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Aug 17
Private Duty Nursing Supplemental Documentation Clarification

​To: County Board Superintendents, and SSAs
From: Jason Tonn
Date: August 21, 2017
Subject: 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.

Aug 16
Pipeline Weekly (Aug 16, 2017)

DODD Newsletter                                  Aug. 16, 2017

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 department.

 

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 disabilities.

Visit Kit @ DODD

This Week @ DODD

Health & Welfare

Complex Care Add-On Rate Increases

DODD has released guidance 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. 

Training & Tools            Operations

Live Chat: 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 Chat.

Don't Overlook 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 Connection.



Aug 14
Memo Monday (Aug 14, 2017)

Complex Care Add-On Rate Increases

Attention: County Board Superintendents, SSA Directors

This memo 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. 

Read Memo

PASRR Evaluation Summary Updated

Attention: 

The 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.  

Revised Form

Survey: Employment Regional Assessment

Attention: 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 to employmentfirst@dodd.ohio.gov.

Take Survey


Aug 11
Data Warehouse (Aug 11, 2017)

Warehouse image linking to DODD.

  DODD Data Warehouse                                                     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.

    Volunteers Needed  

   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 emma.schlegel@dodd.ohio.gov

 Featured Report:   

Contact Information

 

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 In-Person Training 

  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!

dodd logo

Visit our website


Aug 10
Complex Care Rate Add-On Guidance

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.

 DDP Criteria

DDP QuestionAnswer
25Cannot Walk
26No Mobility
27Cannot roll from back to stomach
27Cannot pull up
33Total bowel support
33Total bladder support
33Total bath or shower support
33Total support putting on clothes
33Total undressing support
33Total support feeding self

*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 09
Pipeline Weekly (Aug 9, 2017)

DODD Newsletter                                                                    Aug. 9, 2017

Boy wearing BB8 headwear.

AdaptAbilities:

Get To Know Peter's Ongoing EI Journey

When his 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) services.

Read More

This Week @ DODD

  Employment First                     Health & Welfare

Q4 Scorecard: 9,200+ Participate in Integrated Employment Services

This spring, 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. 

Well-Informed: Feeding Tubes

Feeding tubes 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 newsletter.

 Training & Tools                        Operations               

Brown Bag 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 Page.

Memo: ICF Cost Reporting

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 Workers' Compensation.

Like Pipeline Weekly? Check out Family Connection.



Aug 08
AdaptAbilities: Get To Know Peter's Ongoing EI Journey

6828.jpg
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.

Peter walker.jpg
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.

At home, 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. 

“We're 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.”
20248071_10159028129735384_5581940722460786420_o.jpg

Aug 08
Well-Informed: Feeding Tubes
Aug 07
Data Warehouse (Aug 7, 2017)

Warehouse image linking to DODD.

  DODD Data Warehouse                                                     August 7, 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.

    Volunteers Needed  

   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 emma.schlegel@dodd.ohio.gov

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.tijerin@dodd.ohio.gov, abby.hammond@dodd.ohio.gov, or emma.schlegel@dodd.ohio.gov.

   New Excel Tip

Moving formulated data to different excel sheets or workbooks? Use this quick tip to easily copy and paste the data!

 

2017 08 04 17 22 Webinar Now

    Data Warehouse NEW USER In-Person Training 

  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!

dodd logo

Visit our website


Aug 07
Memo Monday (Aug 7, 2017)

CMS Approves Waiver Amendments

Attention: Providers, County Boards, SSAs

The Centers 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.

Read Memo

DODD Takes Authorization Role for PDN

Attention: Private Duty Nurses

As a 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.  

Read Memo

DODD Offers Direction on ICF Cost Reporting

Attention: ICFs

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.

Read Memo

Medical Equipment Service Changes Name

Attention: Providers, County Boards

Please 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.  


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