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Tags Posts tagged with "Waiver"

Waiver

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ODP Announcement 22-059 informs readers that the Office of Developmental Programs (ODP) is pleased to announce that an amendment to the AAW was submitted to CMS on May 9, 2022. The submitted AAW includes modifications that were made as a result of public comment. The AAW amendment includes the following substantive changes:

  • Adding reserved waiver capacity for individuals who are discharged from a state center. Reserved waiver capacity is also being added for participants who have been incarcerated for more than six consecutive months;
  • Aligning provider qualifications in the AAW with the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) waivers, whenever possible;
  • Allowing relatives to deliver the Life Sharing component of the Residential Habilitation service;
  • Requiring that agencies that provide Residential Habilitation/Life Sharing must be qualified and enrolled to provide Residential Habilitation/Life Sharing in the Consolidated or Community Living waivers;
  • Increasing the annual fiscal limit in the transportation service to $5,000 per participant’s ISP year;
  • Allowing one of the four required monitoring conducted by the Supports Coordinator each year to be conducted remotely;
  • Adding a new service, Remote Supports; and
  • Delivering direct services using remote technology.

The requirements in the AAW will become effective when Appendix K flexibilities expire, six months after the expiration of the federal COVID-19 public health emergency.

Please note that aligning the Assistive Technology service, where possible, with the Consolidated, Community Living, and P/FDS waivers includes adding generators for the participant’s primary residence.

The full AAW application, as well as a record of substantive changes, is available here.

CMS has 90 days to review the amendment, and changes may occur to the content based upon discussion with CMS during the approval process. The proposed effective date of July 1, 2022, is also subject to change. ODP will inform all stakeholders when CMS has officially approved the AAW and will make the approved waiver available at that time.

Questions about this communication should be directed via email.

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ODP Announcement 22-039 describes actions the Administrative Entities (AEs) and Supports Coordination Organizations (SCOs) must take when an Office of Developmental Programs’ (ODP) waiver or base participant is admitted to a Nursing Facility (NF) to ensure a coordinated transition to Long-Term Care (LTC) services and prevent service interruptions.

When an ODP waiver participant (Adult Autism, Consolidated, Community Living, or Person/Family Directed Support) is identified for NF admission, he or she will transition from the ODP waiver to Community Health Choices (CHC) for their Long-Term Services and Supports (LTSS). Nursing services are started the day of admission into the NF, ensuring health and safety. The individual must begin to receive CHC services on the day he or she is admitted to the NF. Individuals cannot be dually enrolled in CHC and an ODP waiver. The AE, county MH/ID program, and/or SC will assist the individual in transitioning to the NF and move the participant into reserved capacity for their ODP waiver.

Enrollment in an ODP waiver or base services in HCSIS prevents the CHC from enrolling the individual in LTSS in eCIS; therefore, the AE must end date the waiver or base enrollment in HCSIS prior to the CHC enrollment date in eCIS/CIS to avoid overlap.

Please review the announcement for further guidance.

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With Senate Bill 1019 passed into law as Act 14, the Department of Drug and Alcohol’s (DDAP) regulatory suspensions are also extended. These regulatory suspensions are “related to federal exemptions granted under the federal public health emergency declaration” until “the last day federal exemptions granted under the federal public health emergency declaration are authorized.” In addition to three DDAP regulatory suspensions, one additional regulation from the Department of State, also relevant to the field, is included in the chart below and also remains suspended.

Statute/Regulation Statute/Regulation Purpose

Waiver Benefit/Explanation

28 Pa. Code § 715.16(e)

 Prohibits narcotic treatment programs (NTPs — methadone clinics) from permitting a patient to receive more than a 2-week take-home supply of medication In response to COVID-19, SAMHSA is allowing up to 28 days of take-home medications for patients on stable dosages, if the physician deems appropriate.
28 Pa. Code § 715.9(a)(4) Requires NTPs to make a face-to-face determination before admission to treatment, for those clients who will receive buprenorphine treatment. In response to COVID-19, SAMHSA is allowing initial evaluations for a patient who will be treated with buprenorphine to be completed via telehealth.
28 Pa. Code § 715.6(d) Requires NTPs to have narcotic treatment physician services onsite. In response to COVID-19, SAMHSA is allowing initial evaluations for a patient who will be treated with buprenorphine to be completed via telehealth.
49 Pa. Code § 16.92(b)(1)

(Department of State)

 Before a patient can be prescribed any controlled substance in Pennsylvania, a person licensed to practice medicine and surgery in the commonwealth, or otherwise licensed or regulated by the State Board of Medicine, must take an initial medical history and conduct an initial physical examination, unless emergency circumstances justify otherwise.

In response to COVID-19, the Department of State suspended the initial medical history and physical examination requirement specifically for the treatment of opioid-use disorder with buprenorphine.

 

In November 2021, the Substance Abuse and Mental Health Services Administration (SAMHSA) announced that the methadone take-home flexibilities will be extended for one year after the eventual expiration of the federal COVID-19 Public Health Emergency. DDAP has submitted its written concurrence with this exemption. SAMHSA has also indicated that they are currently considering mechanisms to make this flexibility permanent. Narcotic treatment programs do not need to do anything additional at this time to continue taking advantage of this flexibility.

Similarly, the U.S. Drug Enforcement Administration (DEA) also announced last week that they are currently working to make their teleprescribing regulations permanent. DDAP will continue to provide additional information and guidance as it becomes available.

If you have any further questions, please contact the Bureau of Program Licensure at (717) 783-8675 or via email.

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ODP Announcement 22-006 is to inform all Waiver Providers and Vendors whose last digit of their Master Provider Index (MPI) number is 3, 4, or 5, as well as new providers who enrolled in the 2020–2021 fiscal year, that they must submit their qualification documentation to their Assigned AE and/or the Office of Developmental Programs’ (ODP) Bureau of Supports for Autism and Special Populations (BSASP). This documentation is due between February 1, 2022 and March 31, 2022

Documentation must include a completed DP 1059 form and/or DP 1088 form, Provider Qualification Documentation Record (providers must use the most recent version found on MyODP), and any other required supporting documentation. For reference to provider qualification, please see Pennsylvania Bulletin Volume 49, Number 40, Subsections 6100.83-84, which contains provider qualification citation specifications.

Inquiries about this communication regarding the ID/A qualification process should be sent to the ODP Provider Qualification inbox. Inquiries about this communication regarding the AAW qualification process should be sent to the AAW Provider Qualification inbox.

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