Tags Posts tagged with "Person/Family Directed Support Waiver"

Person/Family Directed Support Waiver

The Office of Developmental Programs (ODP) is informing all interested parties of the submission of the Consolidated, Community Living, Person/Family Directed Support (P/FDS), and Adult Autism Waiver amendments to CMS. The waiver amendments are available on the Department of Human Services (DHS) website. It is anticipated that the amendments will be effective November 1, 2023.

Please review the announcement for additional information and details.

Deadline, as Letters on a Clock
On January 14, 2020, the Office of Developmental Programs released an updated version of the Provider Agreement for Participation in Pennsylvania’s Consolidated, Person/Family Directed Support, Community Living Waivers, and Adult Autism Waiver. Providers were informed that a signed copy of this document must be received no later than close of business on March 1, 2020.

As of February 21, 2020, many providers have not submitted their signed agreements. Failure to submit a signed agreement may impact providers’ ability to successfully submit claims for services rendered after March 1, 2020.

View/download the Provider Agreement for Participation in Pennsylvania’s Consolidated, Person/Family Directed Support, Community Living Waivers and Adult Autism Waiver and the accompanying letter from Deputy Secretary for Developmental Programs Kristin Ahrens.

Submit Signed Agreements to:
ra-ODPProvideragreem@pa.gov OR

Department of Human Services Office of Developmental Programs
Attention: Provider Agreement
625 Forster Street
Health and Welfare Building, Room 413
Harrisburg, PA 17120

ODP Bulletin 00-20-02 provides the Office of Developmental Programs’ (ODP) requirements and standardized processes for preparing, completing, documenting, implementing, and monitoring Individual Support Plans (ISPs) to ensure they are:

  • Developed to meet the needs of the individual.
  • Developed and implemented using the core values of Everyday Lives: Values in Action, LifeCourse Principles, Positive Approaches and Practices, and Self Determination to result in an enhanced quality of life for every individual.
  • Compliant with the approved Consolidated, Community Living, and Person/Family-Directed Support (P/FDS) Waivers and MA State Plan as it pertains to Targeted Support Management (TSM).

This bulletin and attachments have been updated to align with the October 1, 2019 amendments of the Consolidated, Community Living, and P/FDS Waivers and provide clarification regarding approved waiver service definitions.

A full ISP is required for any individual who:

  • Is enrolled in the Consolidated, Community Living, or P/FDS Waiver.
  • Receives Targeted Support Management.
  • Is not eligible for Medical Assistance and receives $2,000 or more in non-waiver services in a Fiscal Year.


  • Is eligible for Medical Assistance and in reserved capacity for waiver enrollment.

An abbreviated ISP may be completed for any individual who is not eligible for Medical Assistance and receives under $2,000 in non-waiver services in a Fiscal Year. Base-Funded Case Management services are not included in the $2,000 limit. Administrative Entities or Supports Coordination Organizations still have the option of completing a full ISP and are encouraged to do so.

All ISPs, including abbreviated ISPs, must:

  • Be completed using the standardized format in the Home and Community Service Information System (HCSIS).
  • Be based on assessed needs of the individual.
  • Be developed using a person-centered planning process to capture information including health and welfare and the individual’s preferences and desires, all of which are intended to identify and implement appropriate services and supports.
  • Be updated, approved, and have services authorized at least annually (every 365 calendar days) and when warranted by changes in the individual’s needs.
  • The Consolidated, Community Living, and P/FDS Waivers state that ISPs for individuals enrolled or enrolling in any of these waivers must contain the following additional information:
    • All unpaid natural supports and funded supports to meet assessed needs. The ISP shall include documentation of services provided through other agencies (for example, Insurance, Office of Vocational Rehabilitation, Aging, Drug and Alcohol, and Education).
    • The frequency, amount, type, and duration of each service.

Further, the Consolidated, Community Living, and P/FDS Waivers stipulate that Supports Coordination Organizations (SCOs) must ensure that ISPs are thoroughly reviewed to assure services accurately reflect an individual’s needs prior to submission to the Administrative Entity for approval and authorization. Upon receipt of the ISP, the Administrative Entity is responsible for:

  • Ensuring all necessary services (both paid and unpaid by ODP) are included on the ISP prior to approval.
  • Ensuring the services are eligible for reimbursement prior to approval and making a service authorization decision.

Once the ISP is approved and authorized by the Administrative Entity, the Supports Coordinator is responsible to provide a completed copy of the signature form to all team members and distribute all approved ISPs to all appropriate team members unless otherwise requested. Providers that have access to the approved ISP in HCSIS are responsible for distributing the ISP to all appropriate staff within their agencies.

