After reviewing hundreds of comments from stakeholders, the Office of Developmental Programs (ODP) has made some initial adjustments to the proposed Performance-Based Contracting waiver for Residential Services. Areas with high volumes of comments included:
- Select/Clinically Enhanced Tiers being reserved for agencies serving 10 or more individuals;
- Competitive Integrated Employment standards;
- Populations served with average Needs Level 4.5+ and average Health Care Level 3.5+ (HCL is established using the Health Risk Screening Tool);
- Primary providers being limited to Needs Group 1-3;
- The number of measures; and
- The timeline for implementation.
ODP is now offering Residential providers a choice of when they are assigned into a tier. This will be based on which data they chose for ODP to review and make a tier determination upon. The choices will be:
- Calendar year 2023 data reviewed with notification of tier assignment occurring in November, to be effective January 1, 2025 – June 2026; or
- Review of Calendar year 2024 data with notification of tier assignment occurring in May, to be effective July 2025 – July 2026.
ODP plans to continue their review of public comments and intends to publish additional information. On July 19, ODP hopes to submit amended the 1915(c) waivers and 1915(b)4 waiver as well as publish the following supporting documents:
- Performance Standards;
- Implementation Plan;
- Attestation; and
- Provider Data Submission Tool.
On January 1, 2025, ODP intends to begin Performance-Based Contracting (pending CMS approval).
ODP will conduct a webinar for residential providers on Monday, July 22, 2024, from 3:00 pm – 4:00 pm, to review publications, changes made as a result of public comment, and instructions for tier determination and data submission. Register here. This webinar will be posted on the PBC Resource Page located on the MyODP website.