To: County Board Superintendents, and SSAsFrom: Jason TonnDate: August 21, 2017Subject: Private Duty Nursing (PDN) Supplemental Documentation Clarification
On July 1, 2017, an amended version of OAC §5160-12-02.3 became effective. This section governs the procedures by which applications for Private Duty Nursing (PDN) under the SELF, Level One, and Individual Options waivers are to be considered. In the past, county boards submitted applications for PDN services to the Ohio Department of Medicaid for approval or denial. Under the new version of the rule, all requests for PDN for individuals enrolled in these three waivers are to be sent to the Ohio Department of Developmental Disabilities (DODD) for determination. Several training events have been held throughout the state to assist county boards with this transition. A replay of the training can be found on the DODD website under Training → Webinar Catalog. Additionally, DODD issued a memo to the county boards on May 31, 2017, containing instructions on the procedures for submitting PDN authorization applications. These procedures also govern applications for waiver nursing under the I/O waiver as found in OAC §5123:2-9-39.
The purpose of this communication is to specify the supplemental documentation that should be reviewed by the county boards and submitted to DODD when requesting a PDN authorization. In addition to completing the Nursing Task Assessment (NTA) tool and the Cost Projection tool as indicated in the May 31 memo, boards should also collect supplemental documentation including the individual's current Plan of Care (485), ISP, and any other significant medical reports, such as nursing notes and seizure logs. Further, boards should encourage individuals and their families to submit whatever information they believe to be relevant to DODD's determination. Details about the individual's family structure, natural supports, employment obligations, or any other relevant information are helpful in conducting a thorough assessment of nursing needs.Once this information is assembled, county boards are to make a written recommendation to DODD regarding approval or denial, either in full or in part, of the application. The boards' written recommendations should include a brief statement describing their reasoning for the recommendations. Any recommendations of denial, in full or in part, should also include suggested alternatives to PDN which the boards feel to be appropriate under the sequencing of services principles found in OAC §5123:2-9-02. The boards' recommendations should then be forwarded to DODD along with all the accumulated documentation.
In recent weeks, the question has arisen as to how much information is enough to conduct a thorough assessment of an individual's medical circumstances. This question has been brought up in several state hearings, and the lack of sufficient information has been used as the basis of decisions. To bring consistency throughout Ohio, we are asking county boards to make all reasonable efforts to obtain three months' worth of medical history, including records of treatment, medication administration, and medical appointments, before sending their recommendations to DODD.
Thank you for attention to these matters. Please do not hesitate to contact us with any questions concerning the amendment of the PDN rules or how to submit your recommendations about approval or denial to DODD.
DODD Launches New Resource Page
Kit @ DODD is
a new webpage for public information officers, communications
professionals, and anyone who wants easy-to-access materials from the
Visit the page
for featured content, social messages, printable documents, logos, and
other media links. Kit @ DODD aims to connect with counties, providers,
and families about resources to support people with developmental
Visit Kit @ DODD
This Week @ DODD
Health & Welfare
Add-On Rate Increases
on common service planning questions related to the complex care rate
add-on. The add-on will be applied to all units of routine
homemaker/personal care services for eligible people enrolled in the
Individual Options Waiver beginning Sept. 1.
Providers, Listen Up!
Get a quick look
at the new Provider Services Management (PSM) application!
Join Jovon Loveless and Jared Mutchler from the provider
certification team to talk about what's new, different, and what to look
forward to as PSM takes over from Provider Certification Wizard.
Register for the 1 PM Aug. 23 DODD Live
Eye Safety during the Solar Eclipse
Excited to take
a look at the upcoming solar eclipse? While Ohioans will be able to see a
partial eclipse of the sun on Aug. 21, eye safety should be front and
center. Here are some tips from
NASA about how to
safely view this phenomenon in the sky and how to help others who you
might support in maintaining their eye safety.
Like Pipeline Weekly? Check out Family
Complex Care Add-On Rate Increases
Board Superintendents, SSA Directors
addresses common service planning questions related to the complex care
rate add-on. The add-on will be applied to all units of routine
homemaker/personal care services for eligible people enrolled in the
Individual Options Waiver beginning Sept. 1, 2017.
PASRR Evaluation Summary Updated
Pre-Admission Screening and Resident Review (PASRR) Evaluation Summary
form has been updated. The revised form can be found on the Department
of Developmental Disabilities' website forms
section. If you have saved copies of the form, please discard and
begin using the current form today.
