DHS COVID-19 PROVIDER GUIDANCE // ODP
ODP Announcement 20-055: Reinstatement
of Quality Assessment & Improvement Cycle 1 Year 3 Activities
Issued: May 11, 2020
Audience
Administrative Entities (AEs), Supports Coordination Organizations (SCOs), Supports
Coordinators (SCs), All Direct Service Providers (Waiver and Base Providers), and Other
Interested Parties
Purpose
This Office of Developmental Program (ODP) communication is intended to provide
guidance for the FY 2020-2021 renewal period. The following topical areas will be
addressed in this communication:
- General Guidance –Consideration for COVID-19 Pandemic
- Person/Family Directed Support (P/FDS) and Community Living Waiver
(CLW) Cap Exceptions
- Reminder: Leap Year to Non-Leap Year
- Variance Process for Established Service Requirements
- Consolidated Waiver Fee Schedule Residential Rate Exception
- Resources
Discussion
ODP extends our utmost appreciation and gratitude to all stakeholders who have had to
adjust their work efforts because of the COVID-19 pandemic to ensure individuals’ and
families’ health, safety and support needs are met.
This communication is intended to provide guidance to all stakeholders who participate
in the FY renewal Individual Support Plan (ISP) process. While ODP has not added any
new services that will impact the 2020-2021 FY renewal ISP, it is anticipated that the
COVID-19 pandemic will continue to influence FY 2020-2021 services.
Please note that ODP will not be performing a one-time automated creation of 2020-
2021 FY Renewal plans.
General Guidance
It is unknown at this time when the impacts of the COVID-19 pandemic will cease. To
ensure adequate planning to meet the anticipated needs of individuals during FY 2020-
2021, all stakeholders involved in the planning process should assume, at a minimum,
that an individual’s level of need will continue to be the same in FY 2020-2021. The
2020-2021 FY renewal ISP should reflect the individual’s level of need as it exists today
as a result of the COVID-19 pandemic. As conditions and needs change during FY 2020-
2021, the individual’s needs should be discussed and evaluated during ISP Team
meetings and the individual’s ISP should be revised to accurately reflect the individual’s
needs. Teams should expect to meet, as needed, to address the impact of restrictions
that were imposed as a result of the COVID-19 pandemic being lifted and changes in the
individual’s supports needs as a result. Meetings may need to occur that are outside the
normal annual meeting.
Guidance to Address Shifts in Services and Service Levels Due to COVID-19 Pandemic
ODP recognizes that the COVID-19 pandemic has caused community-based service
delivery to shift to alternative approaches and supports, such as using a remote option
for the provision of services. Fiscal year 2020-2021 ISPs should reflect services,
utilization levels and time frames that most accurately reflect and will meet the
individual’s anticipated needs.
ISP teams should reference ODP’s Transition Guidance Toolkit and probe guidance in the
annotated ISP to assess risk related to the COVID-19 pandemic and determine for each
individual what services and supports are needed for the individual to be able to safely
resume activities or engage in new activities. All conditions outlined in Appendix K of the
Intellectual Disabilities/Autism Waivers Operational Guidance (version 1.0) continue to
apply.
Guidance to Drafting FY 2020-2021 Renewal Plans
When creating draft FY renewal ISPs, the Home and Community Services Information
System (HCSIS) is designed to copy the exact information specified on the existing
approved FY 2019-2020 ISP into FY 2020-2021 renewal ISP. This includes all partial year
FY 2019-2020 service segments, units, and Service Start Date and Service End Date. As a
result, there will be instances where because services are provided as a result of the COVID-19 pandemic, plan revisions are needed to the 2020-2021 FY Renewal service
lines. In these cases, the Service Start and End Date will require adjustment to reflect
the number of days found in the COVID-19 FY 2019-2020 service lines. Where services
are provided as a result of the COVID-19 pandemic, the SCO and AE should ensure the
ISP Service End Date reflects the same duration as the FY 2019-2020 service line. See the
following chart for different Start and End Dates that may be in the FY 2019-2020 ISP
and the Start and End Dates associated with the same duration for the 2020-2021 FY
renewal ISP.
