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Tags Posts tagged with "Residential Habilitation"

Residential Habilitation

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The Office of Developmental Programs (ODP) released the Room and Board Bulletin, which was initially released in March 2025. ODP extends gratitude to all stakeholders who participated in the development of the bulletin.

ODP hosted two webinars; both were recorded, and the links are below for viewing.

Room and Board Training for Residential Habilitation and Life Sharing Professionals
The first webinar was targeted towards professionals, Residential Habilitation providers, and Life Sharing providers, in order to provide an explanation of Room and Board polices and regulations, how the polices should be implemented, and an overview of the attachments of the bulletin.

Room and Board Training for Individuals and Families
The second webinar was created for individuals and families. Individuals who receive Residential Habilitation (who live in a group home) or Life Sharing must have a Room and Board contract. This webinar covers the reason for the Room and Board contract, what will be covered within the contract, and an overview of the bulletin, including an explanation of the Room and Board policies and regulations.

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The Office of Developmental Programs (ODP) has shared Bulletin 00-25-01: Room and Board for Individuals Enrolled With the Office of Developmental Programs and 5 accompanying documents:

The sixth document referenced in the bulletin, a version of the Room and Board Agreement translated in Spanish, will be released soon. Stakeholders will be notified when this version of the agreement is ready for use.

This bulletin is to clarify Room and Board requirements outlined in 55 Pa. Code Chapter 6100 (relating to Services for Individuals with an Intellectual Disability or Autism).

ODP has scheduled two trainings:

  1. Room and Board Training: For Residential Habilitation & Life Sharing Professionals
    Friday, March 28, 2025, 1:00 pm – 2:30 pm
    If you are a professional, please register here.
  2. Room and Board Training: For Individuals and Families
    Thursday, April 3, 2025, 11:30 am  – 1:00 pm
    If you are an individual or family member, please register here.

These trainings will include:

  • The intent of Room and Board;
  • An explanation of Room and Board policies and regulations;
  • An explanation of policy implementation; and
  • An overview of the attachments to the bulletin.

There will be time during the sessions to answer questions submitted by participants during the webinars. For this reason, ODP kindly asks stakeholders to save questions about the bulletin until after the training is held.

Please see the bulletin for additional details and information.

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Young caregiver helping older lady to stand up

The Office of Long-Term Living (OLTL) recently shared additional guidance for providers related to the Centers for Medicare & Medicaid Services (CMS) Home and Community-Based Services (HCBS) Settings Final Rule.

This clarification applies to Residential Habilitation and Personal Care Home Providers.

Regulations at 42 CFR 441.301(c)(4)(vi)(B) require that participants in residential settings have the ability to close and lock doors within their living units. As a part of the Office of Long-Term Living (OLTL) residential provider reviews, it was found that several sites did not meet this requirement. As remediation, some providers opted to have participants sign a form stating that they do not wish to have a lock on their doors, which OLTL’s settings review panel accepted as compliant.

The Centers for Medicare & Medicaid Services (CMS) has reviewed OLTL’s oversight activities and has deemed that participant sign-off waiving installation of locks does not sufficiently satisfy the requirement. CMS has determined that all doors with access to participant units or private spaces (such as a bedroom) must have locks installed. The participant’s choice is whether to utilize the lock or not. Based on this feedback, as OLTL moves forward with ongoing oversight of HCBS settings requirements, all doors to participant units/private spaces in residential settings will be required to have working locks in order to be deemed compliant for future settings reviews.

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The Office of Developmental Programs (ODP) has updated the AAW Provider Information Table to reflect the following updates:

  • The addition of the American Sign Language (ASL)-English Interpreter Service. This new service has been added to ensure effective communication for those participants that utilize ASL.
  • Residential Habilitation Provider Qualifications have been updated to reflect additions designed to ensure all residential providers are financially prepared, new providers have prior experience before delivering residential services, and services will continue without interruption when organizational changes occur at the executive level.
  • Assistive Technology devices that cost less than $750 do not require an independent evaluation by a professional certified by SHIFT, an online education and accreditation platform, but may be completed if the service plan team believes it to be beneficial.
  • Transportation service limit has been increased to $10,000 per participant’s service plan year, which includes both Transportation-Trip and Transportation-Public.
  • The Transportation service section has also been updated to include guidance previously released in ODP Announcement 24-005: Adding the Transportation Service to an Individual Support Plan (ISP) in the Adult Autism Waiver (AAW). The information also includes a change to how Transportation-Public is added to the ISP.
  • The Community Transition service has been updated to allow for non-recurring set-up expenses for individuals who are transitioning from another provider-operated living arrangement to a living arrangement in a private residence where the person is directly responsible for their living expenses.
  • The Career Planning and Supported Employment services sections have been updated to include information previously released in ODP Announcement 20-004: Clarifications and Training Requirements for Adult Autism Waiver (AAW) Employment Services.
  • Other updates and changes to AAW services due to the January 1, 2025, Waiver Amendment.

