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Tags Posts tagged with "P/FDS Waiver"

P/FDS Waiver

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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 Developmental Programs (ODP) has shared the announcement Additional Guidance for the End of Appendix K Flexibilities in the Consolidated, Community Living, Person/Family Directed Support (P/FDS) and Adult Autism Waivers. The purpose of the communication is to provide additional guidance on which Appendix K waiver flexibilities have been added to the approved intellectual disability/autism waivers (ID/A), which are the Consolidated, Community Living, and P/FDS Waivers, and the Adult Autism Waiver (AAW), as well as which Appendix K flexibilities will be ending November 11, 2023. You can view a quick guide for ID/A Waivers and a quick guide for the Adult Autism Waiver.

Please review all documents for additional information and details.

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The Office of Developmental Programs (ODP) has shared a list of current Agency With Choice (AWC) Financial Management Service (FMS) organizations that are available to support participants and surrogates who have chosen to self-direct some or all of their Participant Directed Services (PDS) using the AWC FMS model and are in the Consolidated, Community Living, or Person/Family Directed Support (P/FDS) waivers. Please view the announcement for additional information and to see the listing.

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ODP Announcement 23-002 reports that the renewals for the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) Waivers have been approved by the Centers for Medicare & Medicaid Services (CMS) with an effective date of January 1, 2023. CMS approves waivers for a five-year period. The current Consolidated, Community Living, and P/FDS Waivers expired June 30, 2022, but were extended twice as discussions continued between the Office of Developmental Programs (ODP) and CMS.

Major changes in the renewals include:

  • Remote Supports has been added as a separate, discrete service in all three waivers.
  • Clarification about the activities that can be performed under the Communication Specialist service has been added, the amount of Communication Specialist services that participants can receive each year has increased from 40 hours to 60 hours, and effective January 1, 2024, the communication specialist will be required to successfully complete training provided by ODP.
  • The amount of Benefits Counseling services that participants can receive each year has increased from 10 hours to 15 hours.
  • The amount of tuition that can be covered through Education Support services has increased from $35,000 to $40,000.
  • Companion services have expanded to support additional participants at their place of employment.
  • Supported Employment services can now support participants during work-related trips.
  • Participant Directed Goods and Services have been added to the Consolidated Waiver.
  • The purpose of the Supports Broker service has been clarified, and recertification requirements for Supports Brokers have been added.
  • The Specialized Supplies service will continue to cover personal protective equipment once Appendix K flexibilities end.
  • Music, Art, and Equine-Assisted Therapy are available to individuals who receive residential services.
  • Staff working for, or contracting with, Residential Habilitation, Life Sharing, or Supported Living providers must complete Department-approved training on the common health conditions that may be associated with preventable deaths.
  • Clarification about requirements for using technology in the provision of waiver services has been added with a focus on protecting individual privacy when using technology.
  • Clarification about experience and education requirements for Supports Coordinators and Supports Coordinator Supervisors has been added, and Supports Coordinators will continue to be allowed to use teleservices to perform some of the required face-to-face monitoring per year.

A list of all major changes made in the renewals is available in the record of change document and each full waiver application approved by CMS, which are available at:

ODP will be holding a webinar to discuss major changes made in these approved waiver renewals on February 9, 2023, from 1:00 pm – 2:00 pm. You can register for the webinar here.

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

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ODP Bulletin 00-22-05, dated August 9, 2022, is to provide 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; and
  • Compliant with the approved Consolidated, Community Living, and Person/Family Directed Support (P/FDS) Waivers and Medical Assistance (MA) State Plan as it pertains to Targeted Support Management (TSM).

A summary of major changes made to information in the attachments is included as attachment 8.

ATTACHMENTS:

  • Attachment 1: ISP Manual for Individuals Receiving Targeted Support Management, Base-Funded Services, Consolidated, Community Living or P/FDS Waiver Services or Who Reside in an ICF/ID
  • Attachment 2: ODP Role Expectations and Required Timeline for ISP Activities
  • Attachment 3: DP 1032 Individual Support Plan Signature Form (Spanish form: DP 1032-S)
  • Attachment 4: Annotated Individual Support Plan
  • Attachment 5: The Basics of the LifeCourse Framework to Guide the Development of the ISP
  • Attachment 6: Questions to Help Facilitate the Development of the ISP
  • Attachment 7: DP 1022 Waiver Service Request Form
  • Attachment 8: Summary of Major Changes Made to ISP Requirements or Processes

OBSOLETE DOCUMENTS:

  • Bulletin 00-20-02, Individual Support Plans for Individuals Receiving Targeted Support Management, Base-Funded Services, Consolidated, Community Living or P/FDS Waiver Services, or Who Reside in an ICF/ID

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ODP Announcement 22-084 informs all interested parties that the Office of Developmental Programs (ODP) is offering a webinar regarding the approved Consolidated, Community Living, and Person/Family Directed Support (P/FDS) waivers effective June 1, 2022. Information and the link to register for the webinar is as follows:

August 19, 2022
1:00 pm – 2:00 pm
Register here.

