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Tags Posts tagged with "P/FDS Waiver"

P/FDS Waiver

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ODP Announcement 22-051 informs stakeholders that the following Fee Schedule Rates have been published as final in the Pennsylvania Bulletin:

  • Family Medical Support Assistance services funded through the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) Waivers;
  • Remote Community Participation Support/Day Habilitation services funded through the Consolidated, Community Living, P/FDS, and Adult Autism Waivers; and
  • Medically Complex Life Sharing services and Transition to Independent Living payments funded through the Consolidated Waiver.

Read the announcement for further details.

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ODP Announcement 22-026 is to announce that the proposed Fee Schedule Rates and Department-Established Fees for Consolidated, Community Living and P/FDS Waiver services, as well as the Community Intellectual Disability Base-funded program were published at 52 Pa.B. 102 (January 1, 2022).

The Department received comments from 134 stakeholders regarding the proposed changes to the Fee Schedule Rates and Department-Established Fees. After reviewing the comments on the proposed rates, the Department determined that an increase to the Fee Schedule Rates for the Agency With Choice Financial Management Services monthly administrative fee from $285.28 to $311.68 was necessary to cover staff wages and the costs of implementing participant directed services in accordance with requirements in the approved Waivers.

No other changes were made to the rates as a result of public comment.

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The Department of Human Services (DHS) is providing final notice of the Fee Schedule Rates and Department-Established Fees for services funded through the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) Waivers as well as the Community Intellectual Disability Base-Funded Program.

The Fee Schedule Rates are effective January 1, 2022, with the exception of the rates for Agency With Choice Financial Management Services (AWC FMS) and direct Community Participation Support services. The Fee Schedule Rates for AWC-FMS will be effective on March 1, 2022. The Fee Schedule Rates for direct Community Participation Support services will be effective six months after the expiration of the federal novel coronavirus (COVID-19) public health emergency, and the temporary increases to the Fee Schedule Rates that are currently in place will end. The Department-Established Fees are effective July 1, 2022.

The full announcement with the specific rates can be found here.

These rates will be in effect for the next three years. Providers have the right to appeal these rates to the Bureau of Hearings and Appeals. Any provider who wishes to appeal must do so within 30 days of the notice, and those who do not appeal within that period will lose the right to challenge rates before the Bureau.

RCPA is hosting a “How to File a Rate Appeal” webinar on March 7, 2022, from 1:00 pm–2:00 pm. Otherwise, you should consult an attorney with experience filing such appeals.

Contact Carol Ferenz with any questions.

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ODP Announcement 22-018 is to make stakeholders aware that the proposed renewals of the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) waivers are available for public review and comment. There is a 30-day public comment period on the information proposed in the waivers that starts on February 12, 2022, and ends on March 14, 2022.

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Image by Werner Moser from Pixabay

ODP Announcement 21-095 discusses the availability of a 30-day public comment period for the proposed fee schedule rates for services funded through the Consolidated, Community Living, Person/Family Directed Support (P/FDS), and Adult Autism Waivers as well as Base-funded programs. Please review the announcement for further details on both the rates and the public comment period.

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Changes to the Remote Supports Component of Assistive Technology in the Consolidated, Community Living and Person/Family Directed Support (P/FDS) Waivers

ODP Announcement 21-094 notifies interested parties of changes to Remote Supports in the most recently approved waiver amendments, including the requirement to complete the Variance Form (DP 1086) when an individual needs more than $5,000 of Remote Supports per fiscal year.

Amendments to the Consolidated, Community Living, and P/FDS Waivers approved by the Centers for Medicare and Medicaid Services (CMS) effective November 22, 2021, contain changes to Remote Supports which are a component of the Assistive Technology service (all requirements contained in the waivers prior to the amendments continue to apply). The Office of Developmental Programs (ODP) has updated Variance Form DP 1086 and the related instructions originally found in Bulletin 00-18-06, Variance Form and Process, to reflect the requirements for intensive remote supports in these amendments.

ODP is holding a webinar on February 16, 2022, from 10:00 am–11:00 am to discuss requirements and best practices for the Remote Supports component of Assistive Technology in the Consolidated, Community Living and P/FDS waivers. The date, time, and link for registration to attend the webinar can be found here.

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ODP Announcement 21-087 is to inform all interested parties of CMS’ approval of amendments to the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) waivers (hereafter referred to as the Intellectual Disability and Autism [ID/A] waivers). The ID/A waiver amendments became effective on November 22, 2021, and are available on the Department of Human Services’ website.

The Office of Developmental Programs (ODP) developed a Record of Change document that contains all of the substantive changes in the approved ID/A amendments. Each full waiver application approved by CMS and the Record of Change document are available as follows:

ODP is also holding a webinar to provide an overview of all substantive changes in the approved ID/A amendments. The date, time, and link for registration to attend the webinar are as follows:

ODP is developing two additional communications regarding the provision of remote supports in residential settings and non-residential settings, including information about webinars that will be held regarding the provision of remote supports.

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

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ODP Announcement 19-102 provides information regarding the amendments submitted to the Centers for Medicare and Medicaid Services (CMS) regarding the Consolidated, Community Living, and P/FDS waivers. It is anticipated that the amendments will become effective October 1, 2019.

