Section 51.14. Residential habilitation service providers

(a) A residential habilitation service provider authorized or identified to provide residential habilitation to a participant shall submit a written request to the Department or the Department’s designee to:

(1) Open a new residential habilitation service location.

(2) Close an existing residential habilitation service location and to establish a new residential habilitation service location.

(3) Combine more than one residential habilitation service location.

(4) Change the approved program capacity of a residential habilitation service location.

(b) To receive prior written approval from the Department or the Department’s designee to open a new residential habilitation service location, to close an existing residential habilitation service location and open a new residential habilitation service location, or to combine residential habilitation service locations, the provider shall submit the following in writing:

(1) A description of the circumstances surrounding the need for the new residential habilitation service location, closure of existing residential habilitation service location and opening a new residential habilitation service location, or to combine residential habilitation service locations.

(2) A description of how the new residential habilitation service location, closure of existing residential habilitation service location and opening a new residential habilitation service location or combining residential habilitation service locations will meet the setting size, staffing patterns, and assessed needs and outcomes of the participants identified to reside in that residential habilitation service location.

(3) A description of the residential habilitation service location including properties surrounding the location.

(i) The provider shall affirm that the property meets the definition of ‘‘integrated and dispersed in the community in noncontiguous locations’’ in § 51.3 (relating to definitions).

(ii) The property may not be located on a campus setting.

(iii) The property must be surrounded by individuals and businesses that are not funded through the ODP.

(c) A provider licensed under Chapters 3800, 5310, 6400 and 6500 shall receive prior authorization to provide residential habilitation enhanced staffing through the use of supplemental habilitation or additional individualized staffing due to a change in the participant’s needs.

(1) The provider shall initiate the prior authorization request process by completing the provider portion of the supplemental habilitation and additional individualized staffing checklist or any approved revisions which can be found on the Department’s web site.

(2) A provider who renders residential habilitation enhanced staffing through supplemental habilitation or additional individualized staffing without authorization longer than 30 days from the date the Department receives the request will not receive payment.

(d) A residential habilitation service provider that does not comply with subsections (a)—(c) will not receive payment until Department approval is obtained.

(e) A residential habilitation service provider shall ensure staff providing the residential habilitation service to a participant meets the staff qualifications included in the approved applicable waiver, including approved waiver amendments.

(f) A residential habilitation provider shall participate in the 6-month review of the residential habilitation service the provider renders under § 51.28(h) (relating to SCO requirements for Consolidated and P/FDS Waiver).

(g) This section does not apply to a provider of HCBS in the Adult Autism Waiver and an SSW provider.

The provisions of this § 51.14(a) and (b) effective July 1, 2012, 43 Pa.B. 588. Immediately preceding text appears at serial pages (361280) to (361281).