You may have recently heard a webinar entitled “Consolidated and PF/D Waiver Renewals: Preview of Proposed Changes Appendices A-H. If you or a family member get these waiver dollars or are on the list for these Waivers, attention needs to be paid regarding the changes that are coming within the next 2 years. There are many positive changes that will provide supports for those with disabilities to live and work in the community. Also, pay close attention to the emphasis on family as the source of caregiving throughout the life span. Settings, such as group homes and sheltered workshops, will no longer be an option. There is some discussion regarding older individuals who already live in group homes and/or go to sheltered workshops to work every day. There may be a “tiered approach” that will allow them to remain in these settings.
Waiver Renewal Webinars will take place in January instead, as was stated, in November and December. There will be a public comment period after the webinars. This is the time for family members, and individuals to voice any concerns regarding the changes. Go to the Office of Developmental Programs (ODP) http://www.dhs.pa.gov/learnaboutdhs/dhsorganization/officeofdevelopmentalprograms/ to register for the webinars.
As you peruse the changes listed below, consider the following questions. Also, think about how these changes affect you or a loved one and share these concerns during the comment period
- How will these changes be funded? Providers are very concerned about developing a new system and not have enough funds to implement the programs.
- This new model puts a lot of emphasis on keeping the individual with the family if he/she cannot manage on his/her own, even with supports. Is an adult child expected to remain in the home forever?
- Will my son/daughter, who has complex issues (safety issues among them) lose his/her group home living arrangement and sheltered workshop due to these changes?
These are just a few of the highlights:
- Expand eligibility to people with Autism regardless of a co-occurring ID diagnosis
-Expand Autism expertise to all ODP waiver programs
-Standardize and equalize access to all options for all ODP participants
- Expand eligibility to children birth to seven with a developmental delay
–Provide children with developmental disabilities currently residing in ICF/ID facilities or at risk of admission the option to live at home with family
–Provide services and supports not already covered, caregiver training and support, respite care, home adaptations
- Community Participation Supports (replaces prevocational and day habilitation services)
-Flexible wrap-around and support community life secondary to employment as a primary goal
– This service involves participation in integrated community settings, in activities that involve persons without disabilities who are not paid or unpaid caregivers
– Selection & participation in community activities, volunteer activities,
– Assisting individuals with disabilities and family caregivers with providing mutual support to one another (through service/support exchange) and contributing to others in the community
-Service settings: at community locations, no more than 3 people in that community location; at a “community hub” (where individuals will meet and then leave for their community destination)-no more than six participants
– By January 2019, individuals will be spending 75% of their time in community locations or hubs (agreed on place to meet by up to 6 individuals with the intention to leave to go to employment sites)
- Enhance Support for Families/Individuals
-Supported living
-Housing tenancy and tenancy sustaining services
-Family/Unpaid Caregiver Training and Consultation
-Promote Self-Directed Goods & Services
-Assure Effective Communication (Communication Specialist)
- New Services for those with Complex Needs
-Consultative Nutritional Services
-Art, Music, and Equine Therapy
- New Services for Increased Employment and Increased community participation
-Community Participation Supports
-Advanced Supported Employment
-Benefits Counseling
- Enhanced Support for Families
-Expanded respite options-allowable settings, changes in rate structure
-Support Families for the Life Span
-Promote Self-Direction, Choice, and Control
-Promote health, wellness, safety and support people with complex needs
- Expanding Residential Options-Residential Habilitation
-Transition residential services from cost based reimbursement to a needs-based fee schedule
-Include participant rights to lease, visitors, private communication, choosing a roommate, lock on bedroom door, etc.
- Life Sharing
-Can live in own home or home of relative or unrelated individual and receive agency-managed services
-Allows relatives who meet qualification standards to provide services for participants age 18 and older
-Align rates to level of need
- Supported Living
-Provide a cost-efficient residential habilitation option for people with less intense needs
-Paid using a daily, needs based fee schedule rate
-Provides participants with the option of selecting a roommate-to share living costs and staffing resources
- Other changes
– New and enhanced standards for employment-related services
– Management standards for residential settings and supports coordination
– Orientation and training plans
– Waiver Funding: no funds for a setting that isolates or segregates the participant from the community of individuals not receiving waiver services, farmstead, or gated community
- Draft Exceptions and Limitations
– Exception process when medical, mental health or behavioral needs or condition affects one’s ability to participate in the community at the standards specified
– Consolidated Waiver: limit of 14 hours per day of In Home and Community Support, Companion and Community Participation Supports (whether utilized alone or in combination with one another
– There will be exceptions made regarding housing and employment when medical, mental health or behavioral needs or condition affects an individual’s ability to maintain health and safety.