681 Allowable cost reimbursement for non-State intermediate care facilities for persons with intellectual disabilities

DEPARTMENT OF
PUBLIC WELFARE

Allowable Cost Reimbursement for Non-State Intermediate Care Facilities for persons with Intellectual Disabilities

[42 Pa.B. 2110]
[Saturday, April 14, 2012]

 The purpose of this notice is to announce the Department of Public Welfare's (Department) intent to amend 55 Pa. Code Chapter 6211 (relating to allowable cost reimbursement for non-State operated intermediate care facilities for the mentally retarded) regarding provider payment methodologies, rates and terminology. These regulations will apply to non-State operated intermediate care facilities for persons with intellectual disabilities (ICF/ID) providers (previously referred to as ICF/MR providers) rendering services for individuals with intellectual disabilities or other related conditions.

Background

 On July 1, 2011, the General Assembly enacted the act of June 30, 2011 (P. L. 89, No. 22) (Act 22), which amended the Public Welfare Code (code) (62 P. S. §§ 101—1503). Act 22 added several new provisions to the code, including section 403.1 (62 P. S. § 403.1). Section 403.1(a)(4), (c) and (d) of the code authorizes the Department to promulgate final-omitted regulations under section 204(1)(iv) of the Commonwealth Documents Law (CDL)¹ to establish or revise provider payment rates or payment methodologies for particular services. In addition, to ensure that the Department's expenditures for State Fiscal Year (FY) 2011-2012 do not exceed the aggregate amount appropriated by the General Assembly, section 403.1 of the code expressly exempts the regulations from the Regulatory Review Act (71 P. S. §§ 745.1—745.12), section 205 of the CDL (45 P. S. § 1205) and section 204(b) of the Commonwealth Attorneys Act (71 P. S. § 732-204(b)).

 The Department's non-State operated ICF/ID program has approximately 178 ICF/ID service locations and 33 providers in this Commonwealth with a total funding level of $362.666 million in Federal and State funding. To improve cost efficiencies of this program, the Department intends to amend 55 Pa. Code Chapter 6211.

 The following is a summary of the major regulatory amendments contemplated by the Department:

 The Department intends to amend 55 Pa. Code § 6211.16(c)(2) (relating to establishment of standard interim per diem rate). Subsection (c)(2) will provide that the Department may apply a cost of living adjustment during the rate development process and eliminate references to the application of an inflationary factor.

 The Department also intends to amend 55 Pa. Code § 6211.16 by adding a new subsection. Subsection (e) will provide that the Department has the authority to apply a rate adjustment factor (RAF) to the standard interim per diem rate for each provider, including those providers who request a waiver of the standard interim per diem rate as specified in 55 Pa. Code § 6211.31 (relating to request for waiver). The ability to apply a RAF will maintain fiscal stability and ensure the Department's expenditures do not exceed the aggregate amount appropriated by the General Assembly.

 The Department intends to amend the deadline under 55 Pa. Code § 6211.31. The Department intends to amend the regulation to provide for an October 31st deadline to submit a request for waiver in place of the March 1st deadline. The request for waiver shall be submitted to the Department in writing by October 31 of the fiscal year for which the waiver is being requested. This amendment adjusts the regulations to current program practice.

 The Department intends to amend 55 Pa. Code § 6211.31 to clarify that for a provider with less than a 12-month cost report who fails to submit a request for waiver of the standard interim per diem rate will be provided a rate established under 55 Pa. Code § 6211.15 (relating to failure to submit cost report).

 The Department also intends to delete references to the language ''mental retardation'' and replace this outdated language with ''persons with intellectual disabilities.'' The Department also intends to replace the references to the ''Office of Mental Retardation'' with ''the Department.''

Fiscal Impact

 The Department does not anticipate savings or costs. Implementation of a rate adjustment factor ensures that the Department's expenditures do not exceed the aggregate amount appropriated by the General Assembly.

Public Comment

 Copies of this notice may be obtained at the local Mental Health/Intellectual Disabilities (MH/ID) County Program or regional Office of Developmental Programs (ODP) in the corresponding regions:

 • Western region: Piatt Place, Room 4900, 301 5th Avenue, Pittsburgh, PA 15222, [phone]

 • Northeast region: Room 315, Scranton State Office Building, 100 Lackawanna Avenue, Scranton, PA 18503, [phone]

 • Southeast region: 801 Market Street, Suite 5071, Philadelphia, PA 19107, [phone] or [phone]

 • Central region: Room 430, Willow Oak Building, P. O. Box 2675, DGS Annex Complex, Harrisburg, PA 17105, [phone]

 Contact information for the local MH/ID County Program may be accessed at https://www.hcsis.state.pa.us/hcsis-ssd/pgm/asp/PRCNT. ASP or contact the previously referenced regional ODP.

 Interested persons are invited to submit written comments for these changes to the Department within 15 days from the date of publication of this notice by sending an e-mail to ODP's rate-setting mailbox at [e-mail], use subject header ''PN 6211 ICF/ID; provider rates'' or send postal mail to the Department of Public Welfare, Office of Developmental Programs, Division of Policy, 5th Floor, Health and Welfare Building, Forster and Commonwealth Avenues, Harrisburg, PA 17120.

 Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at [phone] (TDD users) or [phone] (voice users).

GARY D. ALEXANDER, 
Secretary

 Fiscal Note: 14-NOT-752. No fiscal impact; (8) recommends adoption.

[Pa.B. Doc. No. 12-681. Filed for public inspection Arpil 13, 2012, 9:00 a.m.]

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¹  The act of July 31, 1968 (P. L. 769, No. 240) (45 P. S. § 1204(1)(iv)). Section 204(1)(iv) of the CDL authorizes an agency to omit or modify notice of proposed rulemaking when a regulation relates to Commonwealth grants and benefits. The Medical Assistance program is a Commonwealth grant program through which eligible recipients receive coverage of certain health care benefits.