WebLong-term care, sometimes referred to as long-term living, is a wide range of assistive services provided to an individual based on their needs. (b)To supervise staff providing service coordination services, a service coordinator supervisor shall meet either of the following: (1)Have at least 3 years of experience in public or private social work and a bachelors degree. Definitions. WebThe Department of Human Services submitted the Community HealthChoices (CHC) 1915 (b) managed care waiver and the CHC 1915 (c) home and community-based services (3)Section 74.26 of 45 CFR (relating to non-Federal audits). HCBS provides for supports and services beyond those covered by the Medical Assistance (also referred to as Medicaid) program that enables a person to remain in a community setting rather than being admitted to a Long Term Care Facility. (3)Recouping a payment for a service the provider cannot verify as being provided in the amount, duration and frequency billed. Number:PA.0354.R04.02 Draft ID: PA.002.04.01 D. Type of Waiver (select only one): Medicaid's Home and Community-Based Services (HCBS) Waiver programs, including the HCBA Waiver, are authorized under Section 1915(c) of the Social Security Act; governed by Title 42, Code of Federal (c)A providers records may be reviewed. Get Legal Help from the your local legal aid office from the Pennsylvania Legal Aid Network or your local Public Defender. WebHome and community-based waiver programs available to people who meet the eligibility criteria include: Alternative Care, a program that supports certain home and community-based services for older Minnesotans, age 65 years and over, who are at risk of nursing home placement and have low levels of income and assets. A Resolution directing the Legislative Budget and Finance Committee to conduct a study on the effect of workforce shortages on State supported Medicaid home (d)The Department or the Departments designee may perform an attestation engagement in accordance with subsection (c). Application for a 1915(c) Home and Community- Based (ii)The term does not include the following: (A)Intermediate care facilities for individuals with developmental or intellectual disabilities or other related conditions. PA Independent Enrollment Broker (PA IEB) Home Page This subsection does not apply to copayments. (a)The Department will only pay for the actual cost of a vendor good or service which may not exceed the amount for a similar vendor good or service charged to the general public. PURPOSE OF THE HCBS WAIVER PROGRAM . PALawHelp.org is a project of the Pennsylvania Legal Aid Network and the Legal Services Corporation. Vendor good or serviceA rendered item or service that is not on the MA fee schedule for which the Department reimburses an OHCDS or provider. For information on visiting the Capitol Complex, please visit pacapitol.com, Email Webmaster (a)A provider may be sanctioned, prohibited or disenrolled from providing services for failure to perform any of the following: (1)Protect the health and welfare of a participant during service delivery. Web6. A provider may file an appeal of a Departmental action in accordance Chapters 41 and 1101 (relating to Medical Assistance provider appeal procedures; and general provisions). WebThe Pennsylvania Department of Aging (PDA) Medicaid Waiver provides home and community based services (HCBS) to seniors who require nursing facility care, but Once all documentation and forms are received by the Division of Aging, the Waiver Provider Analyst will review your Provider Application packet. Weba Waiver at your local Area Agency on Aging, Center for Independent Living, or County Mental Health/Mental Retardation Office. Policy and Procedures WebApplication for 1915(c) HCBS Waiver: PA.0235.R05.06 - Jul 01, 2017 (as of Jul 27, 2018) Page 1 of 229 . (v)Most recent audit or financial review if the applicant has completed an audit or financial review within the previous 5 years. (8)Comply with the applicable approved waiver, including approved waiver amendments as posted on the Departments publicly accessible web site. The approved applicable Federal waivers, including approved waiver amendments, are incorporated by reference and can be found on the Departments web site at http://www.portal.state.pa.us/portal/server.pt?open=514&objID=733116&mode=2. 55 Pa. Code Chapter 52. Long-Term Living Home And (c)A disenrolled provider shall cooperate with the Department, new providers of services and participants with transition planning to ensure participants continuity of care. WebFund an array of home and community based services that promote community living and Home and Community Based Services (HCBS) and Waivers Office of Developmental Supports. WebSpecial home and community-based waiver group under 42 CFR 435.217) Note: When the special home and community-based waiver group under 42 CFR 435.217 is For more information, go to Provider Resources. Home- and Community-Based Services (HCBS) are types of person-centered care delivered in the home and community. These applications have been approved by CMS, and will become effective January 1, 2018. Via the 1915 (c) Waiver, home and community based services (HCBS) are provided. The website that offers screening for home and community based services and accepts applications for some home and community based services is: www.compass.state.pa.us. No statutes or acts will be found at this website. (f)A provider shall maintain appropriate licenses