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Feb 22
CMS Approves HCBS Waiver Amendments

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The Centers for Medicare and Medicaid Services (CMS) approved the amendments to the Level One, Self-Empowered Life Funding (SELF), and Individual Options (IO) Waivers this week.  

The changes will be effective April 1, 2017 and include the following:

  • New adult day waiver services were added to all waivers, including Career Planning, Individual Employment Supports, and Group Employment Supports.
  • Changes were made to the Adult Day Supports and Vocational Habilitation services in all waivers to include new service definitions and the availability of rate modifications when certain criteria are met.
  • Budget limitations for adult day waiver services and Non-Medical Transportation services were increased within all waivers.
  • A new Money Management service was added to the IO and Level One Waivers.
  • Changes were made to the SELF Waiver that including changing the billable units for Community Inclusion – Personal Assistance from hourly units to 15-minute units, allowing this service to be billed at ratios for people who share services with others, and eliminating the $25,000 sub-cap for adults enrolled in SELF.


See the  waiver amendments or read the approval letters from CMS. 

See more about Ohio's State Transition Plan.

Feb 22
Notification of Change in Process for ICF evaluators

ICF/DC Consent Information

Process Change effective  2/24/17

To:            ICF Directors, ICF Evaluator Staff, DC Superintendents, DC Evaulator Staff

From:       Matt Turner, MHA4

Date:         February 22, 2017

Subject:   Notification of Change in Process for ICF evaluators

The process for processing a consent has been updated.  The full memo is at the below link. 

 For full details please click to open notice

 

Feb 22
OH-0877
Feb 22
OH-0380
Feb 22
OH-0231
Feb 22
Pipeline Feb/22/2017 (Budget Creates Additional Waivers, Increases Options, Overtime Rule to be Refiled, Public Notice: TDD Amendment Changes, Regional Sessions for ICF Reimbursement)

NEW Format.Header 2017

Pipeline Weekly                                                           February 22, 2017  

Budget Creates Additional Waivers, Increases Options

In testimony before the House Finance Committee, Director Martin shared Executive Budget recommendations for state fiscal years 2018 and 2019, including new state-funded waivers targeted to support people interested in moving out of a facility and those on a waiting list.  

Watch

Man and woman going over a receipt.

Overtime Rule to be Refiled

Rule 5123:2-9-03 places a limit on the number of hours an independent provider may provide home and community based services in a work week and establishes exceptions to the limit. 

Based on feedback offered by stakeholders, the department is designating the rule “to be refiled”, affording time for additional dialogue with people participating in waiver services and their families. 

More

Public Notice: TDD Amendment Changes

This amendment reflects the final step in a multiple year effort to enroll people who received services under the Transitions DD waiver in alternative Ohio DD waivers that meet their health, safety and welfare needs.

More

Regional Sessions for ICF Reimbursement

In March, DODD will host regional sessions addressing proposed changes in the upcoming state budget that would modernize an aging intermediate care facility (ICF) reimbursement system. Presentations will detail background on current recommendations and a time frame for implementation. 

More

This Week @DODD

 Training & Tools

MyLearning Training, Webinars

If you have username and password for any DODD online application, you have access to training at DODD MyLearning. The list of training available will continue to grow and already includes Internal Compliance, Community Integration, and Money Management.  

HCBS Updates

Don't Forget Our February BBT 

February's Brown Bag Thursday features Stacy Collins and members of the Medicaid and billing teams discussing the redesign of Adult Day Services. 

  Health & Welfare 

How to Report Abuse 

Scott Phillips from the MUI Registry Unit at DODD discusses abuse of people with disabilities in Ohio, the importance of reporting abuse, and why cases of abuse often go unreported.

 

 

Employment First 

DODD Live Chats on HCBS

Live Chats on the proposed HCBS/Adult Day waiver modification will be held on February 22 and March 3 to help answer any questions about the upcoming implementation.

Like Pipeline Weekly? Check out Family Connections.

Feb 21
Rule 5123:2-9-03 hearing

On February 9, the Department conducted a public hearing on proposed new administrative rule 5123:2-9-03 (Limit on Number of Hours an Independent Provider May Provide Home and Community-Based Services in a Work Week). The rule was developed in response to the U.S. Department of Labor Home Care Final Rule which applies minimum wage and overtime protections to domestic service workers, including those who provide services to individuals enrolled in Medicaid Home and Community-Based Services (HCBS) waivers administered by the Department. 

 

Rule 5123:2-9-03 places a limit on the number of hours an Independent Provider may provide HCBS in a work week and establishes a process and the circumstances under with the limit may be exceeded.  Based on feedback offered by stakeholders, the Department is designating the rule "to be refiled" to afford time for additional dialogue with individuals and families who receive HCBS.

Feb 17
ICF/DCs Helpful Hints Related to DODD Imagine Portal

Date:      February 17, 2017

Subject: Helpful Hints

The purpose of this communication is to provide guidance for ICF/DCs related to the DODD Imagine portal for completing level of care work and transitioning individuals from ICF/DCs to waivers. 

