By Patrick DeMico
Today, the Pennsylvania Office of Developmental Programs (ODP) released its proposed rates for fiscal year 2017/18. Beginning January 1, 2018 and for the first time, all community residential services will be reimbursed from a fee schedule. This a significant departure in methodology from provider-specific cost based rates, which have funded community residential services for nine years.
Equally significant is that ODP has abandoned its geographic area methodology, which previously established rate differentials for services in different regions of the Commonwealth. A two-area methodology (reduced from three areas) had been proposed earlier this year; however, ODP ultimately determined that service providers should be reimbursed equitably across the state for all services. This will likely benefit more consumers of service with intellectual disability (ID), and the Direct Support Professionals (DSPs) who serve the vital roles as caregivers across the ID system. Statewide rates provide a mechanism for Pennsylvania to more effectively address DSP wages through increases appropriated to services.
The previously proposed area designation differential would have been 11% between the two proposed areas; however, based upon population and expected claims the statewide rate formula resulted in rates approximately 7% above the previously proposed base rate for all providers. Other rate adjustments have clearly been factored into changes processed by ODP, so it is essential that service providers carefully examine the proposed fee schedule for the specific impact on their organizations.