ODP Communication
UPDATING PROVIDER AND AE CONTACT INFORMATION
FOR PROVIDER MONITORING FISCAL YEAR 2016-2017
ODP Communication Number: Announcement 056-16
The mission of the Office of Developmental Programs is to support Pennsylvanians with developmental disabilities to
achieve greater independence, choice and opportunity in their lives.
ODP’s Everyday Lives Conference - September 14-16, 2016 - Hershey, PA- Registration Now Open
AUDIENCE: Providers of Consolidated and Person/Family Directed Support (P/FDS) Waiver
services including direct vendors and Administrative Entities (AEs)
PURPOSE:
This Office of Developmental Programs (ODP) Announcement is intended to instruct
Providers and AEs to confirm, update and/or submit their provider monitoring contact
information to the Office of Developmental Programs (ODP).
DISCUSSION:
Direct providers of Consolidated and P/FDS Waiver services are required to keep ODP informed
regarding their current primary and secondary contact person for Provider Monitoring. The
primary contact person is the individual who the entity has assigned to receive the unique
electronic Provider Monitoring link from ODP which is utilized to submit the agency’s Provider
Monitoring Self- Assessment during the Self-Reporting phase. The identified primary and
secondary contact persons will receive information related to provider monitoring electronically
from ODP. The primary contact person may also receive ongoing directions and communications
from ODP and the AE regarding Provider Monitoring.
AEs are also required to inform ODP regarding their assigned primary and secondary contact
person for Provider Monitoring. The primary person will be the individual who will receive the
electronic Provider Monitoring link from ODP which is utilized in submitting the on-site review
results of each assigned provider. This person will also receive ongoing directions, communications
and information from ODP regarding Provider Monitoring.
ISSUE DATE 8/22/16
ODP Announcement 056-16
Page 1
In the previous Fiscal Years (FY), ODP has noted that; providers and AEs who have not updated the
ODP Provider Monitoring Contact information as requested have experienced difficulties in
complying with ODP requirements.
ODP directs all providers of Consolidated Waiver and P/FDS Waiver services to check that their
identified Provider Monitoring primary and secondary contact persons and corresponding email
addresses are present and correct on the “Listing of Registered Provider Contacts” document that
can be found on the ODP Provider Information Center (PIC) by following this path: ODP Business
Practice Information > Courses > Provider Monitoring > Provider Monitoring Process 2015-16>Topic
1 Provider Monitoring Overview > Resources >. Please note: you must first log into the PIC to
access this information. Once the provider clicks the link, they should receive the following screen:
Providers are able to locate their information statewide or regionally. Clicking on the chosen link
will open the PDF version of the document contact listing. If any of the information listed is
incorrect, please submit the correct information on the Provider Contact Information Form located
at the end of this document and send it to the ODP Provider monitoring mailbox at: raodpprovidermonito@pa.gov identifying the subject line as “Updated Provider Monitoring Contact
(Provider Name)”. A copy of the form should also be emailed to the Lead AE. This task must be
completed by close of business September 12, 2016.
ODP also instructs all AEs to review the “AE Listing of AE Monitoring Contacts” document found on
the ODP AE Information Center (AEIC) to ensure that all their contact information is correct utilizing
the following path: ODP Business Practice Information >Provider Monitoring > Provider Monitoring
Process for 2015-16> Topic 1 Provider Monitoring Overview > Resources >. If any of the
information listed is incorrect, please submit the correct information to the ODP Provider
ISSUE DATE: 8/22/2016
ODP Announcement 056-16
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Monitoring mailbox at: ra-odpprovidermonito@pa.gov with the subject line “Updated AE Provider
Monitoring Contact (AE Name).”
If you have any questions about anything discussed in this communication, please e-mail the ODP
Provider Monitoring mailbox at: ra-odpprovidermonito@pa.gov.
Obsolete Documents:
This Informational Memo obsoletes Informational Memo 071-15.
ISSUE DATE: 8/22/2016
ODP Announcement 056-16
page 3 of 4
ODP Provider Monitoring Contact Information Form
Providers must ensure they meet the conditions of the legal agreements set forth by the Office of
Developmental Programs (ODP). The following information is being collected in order to ensure
that ODP communications related to provider monitoring activities are sent to the appropriate
persons. This form should be completed in its entirety and sent to the ODP Provider Monitoring
Mailbox at ra-odpprovidermonito@pa.gov.
Note: If you are an existing provider that wishes to update their contact information, please mark
the appropriate space next to “Update.” If you are a new provider, please mark the appropriate
space next to “New Provider.” If you are a provider of transportation services only or a provider of
vendor services only, please mark the appropriate space.
____ Update
____ New Provider
____ Transportation Only
____ Vendor Only
Primary Region:
Lead AE:
MPI Number:
Legal (IRS) Provider Organization Name:
Chief Executive Officer/Director:
CEO/Director Mailing Address:
CEO/Director Email:
CEO/Director Phone Number:
Primary Contact First Name:
Primary Contact Last Name:
Primary Contact Mailing Address:
Primary Contact Email:
Primary Contact Phone Number:
Secondary Contact First Name:
Secondary Contact Last Name:
Secondary Contact Mailing Address:
Secondary Contact Email:
Secondary Contact Phone Number:
ISSUE DATE: 8/22/2016
ODP Announcement 056-16
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