replaced with Small Group Employment.
  • The list of services that do not require a provider to have access to a Human Rights Team funded through the Adult Autism Waiver has been expanded to include:
    • Vehicle Modifications
    • Home Modifications
    • Public Transportation

Attachment 2: Individual Plans and Informed Consent remains unchanged.

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With the publication of Bulletin 00-21-01: Guidance for Human Rights Teams (HRT) and Human Rights Committees (HRC), the Office of Developmental Programs (ODP) is releasing a four-part webcast series titled Human Rights In Depth. The focus of the webcast series is standards for service provision and requirements for Human Rights Teams and Human Rights Committees as identified in the 55 Pa. Code 6100 Regulations and the Guidance for the Development of Human Rights Teams and Human Rights Committees Bulletin. The content in the webcast series should not be considered as an acceptable alternative to fully reading the complete 6100 Regulations and HRT/HRC Bulletin. This webcast series was designed to support providers in meeting applicable regulatory requirements.

The four webcasts provide detailed discussion of the following topic areas:

  1. Responsibility to Inform and Strategies to Support People in Exercising their Rights
  2. How to Make a Determination
  3. Human Rights Teams
  4. Human Rights Committees

Human Rights In Depth can be accessed at anytime via MyODP. To find the webcasts, go to the MyODP.org homepage and then select Training > Intellectual Disability > Human Rights.

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The Department of Human Services (DHS) is implementing temporary increases to the fee schedule rates for community participation support (CPS) and transportation trip services. These increases are being made due to impacts on service as a result of the COVID-19 pandemic. The temporary increases to existing fee schedule rates are retroactive to January 1, 2021. The temporary increases to the fee schedule rates will end on June 30, 2021.

These temporary increases to the rates will also apply to the department-established fees under 55 Pa. Code § 4300.115(a) (relating to department established fees) for base-funded services managed through county programs for individuals with an intellectual disability under the Mental Health and Intellectual Disability Act of 1966 (50 PS §§ 4101—4704); 55 Pa. Code Chapter 4300 (relating to county mental health). The temporary fee schedule rates will be loaded to PROMISeTM, and providers can begin billing the increased fee schedule rates on February 3, 2021.

The Home and Community Services Information System (HCSIS) will automatically be updated to include the new community participation support and transportation trip fee schedule rates, and critical revisions to individual support plans (ISPs) will not be necessary to implement the change to the fee schedule rates. Providers should review service authorizations to confirm that they are billing the increased fee schedule rate.

The Office of Development Programs (ODP) will be publishing a notice of temporary fee schedule rates in the Pennsylvania Bulletin that includes instructions for submitting public comments.

ODP Announcement 21-017 includes the new fee schedule rates.

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Updated Office of Developmental Programs (ODP) Announcement 20-101 provides an update regarding temporary closure guidance for older adult daily living centers, structured day programs, Living Independence for the Elderly (LIFE) day centers, adult training facilities, and vocational facilities related to the community spread of COVID-19. It also provides guidance regarding what to do when an individual or staff member is diagnosed with COVID-19 and has previously spent 15 minutes or more in the facility within a 24-hour period, starting from two days before illness onset (or, for asymptomatic patients, two days prior to test specimen collection) and ending with the time the person is isolated.

Additionally, this announcement describes the process for reopening facilities using the Community Participation Support and Older Adult Facility Reopening Tool. Updates appear in red.

Updates Include:

  • Facilities are recommended to remain closed for two consecutive weeks following a substantial community spread level.
  • The facility is recommended to be closed for a minimum of 14 days.
  • A facility may reopen on the Saturday after the second consecutive week in low or moderate community spread. Providers may elect to remain closed in moderate community level of spread to promote the health and safety of individuals and staff.
  • Additionally, the ODP Community Participation Support Reopening Matrix has been updated.

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Office of Developmental Programs (ODP) Announcement 21-014 serves as notice that the United States General Services Administration has announced a change for the rate of transportation mile reimbursement, procedure code W7271, beginning on January 1, 2021. The new rate is $0.56 per mile.

This communication provides notice of the rate change and also 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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Image by Wilfried Pohnke from Pixabay

Pennsylvania is participating in the Federal Pharmacy Partnership Program in order to coordinate vaccination for skilled nursing facilities, which are licensed by the Department of Health (DOH), as well as personal care homes, assisted living facilities, and intermediate care facilities for people with intellectual disabilities licensed by the Department of Human Services (DHS). The Federal Pharmacy Partnership Program began vaccinating those associated with skilled nursing facilities on December 28, 2020 and expanded their efforts to personal care homes and assisted living facilities earlier in January.

Other long-term and congregate care settings included in Phase 1A of Pennsylvania’s Interim Vaccination Plan, including group homes for people with disabilities; residential treatment facilities and long-term structured residences for adults with behavioral health needs; and private psychiatric hospitals, are not included in the federal partnership but are still in the first prioritization group due to the risk of COVID-19 outbreaks in congregate settings serving people who have co-occurring medical needs that put them at risk of more severe cases if they contract COVID-19. Some personal care homes and assisted living facilities were also not enrolled in the Federal Pharmacy Partnership Program. DHS and DOH are partnering with Rite Aid beginning this week to vaccinate DHS-licensed long-term care facilities not included in or not currently scheduled or enrolled with the Federal Pharmacy Partnership Program.

Phase 1A facilities eligible for this vaccination through this partnership will be contacted in the near future by their licensing office with details to assist them in preparing for vaccinations and vaccination clinic schedules for their area. Some facilities may have already been contacted by Rite Aid and have scheduled their vaccinations. This effort is separate from the Retail Pharmacy Partnership program, so please wait for further direction and do not contact Rite Aid locations directly.

If you have questions about this process, please email your licensing office:

As facilities prepare to vaccinate through either of these partnerships or local relationships, we know that residents and staff may have questions about the vaccine. DHS and DOH, in partnership with the Jewish Healthcare Foundation, have created a COVID-19 Vaccination Toolkit with information about the COVID-19 vaccines, including resources about encouraging vaccine participation, information on vaccine efficacy and safety, and examples of how facilities can encourage their staff and residents to participate in this process. The toolkit can be accessed here.

We are continuing to develop resources that may be helpful as the vaccination process continues. If you think of additional resources that would be helpful, please let your licensing office know.

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