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The Pennsylvania Office of Medical Assistance Programs (OMAP) Pediatric Shift Care Team held a Stakeholder Update Call on December 16, 2024. The presentation provided an overview of the Pediatric Shift Care Initiative Updates, implementation of the Pediatric Complex Care Resource Centers, and online training curriculum as well as content development.

Please send any questions electronically to the Pediatric Shift Care Team.

Image by StockSnap from Pixabay

The Long-Term Services and Supports (LTSS) Subcommittee meeting was held yesterday, November 6, 2024. During the meeting, a number of presentations were given. In addition to the presentations, the agenda and a document that provided follow-up items from the October 2, 2024, LTSS Subcommittee meeting were provided.

Members should take time to review the PowerPoint presentations from the meeting below:

The 2025 meeting dates for the LTSS Subcommittee were also shared:

  • January 8, 2025
  • February 5, 2025 (virtual only)
  • March 5, 2025 (virtual only)
  • April 2, 2025
  • May 7, 2025
  • June 4, 2025
  • July 2, 2025
  • August 6, 2025
  • September 3, 2025
  • October 1, 2025
  • November 12, 2025
  • December 3, 2025

The meetings will continue to be held from 10:00 am – 1:00 pm.

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.

The Centers for Medicare and Medicaid Services (CMS) has released an informational bulletin, as well as a slide presentation, that are related to continuity of coverage for individuals receiving home and community-based services (HCBS). The purpose of the bulletin is to highlight the federal renewal requirements and available flexibilities to promote continuity of coverage.

On July 19, 2024, the Office of Mental Health and Substance Abuse Services (OMHSAS) presented a Value-Based Purchasing (VBP) Provider Technical Assistance Webinar. The webinar, developed and presented by OMHSAS and their partner Mercer, provided an excellent overview of the VBP landscape and valuable guidance for providers to consider future efforts to incorporate VBPs into their service matrix.

OMHSAS supports providers interested in pursuing VBP programming to contact and collaborate with their respective BH-MCOs on VBP options. The Value-Based Purchasing (VBP) Provider Technical Assistance PowerPoint provides an outline of the information covered in the webinar. Should you have any questions or comments, please contact the OMHSAS VBP Resource Account via email.

If you have any additional questions, please contact RCPA Policy Directors Jason Snyder or Jim Sharp.

Photo by Markus Winkler on Unsplash

Deputy Secretary Ahrens of the Office of Developmental Programs (ODP) shared a PowerPoint today, July 25, 2024, at the MAAC meeting. Highlights included ODP’s plan to publish several documents. ODP will be submitting 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. In addition, ODP Bulletin 00-24-01: Performance-Based Standards for Residential Services and an ODP announcement regarding the waiver submission, including an implementation guide and provider self-assessment, will be released tomorrow, July 26.

RCPA will share these documents with members as soon as they are available.

Today, June 3, the Office of Developmental Programs (ODP) held the first of four Provider Preparedness Summits for Residential Services providers. The purpose of the summits are to take a deeper dive into the specifics that are being proposed for implementation of performance-based contracting (PBC).

The PowerPoint is now available, and a recording of the session will be posted shortly on the MyODP website.

ODP staff in attendance answered many questions submitted by providers. One of the key takeaways from today’s summit is that ODP will be postponing the due date for residential provider agreements to be signed and submitted to ODP. Originally, they were projected to be due by June 30, 2024; however, ODP has now stated that the due date will be July 31, 2024. The agreement has not yet been published, but it is expected to be released tomorrow, June 4, 2024.

There are three additional summits planned, and ODP will be recording each summit. Providers are encouraged to attend all four sessions as well as watch a pre-recorded webinar. All of these resources can be found on the MyODP website.

Contact Carol Ferenz for further information.

Last week, Governor Shapiro presented his proposed budget for 2024/2025. The PowerPoint with the Human Services Spending Overview outlines the priorities, and the recording is available on the DHS YouTube channel.

RCPA staff will continue to advocate for appropriate levels of funding for our members’ services in the community. We will keep you updated with information as the process continues. If you have any questions, please contact your RCPA Policy Director.

The meeting documents from the December 6, 2023, Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting are available below. documents include the agenda, transcript, and PowerPoint presentations.

The next MLTSS Subcommittee meeting is scheduled for January 3, 2024, from 10:00 am – 1:00 pm in the PA Department of Education’s Honors Suite at 333 Market St. in Harrisburg, PA. The option to participate via webinar is also an option. Register here to participate in the meeting via webinar. After registering, you will receive a confirmation email containing information about joining the webinar.

If you plan to participate via phone, the dial-in number is: 1-(631) 992-3221; Access code: 809-647-074#.