Reminder: Webinar on PBC Transition to Be Hosted by iCareManager, The BI Collaborative, and Millin Sept. 19
Performance-Based Contracting
Webinar on PBC Transition to Be Hosted by iCareManager, The BI Collaborative, and Millin August 28 and Sept. 19
UPDATE: ISAC Meeting Held August 27, 2024
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.
Guide for Using IM Overview Dashboard to Assess Performance-Based Contracting Measures Now Available
The Office of Developmental Programs (ODP) has shared ODPANN 24-082. The announcement advises providers of the availability of the Incident Management (IM) Overview Dashboard to Assess Performance-Based Contracting (PBC) Measures RM-IM.01.2, .01.3, and .01.4 Guide on MyODP. Please view the announcement for information on the guide and how to access it.
Reissue of Performance-Based Contracting Provider Data Available
The Office of Developmental Programs (ODP) has shared a reissue of ODPANN 24-081. The communication is being reissued to provide agencies with Performance-Based Contracting (PBC) specific data and instructions on how to access available data in the EIM Dashboard. Please view the communication for important information and details.
ODP Releases Performance-Based Contracting Frequently Asked Questions
The Office of Developmental Programs (ODP) has published ODPANN 24-078, which is a resource that has been developed from questions submitted to the Performance-Based Contracting (PBC) Resource Account. Questions have been categorized by topic and performance measures.
The FAQ can be accessed at Performance-Based Contracting FAQs – MyODP. ODP will continue to update this site with answers to recurring questions that are sent to the RA account.
Performance-Based Contracting Residential Provider Data Submission Tool is Live for August
ODP Announcement 24-074 shares that the Residential Services Provider Performance-Based Contracting (PBC) Data Submission Tool is now available for all providers choosing to submit data and documentation during the August review period (August 1 – August 31, 2024).
The Data Submission tool is web-based in QuestionPro. In addition to this communication, ODP will send a notification with instructions to residential providers via the QA&I listserv with details for completing the PBC Data Submission Tool.
There are three separate tools, one for each tier category:
- Primary Provider Residential Data Submission Tool
- Select Provider Residential Data Submission Tool
- Clinically Enhanced Provider Residential Data Submission Tool
The announcement contains more details about the process of choosing the proper data submission tool and information, as well as links for virtual office hours available with ODP staff.
Please direct any questions about this information to this email.
ODP Provides PBC Updates at Provider Preparedness Summit 5
The Office of Developmental Programs (ODP) presented updates for residential providers on Performance-Based Contracting (PBC) this morning, July 29. The Deputy Secretary also reminded residential providers that ALL providers must submit a Residential Provider agreement to ODP by August 31, 2024. Those who have not yet submitted an agreement will be receiving a warning letter.
An overview of updates included revisions to proposed waiver submissions, an implementation plan, supporting documents, instructions for tier determination, and provider data submission. Additional information was also shared on the following:
- Adjusted Timeline: Residential providers with a signed and submitted Agreement for Provision of Residential Services may choose when to submit data and documentation to determine the PBC tier. Providers may submit information between August 1–31, 2024, or between February 15–March 15, 2025.
- Clarification on Staff Credentialing: ODP noted that the credentialing standard is the National Alliance for Direct Support Professionals (NADSP) for Primary and Select tiers and NADSP and/or the National Association for the Dually Diagnosed (NADD) for the Clinically Enhanced tier.
- Reduction of Measures: Measure changes were highlighted in red on the presentation.
- Pay for Performance and Use of ARPA Funds: ODP clarified that Pay for Performance is available for Select and Clinically Enhanced providers. Use of ARPA funds has been extended for the department through June 2026 and will be available for P4P.
- Preparedness Tools and Scoring: ODP will be using a scoring document for provider’s submitted data, which has composite scoring ability. If a provider falls short, they will have the opportunity to prove they met the measure.
View the full presentation here.
ODP Submits PBC Waiver Amendments, Shares PBC Resources
ODP Announcement 24-071 informs stakeholders of the submission of the Performance-Based Contracting (PBC) 1915(b)4 Waiver and 1915(c) Waiver amendments to the Centers for Medicare and Medicaid Services (CMS). The Office of Developmental Programs (ODP) has included with this announcement multiple documents and resources that are essential for understanding and implementing PBC. The documents are:
- PBC Residential Services Implementation Guide
- PBC Residential Services Provider Self-Assessment Toolkit, which includes:
- Residential Performance-Based Contracting Attestation (fillable form).
Submitted amendments for Consolidated and Community Living 1915(c) and 1915(b)(4) Selective Contracting Waiver for Residential Services are available online. All significant changes resulting from public comments can be found in the PBC Implementation Guide under Appendix A, titled, “Significant Changes to Performance-Based Contracting Proposal as a Result of Public Comment April 20-June 4, 2024.”
As a reminder, all residential providers must sign and return the Residential Provider Agreement to ODP by July 31, 2024. Please direct any questions about this information to ODP electronically.
ODP Publishes Performance-Based Standards and Documents for Residential Providers
ODP Bulletin 00-24-01 Performance-Based Standards for Residential Services has been published, providing detailed information regarding the standards that will be utilized to evaluate performance of residential providers in PA. An expected timeline for implementation of residential performance standards and tier assignment and the evaluation standards that will be used to assign tiers to providers have also been published.
ODP submitted waiver amendments for the 1915(c) waiver and the new 1915 (b)(4) waiver to the Centers for Medicare & Medicaid Services (CMS) on July 26, 2024. RCPA anticipates the fee schedule rates will be published in the PA Bulletin on August 31, 2024. Implementation of the new rates will happen October 1, 2024, with an effective date of July 1, 2024.
All non-residential services, including participant directed services, will receive an 8% increase. All residential services will receive a 6% increase. Implementation of PBC will include rate add-ons of:
- Select Providers: 3%
- Clinically Enhanced Providers: 5%
Pay for Performance will also be available.
ODP will hold a webinar on Monday, July 29, to provide an overview of these changes. You can register for the meeting here. Please direct any questions about this information to ODP electronically.
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