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PA Bulletin, Doc. No. 16-2086



Availability of the Renewals of the Office of Developmental Programs' Consolidated and Person/Family Directed Support Waivers

[46 Pa.B. 7600]
[Saturday, December 3, 2016]

 The Department of Human Services (Department) is making available for public review and comment, Appendices A—H of the Office of Developmental Programs' proposed renewals of the Consolidated and Person/Family Directed Support (P/FDS) Waivers.


 Home 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 Consolidated and P/FDS 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. A separate notice will be published announcing the availability of Appendices I and J for public comment upon completion of the rate setting process.

 In the request for renewal of the Consolidated and P/FDS Waivers, the Department proposes the following substantive changes to Appendices A through H effective July 1, 2017:

 • Include in the target group the following:

 o People with a diagnosis of autism who do not have an intellectual disability.

 o Children under 8 years of age who have a developmental disability with a high probability of resulting in an intellectual disability or autism.

 o Children under 3 years of age with an intellectual disability.

 • Add reserved capacity in the Consolidated Waiver for individuals who are no longer in the custody of the Office of Children, Youth and Families, individuals who are no longer eligible for the Early Periodic Screening, Diagnostic and Treatment benefit through Medical Assistance, and individuals who are discharged from residential treatment facilities or State hospitals, or released from prison.

 • Modify the process for annual recertification of level of care criteria.

 The Department is also proposing the addition of new services and revisions to existing services to ensure compliance with CMS' Home and Community-Based Services (HCBS) Final Rule (see 79 FR 2948 (January 16, 2014)) to promote employment in alignment with Governor Wolf's Executive Order 2016-03—Establishing ''Employment First'' Policy—to increase residential service options that provide support in private homes and defray enrollment into licensed residential programs, and to adopt recommendations from the Department's vision of Everyday Lives that sustain families and promote community integration.

 The Department proposes additional changes to augment participant-centered service planning and delivery and participant-direction of services and strengthen participant rights and safeguards. Moreover, the Department proposes revisions to the quality improvement strategy to align with CMS requirements, enhance stakeholder participation and simplify reporting requirements. These changes include the following:

 • Align participant-centered service planning and delivery with CMS' HCBS Final Rule and clarify expectations related to monitoring of Waiver service delivery.

 • Strengthen enforcement powers to apply progressive sanctions to underperforming common law and managing employers.

 • Specify when the Department's fair hearing and appeals process is not available.

 • Strengthen safeguards to ensure participant rights, including refinement of critical incident protocols, oversight of medication administration and oversight of restrictive interventions.

 • Revise the quality oversight and reporting process to align with the new CMS Quality Strategy and streamline performance measures.

 The proposed documents regarding the renewals of the Consolidated and P/FDS Waivers are available at

Fiscal Impact

 It is anticipated that there will be an additional cost of approximately $19.4 million ($9.347 million in State funds) to the Commonwealth in Fiscal Year 2017-2018 and $31 million ($14.936 million in State funds) in subsequent years.

Public Comment

 Interested persons are invited to submit written comments regarding the proposed renewals of the Waivers. Comments should be addressed to Julie Mochon, Depart-ment of Human Services, Office of Developmental Programs, 625 Forster Street, Room 501, Harrisburg, PA 17120. Comments may also be submitted to the Department at Comments received within 45 days of publication of this notice will be reviewed and considered for revisions to the proposed renewals of the Waivers.

 The Department will also hold three webinars to receive comments on the proposed renewals of the Consolidated and P/FDS Waivers. The dates, times and registration link to participate in these webinars are as follows:

 January 12, 2017
1 p.m. to 4 p.m.

 January 13, 2017
9 a.m. to 12 p.m.

 January 17, 2017
1 p.m. to 4 p.m.

 The following link must be used to register for any of the previously listed webinars: Participants are able to participate in the webinar by phone, but will need a computer to provide comments during the webinar. 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 to mail to the address previously provided.

 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 following toll free numbers:

 (800) 654-5984 (TDD users)
(800) 654-5988 (voice users)
(844) 308-9292 (Speech-to-Speech)
(844) 308-9291 (Spanish)

 Copies of this notice and the proposed renewals of the Waivers may be obtained at the 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: Room 430, Willow Oak Building, P.O. Box 2675, DGS Annex Complex, Harrisburg, PA 17105, (717) 772-6507


Fiscal Note: 14-NOT-1076. (1) General Fund; (2) Implementing Year 2016-17 is $0; (3) 1st Succeeding Year 2017-18 is $9,347,000; 2nd Succeeding Year 2018-19 through 5th Succeeding Year 2021-22 are $14,936,000; (4) 2015-16 Program—$1,202,000,000 2014-15 Program—$1,074,000,000; 2013-14 Program—$1,026,000,000 (7) In-tellectual Disabilities—Community Waiver Program; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 16-2086. Filed for public inspection December 2, 2016, 9:00 a.m.]

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