and certifications as required by State and Federal requirements. Pennsylvania Waiver Factsheet | Medicaid It generally helps provides assistance with skill development, respite, transportation, and (8)The providers signature indicating the provider will implement the CAP. (d)The requirements of this section are in addition to the recordkeeping provisions in Chapters 2380 and 2390 (relating to adult training facilities; and vocational facilities), 6 Pa. Code Chapter 11 (relating to older adult daily living centers) and 28 Pa. Code Chapters 601 and 611 (relating to home health care agencies; and home care agencies and home care registries). (a)The Department may grant a waiver to a provision of this chapter which is not otherwise required by Federal and State law and does not jeopardize the health, safety or well-being of a participant. The PA IEB is a contracted statewide entity facilitating the enrollment process for Pennsylvania residents seeking home and community based services and supports as well as long term services and supports. General Policies and Procedures; Policy and procedures for communication with persons with limited English proficiency; Chester Springs, PA 19425 (610) 453-5005 . These programs provide funding for supports merger, acquisition) Waiver Please direct comments or questions to, PROVIDER QUALIFICATIONS AND PARTICIPATION 52.11. In order to qualify for Aging Waiver services, you must meet eligibility requirements. (5)An individual holding the participants power of attorney for health care or health care proxy. Pennsylvania Bulletin Home and community-based services are also known as waiver-funded services or waiver programs. (b)Prior to hiring an employee, a provider shall obtain a criminal history check which is in compliance with the following for each employee who may have contact with a participant: (1)A report of criminal history record information from the Pennsylvania State Police or a statement from the Pennsylvania State Police that the Pennsylvania State Police Central Repository does not contain information relating to that person, under 18 Pa.C.S. (b)A provider shall retain documentation of the amount charged for the vendor good or service. WebWhat It Is. (o)A provider which is not an SCE shall cooperate with the participant, the SCE and the Department to resolve delays in service provision. (3)The current Department-approved CAP, if the provider has a CAP. Participation in self-directed PAS is voluntary Participants set their own provider qualifications and train their PAS providers Participants determine how much Request Information (2 of 3) F. Level(s) of Care. Protective Service responds to reports of suspected abuse, neglect, exploitation, abandonment, inappropriate relocation and emergency/crisis situations. (c)A service coordinator shall have at least 40 hours of training within the first year of employment. (l)A provider shall ensure that each employee possesses a valid Social Security Number. (f)The Department may develop a CAP for a provider to implement in response to the statement of findings. Learn more about theAutism Waiver. Waiver 2730, unless otherwise noted. The numbers in parentheses that follow each state indicate how many 1915 (c) waivers that state has. HOME AND Waivers offer an array of services and benefits such as choice of qualified providers, due process, and health and safety assurances. (d)The hiring policies shall be in accordance with the Department of Agings Older Adults Protective Services Act policy as posted on the Department of Agings web site at http://www.portal.state.pa.us/portal/server.pt?open=514&objID=616725&mode=2. (a)A provider assuming ownership shall report a change in ownership or control interest of 5% or more in writing to the Department at least 30 days prior to the effective date of the change. (c)Each participant need must be addressed by an informal community support, TPR or service unless the participant chooses for a need to not be addressed. Personal assistance servicesServices aimed at assisting the participant to complete ADLs and IADLs that would be performed independently if the participant did not have a disability. B. Independence Waiver Attendant Care waiverA Federally-approved 1915(c) waiver under section 1915(c) of the Social Security Act that authorizes services to participants 18 years of age or older but under 60 years of age with physical disabilities. (k)The SCE or the Departments designee shall assist a participant to collect and send information to the Department to determine the participants continued eligibility for the waiver or Act 150 program, including financial eligibility. Services offered include all regularly covered Medicaid services (hospital, physician, lab, prescriptions) plus the (2)Developing and modifying a participants service plan. This section cited in 55 Pa. Code 52.42 (relating to payment policies). Home (b)Monitoring may be announced or unannounced. The methods used by the provider to reduce the number of preventable incidents shall be documented on the providers QMP. Home and Community-Based Services - RAND Corporation You can also call the Recipient Call Center at (800) 362-1504 to update your information, or you can complete Form 295 and submit it to Medicaid. Home and Community (6)Provide the participant with a list of providers in the participants service location area that are enrolled to render the service that meet the participant needs. This chapter sets