CMS has 90 days to review the amendments and changes may occur to the content based upon discussion with CMS during the approval process. Each full waiver application, as well as a side-by-side of substantive changes made as a result of public comment is available online here.

The amendments align with 55 Pa. Code Chapter 6100 regulations when effective, ensure compliance with the Home and Community-Based Settings regulations, and align with the Office of Developmental Programs’ Everyday Lives recommendations.

The amendments include a plan to serve medically complex children in a community home when transitioning from an extended hospital stay if they are unable to return to their family home. Also, the scope of professionals who can diagnose intellectual disability has been expanded.

ODP is adding the expectation that all providers of Community Participation Support services must offer individuals opportunities to participate in community activities that are consistent with the individual’s preferences, choices, and interests. On-call and remote support is proposed in order to support the fading of service and dependence on paid staff. The number of procedure codes and staffing levels has been decreased to more accurately reflect service delivery.

Starting January 1, 2022, CPS services may not be provided in any facility required to hold a 2380 or 2390 license that serves more than 150 individuals at any one time, including individuals funded through any source. All participants receiving prevocational services must have a competitive integrated employment outcome included in their service plan. There must be documentation in the service plan regarding how and when the provision of prevocational services is expected to lead to competitive integrated employment. CPS may not be provided in newly funded (on or after January 1, 2020) licensed 2380 or 2390 locations which serve more than 25 individuals in the facility at any one time.

Residential Habilitation, Life Sharing, and Supported Living Services will be required to utilize the recommendations provided in the Health Risk Screening Tool. SCs will be expected to monitor the implementation of the recommendations and incorporate them into the Individual’s Plan. Also, clarification is provided regarding the location parameters for newly funded sites.

ODP is proposing that respite can be provided by nurses for children with medical needs to assure the appropriate level of care is available.

Qualifications required for Support Service Professionals, Individuals, and Agency Providers have been clarified, including timelines for completion of certification requirements. Additionally, supported employment can be provided to individuals until OVR services are available, particularly when OVR has established a waiting list.

For a side-by-side comparison of substantive changes made as a result of public comment, see this online document. Questions about this communication should be directed to the appropriate ODP Regional Office.

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ODP Announcement 19-066 serves as notice of the opportunity for public comment on proposed changes to the Consolidated, P/FDS, and Community Living Waivers. These changes (referred to as waiver amendments) are anticipated to be effective on October 1, 2019. As part of this process, ODP is seeking your valuable feedback and comments on the proposed waiver amendments. There is a 30-day public comment period that began on June 8, 2019 and ends on July 8, 2019.

Whenever substantive changes are made to an approved waiver, ODP must submit an amendment to the Centers for Medicare and Medicaid Services (CMS) for approval. ODP proposes to amend the Consolidated, P/FDS, and Community Living Waivers as follows:

  • Increase the number of individuals served in the Consolidated and Community Living waivers as provided for in the Governor’s proposed budget to support more people in the community.
  • Add planning requirements for Administrative Entities to address access to needed waiver services upon graduation to individuals who will graduate from special education and who are not eligible to continue their education through the next year.
  • Provide for support of children with medical needs who transition from a facility that does not meet waiver home and community-based settings requirements to live with their families or, if living with their family is not possible, in the home of another nurturing caregiver.
  • Increase community participation of waiver participants through changes in service definitions, such as the addition of an on-call and remote support component to the Community Participation Support service and clarification as to where newly enrolled licensed facilities can be located.
  • Increase competitive integrated employment of waiver participants by allowing Supported Employment services to be provided when a waiver participant has received an offer of competitive integrated employment and the Office of Vocational Rehabilitation (OVR) has not made an eligibility determination at that time and by clarifying where Advanced Supported Employment services can be provided.
  • Develop and support qualified staff by extending the timeframe by which requirements for employment credentials or certificates must be obtained to July 1, 2019 for Supported Employment, Small Group Employment, and the prevocational component of the Community Participation Support service.
  • Promote health, wellness, and safety by clarifying that Supports Coordinators should review information in health risk screening tools when applicable and determine whether there have been any changes in orders, plans, or medical interventions prescribed or recommended by medical or behavioral professionals when Supports Coordinators monitor a waiver participant’s health and safety, and develop Individual Support Plans (ISPs).
  • Clarify the role direct service professionals perform through Communication Specialist services.

The proposed amendments to the Consolidated, P/FDS, and Community Living Waivers effective October 1, 2019 are available here.

Information regarding the proposed waiver amendment changes, including how to provide comments, can be found in the Pennsylvania Bulletin, Volume 49, Number 23, published on Saturday, June 8, 2019.

Comments received by 11:59 pm on July 8, 2019 will be reviewed and considered for revisions to the waiver amendments submitted to CMS.

Comments should be addressed to Julie Mochon, Department of Human Services, Office of Developmental Programs, 625 Forster Street, Room 510, Harrisburg, PA 17120. Comments may also be submitted to ODP at this email.

ODP will also hold two webinars to receive comments on the proposed waiver amendments. Dates, times, and links for registration to attend these webinars are as follows:

  • Thursday, June 20, 2019, 1:00 pm to 3:00 pm
  • Monday, June 24, 2019, 10:00 am to 12:00 pm

Register for webinars using this link. Questions about this communication should be submitted via email.

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