Survey: Employment Regional Assessment
Providers, County Boards, ICFs
In order to
develop regional technical assistance plans around community employment
and community life engagement, DODD would like to add to what we
learned from the Employment First regional stakeholder meetings earlier
this year. Providers, intermediate care facilities, and county boards
of developmental disabilities are encouraged to take this
survey. Please respond by Aug. 25, and email questions
August 11, 2017
August is National Eye Exam Month
The DODD actively serve 18,228 individuals with visual
impartments, of which 1,466 are under the age of 18. Vision problems,
without care can hinder a child's experience at school, therefore, it is
very important that children regularly receive eye exams.
Regardless of age, eye exams are a great preventative
measure for all. As employees, we should receive eye exams and care so
we can better care for those we serve.
Tableau Dashboards to show county board data are currently in development.
These dashboards will be helpful to provide exciting visuals of your
county's data. We are in need of volunteers to test these dashboards and
provide us with feedback. If you would like to help, or have any related
questions, email email@example.com.
It is important that we have updated contact information on
those we serve. To easily look at the available contact information,
run the Contact Information report. After running this report you can
identify fields with missing information that can be updated.
Data Warehouse NEW USER
The DODD Data, Analytics and Research department will
be holding two in-person Data Warehouse trainings in October.
The classes will be Friday, October
6th at 9:00am-11:30am and 1:00pm-3:30pm. These training will be at
the State Library of Ohio (274 E. First Avenue, Columbus, Ohio 43201).
Sign up here!
Visit the Data Warehouse
Visit our website
To: County Board Superintendents, SSA Directors
From: Division of Medicaid Development & Administration
Date: Aug. 14, 2017
Subject: Complex Care Add-On Guidance
This communication addresses common service planning questions related to the complex care rate add-on. The add-on will be applied to all units of routine homemaker/personal care services for eligible people enrolled in the Individual Options Waiver beginning Sept. 1, 2017.
Eligibility for the complex care add-on is determined through responses to specific questions on the Ohio Developmental Disabilities Profile (ODDP). If the person is assessed to need the highest level of support in each of those areas, the person would meet the criteria for the add-on. The complex care add-on rate is $0.63 per unit; the cost of the add-on is currently being funded by the state.
*All above criteria must be met to qualify for the complex care add-on.
The add-on is added to cost projection in MSS the same way that you add any other add-ons: in the Manage Individual Section under Add-ons for that person. MSS will only allow you to add it for dates that the DDP reflects that the person qualifies for the add-on. DDP information from IDS is updated nightly for any DDPs that have been changed that would result in the person qualifying or no longer qualifying for the add-on.
The field recently received a message from DODD that a list of individuals who qualify for the complex care add-on was sent to each county superintendent. That reminder is available here.
As of Sept. 1, the final rule OAC 5123:2-9-30 Home and Community-Based Services Waivers - Homemaker/Personal Care Under the Individual Options and Level One Waivers and Appendix A will be moved to the department's effective rules.
For assistance with troubleshooting MSS changes, please email MSSSupport@dodd.ohio.gov.
For questions regarding how to answer specific DDP questions, please call 1-800-617-6733.
Aug. 9, 2017
Get To Know Peter's Ongoing EI Journey
picture was submitted by his parents for a billboard in their Guernsey
County hometown nearly two years ago, Peter's family never
anticipated their son would achieve statewide celebrity status in some
circles -- or become the "face" for Early Intervention (EI)
Health & Welfare
Scorecard: 9,200+ Participate in Integrated Employment Services
people participating in integrated employment services worked an average
of 18.5 hours per week and earned $8.85 per hour on average. Learn more
about community employment in the 2017
Fourth Quarter (Q4) Scorecard that outlines progress on DODD
initiatives through June 30.
carry necessary nutrition directly into the stomach or into the
intestine, and can be temporary or permanent. Learn more about
types of feeding tubes and best practices for maintaining health and
wellness when using the devices in this month's Well-Informed
Training & Tools
Thursdays Wrap Up
As Brown Bag
Thursday discussions come to an end, DODD will host four more throughout
the rest of the year. The final topics of the lunch-hour webinars focus
on assistive technology, elements and outcomes of person-centered
planning, and national data. Register for one of these conversations on
the DODD Training
Memo: ICF Cost
DODD is offering guidance
to intermediate care facility (ICF) providers on how they should
account in their cost reports for any amount received as a result of
the Third Billion Back -- a rebate plan through the Ohio Bureau of
Miss a week?
When his picture was submitted by his parents for a
billboard in their hometown nearly two years ago, Peter’s family never anticipated their son would achieve statewide celebrity status in some circles.
But, as his face pops
up around the internet, Peter, from Guernsey County, has slowly but surely become the face of Ohio Early Intervention.
Which is fitting -- Jaynell, his mother, says he loves
being the center of attention.
“I thought it was amazing. I took screenshots of the website
and passed it around in several online groups. My family shared it all over
their Facebook accounts,” Jaynell says.
