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PA Bulletin, Doc. No. 14-2638

NOTICES

Availability of Amendments to the Office of Developmental Programs' Consolidated and Person/Family Directed Support Waivers with Accompanying Home and Community-Based Settings Transition Plans

[44 Pa.B. 7965]
[Saturday, December 20, 2014]

 The Department of Human Services (Department) is making available for public review and comment the Office of Developmental Programs' proposed Consolidated and Person/Family Directed Support (P/FDS) waiver amendments and accompanying transition plans. The purpose of these amendments is to increase the number of unduplicated recipients served in each waiver, increase reserved capacity for the waiting list initiative and unanticipated emergencies, as well as add transition plans for home and community-based settings that are specific to each waiver.

Background

 To receive Federal matching funds for home and community-based waiver services, the Department must receive approval from the Centers for Medicare and Medicaid Services (CMS) for the unduplicated number of participants to be served during each year of the approved waiver. The number of unduplicated participants is estimated for each year of the waivers and, with Federal approval, can be adjusted.

 The budget for Fiscal Year (FY) 2014-2015 provides funding to serve an additional 700 young adults who are graduating from the special education system to continue to live independently in the community through enrollment in the P/FDS waiver. Two changes must be made to the P/FDS waiver to ensure these young adults can be enrolled in the waiver. First, the P/FDS waiver reserves capacity for the ''waiting list initiative'' which ensures that these young adults who are graduating can be enrolled in the waiver. This reserved capacity category is necessary because these graduates do not necessarily meet the enrollment criterion of having an emergency need. As a result, this amendment will increase reserved capacity for the waiting list initiative in Waiver Year 3 (FY 2014-2015) from 0 to 700 to ensure these individuals have access to needed waiver capacity. Second, the maximum number of unduplicated participants the Department intends to serve in the P/FDS waiver must be increased from 12,600 to 13,300 for Waiver Year 3 (FY 2014-2015), Year 4 (FY 2015-2016) and Year 5 (FY 2016-2017).

 The budget for FY 2014-2015 also provides funding to serve an additional 400 individuals who are on the emergency waiting list access to home and community-based services through enrollment in the Consolidated waiver. The unduplicated number of participants served will increase from 17,867 to 18,067 for Waiver Year 3 (FY 2014-2015) and from 17,982 to 18,067 for Waiver Year 4 (FY 2015-2016). This amendment will then decrease reserved capacity for hospital/rehabilitation care for Waiver Year 3 (FY 2014-2015), Year 4 (2015-2016) and Year 5 (FY 2016-2017) from 750 to 550. The Department has found in the first 2 years of implementation of reserved capacity for this purpose that this number is higher than necessary to serve those individuals that require hospital/rehabilitation care beyond 30 days and up to 6 consecutive months. The Consolidated waiver amendment will also increase reserved capacity for individuals/participants who are identified as meeting the unanticipated emergency criteria in Waiver Year 3 (FY 2014-2015) from 20 to 120.

 CMS published a final rule for home and community-based services at 79 FR 2948 (January 16, 2014), with an effective date of March 17, 2014. This final rule amends the Medicaid regulation for home and community-based services waivers under section 1915(c) of the Social Security Act (42 U.S.C.A. § 1396n(c)) to provide requirements regarding characteristics of settings that are home and community-based as well as settings that may not be home and community-based (42 CFR 441.301) (relating to contents of request for a waiver)). The final rule requires that a transition plan be submitted with each waiver amendment. The proposed transition plans for the Consolidated and P/FDS waivers include the steps that the Department anticipates taking to achieve compliance in the following areas: unallowable settings, settings that are presumed not eligible; qualifications for all home and community-based settings; and requirements for provider-owned or controlled home and community-based residential settings.

Fiscal Impact

 It is anticipated that there will be an approximate cost to the Commonwealth, in relationship to the waiver amendments, of $19.818 million ($9.152 million State funds) in FY 2014-2015. These estimated costs are for FY 2014-2015 home and community-based waiver services for the 700 graduates from the special education system and the 400 emergency waiting list individuals.

Public Comment

 The Consolidated waiver amendment and accompanying transition plan are available at http://www.dhs.state.pa.us/learnaboutdhs/waiverinformation/consolidatedwaiverforindividualswithintellectualdisabilities/index.htm. The P/FDS waiver amendment and accompanying transition plan are available at http://www.dhs.state.pa.us/learnaboutDHS/waiverinformation/personfamilydirectedsupportwaiver/index.htm.

 Interested persons are invited to submit written comments regarding the proposed waiver amendments and accompanying transition plans. Comments should be addressed to Julie Mochon, Department of Human Services, Office of Developmental Programs, 625 Forster Street, Room 501, Harrisburg, PA 17120, RA-odpcomment@pa.gov. Comments must be submitted by February 2, 2015.

 The Department will also hold two webinars to receive comments on the proposed transition plans for the Consolidated and P/FDS waivers. Dates, times and links for registration to attend these webinars are as follows:

 January 14, 2015, 1 p.m. to 4 p.m. Register at http://myaccount.maestroconference.com/conference/register/2C0A3EGS75JYS7HW

 January 15, 2015, 9 a.m. to 12 p.m. Register at http:// myaccount.maestroconference.com/conference/register/L8VF3HSLCP25UEK5

 To assist the Department in accurately capturing verbal comments, individuals are asked to submit a written copy of their comments by e-mailing them or mailing them to the addresses previously provided.

 Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

 Copies of this notice, waiver amendments and transition plans may be obtained at the regional Office of Developmental Programs (ODP) 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: Room 430, Willow Oak Building, P. O. Box 2675, DGS Annex Complex, Harrisburg, PA 17105, (717) 772-6507

 Contact information for the local Mental Health/Intellectual Disability County Program or Administrative Entity may be found at https://www.hcsis.state.pa.us/hcsis-ssd/pgm/asp/PRCNT.ASP or contact the previously referenced regional ODP.

BEVERLY D. MACKERETH, 
Secretary

Fiscal Note: 14-NOT-924. (1) General Fund; (2) Implementing Year 2014-15 is $9,152,000; (3) 1st Succeeding Year 2015-16 through 5th Succeeding Year 2019-20 are $22,636,000; (4) 2013-14 Program—$1,027,000,000; 2012-13 Program—$932,000,000; 2011-12 Program—$855,000,000; (7) Intellectual Disabilities—Community Waiver Program; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 14-2638. Filed for public inspection December 19, 2014, 9:00 a.m.]



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