FY 2019-2020 COVID-19 Service Start Date
| FY 2019-2020
COVID-19 Service
End Date
| FY 2019-2020
COVID-19 Service
Number of Days
| FY 2020-2021
COVID-19 Service
Start Date
| FY 2020-2021
COVID-19 Service
End Date
| FY 2020-2021
COVID-19 Service Number of Days
|
3-12-2020 | 6-30-2020
| 110
| 7-1-2020
| 10-18-2020
| 110
|
3-15-2020
| 6-30-2020
| 107
| 7-1-2020
| 10-15-2020
| 107
|
3-17-2020
| 6-30-2020
| 105
| 7-1-2020
| 10-13-2020 | 105
|
Person/Family Directed Support Waiver (P/FDS) and Community Living Waiver (CLW) Cap Exceptions
ODP will not be approving any new P/FDS or CLW cap exceptions unless services, as a
result of the COVID-19 pandemic, are extended beyond current expectations.
Individuals approved for a P/FDS or CLW cap exception in FY 2019-2020 will continue to
be exempt from the cap in FY 2020-2021 due to the COVID-19 pandemic. For individuals
currently not approved for a cap exception and whose anticipated needs are expected
to exceed the P/FDS or CLW cap in FY 2020-2021, due to the COVID-19 pandemic, refer
to Appendix K of the Intellectual Disabilities/Autism Waivers Operational Guidance
(version 1.0) and the ODP message issued via the AE Listserv on Wed 4/29/2020 at
12:19 PM.
Due to the auto authorization functionality within HCSIS, SCs should mark ISPs for
manual review for FY 2020-2021 ISPs approved for an individual cap exception. AEs will
conduct manual reviews of ISPs to ensure that the approved cap is not exceeded. AEs
will need to manually approve and authorize the ISPs with approved exceptions to
ensure the content and services are aligned with the COVID-19 Appendix K Operational
Guidance in ODP communication 20-027. AEs should identify and report to their designated ODP Regional Office any individual for whom an individual exception is no
longer needed.
It is ODP’s expectation that ongoing planning efforts to transition individuals to the CLW
continue for individuals who are approved for a P/FDS cap exception prior to the COVID19 pandemic. After the FY renewal period, ODP intends to request updates from
applicable parties on transition efforts. A future ODP communication will outline AE
reporting requirements to support ODP assessment of transition efforts.
Cap exception questions should be directed to your ODP Regional Program Office.
Leap Year to Non-Leap Year
Since FY 2019-2020 was a leap year with 366 days, FY 2020-2021 ISPs must be adjusted
to ensure the units and dollar amounts reflect a 365-day fiscal year period versus a 366-
day fiscal year period, where applicable.
Variance Process for Established Service Requirements
- Ongoing variances for services that are not as a result of the COVID-19 pandemic
should continue to be submitted based on annual dates.
- A provider should not render services and supports that are not as a result of the
COVID-19 pandemic beyond the applicable waiver requirement without first
receiving approval as stipulated in ODP Bulletin 00-18-06.
- Variance requests for services provided to an individual as a result of the COVID19 pandemic are not required as stipulated in the Appendix K Operational Guide.
- Variance approvals that are not as result of the COVID-19 pandemic that overlap
into FY 2020-2021 (i.e. Intensive Staff Support), require a new approval when the
current approval expires.
- Service, service units and service date segments on the FY renewal ISPs should
accurately reflect approved units and approved variance timeframes.
- For more information regarding the Variance process and form, see ODP Bulletin
00-18-06, titled “Process to Request a Variance in Waiver Programs.”
Consolidated Waiver Fee Schedule Residential Rate Exemption
ODP will carry forward all approved Needs Exception Allowances from FY 2019-2020 to
FY 2020-2021.
Resources
- For information related to special considerations, please contact the ODP Regional
Program Office assigned to your region.
- For questions related to the participant-directed services rate table or calculator, please
e-mail the ODP, Division of Provider Assistance and Rate Setting mailbox: raratesetting@pa.gov
- For instructions on how to perform a FY renewal ISP