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Ohio Home Care Program: Informational Forum About Important Changes Summer 2005

2. Agenda. Why are we here today?(Background context and timeline)Ohio Home Care program changes(Now and in the future)Question and answer session. 3. What is the Ohio Home Care program?. CoreCore PlusThe Ohio Home Care WaiverThe Transitions Waiver. 4. Why is the Ohio Home Care progr

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Ohio Home Care Program: Informational Forum About Important Changes Summer 2005

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    1. 1 Ohio Home Care Program: Informational Forum About Important Changes Summer 2005 Ohio Department of Job & Family Services (ODJFS) Office of Ohio Health Plans Bureau of Home and Community Services

    2. 2 Agenda Why are we here today? (Background context and timeline) Ohio Home Care program changes (Now and in the future) Question and answer session

    3. 3 What is the Ohio Home Care program? Core Core Plus The Ohio Home Care Waiver The Transitions Waiver

    4. 4 Why is the Ohio Home Care program being redesigned? Better meet consumer needs Increase consumer choice and control Cost effectiveness and cost management

    5. 5 Background Case management reviews in 2001 ? Consumer forums in 2003 ? Consumer self-directed care waiver survey in 2004 ? Your feedback about increased consumer choice and control ? Program changes

    6. 6 What We’ve Done So Far. . . Program Eligibility Assessment Tool (PEAT) (Spring 2004) New rules (July 2004) Single case management agency (October 2004) Conditions of participation rule (August 2005) More rule changes (October 2005) Program changes (January 2006)

    7. 7 Now for the changes…

    8. 8 Changes to the Transitions Waiver No programmatic changes are planned for the Transitions Waiver at this time. Same services Same eligibility Possible changes to delivery? Same services Same eligibility Possible changes to delivery?

    9. 9 Changes to Core Individuals on Medicaid who need up to 14 hours per week of a combination of nursing and/or home health aide services will continue to receive them. Core = Home Health

    10. 10 Changes to Core

    11. 11 Changes to Private Duty Nursing 60-day acute care extended benefit Extended services for children

    12. 12 Changes to Private Duty Nursing - Adults

    13. 13 Changes to Private Duty Nursing - Children

    14. 14 Changes to Core Plus

    15. 15 Changes to the Ohio Home Care Waiver

    16. 16 More information about the Ohio Home Care program redesign Each waiver enrollee will be assigned a funding level. The All Services Plan (ASP) will be developed using a person-specific funding level reimbursement formula. Funding levels will be created using information from the Program Eligibility Assessment Tool (PEAT).

    17. 17 Comprehensive Benefit Package

    18. 18 Provider Types Current Provider Types: Medicare certified agencies Other accredited agencies (i.e., CHAP & JCAHO) Independent RNs/LPNs ODJFS-administered HCBS waiver providers (e.g., registered dieticians or social workers) New Provider Types: Non-agency-employed providers Non-agency-employed personal care aides (e.g., neighbors, friends and family, excluding legally responsible family members) Current Provider Types: Medicare certified agencies Other accredited agencies (i.e., CHAP & JCAHO) Independent RNs/LPNs ODJFS-administered HCBS waiver providers (e.g., registered dieticians or social workers) New Provider Types: Non-agency-employed providers Non-agency-employed personal care aides (e.g., neighbors, friends and family, excluding legally responsible family members)

    19. 19 Other Changes Conditions of Participation rule, effective 8/1/05 Ongoing development of provider service delivery standards Consumer’s family member as a non-agency employed personal care aide Rates

    20. 20 Rate Justification The Ohio Home Care Program currently pays RNs and LPNs the same rate and has since 1998 LPNs receive 70% of RN salaries in other settings in Ohio Ohio will bring LPN rates of payment to a level comparable to LPN rates paid throughout the state

    21. 21 Recap Subject to CMS & JCARR Approval Renew and modify Ohio Home Care Waiver 1200 slots in ’06 – ’07 Target consumers in nursing facilities & hospitals Modify Core Plus 60-day PDN Core Plus to waivers Funding levels LPN rate differential

    22. 22 Coming Attractions Greater consumer choice and control through a self-directed care waiver Delegated nursing tasks to non-licensed providers Child day health services Legally responsible family members as paid providers

    23. 23 Keeping You Informed Ongoing Communication Possibilities Newsletters Olmstead Task Force ootf@ohiosilc.org 1-800-566-7788 Teleconferencing and/or video conferencing BHCS web page…

    24. 24 BHCS Web Page

    25. 25 Contact Information ODJFS - Office of Ohio Health Plans Bureau of Home and Community Services 30 E. Broad Street, 33rd Floor Columbus, Ohio 43215-3414 Phone: (614) 466-6742 Fax: (614) 466-6945 Email: bhcs@odjfs.state.oh.us http://jfs.ohio.gov/ohp/ohc/

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