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PA Bulletin, Doc. No. 20-1752

NOTICES

DEPARTMENT OF
HUMAN SERVICES

Availability of Amendments to the Office of Developmental Programs' Consolidated, Person/Family Directed Support, Community Living and Adult Autism Waivers

[50 Pa.B. 7110]
[Saturday, December 12, 2020]

 The Department of Human Services (Department) is making available for public review and comment the Office of Developmental Programs' proposed amendments to the Consolidated, Person/Family Directed Support (P/FDS), Community Living and Adult Autism waivers.

Background

 Whenever substantive changes are made to an approved waiver, the Department must submit an amendment to the Centers for Medicare & Medicaid Services (CMS) for approval. The Department proposes the following substantive amendments to all four waivers effective March 1, 2021:

 • Promote health, wellness and safety by allowing certain services to be provided in a hospital consistent with amendments to the Social Security Act (42 U.S.C.A. §§ 1396—1396w-5) by the Coronavirus Aid, Relief and Economic Security Act (Pub.L. No. 116-136).

  o In the Consolidated, P/FDS and Community Living waivers, services that can be provided when a participant is hospitalized are: Supplemental Habilitation; In-Home and Community Support; Companion; Supports Broker; Supports Coordination; and Behavioral Support.

  o In the Adult Autism waiver, services that can be provided when a participant is hospitalized are: Temporary Supplemental Services; Supports Coordination; and Specialized Skill Development.

  o Participants who receive services when hospitalized will not be disenrolled from the waiver and will not need to have waiver capacity reserved to allow them to reenroll in the waiver when discharged from the hospital.

 • Promote self-direction, choice and control by allowing certain services to be provided directly to the participant using remote technology.

  o In the Consolidated, P/FDS and Community Living Waivers, direct services that can be rendered using remote technology are: In-Home and Community Support; Companion; Behavioral Support; Supported Employment; Communication Specialist; Music Therapy; Art Therapy; Therapy Services; Consultative Nutritional Services; and Supports Broker.

  o In the Adult Autism Waiver, direct services that can be rendered using remote technology are: Career Planning; Supported Employment; Specialized Skill Development; and Nutritional Consultation.

 • Support flexibility in service delivery and increase participant choice and independence by expanding options to receive remote support that meets a participant's needs in a cost-effective manner through the Assistive Technology service.

 • Promote the safety of participants and support quality services through the clarification of criminal history clearance requirements that providers must comply with to be qualified to render services in the waivers.

 The following proposed changes solely apply to the Consolidated, P/FDS and Community Living waivers:

 • Increase participants' access to needed vendor goods and services by allowing Supports Coordination Organizations to be Organized Health Care Delivery Systems.

 • Increase participants' connection to their communities by clarifying that Housing Transition and Tenancy Sustaining Services must be used to find homes in integrated settings in alignment with the CMS Home and Community Based Settings Rule.

 • Promote competitive integrated employment by allowing staff rendering the Benefits Counseling service the option of obtaining the Work Incentive Practitioner credential.

 • Support participants with complex needs by focusing on restrictive interventions implemented by staff versus staff to individual ratios.

 • Reduce the amount of redundant information participants receive by clarifying that the Vendor Fiscal/Employer Agent and Agency With Choice wage ranges for Support Service Professionals will only be issued when there is a change to the wage ranges.

 The following proposed changes solely apply to the Adult Autism waiver:

 • Promote health, wellness and safety by ensuring that individuals on the Priority 1 interest list are added to the Adult Autism waiver waiting list.

 • Simplify the system by aligning the level of care process and use of the Supports Intensity Scale in the Adult Autism waiver with the Consolidated, Community Living and P/FDS waivers.

 • Develop and support qualified staff by delaying the implementation date of certification/training requirements for Supported Employment and Career Planning services due to the novel coronavirus (COVID-19) pandemic.

Fiscal Impact

 It is anticipated that there will be no increase or decrease in costs associated with the proposed changes to the Consolidated, Community Living, P/FDS and Adult Autism waivers.

 The amount of funding available is dependent upon the funds appropriated by the General Assembly for the current fiscal year. Therefore, until a budget bill is enacted that is intended to fund an entire 12-months of Fiscal Year 2020-2021, the fiscal impact is estimated.

Public Comment

 The proposed amendments to the Consolidated, P/FDS, Community Living and Adult Autism waivers, effective March 1, 2021, are available at https://www.dhs.pa. gov/Services/Disabilities-Aging/Pages/Proposed-Waiver-Amendments.aspx.

 Interested persons are invited to submit written comments regarding the proposed waiver amendments. Comments should be addressed to Julie Mochon, Department of Human Services, Office of Developmental Programs, 625 Forster Street, Room 510, Harrisburg, PA 17120. Comments may also be submitted to the Department at RA-odpcomment@pa.gov using subject header ''Waiver Amendment Comments.''

 Comments received within 30 days of publication of this notice will be reviewed and considered for revisions to the proposed waiver amendments.

 The Department will also hold two webinars to receive comments on the proposed waiver amendments; one webinar for the Consolidated, P/FDS and Community Living Waivers and one for the Adult Autism Waiver. The date, time and link for registration to attend the webinar for the Consolidated, P/FDS and Community Living waivers are as follows:

January 11, 2021
1 p.m. to 3 p.m.

 The following link must be used to register for the previously listed webinar: https://attendee.gotowebinar.com/register/6919419499151760396.

 The date, time and link for registration to attend the webinar for the Adult Autism waiver are as follows:

January 8, 2021
10 a.m. to 12 p.m.

 The following link must be used to register for the previously listed webinar: https://attendee.gotowebinar.com/register/7997069537232835084.

 Participants are able to participate in the webinars by phone, but will need a computer to provide comments during the webinars. To assist the Department in accurately capturing comments provided during the webinars, individuals are asked to submit a written copy of their comments by e-mail or mail to the previously listed address.

 Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service by dialing 711 or by using one of the 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 and documents containing the changes proposed in the waiver amendments may be obtained by contacting Julie Mochon, Office of Developmental Programs, 625 Forster Street, Room 510, Harrisburg, PA 17120, RA-odpcomment@pa.gov.

TERESA D. MILLER, 
Secretary

Fiscal Note: 14-NOT-1413. No fiscal impact; (8) recommends adoption.

[Pa.B. Doc. No. 20-1752. Filed for public inspection December 11, 2020, 9:00 a.m.]



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