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Tags Posts tagged with "Residential Habilitation"

Residential Habilitation

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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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