  • All ICFs and DCs must review your current census to ensure you have the correct individuals listed for your facilities. If past individuals are listed that are deceased or no longer reside there, a discharge NICS must be submitted to remove that individual’s association with that facility.  After completing the discharge NICS, email the name of individuals, date of discharge, and reason to LOC@dodd.ohio.gov  
  • ICF/DCs, as the evaluator in the DODD portal, can no longer create a notification of individual’s change of status (NICS) admission request from the main NICS tab.  The consent process (directions on pages 32-39 of the ICF LOC user guide. Page 40 is not applicable) must be completed to give read access to the facility for the individual’s record.  Read access then allows the evaluator to review the individual’s level of care and submit a NICS admission request if applicable.
  • Redeterminations:
  • ICFs and DCs must assure level of care redeterminations are completed every twelve (12) months and when the individual has a significant change of condition. 
  • All LOCs can be submitted to DODD through the redetermination tab on the ICF evaluator’s dashboard.  An individual’s redetermination will be populated on the ICF redetermination tab 90 days from the LOC end date.
  • The ICF evaluator will receive an alert fifteen (15) day prior to the LOC end date.   If the redetermination is not completed before the last date of the LOC, a new LOC assessment including a clinician’s verification form (CVF) must be completed. 
  • The effective date for the new LOC will be based upon the date of receipt of a completed LOC assessment packet to DODD.
  • If the redetermination is not completed in a timely manner, a gap in LOC will result in a gap of payment for the institution.

Key information to remember when transitioning a person between ICF and waiver services:

  • Boards and ICF/DCs MUST collaborate on a proposed waiver enrollment start date.  Once a date has been determined, it is imperative that both the County Board and ICF/DC submit the applicable NICS no less than 30 days from the requested waiver start date.  However, the NICS can be submitted up to 90 days prior to the waiver start date.  If the proposed waiver start date must be changed, DO NOT submit a different NICS.  Immediately notify LOC@dodd.ohio.gov and request that the assistance.  DODD reviewers can make changes in the system if the waiver start date has not already passed.  Please be aware that it is necessary to follow the above timelines and process to assure there is no delay in enrollment.
  • The board must review and attest to the current LOC.  If the County Board is unable to see the ICF LOC or is not the reporting County for that individual’s record, then they must complete an individual transfer record request (ITR).  Once the board can attest to the LOC, the board must submit the ICF/DC to Waiver NICS. In the event the board chooses not to attest to the current LOC, the board must complete a full, initial LOC assessment which includes the CVF. 
  • If the board has not had the opportunity to complete the full LOC assessment which includes the CVF, after the ICF/DC to waiver NICS is processed by DODD, and the waiver is enrolled, the board can choose complete the Change of Condition rather than waiting until the following year at redetermination time.
  • DO NOT wait until the planned waiver enrollment date to complete the ICF to waiver NICS.  This ONLY holds up the waiver enrollment process.  If there is a gap between the date of discharge from the ICF and the proposed date of enrollment, then this may interrupt services to the individual. 
  • ICF/DCs must complete a Discharge NICS in a timely manner.  The discharge NICS should be submitted as soon as the date has been agreed upon by the ICF and board.  DO NOT wait until the actual date of discharge to submit the discharge NICS.  

 

Moving an individual’s LOC (either from an ICF to a Waiver or a Waiver to an ICF or ICF to ICF) requires planned, ongoing coordination from both the parties to ensure that there is no gap in services. All questions related to LOC should be submitted to LOC@dodd.ohio.gov
Feb 16
Changes to DODD portal and usage of for 9401

Changes to DODD portal and usage of form 9401


To:          ICF Directors, DC Superintendents, CB Superintendents, COG Directors

From:     Amy Coey

Date:      February 16, 2017

 

Subject: Changes to DODD portal and usage of form 9401


The purpose of this communication is to provide information about the new level of care letter function in the DODD portal and notify ICF/DCs about the usage of ODM form 9401

As a new function to the DODD portal, ICF/DCs will have access to Level of Care notification letters for those individuals who reside in their facilities.
Beginning Thursday, February 23, 2017, LOC determination letters will be mailed out and electronic copies saved into the DODD portal under each individual. 
Individuals or the guardian on behalf of the individual, will receive letters via mail.  All letters will be stored electronically in the SharePoint folder associated with each individual in the DODD portal.
Applicable letters include:

  • Level of care approval letters: these are generated when a new level of care or a redetermination of level of care is completed
  • Incomplete level of care letter: this letter will be generated when a level of care is incomplete and additional documentation is needed
  • Does not meet LOC or LOC denial: this letter will be generated when a level of care was denied or the facility has failed to submit all the paper work for an incomplete LOC


Effective immediately:  ICFs and DCs should no longer submit ODM 9401 forms to County Department of Job and Family Services for changes in income or death of an individual.  If there is a change in income or death of an individual, the ICF or DC must call or email their local CDJFS to report the change. 

All questions related to this memo or Level of Care should be directed to LOC@dodd.ohio.gov

Feb 15
ICF Reimbursement Presentation Opportunities

DODD will be hosting 4 regional sessions to present changes to the ICF Reimbursement methodology as being proposed in the FY18-19 budget. 

As required by the FY16-17 budget, DODD contracted with a reimbursement expert (Public Consulting Group or PCG) to make recommendations to modernize the current methodology which is over 20 years old.  Coy Jones of PCG will present analyses conducted which led to the recommendations proposed in the budget and also detail timeframes for implementation. 

Please register for the session of your choice using the links below. Each presentation will be the same so there is no need to attend multiple sessions and space is limited.  Please contact Josh Anderson of DODD should you have questions at Joshua.Anderson@dodd.ohio.gov.

Session March 7, 2017 from 10:00 a.m.-12:00 p.m. location Ohio Department of Natural Resources - Columbus, OH

Session March 8, 2017 from 10:00 a.m.-12:00 p.m. location Hamilton County Board of DD - Queensgate Facility - Cincinnati, OH

Session March 9, 2017 from 10:00 a.m.-12:00 p.m. location Summit County Board of DD - Talmadge, OH

Session March 10, 2017 from 10:00 a.m.-12:00 p.m. location Lucas County Board of DD - Toledo, OH

Josh Anderson

Manager of Operations

Department of Developmental Disabilities

Division of Medicaid Development and Administration

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