1. Program Definition and Services

Nursing Facility Transition (NFT) Services in Pennsylvania provide short-term support to individuals with physical disabilities, intellectual/developmental disabilities, and chronic conditions residing in institutional settings. The program aims to help maintain individuals with disabilities in the community, averting the need for long-term services and institutional supports. Services include:

• In-Home Personal Care: Individual support in the individual/family home or community (PERS Device Installation, 24/7 Monitoring Services, Emergency Notification, Fall Detection Technology, and Mobile PERS Units)
• Residential Personal Care: Supervision and care in a licensed residential, community-based setting (Device Maintenance, Training and Education, Service Coordination, and Documentation)

2. Regulations

The program is governed by the following regulations:

• 55 Pa. Code Chapter 52 (OLTL Home and Community-Based Services)
• 55 Pa. Code Chapter 6100 (Support for Individuals with an Intellectual Disability or Autism)
• Federal 1915(c) Home and Community-Based Services (HCBS) waiver regulations
• Olmstead Enforcement and federal Money Follows the Person (MFP) rebalancing initiatives

3. Licensing or Certification

Providers must be certified/qualified by the Pennsylvania Department of Human Services and follow all Home and Community-Based Services (HCBS) requirements.

4. Responsible State Agency

The Department of Human Services (DHS) Office of Long-Term Living (OLTL) and Office of Developmental Programs (ODP) are responsible for reviewing applications and certifying transition service providers.

5. Application Process

The application process is conducted through the electronic PROMISe™ Medicaid Portal and the HCSIS System. Providers must submit forms online to initiate the application process.

6. Required Documentation

While specific documentation requirements vary based on the target waiver, providers typically need to submit:

• Proof of compliance with state safety and operational rules
• Agency-specific policies and procedures
• Staff qualifications and training records
• Proof of general and professional liability insurance

7. Timeline for Approval

The exact timeline for approval fluctuates based on agency capacity. Providers should contact their regional Administrative Entity or managed care plan for detailed information on current processing timeframes, which generally take 2 to 3 months.

8. Pre-Application Process

Prospective providers must complete specific foundation tasks before applying. They must establish their business entity structure with the PA Department of State (PennFile) and secure necessary federal identification numbers, including an IRS EIN and a Type 2 Organizational NPI.

9. Pre-Application Training

The state hosts mandatory administrative and compliance training sessions online. Access details are sent to qualified applicants or made available via state learning management platforms (such as MyODP) once preliminary organizational paperwork is established.

10. Additional Notes

• Providers must ensure that intensive care or community home transition settings meet all state accessibility and environmental safety guidelines.
• In-Home Personal Care and community coordination must be provided directly by the certified agency's employed personnel.
• All direct care staff must conduct mandatory background clearances, including PA State Police and Child Abuse History screenings.
• Providers must maintain detailed records of face-to-face services, housing search evaluations, and relocation expenses for Medicaid documentation and billing verification.

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