Fee Schedule Rates and Department-Established Fees for Services Funded Through the Office of Developmental Programs' Adult Autism Waiver
[52 Pa.B. 1326]
[Saturday, February 26, 2022]
The Department of Human Services (Department) is providing final notice of the Fee Schedule Rates and Department-Established Fees for services funded through the Adult Autism Waiver. The rates are effective July 1, 2021.
Under 55 Pa. Code § 6100.571 (relating to fee schedule rates), which was effective October 5, 2019, the Department is required to update the data used in establishing the fee schedule rates at least every 3 years. The Department has reviewed and revised its rates for Adult Autism Waiver services to comply with this requirement as well as to comply with the requirement in the Home and Community-Based Waiver Instructions, Technical Guide and Review Criteria to ensure at a minimum of every 5 years that rates are adequate to maintain an ample provider base and ensure quality of services.
Fee Schedule Rates and Department-Established Fees
The proposed Fee Schedule Rates and Department-Established Fees for Adult Autism Waiver services were published at 52 Pa.B. 98 (January 1, 2022). The Department received comments from ten stakeholders regarding the proposed changes to the Fee Schedule Rates and Department-Established Fees. A summary of the comments received and the Department's responses are available at https://www.dhs.pa.gov/providers/Providers/Documents/ODP/Public%20Notices%20Related%20to%20 Rates/AAW%20Rate%20Comment%20and%20Response %20Summary%20Placeholder.pdf. After reviewing the comments on the proposed rates, the Department determined that no changes were necessary to the Fee Schedule Rates or Department-Established Fees for services funded through the Adult Autism Waiver.
The final Fee Schedule Rates and the Department-Established Fees represent the maximum rates the Department will pay for each service. The final Fee Schedule Rates and the Department-Established Fees are included in the following tables and can also be found online at https://www.dhs.pa.gov/providers/Providers/Pages/ODP-Rates.aspx.
FEE SCHEDULE RATES FOR ADULT AUTISM WAIVER SERVICES EFFECTIVE JULY 1, 2021
Rates in the table are per 15-minute unit unless otherwise noted.
Service Name Staffing Level Procedure
Statewide Fee Day Habilitation >1:6 W7063 $3.34 <1:6—1:3.5 W7064 $4.04 <1:3.5—>1:1 W7065 $6.30 1:1 W7066 $12.39 Residential Habilitation Community Home Light W7228 $153.52
Limited W7229 $215.54
Extensive W7230 $281.34
Intensive W7231 $546.13
Intensive + W7232 $644.82
Life Sharing Low W7052 $165.06
Medium W7054 $200.44
High W7053 $235.81
Specialized Skill Development Behavioral Specialist (Plan Development) 1:1 96156 $1,750.61
Behavioral Specialist (Consult) 1:1 96171 $21.88 Behavioral Specialist (Direct) 1:1 96159 $21.88 Systematic Skill Building (Plan Development) 1:1 W7214 $610.82
Systematic Skill Building (Consult) 1:1 W7216 $17.61 Systematic Skill Building (Direct) 1:1 W7215 $17.61 Community Support 1:1 W7201 $11.54 1:2 W7204 $6.23 1:3 W7205 $4.46 Small Group Employment < 1:6 to > 1:3.5 W0012 $3.11 < 1:3.5 to > 1:1 W0011 $4.55 Supported Employment Intensive Job Coaching (Direct) 1:1 W7200 $18.64 Intensive Job Coaching (Indirect) 1:1 W7207 $18.64 Extended Employment Supports (Direct) 1:1 W7206 $18.64 Extended Employment Supports (Indirect) 1:1 W7202 $18.64 Career Planning Vocational Assessment 1:1 W7071 $18.64 Job Finding 1:1 W7077 $18.64 Therapies Counseling 1:1 T2025 $22.38 Speech/Language 1:1 T2025 $23.56 Nutritional Consultation 1:1 S9470 $17.48 Family Support 1:1 without participant present 90846 $19.49 1:1 with participant present 90847 $19.49 Other H0046 $19.49 Day unit Respite Licensed Out-of-Home All staffing levels W7211 $280.06
Unlicensed Out-of-Home All staffing levels W9495 $214.64
15-minute unit Respite In-Home 1:1 W7213 $9.60 Licensed Out-of-Home All staffing levels W7212 $7.00 Unlicensed Out-of-Home All staffing levels W9596 $5.37 Supports Coordination Plan Development 1:1 W7199 $1,107.67
Ongoing 1:1 T2024 $23.77 Transportation—Trip Zone 1 W7274 $18.83 Zone 2 W7275 $33.85 Zone 3 W7276 $50.46 Temporary Supplemental Services 1:1 W7236 $11.82
DEPARTMENT-ESTABLISHED FEES FOR RESIDENTIAL HABILITATION SERVICES THROUGH THE ADULT AUTISM WAIVER EFFECTIVE JULY 1, 2021
Rates in the table are per day.
Service Staffing Level Procedure
Statewide Fee Licensed Residential Habilitation
All staffing levels W7233 $35.06
Copies of this notice may be obtained by contacting the Bureau of Supports for Autism and Special Populations at P.O. Box 2675, Harrisburg, PA 17105, RAemail@example.com.
It is anticipated that there will be a total cost to the Commonwealth in Fiscal Year (FY) 2021-2022 of $9.378 million ($4.013 million in State funds). In FY 2022-2023, the cost is $9.378 million ($4.485 million in State funds). For FY 2023-2024 and subsequent years the total cost is $9.378 million ($4.501 million in State funds).
Fiscal Note: 14-NOT-1498. (1) General Fund; (2) Implementing Year 2021-22 is $4,013,000; (3) 1st Succeeding Year 2022-23 is $4,485,000; 2nd Succeeding Year 2023-24 through 5th Succeeding Year 2026-27 are $4,501,000; (4) 2020-21 Program—$27,262,000; 2019-20 Program—$25,252,000; 2018-19 Program—$30,842,000; (7) Autism Intervention and Services; (8) recommends adoption. Funds have been included in the budget.
[Pa.B. Doc. No. 22-328. Filed for public inspection February 25, 2022, 9:00 a.m.]
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