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Tags Posts tagged with "OLTL"

OLTL

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The Centers for Medicare and Medicaid Services (CMS) has approved the Office of Long-Term Living’s (OLTL) Community HealthChoices (CHC) Waiver renewal. The renewal will be effective on January 1, 2025.

The current approved CHC Waiver document is available here. Additional information about the CHC Waiver is located here.

Changes in the approved renewal include:

  1. Amend the following service definitions:
    1. Benefits Counseling
    2. Employment Skills Development Home Adaptations
    3. Telecare
  2. Add teleservices to the following services (details regarding teleservices can be found within each service definition as well as in the Main Module):
    1. Cognitive Rehabilitation
    2. Counseling Services
    3. Nutritional Consultation
  3. Add Chore Services as a new waiver service.
  4. Add language to reinforce that if a participant’s rights in a setting need to be modified due to an assessed need, it must be documented in the Person-Centered Service Plan (PCSP), and if a provider creates a treatment or service plan, that plan must be incorporated into the PCSP.
  5. Remove references to the Organized Health Care Delivery System (OHCDS) and the Participant Review Tool.
  6. Reduce timeframes for developing and implementing Person-Centered Service Plans from 30 days to 15 business days.
  7. Reduce the years of experience needed for Structured Day Habilitation Support Staff from five years to two years.
  8. Update Appendix C-5 to include information about the Home and Community-Based Settings Rule.
  9. Update Appendix E: Participant Direction of Services that Service Coordinators are responsible to inform the participant of the availability of the direct care worker referral and matching system.
  10. Update Appendix G: Participant Safeguards to the current process.
  11. Update the Quality Strategy to current process.
  12. Modify language throughout for better readability.

Questions about the 2025 CHC renewal can be submitted electronically.

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The Office of Long-Term Living (OLTL) has announced new services that will be available as a result of the Community HealthChoices (CHC) Waiver renewal and OBRA Waiver renewal. Effective January 1, 2025, the following services will be available:

Chore Services – CHC Only

  • Provider Type: 59
  • Specialty Code: 431
  • Procedure Code: S5131

Teleservice Cognitive Rehabilitation Therapy – CHC and OBRA

  • Provider Type: 59
  • Specialty Code: 207
  • Procedure Code: W0176

Teleservice Counseling Services – CHC and OBRA

  • Provider Type: 59
  • Specialty Code: 231
  • Procedure Code: W0175

Teleservice Nutritional Consultation – CHC and OBRA

  • Provider Type: 59
  • Specialty Code: 230
  • Procedure Code: W0170

The rates for the OLTL Home and Community-Based Services (HCBS) rates, effective January 1, 2025, are available here.

Additional information on the licensure and certification requirements can be found in the Service Definitions under Appendix C of the waivers. Please note that these documents have not received final approval from the Centers for Medicare & Medicaid Services (CMS). Once approval is received, a ListServ message will be sent with links to the final approved waiver applications.

The Fee for Service rates for Teleservice Cognitive Rehabilitation Therapy, Teleservice Counseling Services, and Teleservice Nutritional Consultation have been added to the fee schedule attached to the ListServ.

For existing OLTL providers to enroll in the services listed above a request must be submitted to the enrollment and certification resource account. The required documentation should include an updated Provider Enrollment Information Form (PEIF), a copy of the required license or certification, and a copy of the job description for the service you are requesting to add to your provider profile. If you have any questions related to the new services you can reach out to the enrollment and certification unit at 1-800-932-0939, option 1, or via email.

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Image by StockSnap from Pixabay

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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Image by Markus Winkler from Pixabay

Message from the Office of Long-Term Living (OLTL):

The Commonwealth is working collaboratively — Governor Shapiro’s office and the health hub agencies (Health, Human Services, Drug and Alcohol Programs, and Insurance) — to develop a statewide maternal health strategic plan. We need your help to make it a robust, comprehensive, collaborative, living, and most importantly, active plan.

As you are likely aware, Pennsylvania, like the nation, is experiencing a maternal health crisis.

According to the Pennsylvania Maternal Mortality Review Committee report, in 2020, Pennsylvania residents experienced a pregnancy-associated mortality ratio of 83 deaths per 100,000 live births with large disparities identified. In total, 107 individuals lost their lives during pregnancy, delivery, or up to one year postpartum.

Those numbers are far worse for Black women, where the rate was twice as high at 163 deaths per 100,000.

We also know that women and birthing people with disabilities experience unique challenges and needs on their health journey, so we are inviting you to join us for a 90-minute Zoom listening session where members of the Commonwealth’s health agencies and members of the statewide maternal health strategic plan can engage with you to learn what specific needs you have and how you feel the Commonwealth should address those needs.

We want our strategic plan to address all Pennsylvania women and birthing people, and sharing your voice at this listening session will help inform our plan.

The Zoom listening session is scheduled from 10:00 am – 11:30 am, on Friday, December 6, 2024. Please RSVP electronically by December 1 if you plan to attend. We will send the Zoom link by end of day December 4 to those who RSVP.

Thank you for considering spending 90 minutes with the disability community and state health team members to share your thoughts and needs around maternal health.

