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Tags Posts tagged with "Performance-Based Contracting"

Performance-Based Contracting

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The Office of Developmental Programs (ODP) met with stakeholders today, October 30, 2024, to discuss waiver amendments and to provide an overview of Performance-Based Contracting.

Waiver Amendments included:

Waiver Capacity:

  • When an individual is in an acute care hospital and receiving waiver services, ODP will not need to reserve (hold) the individual’s waiver. They will maintain enrollment in the waiver.
  • Language was updated for waiver capacity for high school graduates in the P/FDS waiver. AEs can reserve the waiver capacity for 180 days prior to when services are needed. Students can remain in service until their 22nd birthday.

Assistive Technology:

  • Updated language to explain when an independent evaluation is required and when it is optional:
    • REQUIRED: A device will cost $750 or more.
    • OPTIONAL: A device will cost less than $750.
  • An independent evaluation can be done if the team decides it would be beneficial.
  • Evaluations are included in the $10,000 lifetime limit.

Community Participation Support:

  • The Community Participation Support provider must complete and update an analysis of the following at least yearly to support individuals to experience meaningful community inclusion:
    • Strongest interests and personal preferences for community activities;
    • Skills, strengths, and other contributions likely to be valuable to employers or the community; and
    • Conditions necessary for successful community inclusion and/or competitive integrated employment.

American Sign Language (ASL) – English Interpreter Service:

  • English Interpreter service will be added to ODP’s waivers effective January 1, 2025.

Music, Art, & Equine Assisted Therapy:

  • The cumulative maximum limit of any combination of Music Therapy, Art Therapy, or Equine Assisted Therapy has increased from 26 to 52 hours per fiscal year.

STAT Overview:

  • The Specialty Telehealth and Assessment Team service was implemented in March 2024. This service may also be delivered to the participant during temporary travel, per ODP’s travel policy.

Waiver Corrections:
Life Sharing:

  • The following may not be authorized for participants who receive Life Sharing services: Residential Habilitation; Supported Living; Respite (15-minute or Day) (has been removed).

Supported Living Corrections:

  • The following services may not be authorized for participants who receive Supported Living services: Life Sharing; Residential Habilitation; Respite (15-minute or Day); Homemaker/Chore; In-Home and Community Supports; Behavioral Supports; Therapies; Shift Nursing; Consultative Nutritional Services; Communication Specialist and Specialize.

Benefits Counseling:

  • New billable indirect activities are added. The limit has increased from 15 hours per fiscal year to 24 hours per fiscal year.

The Performance-Based Contracting Review Included:

  • Effective January 1, 2025, Performance-Based Contracting will be implemented for the following services funded through the Consolidated and Community Living Waivers:
    •  Residential Habilitation;
    •  Life Sharing; and
    •  Supported Living.
  • Changes to Enrollment of New Providers.
  • What are Performance Standards?
  • What are Provider Tiers?
  • What Do These Changes Mean to Individuals and Families?

All performance-based contracting questions can be sent electronically.

Please see the distributed PowerPoint for additional information.

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ODP Announcement 24-096 is to inform all interested parties that the Centers for Medicare and Medicaid Services (CMS) approved the 1915(b)(4) Performance-Based Contracting Waiver and the Consolidated, Community Living, and P/FDS Waiver amendments effective January 1, 2025.

As communicated in ODP Announcement 24-071, the waivers were submitted to CMS on July 26, 2024. Since that time, ODP has engaged in discussions with CMS. No substantive changes were made to the waivers based on those discussions. Information regarding Performance-Based Contracting for Residential Habilitation, Life Sharing, and Supported Living services delivered through the Consolidated and Community Living Waivers can be accessed at Performance-Based Contracting – MyODP. In addition to changes needed to implement Performance-Based Contracting, the following major changes were included in the Consolidated, Community Living, and P/FDS Waivers:

  • American Sign Language – English Interpreter service will be added.
  • Billable indirect activities will be added to the Benefits Counseling service and the fiscal year limit will increase from 15 to 24 hours.
  • Clarification about evaluations will be added to the Assistive Technology service.
  • The fiscal year limit for Music, Art and Equine Assisted Therapy will increase from 26 to 52 hours.

Each full waiver application, as well as a record of all substantive changes, is available online at:

ODP will be holding one webinar to provide a general overview of Performance-Based Contracting and additional major changes made in the approved waivers. There will be time during the session for presenters to answer questions submitted by participants during the webinar.

The date, time, and registration link for these webinars are as follows:
Consolidated, Community Living, and P/FDS Waiver Amendment Overview
Wednesday, October 30, 11:00 am to 12:00 pm — Register Here.

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The Office of Development Programs (ODP) will be hosting the first quarterly residential provider forum to provide support for provider Performance-Based Contracting (PBC) preparedness. During this session, ODP will provide a status update on PBC applications; review the PBC presented to the Information Sharing and Advisory Committee (ISAC) Provider Performance Review Subcommittee; review the emerging themes or trends with the application submissions; and offer the opportunity for providers to ask questions.

Audience:
Residential Providers

Date:
October 4, 2024, 11:30 am – 1:00 pm

Register Here

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The Information Sharing and Advisory Committee (ISAC) met today and discussed several items of interest. Deputy Secretary Ahrens provided an update on the budget and Performance-Based Contracting, including changes made to the program based on public comment. The Deputy Secretary reported that more than 95% of current residential providers have signed a new contract, and a small number have submitted their data to be evaluated for a tier assignment in the first submission period. The majority of providers appear to be waiting until February 2025 to submit data for tier assignments.

UPDATE: The PowerPoint presentation is now available and can be viewed here.

ODP is still in the procurement process of finding a Performance Analysis Service (PAS) provider.  Madeline Wagner has joined the ODP staff as the PBC Measure Coordinator and began in July. The Supports Coordinator Strategic Thinking Group is planning to reconvene on September 11, 2024.

ODP staff provided updates on the strategies that are being utilized to work toward ISAC recommendations. Recommendation #2, Promote Self-Direction, Choice & Control, and Recommendation #14, Racial Equity were reviewed.

Recommendation #1, Assure Effective Communication, and also Recommendation #8, Simplify the System, were also discussed.

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