Please view the announcement and table for additional information and details. New services, updated language, and changes to services are highlighted in gray in the table.

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The Office of Developmental Programs (ODP) has shared communication ODPANN 24-129. This announcement informs potential providers and stakeholders of changes to the enrollment process for NEW providers seeking to offer Residential Habilitation, Life Sharing, and Supported Living services in the Consolidated or Community Living Waivers by December 31, 2024. Potential new providers will not be eligible to provide residential services effective January 1, 2025. Enrollment for new providers of these services is closed.

Please view the announcement for information and details.

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Today the Department of Human Services (Department) published final notice of Fee Schedule Rates for services funded through the Consolidated, Community Living, Person/Family Directed Support (P/FDS), and Adult Autism Waivers and the Department-established fees for base-funded services as a correction to the rates previously published August 1, 2024.

Due to a calculation error, the Department has made corrections to the Fee Schedule Rates for the following services funded through the Consolidated, Community Living, and P/FDS Waivers and base-funding:

  • Community Participation Support, effective July 1, 2024; and
  • Life Sharing Without Day 1-person needs group 3 and 4, effective October 1, 2024.

Additionally, due to a mistake in aligning the procedure code with the correct Statewide fee, the Department is republishing the Fee Schedule Rates for the following services funded through the Adult Autism Waiver effective July 1, 2024:

  • Residential Habilitation
  • Specialized Skill Development
  • Supported Employment
  • Career Planning
  • Therapies
  • Day Unit Respite
  • 15-Minute Unit Respite
  • Supports Coordination
  • Transportation — Trip

This publication presents an opportunity for providers to appeal these specific rates. The deadline for filing an appeal for these rates is December 2, 2024.

For further information, view ODPANN 24-107 or contact Carol Ferenz, IDD Division Director.

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In order to continue providing residential services after December 31, 2024, residential service providers must complete and return the Office of Developmental Programs (ODP) Agreement for Provision of Residential Services. A copy of the agreement and accompanying cover letter will be sent to your agency within the next 24 hours. The documents will be emailed to your agency’s primary QA&I contact as listed on MyODP. Completed Agreements must be submitted no later than July 31, 2024. If your agency does not receive these materials, or if your QA&I contact has changed, please contact ODP Provider Enrollment.

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As of December 2, 2023, Residential Habilitation procedure codes that reflect Needs Group 5 (NG5) have been loaded into the Home and Community Services Information System (HCSIS). These procedure codes have not been automatically added to provider service offerings. Providers will need to add the appropriate NG5 procedure codes via the service management screens in HCSIS. The instructions for adding a service can be found on the HCSIS Provider Updates Tip Sheet.

For any future NEA NG5 requests, please contact the rate setting mailbox for guidance. Previous communication regarding NG5 can be found here.

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Included in the August 24, 2019 Pennsylvania Bulletin was a notice from the Department of Human Services (DHS) about a change in the fee schedule rates for Personal Assistance Services (PAS) procedure codes (W1793, W1793TT, W1792, and W1792TU), and for Residential Habilitation procedure codes W0100 and W0102 in the Medical Assistance OBRA Waiver. The changes in the fee schedule rates for these services will be effective on January 1, 2020.

The existing fee schedule rates for PAS (Agency) and PAS (CSLA), procedure codes W1793 and W1793 TT, are increased by 2%. The intent of the increase is to provide for a wage increase for direct care workers providing agency-directed personal assistance services. DHS is also increasing the PAS (Consumer) and PAS (Consumer Overtime) rates, procedure codes W1792, and W1792 TU, to maintain equity in all the PAS rates in the OBRA waiver.

In addition, the existing fee schedule rates for Residential Habilitation procedure codes W0100 and W0102 are increased to include a 3 percent vacancy factor. A vacancy factor had not previously been included in the rate methodology; however, the Department recognizes that providers may not always deliver services to participants at full capacity. Therefore, a 3 percent vacancy factor will be applied to adjust the rates to account for the days the residential provider did not provide services to the participant. The provider cannot bill for days the participant did not receive services, but rather is paid a higher rate for days the participant received services. A vacancy factor of 3 percent was applied to reflect payment to providers for an average number of vacant days.

The fee schedule rates are available in the notice. Written comments regarding these fee schedule rates will be accepted through close of business on Monday, September 23, 2019 and should be sent to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: Marilyn Yocum, PO Box 8025, Harrisburg, PA 17105-8025. Comments may also be submitted to the Department via email. Comments received within 30 days will be considered in subsequent revisions to the fee schedule.

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