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tsm

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NOTE TO INSPECTOR: The word "iridium" on the pen's nib is not a brand: it's the name of the metal of which the nib is made. Thanks. Inky old fountain pen on a $100 bill.

The Office of Developmental Programs (ODP) has shared ODPANN 26-031. The purpose of this announcement is to inform stakeholders that rates effective July 1, 2026, for Supports Coordination funded through the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) Waivers and TSM have been published as final in the Pennsylvania Bulletin, Volume 56, Number 10, published on Saturday, March 7, 2026.

To align payment with outcomes, beginning July 1, 2026, all SCOs will receive:

  • Monthly case rates for Consolidated and Community Living Waiver participants;
  • Monthly case rates for P/FDS Waiver participants and individuals who receive Intensive TSM;
  • A standard case rate for individuals receiving Standard TSM paid upon completion of an annual Individual Support Plan and upon completion of required mid-year monitoring; and
  • One flat fee-for-service rate that covers each individual’s initial person-centered planning and initial Individual Support Plan development.

Please view the announcement for more details.

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The purpose of the Office of Developmental Programs (ODP) Bulletin 00-22-01 is to communicate and clarify the requirements for Targeted Support Management (TSM) that were approved by the Centers for Medicare and Medicaid Services (CMS). Changes to TSM discussed in this bulletin include:

  • Expansion of TSM services, effective August 20, 2017, to individuals with autism.
  • Expansion of TSM services, effective July 1, 2021, to children age 8 or younger with a developmental disability who are eligible for Medical Assistance (MA) and who have been determined to need an Intermediate Care Facility for Other Related Conditions (ICF/ORC) level of care.
  • Expansion of TSM services, effective July 1, 2021, to individuals age 0 through 21 with a medically complex condition that is a chronic health condition that affects three or more organ systems, and that the individual requires medically necessary skilled nursing intervention to execute medical regimens to use technology for respiration, nutrition, medication administration, or other bodily functions. Individuals must be eligible for MA and have been determined to need an ICF/ORC level of care.
  • Clarification regarding the use of the LifeCourse framework and tools.
  • Clarification of expected assessment activities and the development of the Individual Support Plan (ISP).
  • Addition of enhanced qualification requirements for TSM providers and Targeted Support Manager Supervisors.
  • Clarification that individuals who are enrolled in and receiving case management services under any Home and Community-Based Services (HCBS) program administered via an 1115, 1915(b) and (c), or 1915(a), (b), or (c) waiver are not eligible to receive TSM.
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