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PA Bulletin, Doc. No. 17-295


Review of Appendices I and J of the Consolidated and Person/Family Directed Support Waivers

[47 Pa.B. 1075]
[Saturday, February 18, 2017]

 The purpose of this notice is to make available for public review and comment Appendices I and J of the Office of Developmental Programs' proposed renewals of the Consolidated and Person/Family Directed Support (P/FDS) Waivers (Waivers).


 Home-based and community-based waivers permitted under section 1915(c) of the Social Security Act (42 U.S.C.A. § 1396n(c)) are approved by the Centers for Medicare & Medicaid Services (CMS) for a 5-year renewal period. The current Waivers expire on June 30, 2017; therefore, the proposed renewals of the Waivers are to be submitted to CMS no later than March 30, 2017.

 In the request for renewal of the Waivers, the Department of Human Services (Department) expects to propose the following substantive changes to Appendices I and J, effective July 1, 2017:

 • The rate determination methods have been updated to include the following new proposed services for which a Medical Assistance Fee Schedule Rate will be set, effective July 1, 2017: Advanced Supported Employment; Community Participation Support; Music, Art and Equine Assisted Therapy; Benefits Counseling; Communication Specialist; Consultative Nutritional Services; Housing Transition and Tenancy Sustaining Services; Family/Caregiver Training and Support (excluding training registration and fees) and Supported Living.

 • Effective January 1, 2018, rates for the following services in the Consolidated waiver only will transition to the Medical Assistance Fee Schedule: Unlicensed and Licensed Residential Habilitation and Unlicensed and Licensed Life Sharing. When this occurs, Additional Individualized Staffing will no longer be available as a discrete service as it will be included in the rate for Residential Habilitation and Life Sharing Services.

 • Effective January 1, 2018, transportation (per trip) will be the only service remaining that utilizes the cost-based methodology. 

 • The registration and fees for the new Family/Caregiver Training and Support Service will have an outcome-based payment for vendor goods and services effective July 1, 2017. In the P/FDS Waiver only, the new Participant Directed Goods and Services will also have an outcome-based payment for vendor goods and services effective July 1, 2017.

 • The factors related to estimated annual average per capita Medicaid costs have been updated to reflect the most recent data available.

 • To reflect consideration for differences in costs observed across this Commonwealth, the Department has established two geographical areas, effective July 1, 2017. The reduction from three areas to two was driven by Commonwealth-specific wage and population data compiled during the fee schedule market-based rate development process.

 The proposed Appendices I and J for the Waivers are available at:

Fiscal Impact

 It is anticipated that there will be an additional $399.413 million ($192.477 million in State funds) cost to the Commonwealth in Fiscal Year (FY) 2017-2018 related to Appendices I and J of the Consolidated and P/FDS Waivers renewals as discussed in this public notice. For FY 2018-2019, the additional cost is estimated to be $427.578 million ($206.007 million in State funds).

Public Comment

 Interested persons are invited to submit written comments regarding the proposed renewals of the Waivers. Comments should be addressed to the Department of Human Services, Office of Developmental Programs, Division of Provider Assistance and Rate Setting, 4th Floor, Health and Welfare Building, 625 Forster Street, Harrisburg, PA 17120. Comments may also be submitted to the Department at Use the subject header ''Appendices I and J.'' Comments received within 30 days of publication of this notice will be reviewed and considered for revisions to Appendices I and J of the proposed renewals of the Waivers.

 Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service by dialing 7-1-1 or by using one of the following toll free numbers: (800) 654-5984 (TDD users), (800) 654-5988 (voice users), (844) 308-9292 (Speech-to-Speech) or (844) 308-9291 (Spanish).

 Copies of this notice may be obtained at the local Mental Health/Intellectual Disability County Program, Administrative Entity or regional Office of Developmental Programs in the corresponding regions:

 • Western Region: Piatt Place, Room 4900, 301 5th Avenue, Pittsburgh, PA 15222, (412) 565-5144

 • Northeast Region: Room 315, Scranton State Office Building, 100 Lackawanna Avenue, Scranton, PA 18503, (570) 963-4749

 • Southeast Region: 801 Market Street, Suite 5071, Philadelphia, PA 19107, (215) 560-2242 or (215) 560-2245

 • Central Region: P.O. Box 2675, Harrisburg, PA 17105, (717) 772-6507


Fiscal Note: 14-NOT-1116. (1) General Fund; (2) Implementing Year 2016-17 is $0; (3) 1st Succeeding Year 2017-18 is $192,477; 2nd Succeeding Year 2018-19 is $206,007; 3rd Succeeding Year 2019-20 is $211,294; 4th Succeeding Year 2020-21 is $215,196; 5th Succeeding Year 2021-22 is $215,196; (4) 2015-16 Program—$1,202,683; 2014-15 Program—$1,074,887; 2013-14 Program—$1,026,790; (7) ID—Community Waiver Program; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 17-295. Filed for public inspection February 17, 2017, 9:00 a.m.]

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