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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 agenda for the November 6, 2024, Long-Term Services and Supports (LTSS) Subcommittee meeting has been released by the Department of Human Services (DHS) Office of Long-Term Living (OLTL). The meeting will be held from 10:00 am – 1:00 pm in the Honors Suite, 1st floor, 333 Market Street, Harrisburg, PA 17126. Attendees have the option to attend in person or via webcast. The links and call information are below:

Conference line: Bridge Number: 1-415-655-0060 PIN: 789-496-398#
Webinar Link
Remote Streaming Link

Comments and questions may be sent via email.

The mission of the LTSS Subcommittee is to be a resource to the Medical Assistance Advisory Committee (MAAC), enabling the committee to advise the Department of Human Services on issues regarding access to service and quality of service.

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In order to gather responses from providers that were not able to submit previously, the Office of Long-Term Living (OLTL) has reopened the Calendar Year (CY) 2023 rate study survey for the following Home and Community-Based Services (HCBS):

  • Adult Day;
  • Structured Day Habilitation;
  • Employment and Training;
  • Personal Assistance (Agency);
  • Personal Assistance (Participant Directed); and
  • Residential Habilitation.

Please complete the survey for CY 2023, which spans from January 1, 2023, through December 31, 2023, unless otherwise specified. Please only complete the survey if you did not previously participate. The reopening of the survey will ensure every provider has ample time to offer input to broaden and improve the resulting analysis. The survey will remain open until Friday, November 15, 2024.

This survey is one piece of the targeted rate review and is intended to collect current provider rate and wage data as well as general feedback on the challenges of providing these services. The information collected in this survey will be used to assist in developing a point of reference for the rate range to evaluate current payment rates. In addition to results from this survey, the review will include payment rate information from Managed Care Organizations (MCO) in OLTL claims data, recent legislative policies, department expectations, and other data obtained from publicly available sources.

HCBS providers that delivered multiple service categories during CY 2023 should fill out this survey separately for each service category you delivered. HCBS providers that did not deliver any of the service categories listed above should disregard this survey. OLTL is partnering with Mercer to perform a rate study exclusive to the service categories listed above at this time.

The information collected for this survey will be used for both this rate study and to meet the requirements of HB 1300 from the 2023–2024 Pennsylvania General Assembly regular session. The information you provide will remain confidential and private and will only be shared publicly through high-level summary reports that do not include provider-level detail. Please comply with the Health Insurance Portability and Accountability Act (HIPAA) and do not share any protected health information (PHI) within your survey responses.

Please note the survey tool does not allow individuals to save and go back to answer questions. Please have all your agency information such as wages, employee information, and financial statements readily available. This will help you to submit accurate information when answering the questions.

HCBS providers can access the survey here.

OLTL and Mercer appreciate your time and this valuable feedback. If you have any questions or need assistance, please reach out via email.

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The Office of Long-Term Living (OLTL) is presenting a live, interactive, 6-session webinar series on housing issues from November 5, 2024, to December 10, 2024, every Tuesday, from 11:00 am – 12:30 pm. The webinars will include targeted content as well as Q&A sessions with housing experts and OLTL staff.

The webinar series targets Service Coordinators, Managed Care Organizations, and Service Coordination Entity support staff who assist program participants in securing and maintaining affordable, accessible housing through Home and Community-Based Services (HCBS). The target audience for these webinars includes individuals and organizations who provide long-term services and supports for older Pennsylvanians and people with physical disabilities.

Register Here

Presenters

  • Leigh Howard, President of DMA, Inc.
  • Carolyn Steinhofer of Housing Equality Center of PA
  • Wendy Davis of PATF

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The Office of Long-Term Living (OLTL) has announced that they are reopening the calendar year (CY) 2023 rate study survey in order to gather responses from providers that were not able to submit previously. The rate study survey is for the following Home and Community-Based Services (HCBS):

  • Adult Day;
  • Structured Day Habilitation;
  • Employment and Training;
  • Personal Assistance (Agency);
  • Personal Assistance (Participant Directed); and
  • Residential Habilitation.

Access the survey here. Please complete the survey for CY 2023, which spans from January 1, 2023, through December 31, 2023, unless otherwise specified. Please only complete the survey if you did not previously participate. The reopening of the survey will ensure every provider has ample time to offer input to broaden and improve the resulting analysis. The survey will remain open until Friday, November 15, 2024.

It is highly recommended that you review the survey questions before starting the survey. This survey tool does not allow individuals to save and go back to answer questions. Have all your agency information such as wages, employee information, and financial statements readily available. This will help you to submit accurate information when answering the questions.

This survey is one piece of the targeted rate review and is intended to collect current provider rate and wage data and general feedback on the challenges of providing these services. The information collected in this survey will be used to assist in developing a point of reference for the rate range to evaluate current payment rates. In addition to results from this survey, the review will include payment rate information from Managed Care Organizations (MCO) in OLTL claims data, recent legislative policies, department expectations, and other data obtained from publicly available sources.

HCBS providers that delivered multiple service categories during CY 2023 should fill out this survey separately for each service category you delivered.

HCBS providers that did not deliver any of the service categories listed above should disregard this survey. OLTL is partnering with Mercer to perform a rate study exclusive to the service categories listed above at this time.

The information collected for this survey will be used for both this rate study and to meet the requirements of House Bill 1300 from the 2023–2024 Pennsylvania General Assembly regular session. The information you provide will remain confidential and private and will only be shared publicly through high-level summary reports that do not include provider-level detail. Please comply with the Health Insurance Portability and Accountability Act (HIPAA) and do not share any protected health information (PHI) within your survey responses.

If you have any questions or need assistance, please reach out via email.

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