Deputy Secretary Ahrens presented an overview of the Office of Developmental Programs’ (ODP) plan that was conditionally approved by the Centers of Medicare and Medicaid Services (CMS) for use of the ARPA funds during a webinar on December 9, 2021. While the infusion of funds will be beneficial to the system of support in PA, RCPA staff will be carefully monitoring the details of the plans as they are released, particularly the rate refresh, and will continue to advocate for fiscal policies that will allow for stability in the service system.

Highlights include:

• Funding to Address High Staff Vacancy and Turnover Rates
  • One time funding for COVID-19 related staffing expenses, recruitment, and retention of Direct Support Professionals or Supports Coordinators to include funding for hazard pay, costs of recruitment efforts, sign-on bonuses, and other incentive payments that are:
    • Provided as a supplemental payment under Appendix K; and
    • Up to 5% of prior year revenue (2% for AWC) for related expenditures between April 1, 2021, and March 31, 2022.
  • Estimated total funding: $200M.

• Updating Fee Schedule Rates
  • Proposed changes in fee schedule to be published in December for a 30-day public comment period and implemented in late January or early February 2022.
  • Rate changes for waiver services will be retroactive to July 1, 2021, for the AAW and January 1, 2022, for the ID/A waivers.
  • Proposed fee schedule includes increases in all regular fee schedule rates (exception — temporarily enhanced fee schedule rates for CPS and Transportation Trip).
  • Estimated fiscal impact of the proposed rate changes for ODP programs is approximately $400M annually (proposed rate updates are still in the final stages of review, so this number may change).

• Funding for Staff Training, Credentialing, and Business Associates Programs for Employment
  • One time funding up to $50,000 or 1% of provider annual revenue, whichever is greater.
  • Estimated total funding $23M.

• Respite and Family Support Funds for Individuals on the Waiting List for ID/A
  • Funding available for one-time family support grants for individuals and families on the ODP waiting list for purchase of respite and other eligible family support service.
  • Estimated funding: $12M.

• Funding for Technology That Enhances HCBS Provision
  • One-time funding for providers to support activities, including the purchase of assistive and/or remote support technology, the purchase and implementation of new software/technology for electronic health records, quality, or risk management functions, and the purchase of technology for professional credentialing identified in ODP provider qualifications.
  • One-time funding for the purchase of technology for Supports Coordination Organizations to improve capacity to conduct remote monitoring of individuals, to improve efficiency of Supports Coordinators, including maximizing time in the field, to obtain or enhance secure inter-office communications, or to implement technology-dependent quality improvement strategies.
  • Estimated funding: $13.5M.

• Technology Accelerator Resources : Initiative is Shared With OLTL
  • Contractor to work with ODP and stakeholders to accelerate adoption of technology through consultation, information dissemination, and training to agencies seeking to adopt remote supports and other technology solutions to support individuals receiving HCBS.
  • This includes funding for two statewide technology summits.
  • Training and materials developed will be available electronically and through ODP’s learning management system to provide access after the funding period.

• Additional Staff to Support Intake, Eligibility of New Populations, Waiver Capacity, and Risk Management
  • Funding will be available for approximately 80 additional county staff for the following.
  • Estimated funding: $25M.

• Incident Detection and Incident Reporting Fidelity System
  • Purchase development and implementation of dashboards/software pairing claims data and incident reports to evaluate provider incident reporting fidelity and detect unreported incidents of abuse and neglect.

• Develop and Implement Selective Contracting
  • Purchase time limited consultation to support the Department to develop and implement selective contracting and alternative payment methods for selected HCBS services for complex populations to improve quality of service provision. Systems improvement will provide for aligning payment with performance measures and outcomes.

• Training to Address Pandemic-Related Needs and Promote Initiatives
  • Peer-to-peer training will be available for individuals and families.
  • Training and materials developed will be available electronically and through ODP’s learning management system.
  • Estimate funding: $4M.

• Purchase of Emergency Preparedness Kits to Non-Residential HCBS Participants
  • Estimate funding: $520k.

• Provide Funding to Support Housing for Individuals Transitioning From Institutional or Congregate Settings
  • One-time funding will be targeted to residential providers for housing adaptations and purchase for individuals transitioning from public or private ICF, children transitioning from congregate care, medically complex adults (when cost effective and to avoid placement in a nursing facility), and adults to age in place or transition to supported living or life sharing.
  • Estimate funding: $15M.

• Transfers from Private Intermediate Care Facility to Community
  • Additional Consolidated Waiver capacity for the transfer of 25 individuals from facility care to HCBS.
  • Estimate funding: $5M.

Visit the DHS web page to view the full spending plan.