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ODP

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The Office of Developmental Programs (ODP) has just sent ODPANN 22-031 UPDATE — ARPA — One-Time Supplemental Payment to Address Staff Training, Credentialing, and Business Associates Programs for Employment. This update corrects that one-time supplemental payments to address staff training, credentialing, and business associates programs for employment is for providers and was not approved for SCOs. ODP will be releasing information in the upcoming weeks that will support SCO needs.

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The purpose of the Office of Developmental Programs (ODP) Bulletin 00-22-01 is to communicate and clarify the requirements for Targeted Support Management (TSM) that were approved by the Centers for Medicare and Medicaid Services (CMS). Changes to TSM discussed in this bulletin include:

  • Expansion of TSM services, effective August 20, 2017, to individuals with autism.
  • Expansion of TSM services, effective July 1, 2021, to children age 8 or younger with a developmental disability who are eligible for Medical Assistance (MA) and who have been determined to need an Intermediate Care Facility for Other Related Conditions (ICF/ORC) level of care.
  • Expansion of TSM services, effective July 1, 2021, to individuals age 0 through 21 with a medically complex condition that is a chronic health condition that affects three or more organ systems, and that the individual requires medically necessary skilled nursing intervention to execute medical regimens to use technology for respiration, nutrition, medication administration, or other bodily functions. Individuals must be eligible for MA and have been determined to need an ICF/ORC level of care.
  • Clarification regarding the use of the LifeCourse framework and tools.
  • Clarification of expected assessment activities and the development of the Individual Support Plan (ISP).
  • Addition of enhanced qualification requirements for TSM providers and Targeted Support Manager Supervisors.
  • Clarification that individuals who are enrolled in and receiving case management services under any Home and Community-Based Services (HCBS) program administered via an 1115, 1915(b) and (c), or 1915(a), (b), or (c) waiver are not eligible to receive TSM.

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ODP Announcement 22-031 provides guidance about the process for providers and Supports Coordination Organizations to request one-time payments to address staff training, credentialing, and business associates programs for employment.

As part of the Office of Developmental Programs’ (ODP) American Rescue Plan Act (ARPA) strategy to strengthen Home and Community-Based Services (HCBS), providers can receive a one-time supplemental payment. The following activities would be supported by this funding:

  • Agency adoption of Centers for Medicare and Medicaid Services (CMS) core competency training for Direct Support Professionals (DSPs);
  • DSP National Association for Dual Diagnosis certifications;
  • Agency completion of National Association for Dual Diagnosis Accreditation; and
  • Lifecourse Ambassador Series for individuals or agency hosting of the series.
    • Providers are encouraged to be creative in their proposals with an eye towards the development of creating or enhancing career ladders for DSPs, portability, and expansion of a well-qualified workforce and employing the principles of Lifecourse.

Providers interested in applying will need to complete and submit the attached Staff Training, Credentialing, and Business Associates Programs for Employment Supplemental Payment Application and submit via email to Rick Smith. Applications will be accepted through June 30, 2022. Funding may be requested up to 1% of ODP eligible service revenue from Fiscal Year (FY) 2019/2020, FY 2020/2021, or $100,000, whichever is greater.

Please see the announcement for full details of this program.

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Image by Dirk Wouters from Pixabay

ODP Announcement 22-030 shares that the proposed amendment to the Adult Autism Waiver (AAW) is available for public review and comment. There is a 30-day public comment period that starts on March 12, 2022, and ends on April 11, 2022.

The Office of Developmental Programs (ODP) is seeking your valuable feedback and comments. Information regarding the proposed waiver amendment changes, including how to provide comments, can be found in the Pennsylvania Bulletin, Volume 52, Number 11, which was published on Saturday, March 12, 2022. The waiver amendment and the record of change document are available here.

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ODP Announcement 22-029 serves to announce an opportunity for providers to have a staff person(s) participate in a virtual certification program with the goal of receiving a Work Incentives Practitioner credential.

Please complete an application for the Office of Developmental Programs (ODP) to get to know your organization and to measure your interest and commitment in having a staff person(s) receive the Work Incentives Practitioner credential and enrolling with ODP to provide the Benefits Counseling service. Applications must be submitted by email to Laura Cipriani no later than April 1, 2022.

