Guest guest Posted July 20, 2005 Report Share Posted July 20, 2005 Dear Friend of ASO:Information from the Arc of Ohio regarding the elimination of CAFS funding. FYI - please share. Sincerely, Barbara C. YavorcikPresidentAutism Society of Ohio701 S. Main St.Akron, OH 44311(330) 376-0211fax: (330) 376-1226email: askASO@...home: byavorcik@...web: www.autismohio.org2005 ASO Bi-Annual Conference"Reaching Beyond the Horizon - Challenging the Autism Spectrum"Friday and Saturday, October 14-15, 2005 Kingsgate Marriott in Cincinnati, Ohio Please note: This is provided for information purposes only. The ASO does not endorse or recommend any providers, methodologies or services. Providing this information should not be construed as an endorsement by the ASO, either explicit or impiled. ============================================================ The Ohio Department of Job and Family Services, in consultation with the Ohio Department of MR/DD, has developed a list of questions and answers regarding the elimination of CAFS funding. The Hotline Telephone Number has been overwhelmed with calls so, in addition to calling, you may want to refer to the guideline for Hotline Operators. Chances are very good that the Hotline Operator will be using these guidelines to refer you to another source of information: What Services were provided under the CAFS program? The program provides Medicaid coverage for counseling and social work, nursing, occupational therapy, physical therapy, psychology, speech language pathology and audiology, transportation, active treatment, and skills development and support services provided through certified Habilitation Centers. Who are the certified habilitation center (CAFS) providers? There are three (3) main types of CAFS providers currently: County Boards of Mental Retardation and Developmental Disabilities, Public School Districts, and some Private Providers. All CAFS providers are certified by the Ohio Department of Mental Retardation and Developmental Disabilities as Habilitation Centers. Will I be able to keep my same provider? It depends on the service. For therapy services, it will depend on whether or not your current provider has a Medicaid provider agreement and provides rehabilitative services under the Medicaid state plan. Can I access therapy services through my Medicaid Card? Consumers who seek services from a Medicaid Provider would need to meet medical necessity criteria in order for Medicaid to cover the service. The services must be rehabilitative in nature. When CAFS ends, how do I access therapy services through my card? Contact the Medicaid Consumer Hotline at 1-800-324-8680, TDD: 1-800-292-3572 for a list of providers. You may also contact your local County Department of Job and Family Services. Please note that physical therapy services and speech and hearing services must be prescribed/ordered by a physician. Who do I call first to arrange therapy services? Contact your physician or call the Hotline number above for a list of providers. It is the consumers responsibility to make sure that the provider chosen participates in the Medicaid program. The consumer should ask if the provider takes Medicaid and if the provider is accepting new patients. Your physician can determine if your needs are rehabilitative in nature. Rehabilitative services provided by clinics must be prescribed by a physician and provided by a licensed physical therapist, speech therapist or audiologist. Do I need a Physician to approve my need for therapy services? Yes, physical therapy and speech and hearing must be prescribed by a physician. What is the difference between rehabilitation and habilitation? Rehabilitative services are services provided temporarily to address a condition caused by a disease, illness or injury. The services are provided to restore an individual’s ability to function at a pre-disease/illness/injury level. Habilitative services are designed to assist individuals in acquiring, retaining, and improving the self-help, socialization, and adaptive skills necessary to reside successfully in home and community based settings. Will I be able to keep the same therapy services after CAFS goes away? Everyone has specific needs and individual circumstances. The answer will depend on your individual needs and circumstances. Are there limits to what I can receive? Yes, for physical therapy, coverage is limited to 30 dates of service per year. Psychology services are limited to 25 dates of service per year. Who can assist me through this change? If you are a Home and Community-Based waiver recipient, the Service and Support Administrator at your County Board of MRDD may be able to help you. You can also contact the Medicaid Consumer Hotline at the number provided above or talk to your local County Department of Job and Family Services. What do I do if I can’t get the service through my card? If you believe you are entitled to a Medicaid covered service, you can request a state fair hearing. The below grid may be used to assist the Hotline if a question arises that may better be answered by the entity responsible for coordination of care. It might be helpful for the Hotline to ask: “Where do you currently receive services? At a school? A county Board?†or “Are you on a waiver?†“If so, which one?†If the individual is on the ODJFS administered Transitions Waiver and has any questions about replacement services: For all inquiries: Refer the individual to his/her case manager at Carestar at: Carestar Cincinnati 1-866-834-4712 Carestar Columbus 1-800-616-3718 Carestar Canton 1-800-423-1046 Carestar Dayton 1-800-538-4218 Carestar Cleveland 1-800-442-1857 If the individual is on an MRDD administered Individual Options (IO) or Level 1 waiver: If s/he asks for information on the CAFS service called “skills development and support (SDS)†or the replacement service called “day habilitationâ€: Refer the individual to his/her local county board of MR/DD If s/he asks for information on the CAFS therapy services and possible replacements through the Medicaid Card: 1.) If the individual is being served by a local county board of MR/DD, the case manager known as a Service and Support Administrator (SSA) may be able to assist the individual in working with the local county department of job and family services 2.)Refer the individual to the local county department of job and family services If s/he asks for information on the service known as “service coordination†or the replacement service called “targeted case managementâ€: Refer the individual to his/her local county board of MR/DD If s/he asks for information on the service called ‘targeted case managementâ€: Targeted case management existed under the CAFS umbrella and will continue to exist after June 30, 2005. Refer the individual to his/her local county board of MR/DD If the individual lives in an ICF/MR facility: If s/he asks about the CAFS service known as “active treatmentâ€: Refer the individual to his/her ICF/MR facility. If the individual is currently receiving CAFS therapy services through a school: Schools are still required to provide services per IDEA. Refer the individual to their local school district. If the individual is currently receiving CAFS therapy services from a private provider (i.e. Children’s Hospital): Refer the individual to the private provider so that the individual can ask whether the private provider holds a valid Medicaid agreement for “Medicaid Card†services. If the individual is currently receiving CAFS therapy services from a County Board of MR/DD provider: Refer the individual to the local County Board of MR/DD. Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.