ISPs are not required, but are encouraged, for individuals residing in an Intermediate Care Facility for Persons with an Intellectual Disability (ICF/ID). For individuals residing in ICFs/ID, the ICF/ID personnel are responsible for developing the individual plan (outside of HCSIS) in accordance with ICF/ID regulations. This includes ensuring that services in the plan meet the individual’s needs. Although Supports Coordinators are not required to develop an ISP for individuals residing in State Centers and private ICFs/ID, they are responsible for maintaining regular contact with the ICF/ID facility, evaluating the individual, and participating in plan development as required under the County Intellectual Disability Service regulations – see 55 Pa. Code §6201.14 (relating to aftercare services). For individuals residing in State Centers and private ICFs/ID, the County Program is not responsible to authorize the plan.



  • Bulletin 00-17-03, Individual Support Plans for Individuals Receiving Targeted Services Management, Base Funded Services, Consolidated, or P/FDS Waiver Services or Who Reside in an ICF/ID.
  • ODP Communication 023-18, ISP Manual Update: Life Sharing Codes in the Consolidated and Community Living Waivers
  • ODP Communication 012-18, ISP Manual Update: Respite Camp Codes in the Consolidated, P/FDS, and Community Living Waivers.

The Office of Developmental Programs (ODP) released notification on Tuesday, January 14, 2020 of the new Provider Agreement for Participation in Pennsylvania’s Consolidated Waiver, Person/Family Directed Support Waiver, Adult Autism Waiver and Community Living Waiver (“Waiver Programs”) that will serve as the statewide “Provider Agreement” between providers of waiver-funded services and ODP, the Department of Human Services, as the Pennsylvania State Medicaid Agency effective January 1, 2020.

This letter from ODP Deputy Secretary Kristin Ahrens was not included in the original distribution. The letter provides further clarification on the applicability of the new Provider Agreement and includes a due date for submission of the signed agreement. In addition, the Provider Agreement Form and Instructions have been updated. Every waiver provider must complete an agreement.

  • The legal entity of each waiver provider is required to submit only one agreement for that legal entity, regardless of the number of services provided or the number of service locations operated by the legal entity.
  • Each agreement must include the original signature of the provider’s Chief Executive Officer/Director/Owner.
  • Please also provide a copy of your agency’s IRS letter 147C to verify the agency’s legal name and FEIN.
  • Completed agreements may be submitted to ODP as an attachment via email.

Completed agreements may also be submitted by traditional mail to:

Department of Human Services Office of Developmental Programs
Attention: Provider Enrollment
625 Forster Street, Room 413
Health and Welfare Building
Harrisburg, PA 17120

Questions relating to the provider agreement process may be directed to the ODP Provider Enrollment Unit. Please note; this agreement is effective as of January 1, 2020. Agreements must be returned by March 1, 2020 to the ODP Provider Agreement resource account. Questions regarding this notification should also be directed to this account.

ODP Announcement 19-126 provides information regarding the Adult Autism Waiver Amendment webinar recording that is now available. This webinar discussed the proposed amendment to the Adult Autism Waiver and obtained public comment on the proposed changes. This webinar was held on September 16, 2019. The webinar was recorded and is now available online along with the PowerPoint presentation. You may find this link on MyODP.org by following this path:

Resources > ODP Information > Waiver Renewals & Amendments > Proposed AAW Amendments

The waiver amendment is also accessible online. An online document containing a side-by-side comparison of the waiver in its previous and amended forms is available.

Questions about this communication should be directed to this email.

ODP Announcement 19-130 serves to announce that the amendments to the ID/A waivers communicated in ODP Announcement 19-102 were approved by CMS on September 24, 2019. These  amendments were submitted to CMS on July 19, 2019. Since that time, ODP has been engaged in ongoing discussions with CMS. One substantive change was made as follows, to allow indirect activities to be rendered on behalf of an individual as part of the Housing Transition and Tenancy Sustaining Service in all ID/A waivers based on those discussions:

Housing Transition services are direct and indirect services provided to participants. Indirect activities that cannot be billed include driving to appointments, completing service notes and progress notes, and exploring resources and developing relationships that are not specific to a participant’s needs as these activities are included in the rate. The following direct and indirect activities are billable under Housing Transition:

  • Conducting a tenant screening and housing assessment that identifies the participant’s preferences and barriers related to successful tenancy. The assessment may include collecting information on potential housing transition barriers, and identification of housing retention barriers… (There was no change to the list of activities covered under Housing Transition. Please see the service definition for the full list of activities).

Each full waiver application approved by CMS is available as follows:

Questions about this communication should be directed to the appropriate Office of Developmental Programs Regional Office.