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PA Bulletin, Doc. No. 22-328

NOTICES

DEPARTMENT OF
HUMAN SERVICES

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.

Background

 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 NameStaffing LevelProcedure
Code
Statewide Fee
Day Habilitation >1:6W7063$3.34
<1:6—1:3.5W7064$4.04
<1:3.5—>1:1W7065$6.30
1:1W7066$12.39
Residential HabilitationCommunity HomeLightW7228$153.52
(per day)
LimitedW7229$215.54
(per day)
ExtensiveW7230$281.34
(per day)
IntensiveW7231$546.13
(per day)
Intensive +W7232$644.82
(per day)
Life SharingLowW7052$165.06
(per day)
MediumW7054$200.44
(per day)
HighW7053$235.81
(per day)
Specialized Skill DevelopmentBehavioral Specialist (Plan Development)1:196156$1,750.61
(per unit)
Behavioral Specialist (Consult)1:196171$21.88
Behavioral Specialist (Direct)1:196159$21.88
Systematic Skill Building (Plan Development)1:1W7214$610.82
(per unit)
Systematic Skill Building (Consult)1:1W7216$17.61
Systematic Skill Building (Direct)1:1W7215$17.61
Community Support1:1W7201$11.54
1:2W7204$6.23
1:3W7205$4.46
Small Group Employment< 1:6 to > 1:3.5W0012$3.11
< 1:3.5 to > 1:1W0011$4.55
Supported Employment Intensive Job Coaching (Direct)1:1W7200$18.64
Intensive Job Coaching (Indirect)1:1W7207$18.64
Extended Employment Supports (Direct)1:1W7206$18.64
Extended Employment Supports (Indirect)1:1W7202$18.64
Career PlanningVocational Assessment1:1W7071$18.64
Job Finding1:1W7077$18.64
TherapiesCounseling1:1 T2025$22.38
Speech/Language 1:1T2025$23.56
Nutritional Consultation1:1S9470$17.48
Family Support1:1 without participant present90846$19.49
1:1 with participant present90847$19.49
OtherH0046$19.49
Day unit Respite Licensed Out-of-HomeAll staffing levelsW7211$280.06
(per day)
Unlicensed Out-of-HomeAll staffing levelsW9495$214.64
(per day)
15-minute unit RespiteIn-Home1:1W7213$9.60
Licensed Out-of-HomeAll staffing levelsW7212$7.00
Unlicensed Out-of-HomeAll staffing levelsW9596$5.37
Supports CoordinationPlan Development1:1W7199$1,107.67
(per unit)
Ongoing1:1T2024$23.77
Transportation—TripZone 1W7274$18.83
Zone 2W7275$33.85
Zone 3W7276$50.46
Temporary Supplemental Services1:1W7236$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.

ServiceStaffing Level   Procedure 
Code
Statewide Fee
Licensed Residential Habilitation 
(Community Homes)—Ineligible
All staffing levelsW7233$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, RA-odpautismwaiver@pa.gov.

Fiscal Impact

 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).

MEG SNEAD, 
Acting Secretary

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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