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Oct 24
Add-On Incentivizes Training, Longevity

Read newest guidance memo from March 16, 2018, here.

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*Updated with correction Nov. 1, 2017

Incentivizing direct care staff longevity and rewarding efforts to complete professional training is one way that the Ohio Department of Developmental Disabilities is responding to the needs voiced by stakeholders to address a shortage of direct service providers felt across the state.

This employee-driven incentive focuses on minimizing additional administrative requirements for agency providers while empowering direct service providers to advance professional goals.

The department will propose the add-on rate to the the Centers for Medicare and Medicaid Services (CMS) April 1, 2018. If approved, the proposed effective date for this add-on rate would be July 1, 2018. Upon approval, the add-on rate may be submitted for all units of homemaker/personal care (HPC) services delivered by direct service providers meeting the criteria specified below. The cost of the add-on will not be attributed to the person's Ohio Developmental Disability Profile (ODDP) range or waiver budget limitation.

Subject to CMS approval, independent providers and agency direct support staff, interested in obtaining the add-on rate must meet all of the following conditions in order to be eligible for the proposed add-on rate

  • Two years of experience in providing direct support to people with developmental disabilities, and


  • Completion of 60 hours of applicable training


  • For providers of HPC services, not including self-directed HPC services

 

Proposed implementation, subject to additional guidance and CMS approval

 

Direct service providers, both independent and agency staff, who have two years of experience in providing direct support to people with developmental disabilities, who have also completed 60 hours of training accredited by the National Alliance for Direct Support Professionals (NADSP), will be eligible to access an add-on rate for homemaker/personal care or HPC services, not including self-directed HPC services.

The two years of experience needed for the add-on rate does not have to be consecutive and may be during any period of time.

See a list of curriculum accredited by NADSP.


Upon completion of 60 hours of applicable training

Direct service providers will track the hours of applicable training they have completed.

Direct service providers working as employees of a provider agency will provide their employer with certificates as proof of successfully completed training once they have completed 60 hours of applicable training.

  • The employer will review a transcript of completed courses or course certificates and verify two years of work experience, after which the employer can bill for that direct care provider's hours of HPC using a billing code that will reimburse the provider at a higher rate.


  • Agency providers will be required to maintain verification of each direct service provider's related experience and training for whom the add-on is billed.

 

Once they have completed 60 hours of applicable training, independent providers will be required to submit evidence of related experience and training to the department's provider certification unit.

  • The department will review a transcript of completed courses or course certificates and verify two years of work experience, after which the provider can bill their hours of HPC using a billing code that will reimburse them at a higher rate.

No re-certification is required to maintain the add-on rate. Once obtained, the provider remains eligible indefinitely.

 

Training applicable toward 60 hours needed for the add-on

 

Those who have successfully completed the DS PATHS Certificate of Initial Proficiency or certificate of Advanced Proficiency are immediately eligible for the proposed add-on rate once effective.*

All NADSP-accredited training taken within the past five years can be applied toward the 60 hours needed for the add-on rate.

The department will have some courses listed as a mandatory part of the 60-hour add-on, available in later guidance. However, these will not be a majority of the total 60 hours. 

The 60 hours of training applicable for the add-on rate must include the following characteristics:

Courses must be curriculum accredited by NADSP, including

Courses must be competency-based, defined as

  • Online modules with learner testing


  • In-person training with pre- and post- evaluations or post-testing or portfolio work

Courses must offer a certificate for courses successfully completed

  • That is continuously available for re-print, re-download, or re-issuance to the learner


  • That includes name of the learner, course title, completion date, hours of training completed, and passing grade

Courses must be completed after Jan. 1, 2012, that fall within the past five consecutive calendar years from the date the last course was completed.

For example
I have some NADSP-accredited training I've completed in the past through Relias, PATHS, or through my agency        I have completed the Ohio DS PATHS Certificate of Initial Proficiency (60 hours plus a portfolio)I completed the Ohio DS PATHS Certificate of Advanced Proficiency (another 60 hours plus a portfolio)

Total the NADSP-accredited training taken within the past five calendar years

 

Complete the remaining hours needed of NADSP-accredited curriculum to reach the 60 hours needed for the add-on rate

Immediately eligible for the add-on rate once effective*Immediately eligible for the add-on rate once effective*

 

Courses that are not applicable toward 60 hours of training for the add-on rate include

  • Courses that are not NADSP-accredited curriculum


  • Courses completed prior to Jan. 1, 2012


  • Any courses that were a part of the provider's eight-hour initial direct support provider training


  • Any courses that are taken as to meet annual training requirements


    • The requirements of rule 5123:2-17-02 (MUI)


    • The rights of individuals set forth in sections 5123.62 to 5123.64
    • The role and responsibilities with regard to services, including person-centered planning, community integration, self-determination, and self-advocacy, (5123:2-2-01)

 

Budgeting and billing

 

Additional information will be available upon CMS approval; however, as proposed, the cost of the add-on would not be attributed to the person's ODDP range or waiver budget limitation.

To receive the enhanced rate, providers must submit a procedure code to be developed by the department prior to the proposed effective date, July 1, 2018, for each unit of service delivered by qualified direct service providers.

County boards will continue to project units of HPC but will not project the number of units to which the add-on will apply.

 

Accessing applicable training

 

Training that meets the characteristics outlined above, i.e. NADSP-accredited and competency-based, may be accessed in-person or online.

Web-based courses that are NADSP-accredited and competency-based include courses from DirectCourse College of Direct Support, Relias Learning, or Ohio PATHS. See a list of curriculum accredited by NADSP.

To encourage direct support staff in accessing this increased add-on rate, the department is providing access to an extensive course catalog with more than 60 hours of web-based training applicable for the add-on rate through DirectCourse College of Direct Support at no cost.

Interested direct service providers may access these free online courses beginning Nov. 1.

Courses may be accessed at any time from any computer or mobile device with an internet connection. A link to the available courses through the DirectCourse College of Direct Support the will be available on the department's website at dodd.ohio.gov/training.


(Previous guidance memo regarding add-on available here.)


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