forth the regulations which apply to providers applying to participate and render MA-funded waiver services under the Federally-approved Aging, Attendant Care, COMMCARE, Independence and OBRA Home and Community-Based Service waivers or the Act 150 program. ProviderA Department-enrolled entity which provides a service. (j)The provider shall notify the Department at least 30 business days prior to any of the following occurrences: (1)Changes in the providers address, telephone number, fax number, e-mail address, provider name change or providers designated contact person. The waivers will govern operation of the CHC Program, Pennsylvanias managed long-term services and supports initiative. (b)An OHCDS may not be reimbursed for rendering service coordination services if it contracts with an entity which is listed on the LEIE, EPLS or Medicheck list. (4)A provider shall monitor the provisionally-hired person awaiting a criminal history check through random, direct observation and participant feedback. (4)Compliance with the terms and conditions of service provision as outlined in this chapter. Draft ID: PA.010.05.00 D. Type of Waiver (select only one): 1. (5)The type, scope, amount, duration and frequency of services needed by the participant. (b)A provider which is required to receive a single audit or an audit in accordance with 45 CFR 74.26 shall comply with the audit requirements. C. Type of Request: amendment . 22) (Act 22), unless otherwise noted. States HCBS programs must be approved by the Centers for Medicare and Medicaid Services (CMS) in a process known as a 1915 (c) waiver. WebThe Social Security Act, as amended in 1981, allowed states to create Medicaid Home and Community-Based Services (HCBS) programs that would pay for home-based services for elderly or disabled individuals. Home and Community Home (5)Standards issued by the Public Company Accounting Oversight Board. 908 North Second Street (l)The provider shall retain books, records and documents related to the fiscal year for a time period greater than 5 years from the providers fiscal year-end if one of the following is applicable: (1)The Department, Departments designee or another State or Federal agency has unresolved questions regarding costs or activities. Aging Home Be a U.S. citizen or a qualified Non-citizen, Meet the level of care needs for a Skilled Nursing Facility, Meet financial requirements as determined by the local, Accessibility Adaptations, Equipment, Technology and Medical Supplies, Personal Emergency Response System (PERS), Specialized Medical Equipment and Supplies. At least two face-to-face visits are required per calendar year. Webwell as additional services Medicaid generally does not cover, known as waiver services or home and community-based services. Application for a 1915(c) Home and Community-Based Services Waiver . Medicaid waiver program (c)The provider shall review the complaint system at least quarterly to: (1)Analyze the number of complaints resolved to the participants satisfaction. (d)A service coordinator shall have at least 20 hours of training annually that includes the training topics under subsection (c). To leave a comment or question, go toContact Us. (A)Licensed by the Department of Health. Services Aging Waiver - Department of Human Services Home MedicheckA Departmental list identifying providers, individuals and other entities precluded from participation in the Commonwealths MA Program. Home & Community-Based Services The goal of home and community-based services is to allow individuals in need of long-term care and supportive services to remain at home and in their communities without jeopardizing their safety. (2)A provider may not hire a person provisionally if the provider has knowledge that the person would be disqualified for employment under 18 Pa.C.S. Waiver Services Home & Community Based Services - Pennsylvania Department (c)The provider shall submit verification of subsection (b) to the Department upon request. The Elderly & Disabled Home and Community Based Waiver Program: This home and community based waiver program is administered by the Division of Services for Aging and Adults with Physical Disabilities (DSAAPD). Services (j)An SCE or the Departments designee shall review the participant need, participant goal and participant outcome documented on the service plan at least annually with the participant. If the provider uses a general notification for all participants or service providers, a single copy of the notification is acceptable. You may be trying to access this site from a secured browser on the server. Alabamas Community Transition (ACT) Waiver / Personal Choices Program. Subscribe for updates using PaLegis Notifications, Study of Staffing Trends for Home and Community-Based Services. (4)Standards issued by the International Auditing and Assurance Standards Board. Support Service Waivers - Department of Human Services OBRA waiverA Federally-approved 1915(c) waiver under section 1915(c) of the Social Security Act named for the Omnibus Budget and Reconciliation Act of 1981 (Pub. A variety of health and human services can be provided. If an applicant does not have a balance sheet, then an applicant shall submit a copy of the business plan indicating assets, liabilities, and anticipated costs and revenues for the next fiscal year. Waiver (c)When subsection (a) conflicts with Chapters 2380 and 2390 (relating to adult training facilities; and vocational facilities), 6 Pa. Code