At 1 month old, Peter was diagnosed with Williams syndrome,
a genetic disorder that affects one in 10,000 people worldwide. Williams syndrome is
present at birth and can affect anyone. The family’s geneticist encouraged them
to sign up for Early Intervention services as soon as possible. At 6 months old,
Peter began occupational and physical therapy, and a short while later, he
started speech therapy.
“Everything I read from various sources online pointed
to [Early Intervention] being a crucial step in development,” Jaynell explains.
Jaynell describes Peter’s delays up to the point of receiving services as challenging. When Peter and his family began taking part in Early Intervention services, he hadn’t hit developmental milestones like rolling over, sitting up, or eating any solid foods, including baby food. He had slack muscles, low tone, and poor neck control. Experts say children with Williams syndrome generally have their own timeline. Jaynell adds that the pace can be exasperatingly slow and tedious.
“Our kids don’t have ‘milestones’, they have inch-stones,”
she says of kids with Williams syndrome.
But, slow progress over time can bring
a heightened sense of joy when achievement comes. When Peter and his family reached out for
Early Intervention services, he had a difficult time learning to eat solid food,
choking so often that Jaynell did not trust anybody else to feed him. After
accessing Early Intervention services, an occupational therapist began working
with the family, teaching Peter how to swallow and giving his parents
techniques to reinforce what was being taught.
Now at 2 years old, Peter is walking with the assistance of a pediatric gait trainer, practicing at home with his family, using the techniques they learned through Early Intervention services to build large motor skills.
Peter has also learned some sign language and is working on his ABCs in speech and sign.
In the past, the frustration of not being able to
communicate what he wanted could build up to hitting or crying. With his vocabulary of simple signs, Peter can
communicate better with the people around him, including making friends at
pre-school, sharing toys, and playing together.
Peter’s parents have modified their
living room to create a place especially for him where he can be calm. Jaynell
explains that this space allows him the chance to sleep and play safely -- with the
occasional time-out. Among his favorite things to do there is to play with soft-sided
picture blocks that have photos of family members and favorite objects.
trying to help him learn that if he wants something on the block, he can show it
to us,” Jaynell says.
This summer, Peter
has been eating a wider variety of foods, and recently became tolerant of cold
foods, Jaynell says, which means, “He’s been enjoying having ice cream with the family."
While Peter’s “inch-stones” have been very gradual, his slow
progress overtime brings real joy to his family when they see him play with friends and eat ice
cream on a hot summer day.
”We credit EI with helping him reach this stage.”
Feeding Tubes, August 2017
August 7, 2017
Tryout This Report:
Mismatched or Missing Medicaid Number
There are about 4,600 Active individuals who are Medicaid
eligible but do not have a Medicaid number in our system. If you want to
see the list for your county, there is a report in the data warehouse you
can run. The “Mismatched or Missing Medicaid Number” report will give you a
list of individuals in your county who are Medicaid eligible, but either do
not have a Medicaid number or have a Medicaid number that does not match
ODJFS. Pease run this report and make any necessary changes. If
you have any questions about running the report, or how to proceed once you
run the report for your county, please feel free to contact Joslyn.firstname.lastname@example.org, email@example.com, or firstname.lastname@example.org.
New Excel Tip
Moving formulated data to different excel sheets or
workbooks? Use this quick tip to easily copy and paste the data!
CMS Approves Waiver Amendments
Providers, County Boards, SSAs
for Medicare & Medicaid Services (CMS) has approved amendments to
waivers. Read about the complex care add-on rate increase, Ohio Shared
Living, and an increased limit for home modification.
DODD Takes Authorization Role for PDN
Private Duty Nurses
reminder, effective July 1, 2017, DODD assumed the responsibility for authorizing
Private Duty Nursing (PDN) for people enrolled in the Level One, SELF,
and Individual Options waivers who are not enrolled in managed care
plans. Please refer to the guidance memo sent to county boards May
31 detailing the process to follow for PDN requests.
DODD Offers Direction on ICF Cost Reporting
The Bureau of
Workers’ Compensation’s has announced that it will be once again
issuing a rebate to private employers and public-taxing districts as
part of the administration’s focus on creating jobs through the Third
Billion Back rebate plan.
Medical Equipment Service Changes Name
Providers, County Boards
be advised that the services of Specialized Medical Equipment and
Supplies and Adaptive and Assistive Equipment will now appear together
in Provider Certification Wizard as Specialized Medical Equipment &
Supplies (Adaptive & Assistive Equipment). As a provider of
Specialized Medical Equipment and Supplies, you are still authorized to
deliver equipment services under the Individual Options and Level One
waivers. This change is being made to align the service with the
official service title, Specialized Medical Equipment & Supplies.