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Tags Posts tagged with "Support Coordination Organization"

Support Coordination Organization

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Photo by National Cancer Institute on Unsplash

The Specialty Telehealth and Assessment Team (STAT) is a 24/7 telehealth service that provides health assessments. The service is consultative and provides disability specific advice of when to best seek additional or in-person medical treatment for the participants. This is a service that occurs in the participant’s private home or residential home to help assess their need for medical attention.

This service does not duplicate any service that is available through the state plan, and, very importantly, this service is not intended to replace in-person exams. The goal is not to prevent people from going to the emergency room or seeing a physician in person when needed. It is a support that can help to alleviate the burden of going to the emergency department or urgent care when it is not absolutely necessary for the individual to be seen in person.

The STAT waiver service is provided as a monthly service and billed in monthly units. One unit equals one month at 55 dollars a unit. All individuals that are involved in an ID/A waiver, Person/Family Directed Support (PFDS) waiver, Community Living waiver, and the Consolidated waiver are eligible for this service. The STAT waiver service is available for individuals of all ages and all living situations as long as they are enrolled in one of the ID/A waivers. In order to access this service, STAT must be added to the ISP via a critical revision or at the time of the annual ISP and must be authorized by the administrative entity prior to the service being used. STAT costs are included in the annual limit for P/FDS and Community Living waivers.

STAT is a unique and specialized service. The physicians that provide this service are educated in the guidelines for the provision of health care to individuals with intellectual and developmental disabilities. All staff who render the service have completed a specialized training curriculum on how to provide medical assessment, treatment interventions, and recommendations regarding the health care needs of individuals with intellectual disabilities, developmental disabilities, or autism. This service is provided and overseen by physicians who are licensed to practice medicine in the Commonwealth of Pennsylvania or have appropriate reciprocity.

The STAT waiver service has been available since March of 2024 and has grown steadily since. There are currently over 5,500 individuals using the service with two providers available, StationMD and Senacare. The service has maintained approximately a 94% treat in place rate since it became available, saving time and resources by avoiding unnecessary Emergency Department and urgent care visits.

We encourage SCs to provide education to individuals, families, and teams about how the STAT service can help.

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The Office of Developmental Programs (ODP) has shared ODPANN 26-008. This communication is to inform all Adult Autism Waiver (AAW) Supports Coordination Organizations (SCO), whose last digit of their Master Provider Index (MPI) number is 6, 7, 8, or 9 as well as new SCOs who enrolled in the AAW during fiscal year 2024/25, that they must submit their qualification documentation to the Office of Developmental Programs (ODP), Bureau of Supports for Autism and Special Populations (BSASP) between February 1, 2026, through March 31, 2026.

Documentation must include a completed AAW SCO Qualification form and SCO Qualification Documentation Record, as well as any other required supporting documentation.

Please view the announcement for more details.

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The Office of Developmental Programs (ODP) has announced a delay in the implementation of the Performance-Based Contracting (PBC) measure RD.01.1, which restricts residential placement options for individuals with higher needs. As originally written, RD.01.1 stated that beginning January 1, 2026, primary tier providers would not be permitted to accept new referrals for individuals assessed at Needs Group 5 (NG5) or higher. This requirement has now been delayed by two years.

  • Effective January 1, 2028, primary tier providers may not accept new referrals for individuals in NG5 or higher.
  • This restriction does not apply to:
    • Individuals already receiving residential services prior to January 1, 2028; or
    • Individuals whose needs assessment results in an increase to NG5 or greater after services have begun.

Until December 31, 2027, it remains permissible for Administrative Entities (AE) and Supports Coordination Organizations (SCO) to refer individuals in NG5 to a primary provider. However, AEs and SCOs may choose to limit these referrals to Select and Clinically Enhanced providers.

Contact:

Questions regarding this announcement should be directed to ODP electronically.

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The Office of Developmental Programs (ODP) has shared ODPANN 25-053. This announcement provides clarification to assist Supports Coordination Organizations (SCO) and Administrative Entities (AE) in properly identifying and planning for individuals who may be eligible for enrollment in the Person/Family Directed Support (P/FDS) Waiver through reserved capacity provisions.

Please review the announcement for additional information and details.

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