Chapter 11 (relating to older adult daily living centers) or 28 Pa. Code Chapters 601 and 611 (relating to home health care agencies; and home care agencies and home care registries), subsection (a) is not applicable. Program Title (optional - this title will be used to locate this waiver in the finder): Community Living Waiver. HOME AND COMMUNITY BASED SERVICES (HCBS) Apply for Benefits. Act 150A State-funded program under the Attendant Care Services Act (62 P. S. 30513058). Alternatives to. This section cited in 55 Pa. Code 52.28 (relating to conflict free service coordination). (e)The provider shall submit a copy of the providers complaint system procedures to the Department upon request. OLTL Waiver Amendments and Renewals (d)The Department will not pay an administrative fee or additional cost for a vendor good or service subcontracted by an OHCDS. WebWhat is the PA Medicaid waiver or Community HealthChoices? Notice 2014-7 provides guidance on the federal income tax treatment of certain payments to individual care providers for the care of eligible individuals under a state Medicaid Home and Community-Based Services waiver program described in section 1915(c) of the (b)If additional information is necessary to ensure that services are provided to a participant in the type, scope, amount, duration or frequency as required by the participants service plan, the SCE shall convey the additional information to a provider. PA Waiver Program WebHelp at Home; Community Health Choices L IFE (Living Independence for the Elderly) Who to contact? (g)The Department may perform a financial review of a provider. Financial reviewA review of billing records against provider documentation to ensure services were provided in the type, scope, amount, duration and frequency as required by the participants service plan and to ensure that a billing for a service rendered by a provider is accurate. Through an innovative approach to providing services to people with developmental disabilities, the Louisiana Department of Health is effectively ending the 25-year-old waiting list for specialized home and community-based services. WebWithin broad Federal guidelines, States can develop home and community-based services waivers (HCBS Waivers) to meet the needs of people who prefer to get long This section cited in 55 Pa. Code 52.42 (relating to payment policies); and 55 Pa. Code 52.52 (relating to subcontracting for a vendor good or service). The training shall include at least the following: (1)Conducting a person-centered assessment. (a)To provide service coordination services, a service coordinator shall meet either of the following: (1)Have a bachelors degree including or supplemented by at least 12 college-level credit hours in sociology, social welfare, psychology, gerontology or another behavioral science. WebOriginal Base Waiver Number: PA.0354 Waiver Number:PA.0354.R04.00 Draft ID: PA.002.04.00 D. Type of Waiver (select only one): E. Proposed Effective Date: (mm/dd/yy) Approved Effective Date: 07/01/17 1. (i)If a participant requires more units of service coordination services than provided for in the participants service plan, then the SCE shall submit: (1)A request to increase the number of service coordination units for the participant to the Department. (b)The Department may prohibit a provider from providing new participants with services if the provider violates subsection (a). (h)A provider may not bill for more units of service coordination services for a participant than provided for in the participants service plan. (4)Department-issued policies and procedures. WebA. (C)Aiding in adapting the physical facilities of the individuals home. Autism Program 79 OBRA Waiver 52 Adult Autism Waiver 80 MA 0192 (c)The Department will only pay for a service in accordance with this chapter and Chapters 1101 and 1150 (relating to general provisions; and MA Program payment policies). This chapter specifies the provider qualifications and payment provisions for providers rendering services under the Aging, Attendant Care, COMMCARE, Independence and OBRA Home and Community-Based Service waivers and the Act 150 program. (c)An OHCDS may not be reimbursed for rendering service coordination services if the OHCDS contracts with an entity which employs a person who is listed on the LEIE or EPLS. (r)A provider shall document the participants progress towards outcomes and goals in the Departments designated information system. Home and Community Co nsumer direction is an option that is available to you under the OLTL's Home and Community-Based Waiver Services and ACT 150. (c)If an OHCDS subcontracts with an entity to provide a vendor good or service, the OHCDS shall ensure the entity complies with 52.51(a) (relating to vendor good or service payment). Application for 1915(c) HCBS Waiver: PA.0354.R04.10 - Jul 01, 2021 (as of Nov 22, 2021) Page 1 of 75017507). Meet the financial requirements as determined by your local County Assistance Office. The Community HealthChoices Program is a Medicaid program. WebThe State of Pennsylvania requests approval for a Medicaid home and community-based services (HCBS) waiver under the authority of 1915(c) of the Social Security Act (the Long Term Care Services Webcommunicate with the helpline may call PA Relay Services by dialing 711. HCBSHome and community-based servicesServices offered as part of a Federally-approved MA waiver or Act 150 program.
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