Home Care Program /Transitions Waiver

[Guest guest]

Dear Friend of ASO;

Following my signature is a new Fact Sheet on the ODJFS (Ohio Department of Jobs and Family Services) Home Care Program, which includes, among other things, the Home Care Waiver, Transitions Waiver and Core Plus Services.

There are no proposed changes to the Transitions Waiver.

This information was provided to us by the ARC of Ohio. 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.

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OHIO HOME CARE PROGRAM REDESIGNFact SheetJuly 21, 2005

**The Ohio Home Care program is ODJFS’ integrated program of home careservices funded through Medicaid. This program currently has four components:Core, Core Plus, the Ohio Home Care waiver, and the Transitions waiver. TheCore and Core Plus benefit packages are provided under Ohio’s Medicaid stateplan. The Ohio Home Care waiver and the Transitions waiver are Medicaid homeand community-based services (HCBS) waiver programs for individuals withdisabilities who would otherwise require institutional care.

**The purpose of the program redesign is to better meet the needs of individualsserved while better controlling cost growth.

**Under the Ohio Home Care program redesign, the Ohio Department of Job andFamily Services (ODJFS) will make changes to the Core Plus Program and theOhio Home Care waiver in 2006 including new options for consumer choice andcontrol.

**Only minor changes are proposed to home health services in the Core benefitpackage and no changes are proposed to the Transitions waiver. Individuals onmedicaid who need up to 14 hours per week of a combination of nursing and/orhome health aide services will be able to continue to receive them.

**In order to be eligible for the redesigned Ohio Home Care waiver, in addition tobeing eligible for Medicaid, individuals will need to have an intermediate (nursingfacility) or skilled (hospital) level of care, meet age-specific criteria, and needpersonal care or waiver nursing services.

**The redesigned waiver will continue to provide a comprehensive benefitpackage. All existing services will continue to be part of the redesigned waiverincluding personal care services, waiver nursing, out-of-home respite, specializedmedical equipment including vehicle modifications, home modifications,emergency response systems, home-delivered meals, supplemental transportation,and adult day health.

Page 2 of 2OHIO HOME CARE PROGRAM REDESIGNFact SheetJuly 21, 2005

**New services which will be added include nutritional consultation, socialwork/counseling, relocation services and child day health care services for childrenwho are enrolled on the Ohio Home Care waiver.

**Services tailored to the needs of each individual will continue to be specified inthe all services plan (ASP). Each waiver enrollee will be assigned a funding leveland the ASP will be developed and financed using a person-specific funding levelreimbursement methodology. Funding levels will be created using informationfrom the Program Eligibility Assessment Tool (PEAT).

**A range of service provider types will continue to be included in the redesignedOhio Home Care waiver, including Medicare certified agencies; other accreditedagencies (i.e., CHAP and JCAHO); ODJFS-administered HCBS waiver providers(e.g., registered dieticians or social workers); independent RNs/LPNs; andindependent personal care aides (neighbors, friends, and family, excluding legallyresponsible family members).

**A rule that defines Ohio Home Care waiver provider conditions of participationwas approved by JCARR and will become effective August 1, 2005. Work iscontinuing on the development of provider service delivery standards.

**A consumer’s family member (except for the consumer’s spouse or parent, if theconsumer is a minor) will be able to become an independent personal care aide andprovide personal care services to the enrollee.

**The goal is to begin to implement the redesigned Ohio Home Care waiver in2006 and phase-in more options for consumer choice and control. Toward thatend, ODJFS will be moving forward with several actions in the short-term whichinclude having discussions with the Centers for Medicare and Medicaid Services(CMS), developing new Ohio Administrative Code (OAC) rules, consulting withother agencies, meeting with consumers and other stakeholders, and training casemanagers.

**We will be holding consumer forums around the state in August and Septemberto share this plan with Ohio Home Care Waiver consumers and gather their input.