To access the current waivers that contain the changes that will be discussed during the webinar, please use the following links:

For each waiver, you will have the option to review the full waiver or the “Record of Change” document that contains a concise version of the substantial changes that were made.

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

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ODP Announcement 22-061 is to announce that the amendments to the Consolidated, Community Living, and P/FDS waivers (hereafter referred to as the Intellectual Disability and Autism (ID/A) waivers) were approved by the Centers for Medicare & Medicaid Services (CMS) effective June 1, 2022.

The ID/A waiver amendments were submitted to CMS on January 3, 2022. Since that time, the Office of Developmental Programs (ODP) has been engaged in ongoing discussions with CMS. Substantive changes were approved as follows:

  • Eligibility was expanded to include children with a developmental disability due to a medically complex condition. The Family Medical Support Assistance service was added to support the complex medical needs of these children. Provider qualification criteria were enhanced to ensure providers have the needed structure to support these children.
  • Delivery of services while the participant is hospitalized is currently allowed through Appendix K flexibilities. Guidance regarding delivery of services while the participant is hospitalized is contained in the Operational Guide. This guidance should continue to be followed until otherwise notified.
  • Homemaker services include infection control measures and intensive cleaning, such as cleaning medical equipment and disinfecting the home.
  • Home accessibility adaptations support individuals to transition from an institutional setting to a private home (including a Life Sharing home) and clarify covered home accessibility adaptations due to changes in Medical Assistance.
  • Transition to Independent Living payments were added to the Consolidated Waiver to support participants to transition from residential habilitation homes to Life Sharing or Support Living.
  • Changes were made to residential qualification requirements to ensure that all residential providers are adequately prepared prior to delivering a service and prior to the provider going through ODP’s qualification process.

The following rates, as communicated in ODP Announcement 22-051, are also effective June 1, 2022, when authorized on an Individual Support Plan:

  • Family Medical Support Assistance services;
  • Medically Complex Life Sharing services in the Consolidated Waiver; and
  • Transition to Independent Living payments in the Consolidated Waiver. Each full waiver application approved by CMS and the record of change document are available here.

ODP will be scheduling webinars soon to discuss the changes made in these approved amendments, as well as changes made to the July 2022 waiver renewals once they are approved by CMS. ODP will release a communication announcing the webinars when the waiver renewals are approved. Questions about this communication should be directed to the appropriate Office of Developmental Programs Regional Office.

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ODP Announcement 22-059 informs readers that the Office of Developmental Programs (ODP) is pleased to announce that an amendment to the AAW was submitted to CMS on May 9, 2022. The submitted AAW includes modifications that were made as a result of public comment. The AAW amendment includes the following substantive changes:

  • Adding reserved waiver capacity for individuals who are discharged from a state center. Reserved waiver capacity is also being added for participants who have been incarcerated for more than six consecutive months;
  • Aligning provider qualifications in the AAW with the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) waivers, whenever possible;
  • Allowing relatives to deliver the Life Sharing component of the Residential Habilitation service;
  • Requiring that agencies that provide Residential Habilitation/Life Sharing must be qualified and enrolled to provide Residential Habilitation/Life Sharing in the Consolidated or Community Living waivers;
  • Increasing the annual fiscal limit in the transportation service to $5,000 per participant’s ISP year;
  • Allowing one of the four required monitoring conducted by the Supports Coordinator each year to be conducted remotely;
  • Adding a new service, Remote Supports; and
  • Delivering direct services using remote technology.

The requirements in the AAW will become effective when Appendix K flexibilities expire, six months after the expiration of the federal COVID-19 public health emergency.

Please note that aligning the Assistive Technology service, where possible, with the Consolidated, Community Living, and P/FDS waivers includes adding generators for the participant’s primary residence.

The full AAW application, as well as a record of substantive changes, is available here.

CMS has 90 days to review the amendment, and changes may occur to the content based upon discussion with CMS during the approval process. The proposed effective date of July 1, 2022, is also subject to change. ODP will inform all stakeholders when CMS has officially approved the AAW and will make the approved waiver available at that time.

Questions about this communication should be directed via email.

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