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ODP Announcement 22-025 is to inform individuals that the Office of Developmental Programs (ODP) updated the data used in establishing rates that impacted the hourly wage and benefits rages effective March 1, 2022.

While the rate setting process resulted in minor decreases to the Upper Bound of the Hourly Wage and Benefits Ranges for several services in Attachment #1, ODP has decided to continue the Upper Bound at the levels that were in effect prior to March 1, 2022, for those services. The Hourly Wage and Benefits Ranges in Attachment #1 have been updated and should be used to pay SSPs and to support claims processing in the Provider Reimbursement and Operations Management Information System in electronic format (PROMISe™) by the VF/EA FMS organization.

This communication will only be updated when changes occur to the information contained within.

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ODP Announcement 22-021 provides guidance on the upcoming rate increases for the Adult Autism Waiver. Compensation is beginning March 1, 2022; the new rates will be implemented in the Home and Community Services Information System (HCSIS) on March 1, 2022. All Individual Support Plans (ISPs), including ISPs in draft, pending review, or pending approval status, will be updated with the new rates for each of the applicable services. An additional fiscal segment will automatically be added on each ISP for each service that is impacted by the rate change.

Providers are strongly encouraged to review Service Authorization Notices or the Provider Service Detail report in HCSIS to confirm the new rates were loaded, authorized, and that they are billing the increased Fee Schedule Rate before attempting to bill for any services rendered March 1, 2022, and after.

Compensation for the Period July 1, 2021, through February 28, 2022

Providers should bill normally for any services rendered from July 1, 2021, through February 28, 2022. 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 July 1, 2021, through February 28, 2022. This is intended to eliminate the provider’s effort of voiding and re-billing claims.

ODP anticipates processing gross adjustments during the April to May 2022 timeframe to ensure all billing for dates of service July 1, 2021, through February 28, 2022, has been completed. Because the rates will be loaded into HCSIS effective July 1, 2021, and the gross adjustment compensation will be issued by ODP, providers should not adjust any claims after April 1, 2022, submitted for services rendered on July 1, 2021, through February 28, 2022.

Adjustment of a claim(s) for services delivered during these dates will result in a duplication of payment that will need to be repaid. Providers are strongly encouraged to bill in a timely manner to minimize the need for corrections.

For questions on how to resolve billing errors for services that were rendered on July 1, 2021, through February 28, 2022, contact Amber Bennett.

Correction to Rates for Small Group Employment and Residential Habilitation Ineligible Fees

Because of an internal editing error, the rates for Small Group Employment and Residential Habilitation: Community Home Ineligible published in the Pennsylvania Bulletin (52 Pa.B. 1326, February 26, 2022) were incorrect. The correct rates, with the corresponding procedure codes, are higher than what was published. The corrected rates are also available on the Department of Human Services’ website.

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Positive Behavioral Supports: Meaningful, Everyday Application

We are always looking for better ways to support someone to achieve the quality of life they desire. This requires a social, behavioral, and biological understanding of that person. Positive Behavioral Support (PBS) is an empirically documented, person-centered approach that can be used in day-to-day supports for all people across all systems. For those of you who are not familiar with PBS, ODP will provide an overview of this framework, sharing examples and ways that this has been implemented. For those of you who have a general understanding of the essential elements of PBS, ODP will provide you with tools and ways to infuse PBS into your programs and supports to strengthen your focus on supporting a positive quality of life.

Please join ODP on one of the following dates and times:

  • Wednesday, April 6, 2022, from 12:30 pm–4:30 pm
  • Thursday, April 7, 2022, from 10:00 am–2:00 pm
  • Tuesday, April 12, 2022, from 2:00 pm–6:00 pm
  • Thursday, April 21, 2022, from 9:00 am–1:00 pm
  • Tuesday, April 26, 2022, from 11:00 am–3:00 pm

To register for a session, you must follow these steps:

  1. Visit this link and log in to MyODP OR create a new account.
  2. Complete and submit the Spring 2022 ASD Seminar Demographics Form.
  3. Return to the main course page to register directly through Zoom.

Notes:

  • You will receive an email confirmation of your registration directly from ASERT Collaborative when you complete all steps mentioned above.
  • Content is repeated for all five dates, so you only need to register for one session.
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