What System Modifications are Most Urgent

Identify training, authorization, or regulatory issues that should be further modified or addressed during the pandemic. Reminder that during staff redeployment ISP training requirements addressing all health and safety needs for each individual are mandatory.

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  1. Yes, Since all “day programs” are closed, all residential should be authorized “Without Day” ASAP.

  2. We have been having a lot of discussion around if our Residential Staff will be considered Health Care staff and exempt from some of the employer mandates. Is this something Provider Alliance can or is pushing for?

    1. Our intent is to align emergency federal aid available to PA with gaps in our system. Certain provisions of the Families First Coronavirus Response Act would cause further harm. We’re trying to avoid that and I believe this intent is shared by ODP. The FMLA definition of a health care provider is very specific. Whether it be exemption from the law or funding to cover costs, we are seeking relief and will keep membership informed. Please share other thoughts. The Deputy Secretary has scheduled weekly meetings with the ID/A associations and it is important that we have your thoughts and experiences represented there.

      1. At the state level, what are the issues and implications surrounding DSPs and other workers being designated as “essential” ?

      2. Today we received the Employer Rights FFCR poster and the provision applies April 1st. This is a concern for us.

    2. If you aren’t already aware; all home and community based services (Residential) are considered life-sustaining and are able to remain working.


  3. We have reached out to our Insurance Broker to explore the provision of Business Interruption; this would theoretically allow us to file claims for loss of Revenue.

    We were informed that viruses are not covered under Business Interruption; that they are an exclusion to the coverage.


  4. ODP just communicated the Providers shouldn’t make requests to change Residential With and Without Day units.

    ODP will adjust them system wide.


      1. Good Morning Joy,

        No I have not heard of any billing issues. As a matter of face ODP will be suspensing Prudent Pay; meaning payments will be made quicker once billed.


        1. With the suspension of Prudent Pay, does that mean they are going to reimburse what has been held back up till now so we are “caught up” or does that start with whatever is billed as of now?

          1. I don’t believe there is a process to release what is already in the system. Going forward there will be no delay in claims processing. I expect you will see the run-off of claims processed before suspension of prudent pay. Does anyone know otherwise?

          2. It does appear that ODP is paying everything currently processed on April 1. I just checked the remittance reports and claims processed the week ending 3/14/2020 are showing to be paid next week.

          3. Rick Smith at ODP confirms that all providers should have received three weeks of payments yesterday.

  5. Appendix K Operational Guidance is now out and posted to this site. Weekly calls continue between associations and the Deputy on COVID-19 management. Please advise of areas where you have concerns or questions. ODP webinars begin March 25.

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